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According to the main international guidelines, patients with obesity and psychiatric/psychological disorders who cannot be addressed to surgery are recommended to follow a nutritional approach and a psychological treatment. A total of 94 patients (T0) completed a battery of self-report measures: Symptom Checklist-90-Revised (SCL-90-R), Barratt Impulsiveness Scale-11 (BIS-11), Binge-Eating Scale (BES), Obesity-Related Well-Being Questionnaire-97 (ORWELL-97), and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Then, twelve sessions of a brief psychodynamic psychotherapy were delivered, which was followed by the participants completing the follow-up evaluation (T1). Two groups of patients were identified: Group 1 ( n = 65), who fully completed the assessment in both T0 and T1; and Group 2-dropout ( n = 29), who fulfilled the assessment only at T0 and not at T1. Machine learning models were implemented to investigate which variables were most associated with treatment failure. The classification tree model identified patients who were dropping out of treatment with an accuracy of about 80% by considering two variables: the MMPI-2 Correction (K) scale and the SCL-90-R Phobic Anxiety (PHOB) scale. Given the limited number of studies on this topic, the present results highlight the importance of considering the patient's level of adaptation and the social context in which they are integrated in treatment planning. Cautionary notes, implications, and future directions are discussed.

Human nutrition is characterized by both automatic and self-regulated processes. One of the dimensions that may be employed in monitoring eating behaviors is the cognitive control played by the executive functions (EFs). The role of EFs in affecting eating behaviors has been assessed in empirical studies, but further analyses are needed in a current society characterized by a food-abundant environment. Accordingly, this study attempted to evaluate the association between weight status and executive functions in response to food-related stimuli. One hundred and forty-four young adults took part in the study (25.7% in overweight condition). The participants completed a set of computerized cognitive tasks to assess cognitive and motor inhibition and working memory in two different conditions: (i) classic versions of the tasks and (ii) modified versions with food cues. The results indicate that food stimuli may influence executive performance and that there is an association between food cue-related executive functioning, particularly in the domain of motor inhibition, and working memory. These results suggest that self-regulation in nutrition may involve executive control. Although further studies are needed, this work suggests the importance of a multidimensional perspective in the analysis of eating behaviors and the relevance of EFs in monitoring our approach to food stimuli in an environmental context.

The global population has been significantly affected by the pandemic in terms of physical and mental health. According to transactional theory, individuals have undergone an adaptation process influenced by cognitive control abilities. Emotional responses to COVID-19-related stimuli may interfere with top-down attentional processes, thereby hindering adaptation. This study aimed to investigate the impact of COVID-19-related stimuli on attentional processing and to determine whether psychological factors could modulate these effects. A sample of 96 healthy undergraduate students participated in an emotional Stroop task in which they were presented with a series of stimuli, including both neutral and negative COVID-19-related as well as non-COVID-19 stimuli. COVID-19-related PTSD, as an index of distress (PTSS), and trait anxiety were evaluated. Results showed that participants were more accurate in identifying COVID-19-related stimuli compared to non-COVID-19 stimuli. Being female and having higher retrospective PTSS scores related to COVID-19 were predictive of faster reaction times for both neutral and negative COVID-19-related stimuli. This heightened attentional bias toward COVID-19-related stimuli suggests that individuals may be more sensitive to stimuli associated with the pandemic. The results suggest that the association between COVID-19 stimuli and attentional biases extends beyond emotional valence, being retrospectively influenced by mental health, suggesting potential pathways to future mental health challenges.

The evolution in conceptualization of sexual desire has stimulated many attempts to measure it. However measures able to assess multiple expressions of desire in all sexual identities are still lacking. The main aim of the present study was to test the psychometric properties of the Sexual Desire and Erotic Fantasies questionnaire - Part 1 Sexual Desire (SDEF1), developed as a sex-positive measure of different sexual desire expressions. The SDEF1 was assessed in 1773 participants from the Italian general population (1105 women, 645 men, and 23 other genders; ranged between 18-78 years old, mean age 29.31 ± 10.35) on an online survey, together with the Sexual Desire Inventory - 2, the International Index of Erectile Function, the Female Sexual Function Index, and the Marlowe-Crowne Social Desirability Scale-Short Form. Results support a factorial structure of six dimensions, including 28 items and accounting for 58.11% of the total variance: sexual desire, negative feelings to sexual desire, autoerotic desire, regular partner desire, attractive person desire, and responsive desire. The confirmatory factorial analysis showed satisfactory indexes (RMSEA = 0.042 [90% CI = 0.039-0.045]; GFI = 0.97; NFI = .96; and CFI = 0.97). Regression coefficients ranged from 0.39 to 0.94 and were all statistically significant (p < 0.001). The SDEF1 showed good psychometric properties such as internal reliability, construct, and discriminant validity, and to differentiate women and men with and without sexual difficulties. Men reported significantly higher levels of desire than women in all areas except for desire for a regular partner, were no gender difference was detected. Desire for autoerotic activity was the factor accounting for more variance explained among genders (11.7%). The SDEF1 could be a useful measure to assess different areas of sexual desire and its use could be recommended for clinical and research purposes., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Numerous studies have found that the COVID-19 epidemic and the measures to stop it have had a substantial impact on the mental health of the general population. Nevertheless, the majority of this research only looked at the variations in the degree of psychopathological symptoms in individuals before and after the first wave of the pandemic. In a sample of N = 380 preschoolers and their mothers assessed through the Symptom Check-List/90-R and of the Child Behaviour Check-List, the present study aimed at exploring psychopathological risk in mothers and their offspring's dysregulation levels before (T1), during (T2) and after (T3) the peak of COVID-19 pandemic. Our main results showed that mothers' relational distress increased from T1 to T2 and then increased again from T2 to T3. Moreover, maternal aggressiveness, hostility, and anxiety scores significantly decreased from T1 to T2 but slightly increased from T2 to T3. In children, dysregulation levels increased from T1 to T2 but decreased from T2 to T3. Children of mothers with clinical scores at the SCL-90/R showed significantly higher dysregulation problems at T1, T2 and T3 than children of mothers with scores below the clinical threshold. This study adds to previous literature in that it evaluates stability or change in maternal and offspring scores not only in the pre-pandemic period and during the first wave of the pandemic, but it also considers the subsequent months, focusing on a broad range of maternal symptoms, rather than assessing depressive and anxiety symptoms as most of previous research did., (© 2023 John Wiley & Sons Ltd.)

As behavioral addictions (BAs) significantly affect well-being, paying attention to the characteristics associated with their onset is relevant. Current studies suggest that BAs should be addressed from an adaptive-maladaptive continuum perspective to define what and how some behaviors became problematic. The multi-faceted nature of behaviors attributed to possible BA involves psychological and individual backgrounds (e.g., attachment style). Given its role in affecting personality processes, social development, and motivational drives, the attachment style would be involved in addiction-like behaviors from adolescence, defined as a critical period for BA onset. This study analyzed the association between the attachment dimensions and two possible BAs that can be included in an adaptive-maladaptive continuum (i.e., social network use and TV series watching). A sample consisting of 493 late adolescents/emerging adults (age range: 18-24) completed questionnaires assessing social network use, TV series watching, and attachment style. The results showed a positive association between problematic attachment styles and BAs. High worry and need for relationships (anxious attachment) would be risk factors for problematic social network use and relationships as secondary (avoidant attachment) would be a risk factor for problematic TV series watching. These findings suggest the importance of further analyzing the role of attachment styles and their dimensions in influencing behavioral expression early to prevent the occurrence of BA.

The increased risk of internalizing and externalizing symptoms in children has been observed in the presence of maternal psychopathology. This study aimed to investigate a potential pathway involving the quality of early interactions between mothers and their children. A sample of 150 mother-child dyads underwent assessment when the children were 3 years old and around the age of 10. Video recordings of feeding exchanges between mothers and children were analyzed to evaluate the quality of mother-child interactions. Maternal psychopathology and child internalizing and externalizing symptoms were measured through self-report and report-form measures completed by mothers. The quality of mother-child feeding interactions at three years of age significantly differentiated ( p < 0.001), eight years later, between mothers at high and low psychopathological risk and between children exhibiting clinical and subclinical internalizing symptoms. Clinically relevant child symptoms were notably more prevalent when the mother-child interaction quality at three years of age was maladaptive, particularly in the context of concurrent high maternal psychopathological risk. The study findings underscore the importance of focusing on the early quality of mother-child feeding interactions to identify potential situations of maternal and child clinical risk for the development of psychopathological symptoms and to guide preemptive measures and policies.

During the second year of life, children's need for autonomy grows, and their behaviors become increasingly complex. Parental sensitivity to children's different cues is important in supporting adaptive psycho-emotional development. The present study assumes that mothers and fathers may respond with varying levels of sensitivity to the child's different cues, with particular attention to requests for greater autonomy. The study also examines the possible role played by interactive contexts (ie., play and feeding) and children's and parents' individual factors. The sample comprised N = 91 families with children aged between 12 and 24 months. Mother-toddler and father-toddler interactions were assessed during feeding and play. Parents completed questionnaires assessing children's temperament, psychopathological risk, and parenting stress. RESULTS: showed that toddlers' demands for autonomy were the most frequent cues in both play and feeding contexts, both with mothers and fathers. Furthermore, parents were more sensitive to toddlers' requests for cooperation than their requests for autonomy, in both interactive contexts. Moreover, mothers and fathers showed higher sensitivity to toddlers' demands for greater autonomy in the play context rather than in the feeding context. Mothers were more sensitive than fathers to toddlers' cues of resistance to parents' actions and to toddlers' requests for cooperation. Results showed differences and specificities in mother-toddler and father-toddler interactions in the two interactive contexts, showing associations between child negative emotionality, parental psychopathological risk and parenting stress, and maternal and paternal sensitivity to toddlers' demands for greater autonomy during play and feeding, respectively. These results confirm the initial hypotheses regarding parental sensitivity and its differential expression according to child cues. Implications are discussed., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: It has been posited that parental distress, the quality of maternal care and offspring's dysregulation can be predicted by maternal maladaptive characteristics. However, only a few studies have considered mothers' personality organizations and features of the p factor in mothers as possible predictors of symptoms in their children., Methods: In a sample of N=524 subjects, this study evaluated the effect of mothers' personality organization and of the p factor on parental distress, parental care and offspring's dysregulation symptoms. Mothers filled out the IPO, the ASR, and the PSI-SF; children's teachers filled out the TRF; children were administered the PBI., Results: We found that different mother groups (neurotic, borderline, psychotic organization) have distinct impact on parental distress, quality of care, and children's dysregulation, mediated by the p factor., Conclusion: This study can contribute to the understanding of the key factors underpinning mothers and children's psychopathology., Competing Interests: The authors report no conflicts of interest in this work., (© 2023 Cimino et al.)

We explored the interrelationships between risk-taking and self-harm in typically developing adolescents by examining various contributing factors, such as personality traits, difficulties in emotion regulation, attachment styles, and maladaptive psychological functioning. A sample of 234 Italian adolescents completed the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA), the Risk-Taking Questionnaire (RT-18), the Difficulties in Emotion Regulation Strategies (DERS), the State Adult Attachment Measure (SAAM), and the Youth Self-Report (YSR). Network analysis was used to visualize and describe the interdependencies among the variables. Risk-taking behaviors were strongly linked to rule-breaking, aggression, and risk propensity, while self-harm behaviors were connected to limited access to emotion regulation strategies and thought problems. Centrality indices indicated that variables such as anxiety/depression, limited access to emotion regulation strategies, and rule-breaking had a high influence within the network. This study provided a comprehensive understanding of the nomological network of risk-taking and self-harm behaviors among adolescents. It highlighted the relative importance of factors such as emotion regulation difficulties and maladaptive psychological functioning in influencing these behaviors. The findings could inform psychological interventions and prevention strategies targeting adolescents at risk for engaging in risk-taking or self-harm behaviors.

Background: Binge-watching (BW) is the consecutive viewing of three or more episodes of the same series in one sitting. Although some negative effects on mental health were evidenced, the continuum of BW from leisure activity to problematic behavior is still unclear. This study aimed to analyze mental health (depression, trait anxiety, social anxiety, impulsivity, alexithymia) of people involved in different expressions of BW., Methods: A cross-sectional survey collected data from 482 respondents. According to a validated BW questionnaire, participants were divided into Problematic BW, Moderate BW, Non-BW, and No-viewer, and differences between groups were tested on psychological dimensions assessed via standardized questionnaires evaluating: trait and social anxiety, depression, impulsivity, and emotional dysregulation., Results: An association between problematic BW and worse mental health conditions was evidenced, and a positive effect of non-problematic BW was supported. A negative linear trend from the BW as a leisure activity to problematic BW was marked, indicating how a possible maladaptive behavior orientation of BW in specific mental health conditions could be figured out as a behavioral addiction., Competing Interests: The authors declare there are no competing interests., (©2023 Favieri et al.)

Objective: New TV-watching patterns increased the practice of binge-watching (BW). Considering the adaptive-maladaptive continuum of BW, the relationship between BW and health outcomes is still unclear. This study aimed to analyze some features of BW related to quality of life, focusing on sleep quality., Methods: Four-hundred eighty-two young adults were classified into four groups according to their BW approach. Then, sleep quality, mood, and quality of life were assessed., Results: All the investigated variables were associated with problematic and moderate BW. No differences emerged between BW as a leisure activity and not watching TV series. Moreover, quality of life is directly affected by BW., Conclusion: Accordingly, BW should be considered a continuum of behavioral patterns from a leisure activity characterized by positive outcomes to a maladaptive behavior characterized by negative outcomes for sleep, mood, and quality of life., Competing Interests: The authors report no conflicts of interest in this work., (© 2023 Forte et al.)

Background: The investigation of sexual fantasies is a delicate issue within sex research. Most studies have focused on the content of these fantasies, rather than on use, experiences, attitudes, and sharing issues, which are fundamental aspects within sexual therapy. The main aim of the present study was to develop and validate the "Sexual Desire and Erotic Fantasies questionnaire-Part 2. Use of Erotic Fantasies (SDEF2)"., Methods: The SDEF2 was completed by 1773 Italian participants (1105 women, 645 men, and 23 other genders)., Results: The final 21-item version presented a five-factor structure (fantasies frequency, fantasies normality, fantasies importance, negative emotions, and sharing and experiencing). The SDEF2 showed good psychometric properties, internal reliability, construct, and discriminant validity, appearing to be able to differentiate between sexually clinical and functional women and men (based on the FSFI and IIEF cut-off scores)., Conclusions: The possibility of assessing fantasies frequency, attitudes, and emotions may be extremely useful both for research and clinical purposes. The current study seems to validate that the SDEF2 is a useful measure of assessing the different aspects related to a fantasizing activity, which was shown to be associated with sexual functioning and satisfaction.

Background: Erotic fantasies are the most common sexual experiences and provide valuable clinical material for understanding individual and relational emotional dynamics. The primary objective of this study is to validate the Sexual Desire and Erotic Fantasies questionnaire (SDEF) Part 3-Inventory of Erotic Fantasies. This questionnaire was designed to be a sex-positive and inclusive measure of the content of erotic fantasies, accessible to individuals of all gender identities, sexual orientations, relationship/romantic status, and sexual behaviors., Methods: The SDEF3 was completed by 1773 Italian participants (1105 women, 645 men, and 23 participants identifying as other genders). Two factorial structures were presented and discussed: a 20-dimension structure for clinical and explorative use and a 6-dimension structure for research purposes., Results: The six-factor version was preferred due to its robust statistical properties and its ability to differentiate between sexually clinical and functional men and women, based on cut-off scores from the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Differences in the frequency of themes in fantasies between gender and sexual orientation were reported and discussed., Conclusions: The current study indicates that the SDEF3 is a valuable and comprehensive measure for assessing various scenarios related to fantasizing activity. It has potential applications in both clinical practice and scientific research.

Binge-watching (BW) refers to a pattern of watching TV series characterized by the consecutive viewing of three or more episodes in one sitting. Although there is some evidence about its effects on mental health, little is known about predictive variables which may affect negative occurrences of BW, such as problematic and addictive behavior. This study aimed to assess the unique contribution of personality traits (i.e., neuroticism, extraversion, agreeableness, openness, and conscientiousness) to binge-watching, while also considering the role of two motivational systems: the behavioral inhibition system and the behavioral activation system. Cross-sectional data from 790 respondents were collected using standardized questionnaires evaluating: BW, personality traits, and the behavioral inhibition/activation system. The possible predictive roles of these variables were tested via hierarchical linear regression models. Our results underline a predictive high-risk role of neuroticism and the behavioral inhibition system and a protective role of conscientiousness in the continuum of BW from a leisure activity to a problematic one.

The COVID-19 pandemic and its protective measures had a tremendous effect on the general population's mental health and deeply affected their lifestyle. The present study carried out a longitudinal analysis to evaluate the long-lasting psychological effects of the pandemic and its impact on the general population's day-to-day routine. Three points in time were considered: the initial period of the lockdown (T1; n = 2766; March 2020), the final period of the lockdown (T2; n = 439; May 2020) and two years after the lockdown (T3; n = 268; July 2022). Frequency analyses were carried out to examine which behavioral changes were maintained following the COVID-19 pandemic and lockdown; furthermore, a repeated measures ANOVA test was run to measure differences in depression, stress, and anxiety levels between the three periods considered; lastly, multivariable ordinal logistic regression analyses were carried out to examine which variables were associated with psychological distress more than two years after the lockdown. The results highlighted that depression at T3 was associated with depression at T2 and negative affect, whereas stress at T3 was associated with stress at T2 and detachment. The psychological effects and lifestyle changes are also discussed.

Using network analysis, we investigated the relationships between maladaptive psychological functioning, difficulties in emotion regulation, and risk-taking in deliberative and affective behavioral decisions. Participants (103 adolescents aged between 13 and 19 years, 62% boys) took the Cold (deliberative) and Hot (affective) versions of the Columbia Card Task and completed the Youth Self-Report (YSR) and the Difficulties in Emotion Regulation Scale (DERS). In contrast to the view that risk propensity increases from preadolescence to middle adolescence and decreases at later ages, our study revealed no age-specific trend. YSR syndrome scales were significantly correlated with risk propensity, but only in the Cold version. The YSR Thought Problems scale was the most central node in the network, linking internalizing and externalizing problems with risk propensity in the Cold CCT. Lack of emotional Clarity was the only DERS consistently linked with risk-taking both in correlation and network analyses. Maladaptive psychological functioning and difficulties in emotion regulation were linked with risk propensity in affective risky decisions through deliberative processes. The statistical significance of direct and indirect effects was further examined using nonparametric mediation analyses. Our study highlights the role of cognitive factors that in each variable set might account for risk-taking in teenagers.

The literature focused on the effect of the COVID-19 pandemic on young adult university students' mental health shows a significant increase in psychopathological symptoms and Internet Addiction (IA). The key role played by attachment and alexithymia has also been suggested, but no study has explored the possible dynamic relationship between these variables. We recruited a sample of n = 410 young adult university students online. We assessed the attachment to parents and peers (through IPPA), alexithymia (through TAS-20), peritraumatic distress symptoms due to COVID-19 (through CPDI), and IA (through IAT). The results showed that the relationship between the attachment to mothers and IA was partially mediated by alexithymia and by the serial mediation of alexithymia and peritraumatic distress, whereas the influence of the attachment to fathers on IA was fully mediated by peritraumatic distress. The direct effects of the attachment to peers on alexithymia, peritraumatic distress, and IA were all significant, as were the indirect paths via the simple mediation of both alexithymia and peritraumatic distress and the multiple serial mediation of alexithymia and peritraumatic distress. Our findings suggested that the relationship between attachment, alexithymia, and psychopathological risk is dynamic in predicting IA during the pandemic among young adult university students and that the different attachment figures exert a peculiar contribution to these processes.

The COVID-19 pandemic has deeply affected the psychophysical wellbeing of children worldwide. Alexithymia, a personality trait involving difficulties in identifying and expressing feelings represents a vulnerability factor for stress-related disorders. Under pandemic stress exposure, we aimed to investigate the role of parents' and children's alexithymia in the psychophysical symptomatology shown by children and to evaluate possible differences according to age, gender and history of COVID-19 infections. The perception of parents and children about the impact of the pandemic on children's emotional, social and physiological wellbeing was also explored. Sixty-five familial triads were surveyed in the period from March to May 2022: children ( n = 33 males; mean age = 9.53, sd = 1.55), mothers (mean age = 44.12; sd = 6.10) and fathers (mean age = 47.10; sd = 7.8). Both parental and children's alexithymia scores were significantly associated with somatic and externalizing symptomatology in children. Self-reported anger and externally oriented thinking scores were higher in younger children (age 8-9.9 years) than in older ones (10-12 years). Girls scored higher than boys in somatic complaints, as reported by parents. No difference emerged between children affected/not affected by COVID-19. Notably, children reported a greater negative impact of the pandemic on their emotional and psychosocial well-being than their parents. The findings emphasize the role of alexithymia in the occurrence of psychophysical symptoms in children during the COVID-19 pandemic. The reduced parental awareness of the emotional burden imposed by the pandemic on children indicates the need to better consider how epidemics affect children's mental health and to develop adequate preventive strategies to support them in these exceptional times.

Several authors found that somatic symptoms during pregnancy such as nausea, vomiting, and levels of sleep, and fear of childbirth were associated with women's post-partum psychopathological difficulties. The present study aimed to verify whether fear of childbirth can mediate the relationship between some somatic symptoms experienced during pregnancy (i.e., nausea, vomiting, and daily sleep duration) and the post-partum depressive and anxious symptoms. N = 258 mothers of children between 3 and 6 months of age filled out self-report questionnaires assessing somatic symptoms during pregnancy, fear of childbirth, and anxious and depressive symptoms during post-partum. Results showed that levels of vomiting during pregnancy (but not nausea and daily sleep duration) was associated with post-partum depression and anxiety. Furthermore, findings showed that fear of childbirth partially mediated the relationships between the levels of vomiting during pregnancy and post-partum state anxiety and depression. These results can have several clinical implications, allowing to implement preventive programs for post-partum depression, considering vomiting and fear of childbirth as important risk factors.

The COVID-19 pandemic has brought about new stressors on university students, with a negative impact on their mental health and well-being. The purpose of this study was to examine the usefulness of a brief psychodynamically oriented intervention on general functioning by investigating changes in symptoms of depression, anxiety, hopelessness, and burnout. The sample was comprised of 67 university students (22.4% males), with a mean age of 23.27 (standard deviation (SD) = 3.27), who asked for psychological help at a psychological university service. Pre- and posttreatment data showed a significant improvement in general functioning and symptom reduction due to the psychological intervention. The mean change was very high for depression ( d  = 1.11) and high for general functioning ( d  = 0.70) and anxiety ( d  = 0.69). Our findings showed the importance of considering university students a vulnerable population that requires specific services within the university context and underlined the fact that mental-health-promotion policies should be extensively implemented., Competing Interests: The authors declare no conflict of interest., (© 2022 Wiley Periodicals LLC.)

The present study aimed to analyze the differences between maternal and paternal parenting stress and children's behavioral functioning, as determined by teacher and parent reports. In addition, it sought to evaluate the presence of clusters based on parenting stress and to determine whether perceptions of children's behavioral functioning varied across these clusters. The sample was composed of the parents and teachers of N = 201 children. Parents completed a self-report questionnaire on parenting stress and parents and teachers filled out report-form questionnaires assessing children's emotional and behavioral functioning. The results showed that mothers had higher levels of parenting stress than fathers, and both parents reported more prosocial behavior in children than did teachers. Furthermore, middle stressed parents had children who expressed more prosocial behavior than did parents in other clusters. The findings also showed that parenting stress influenced partners' perceptions of children's behavioral functioning. The multiplicity of child observers facilitated a better understanding of how parenting stress, linked to parent-child interactions, may play an important role in shaping parents' perceptions of their children., Competing Interests: Competing interestsAll authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript., (© The Author(s) 2022.)

Research has shown that Postnatal maternal depression (PND) is associated with children's emotional and behavioral problems during infancy, but the possible effect of father-child relationship quality on this association is yet to be thoroughly investigated. We recruited 401 families (802 parents; 401 children) via mental health clinics in Central Italy. We divided families into two groups: Group 1 included families with mothers with PND; Group 2 included families with mothers without PND (control group). The assessment took place at T1 (18 months of age of children) and T2 (36 months of age of children): postnatal maternal depression was measured through the Edinburgh Postnatal Depression Scale (EPDS); parent-child relationship quality was assessed through the Scale for the Assessment of Feeding Interactions (SVIA); and the child emotional-behavioral functioning was evaluated with the Child-Behavior-Checklist (CBCL). Compared to the control group, the children of the groups where mothers had PND, showed overall higher scores (i.e., more maladaptive) on the CBCL. A direct effect of postnatal maternal depression on children's emotional-behavioral functioning was found, both at T1 and at T2. A mediation effect of father-child relationship quality between postnatal maternal depression and child outcomes was also found. These results could inform prevention and intervention programs in families with mothers with PND., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cimino, Tambelli, Di Vito, D’Angeli and Cerniglia.)

Bariatric surgery is indicated for treatment of severely obese people and can lead to significant weight loss as well as reduction of comorbidities associated with obesity. The present study aims to investigate the relationship between different psychological factors (e.g., tendency to binge eating, impulsivity, alexithymia), adherence to the nutritional plan, and weight loss after bariatric surgery. Forty-five candidates for bariatric surgery accessing a center for the care of obesity were assessed at T0 (pre-surgery) and T1 (6 months post-surgery) through anthropometric and psychometric measures. Simple linear correlations and linear regressions were conducted to evaluate the relationship between the psychological variables, adherence to nutritional plan, and weight loss 6 months after bariatric surgery. Non-planning impulsivity was the principal factor that succeeded in explaining adherence to the diet plan among all the variables considered. Adherence to the nutritional plan and non-planning impulsivity were considered reliable short-term predictors of weight loss after bariatric surgery. This evidence explains the usefulness of promoting research on psychological predictors of outcome in bariatric surgery. Mid- and long-term weight maintenance and quality of life need to be investigated through further follow-up.

As COVID-19 pandemic spread all over the world, it brought serious health consequences in every medical field, including mental health. Not only healthcare professionals were more prone to develop anxiety, depression, and stress, but the general population suffered as well. Some of those who had no prior history of a psychiatric disease developed peculiar symptoms following infection with SARS-CoV-2, mostly because of psychological and social issues triggered by the pandemic. People developed traumatic memories, and hypochondria, probably triggered by social isolation and stress. Infection with SARS-CoV-2 has influenced the mental health of psychiatric patients as well, exacerbating prior psychiatric conditions. In this review, we focus on analyzing those cases of mania in the context of bipolar disorder (BD) reported after COVID-19 disease, both in people with no prior psychiatric history and in psychiatric patients who suffered an exacerbation of the disease. Results have shown that COVID-19 may trigger a pre-existing BD or unmask an unknown BD, due to social and psychological influences (decreased social interaction, change in sleep patterns) and through biological pathways both (neuroinflammation and neuroinvasion through ACE-2 receptors expressed in the peripheral and central nervous systems (PNS and CNS respectively). No direct correlation was found between the severity of COVID-19 disease and manic symptoms. All cases presenting severe symptoms of both diseases needed specific medical treatment, meaning that they concur but are separate in the treatment strategy needed. This review highlights the importance of a now widespread viral disease as a potential agent unmasking and exacerbating bipolar mood disorder, and it can hopefully help physicians in establishing a rapid diagnosis and treatment, and pave the road for future research on neuroinflammation triggered by SARS-CoV-2., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Del Casale, Modesti, Rapisarda, Girardi and Tambelli.)

Background: Earlier diagnosis and improved treatments have led to better outcomes in breast cancer, making quality of life a key issue. Sexuality represents a pillar of quality of life, although it is often neglected by both healthcare providers and patients when it comes to cancer. This study aims to explore the differences in sexual functioning, distress, psychopathology, emotions, and cognitions between breast cancer patients under hormonal treatment and controls., Methods: Seventy-nine women (age range between 24 and 69 years) in hormonal therapy for breast cancer completed a self-reported protocol. A matched control group of 103 women was randomly extracted from an Italian general population database. Eight self-report questionnaires exploring biopsychosocial factors were administered., Results: The current study showed an impaired sexuality in breast cancer patients compared to controls. Breast cancer women under hormonal treatment were characterized by diminished or absent sexual activity (chi 2  = 36.16; p < 0.001), lower level of sexual functioning in all areas except for pain (F (1,180)  = 8.1; p < 0.01), higher sexual (F (1,180)  = 10.08; p < 0.001) and psychological distress (F (1,180)  = 6.23; p < 0.05), higher scores in Difficulties in Identifying Feelings (F (1,180)  = 7.31; p < 0.01) and Externally Oriented Thinking (F (1,180)  = 6.64; p < 0.05), higher level of negative emotions related to sexuality (F (1,180)  = 11.13; p < 0.001), and more rigid cognition towards peculiar aspects of sexuality, such as Failure Disengagement Thoughts (F (1,180)  = 22.01; p < 0.001) and Age related Beliefs (F (1,180)  = 5.7; p < 0.05)., Conclusions: Health care providers do not usually assess those issues in their routine practice, so that sexuality remains an unmet need with remarkable effects on general health and quality of life., (© 2021. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)

Empathy refers to the capacity to experience emotions similar to those observed or imagined in another person, with the full knowledge that the other person is the source of these emotions. Awareness of one's own emotional states is a prerequisite for self-other differentiation to develop. This study investigated gender differences in empathy during adolescence and tested whether emotional self-awareness explained these differences. Two-hundred-eleven adolescents (108 girls and 103 boys) between 14 and 19 years completed the Interpersonal Reactivity Index (IRI) and the Toronto Alexithymia Scale (TAS-20) to assess empathy and emotional self-awareness, respectively. Overall, girls obtained higher scores than boys on IRI subscales like emotional concern, personal distress, and fantasy. Regarding emotional self-awareness, we found gender differences in TAS-20 scores, with girls reporting greater difficulty identifying feelings and less externally oriented thinking than boys. Difficulty identifying feelings explained the greatest personal distress experienced by girls. Lower externally oriented thinking accounted for girls' greater emotional concern and fantasy. These findings offer an insight into the role of emotional self-awareness-which is essential for self-other differentiation-as an account for gender differences in empathic abilities during adolescence. In girls, difficulty identifying feelings can impair the ability to differentiate between ones' and others' emotions, leading them to experience self-focused and aversive responses when confronted with others' suffering. Conversely, in boys, externally oriented thinking can mitigate personal distress when faced with others' discomfort.

The pandemic period which has characterized the last two years has been associated with increasingly worsening psychological conditions, and previous studies have reported severe levels of anxiety, mood disorder, and psychopathological alteration in the general population. In particular, worldwide populations have appeared to present post-traumatic stress symptoms (PTSS). Surprisingly, no studies have evaluated the effect of COVID-related PTSS on cognitive functioning. This study focused on the association between high levels of PTSS related to COVID-19 and alterations in executive functioning by considering executive inhibitions in populations not infected by the virus. Ninety respondents from the Italian population participated in the study. A higher percentage of PTSS was reported. Moreover, respondents with high post-traumatic symptomatology presented deficits in the inhibition of preponderant responses, demonstrating an executive deficit which could be expressed by a difficulty in controlling goal-directed actions. This was underlined by worse performances in elaborating incongruent stimuli in the Stroop task and no-go stimuli in the Go/No-Go task. This report presents preliminary findings underlining the effect of the COVID-19 pandemic on cognitive functions. The results confirmed a persistently higher post-traumatic symptomatology related to the COVID-19 pandemic in the Italian population and highlighted an association with cognitive inhibition impairment.

Background: Most studies on chemsex focus on the health risks associated with the practice, whereas less attention has been paid to the perception of sexual gratification in men who have sex with men (MSM) who use these substances., Aim: The purpose of this study was to explore the effects of chemsex substances on sexual response, motivations to engage in chemsex and the relationship with sober sex., Methods: Thirty-one Italian cisgender MSM involved in sexualized drug use were interviewed and transcripts were thematically analyzed., Outcomes: An ad hoc grid exploring sociodemographic data, chemsex sexual experience, motives, and relationships with sober sex was used during telephone-based interviews., Results: Participants showed significant individual differences in how chems may affect their sexual experience. The most reported effects were an increase in sexual desire and subjective arousal, access to higher disinhibition, possible erection and ejaculation difficulties, significant extension of the sexual experience duration, and an intensified perception of intimacy and pleasure. All the positive outcomes of substances on sex creates a great curiosity around chemsex, which is among the primary motives to engage in chemsex for the first time. Over time, other motives may emerge, also connected to substance abuse and craving. Some men reported to be motivated by their partners and friends and to use chemsex to cope with depressive mood/anxiety symptoms, stress and sexual problems. Many differences were reported between chemsex and sober sex. Chemsex seems to embody the idea of transgressive and exciting sex, while sober sex is outlined as a more intimate encounter, that can be significantly affected by performance anxiety., Clinical Translation: These results offer some new perspectives that may add interesting information to the literature and be fundamental for future prevention and harm-reduction projects., Strengths & Limitations: Although this study is based on a small group of Italian MSM and the interviews were not audio-recorded, transcripts were consistent with scientific literature that considers it important to pay attention to the positive links between sex and substance use., Conclusion: The promotion of safer sexual behavior should contemplate an in-depth discussion and recognition of both pleasurable and distressing aspects of chemsex sexual experience, its motivations over time and perceived differences with sober sex. Nimbi FM, Rosati F, Esposito RM, et al. Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. J Sex Med 2021;18:1955-1969., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

During the second year of life, mother's sensitivity in encouraging child autonomy supports children's emotional-affective individuation. In the feeding context, there is a clear transition from dependence on the mother to an emerging autonomy. Several studies have found an association between children's poor growth which is not related to organic pathologies, and maladaptive mother-child interactions that are characterized by poor maternal sensitivity. Despite this evidence, no studies have investigated maternal sensitivity to specific child's cues, such as demands for autonomy, during feeding interactions between mothers and their underweight children. This study aimed to assess how mothers' psychopathological risk and toddler's dysregulation profile are associated with mother-toddler interactional quality during feeding, with particular attention to mothers' sensitivity to child's specific cues (e.g. need of autonomy, requests for cooperation, request to stop the interaction, etc.). One hundred fifty mother-toddler dyads (N = 73 with underweight children and N = 77 with normal weight children) with children aged between 18 and 30 months, were recruited. Mother-toddlers feeding interactions were assessed through specific rating scales applied to the video-recorded interactions and mothers filled out questionnaires on children's emotional-behavioral functioning and their own psychopathological risk. Results showed a significant association between the quality of mother-toddler feeding interaction and children's weight. Underweight children showed less demand for autonomy and request for cooperation than normal weight children. Moreover, mothers of underweight children were less sensitive to toddler's cues of wanting to stop the interaction and demands for autonomy compared to mothers of normal weight children. Lower facilitations were associated with toddler's more dysregulated profile and with mother's higher psychopathological risk, and high toddler's dysregulation profile was associated with lower maternal sensitivity to child's cues of wanting to interrupt interactions and with worse mother's mood. Assessing maternal sensitivity in relation to toddler's specific cues might be particularly relevant in the feeding context. It might help to detect some dysfunctional interactive patterns and allow the implementation of prevention and treatment programs., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

International research has evidenced the psychological impact of the COVID-19 pandemic on families, and the key role played by parenting stress levels. Although significant associations with parents' past trauma and resilience have been shown, this study aimed to explore their complex interplay on the relationship between parents' peritraumatic distress due to COVID-19, parenting stress, and children's psychopathological difficulties. We recruited 353 parents with children aged two to 16 years via an online survey during the Italian second wave of COVID-19. Parents' peritraumatic distress due to COVID-19, parenting stress, past trauma and resilience, and children's psychological difficulties were assessed through self-report and report-form questionnaires. Parents' past traumas significantly predicted peritraumatic distress due to COVID-19 and children's psychological difficulties. The relationship between past traumas and children's psychological difficulties was serial mediated by parents' peritraumatic distress and parenting stress. Direct and total effects of parent's resilience on parent's peritraumatic distress were not significant, but there were significant indirect effects via parenting stress and via parents' peritraumatic distress and parenting stress, indicating inconsistent mediation. This study evidenced the key risk and protective role played by, respectively, parents' past traumas exposure and resilience on the relationship between parents' psychological difficulties due to COVID-19, parenting stress, and children's psychological difficulties, with important clinical implications.

International research has underlined a worrying increase in Internet and Instagram addiction among emerging adults during the COVID-19 pandemic. Although the role played by alexithymia and psychological distress due to COVID-19 has been evidenced, no study has explored their complex relationship in predicting emerging adults' Internet and Instagram addiction. The present study aimed to verify whether peritraumatic distress due to the COVID-19 pandemic mediated the relationship between emerging adults' alexithymia and their Internet/Instagram addiction, in a sample composed of n = 400 Italian emerging adults. Results showed that females had higher peritraumatic distress due to COVID-19 than males, whereas males had higher externally oriented thinking and higher levels of Internet addiction than females. Emerging adults' psychological distress due to COVID-19 significantly mediated the effect of alexithymia on Internet and Instagram addiction. Our findings supported the presence of a dynamic relationship between individual vulnerabilities and the co-occurrence of other psychological difficulties in predicting emerging adults' Internet and Instagram addiction during the pandemic, with important clinical implications.

The scientific literature has shown the key role played by attachment to parents and peers and difficulties in recognizing, processing, and regulating emotions (i.e., alexithymia) in the (mal-)adaptive psychological response to the COVID-19 pandemic during late adolescence. No study has yet explored the complex interplay between these variables. We recruited a sample of 454 late adolescents (Mage = 22.79, SD = 2.27) and assessed attachment to parents and peers, alexithymia, and peritraumatic distress due to COVID-19 through self-report instruments. Attachment to fathers and peers, but not to mothers, and alexithymia significantly predicted levels of peritraumatic distress. Alexithymia fully and partially mediated the effect of, respectively, attachment to mothers and attachment to peers on peritraumatic distress due to COVID-19. These findings suggested that intervention programs focused on the promotion of peer social relationships, supportive parent-adolescent relationships, and the ability to recognize and discriminate one's own and others' emotions are needed in helping late adolescents to face the current health emergency and preventing short- and long-term psychopathological consequences related to the COVID-19 pandemic.

The study aimed to longitudinally explore the effects of parental prenatal attachment and psychopathological symptomatology on neonatal global DNA methylation (5-mC) variation between birth and the first month of life. Eighteen mothers and thirteen fathers were assessed before childbirth (t0) by Perceived Stress Scale (PSS), Prenatal-Attachment Inventory, and Paternal Antenatal Attachment Scale; 48 hr after childbirth (t1) by SCL-90-R; and one month after childbirth (t2) by PSS. At t1 and t2, buccal swabs from parents and newborns were collected. In newborns' 5-mC and single nucleotide polymorphisms (SNPs) of DAT, MAOA, BDNF, and 5-HTTLPR genes were detected, while in parents only SNPs were measured. At t1, newborns' 5-mC was negatively associated with maternal psychopathological symptoms, while at t2, newborns' 5-mC was positively associated with paternal psychopathological symptoms and negatively with paternal prenatal attachment. The variation of newborns' 5-mC from t1 to t2 was predicted by paternal psychopathological symptoms. No significant correlations among parental SNPs and 5-mC levels were found. Results highlight parent-specific influences on newborn's DNA methylation. At birth, maternal psychological symptoms seem to have an effect on newborns' 5-mC, while after one month of life, paternal psychological characteristics could have a specific role in modulating the newborns' epigenetic responses to the environment., (© 2020 Wiley Periodicals LLC.)

Several studies have shown an association between adolescents' attachment relationships and social media use. Instagram is the social media platform most used by teenagers and recent studies have shown an association between Instagram use and increased psychopathological risk. The present study aims to verify whether psychopathological risk mediates the relationship between an adolescent's attachment to their parents and peers and their Instagram addiction. N = 372 adolescents are assessed through self-report questionnaires evaluating Instagram addiction, the adolescents' attachments to parents and peers, and their psychopathological risk. The Bergen Instagram Addiction Scale (BIAS) is developed by adapting the Bergen Social Media Addiction Scale. Results show the validity and reliability of the BIAS, confirming a one-factor structure. Findings show that a worse attachment to parents and peers is associated with adolescents' psychopathological risk, which is associated with Instagram addiction. This finding has important clinical implications. Being able to intervene in adolescents' relationships with parents and peers and the ways in which adolescents feel in relation to others could allow for a reduction in adolescents' psychological difficulties, involving reduced Instagram use as a vehicle for the expression of their psychopathological symptoms.

Background: The COVID-19 pandemic is a worldwide public health emergency that forced the Italian Government to deliberate unprecedented actions, including quarantine, with a relevant impact on the population. The present study is one of the first Italian nationwide survey within the first period of the COVID-19 outbreak aimed to understand the social and psychological impact of the COVID-19 outbreak. Methods: An online survey collected information on sociodemographic data, history of direct or indirect contact with COVID-19, and other information concerning the COVID-19 emergency. The General Psychological Well-Being Index and a modified version of the PTSD Checklist for DSM-5, focused on the COVID-19 experience, assessed the respondents' general psychological condition. Results: Of 1,639 respondents equally distributed in the Italian territory, 5.1% reported PTSD symptomatology, and 48.2% evidenced lower psychological well-being linked to COVID-19 diffusion. Lower psychological well-being was significantly higher in women, younger than 50 years, and with health risk factors. Lower psychological well-being was also detected in individuals who did not know if they were infected, who have had direct exposure or were uncertain about their exposure to COVID-19, or who knew infected people. Regarding the social and behavioral consequences, respondents perceived worsening in demographic, economic, social, and relational conditions. Moreover, they reported increased film viewing, cookhouse time, social media use, and decreased physical activity. Conclusion: The COVID-19 pandemic appears to be a risk factor for psychological diseases in the Italian population, as previously reported in the Chinese people. About half of the respondents reported a significant psychological impact. Moreover, we confirmed the role of restraining measures that led to modify lifestyles, social perception, and confidence in the institutions. These results underline the need for further studies aimed to develop psychological interventions to minimize the consequences of the COVID-19 pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer CL declared a shared affiliation, though no other collaboration, with the authors FF, MC, GF, and RT to the handling editor., (Copyright © 2021 Favieri, Forte, Tambelli and Casagrande.)

Purpose: This study aimed to assess the direct and indirect impact of COVID-19-related aspects on self-reported sleep quality, considering the moderator role of some psychological variables., Methods: During the first weeks of the lockdown in Italy, 2286 respondents (1706 females and 580 males; age range: 18-74 years) completed an online survey that collected sociodemographic information and data related to the experience with the COVID-19 pandemic. Some questionnaires assessed sleep quality, psychological well-being, general psychopathology, Post-Traumatic Stress Disorders symptoms, and anxiety. The path analysis was adopted., Results: The study confirms a direct effect of some aspects ascribable to the pandemic, with a mediator role of the psychological variables. Lower sleep quality was directly related to the days spent at home in confinement and the knowledge of people affected by the COVID-19. All the other aspects related to the COVID-19 pandemic influenced sleep quality through the mediator effect of psychological variables., Conclusion: This study highlighted that the psychological condition of the population has been influenced by the COVID-19 pandemic and the government actions taken to contain it, but it has also played an important role in mediating the quality of sleep, creating a vicious circle on people's health. The results suggest that a health emergency must be accompanied by adequate social support programs to mitigate the fear of infection and promote adequate resilience to accept confinement and social distancing. Such measures would moderate psychological distress and improve sleep quality., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Casagrande et al.)

The purpose of this study was to investigate sex-related differences in the electrophysiological response to socioemotional stimuli (positive, negative, and ambiguous) depicting couple interactions. The associations between anxiety and avoidance attachment dimensions (measured with the Experiences in Close Relationships-Revised questionnaire) and the strength of cortico-limbic circuit intensity was explored, recorded using a 256-Hydrocel Geodesic Sensor-Net. Event-related potentials (ERPs) and standardized low-resolution electromagnetic tomography (sLORETA) data were analyzed for a total sample of 74 participants. Regression analyses showed that the women presented increased brain intensity compared with that in men, and the avoidance score was positively associated with brain intensity, particularly in response to negative socioemotional stimuli. The interaction sex per avoidance was a significant predictor of intensity in many brain areas, with women displaying significantly more pronounced positive associations between avoidance and brain intensity than men. In conclusion, the findings of the present study showed that women appeared to be more emotionally involved during the socioemotional task. Avoidance was positively associated with intensity of the cingulate and prefrontal regions, and these associations were more pronounced in women than in men. These findings suggested that avoidance seems to represent two different socioemotional strategies, in which women appear to activate an avoidant strategy to modulate increased emotional involvement in relationships, whereas men appear to adopt avoidance with a more intense emotional suppression.

Epigenetic mechanisms, in particular DNA methylation, have been implicated in the etiopathogenesis of psychopathologies in adulthood. The significance of this mechanism in child psychopathologies, however, is much less recognized. Here, we examined whether global DNA methylation alteration was associated with the presence of disruptive mood dysregulation disorder (DMDD) in children. Moreover, in light of the relevance of the interplay between children and parents for the onset and maintaining of psychopathology during development, we measured the association between psychological symptoms, attachment styles, and global DNA methylation levels in healthy and DMDD mother-child dyads (mothers: N = 126, age = 38.3 ± 2.5 years; children: N = 150, age = 8.2 ± 0.9 years, gender ratio [f/m] = 72/78). We did not observe any significant differences in global DNA methylation levels in DMDD children when compared with healthy peers, and children's symptoms did not correlate with variations in this parameter. The mothers showed different levels of psychological symptomatology. Notably, mothers with high psychological symptomatology showed the lowest levels of global DNA methylation. Maternal global DNA methylation levels were associated with maternal hostility, interpersonal sensitivity, psychoticism, and general severity index. Moreover, we found an effect of maternal mental health on the severity of children's symptoms, independently from both maternal and child DNA methylation levels. Despite here DNA methylation does not appear to be involved in the maternal inheritance of vulnerability to depression, this biological link could still arise in later stages of the child's development., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Carola, Cimino, Bussone, Cerniglia and Tambelli.)

Background: Our study aimed to test the hypotheses that an increased level of loneliness experienced during coronavirus disease 2019 (COVID-19) confinement was predictive of internalizing symptoms and that this pathway was mediated by emotion dysregulation levels. Methods: To reach this aim, we performed an online longitudinal survey recruiting 1,330 participants at Time 1 (at the beginning of the lockdown) and 308 participants at Time 2 (few days before the end of the lockdown). All filled out a set of questionnaires: demographic data, University of California, Los Angeles Loneliness scale, Difficulties in Emotion Regulation Scale-18 items, and Depression Anxiety and Stress Scale-21 items. Hypotheses were tested using structural equation modeling in two steps and controlling for age. First, hypotheses were tested on cross-sectional data. Then, a cross-lagged panel analysis was performed on longitudinal data. Results: Models obtained a good fit and evidenced the predictive role of loneliness levels on the three outcomes (i.e., depression, anxiety, and stress). Moreover, we found that emotion dysregulation levels partially mediated the longitudinal relationship between loneliness and both depression and stress but not between loneliness and anxiety levels. Conclusions: This study points out that a central goal of clinical intervention could be the ability to regulate negative emotional states., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Velotti, Rogier, Beomonte Zobel, Castellano and Tambelli.)

Background: International research has emphasized that youths are at higher risk for the onset of internet addiction (IA), but studies investigating biological, psychological, and social factors associated with this condition are limited., Objective: This study aims to investigate the possible association between IA and genetic polymorphisms in monoamine oxidase A (MAO-A), serotonin-transporter (5-HTTPR), dopamine receptor (DRD4), and dopamine transporter (DAT1) genes by considering the role played by the perception of young adults in their family functioning and their depression, anxiety, and avoidant personality problems., Methods: In a sample of 104 male and female young adults aged between 19 and 23 years (mean age 21.87, SD 2.29 years) recruited from universities in the central southern part of Italy, we addressed the presence of IA using the Young criteria of the IA test. Moreover, the perception of young adults of their family functioning and their psychopathological symptoms were assessed through the Family Assessment Device (FAD) and the Adult Self-Report, respectively., Results: We found no significant association between IA and any genetic polymorphisms, neither among males or females. Young adults with IA reported significantly higher scores in the subscale of FAD affective responsiveness (AR; P=.01) and in depressive problems (P=.02), anxiety problems (P=.009), and avoidant personality problems (P=.003) than those in the control group. Results of mediation analyses showed a mediation role played by depressive symptoms (B=0.99; 95% CI 0.22 to 1.97) and avoidant personality problems (B=1.09; 95% CI 0.32 to 2.05) of young adults on the relationship between the FAD, AR, and IA. Finally, this relationship was moderated by the genotype of the 5-HTTLPR (P<.001), DAT1 (P<.001), and MAO-A (P<.001) genes in young adults., Conclusions: This exploratory study supports the recent evidence on the mutual relationship among biological, individual, and social risk factors associated with IA in young adulthood. Our findings may have important clinical implications for the development of prevention and treatment programs., (©Luca Cerniglia, Silvia Cimino, Eleonora Marzilli, Esterina Pascale, Renata Tambelli. Originally published in JMIR Mental Health (http://mental.jmir.org), 24.12.2020.)

Parental pre-natal representations predict the interactive patterns that parents will put in place after childbirth. Early interactions defined by high parental emotional availability (EA) influence the development of security in children. To date, research on the predictive role of parental pre-natal representations on child attachment is still poor. Moreover, investigations on pre-natal representations have mainly focused on mothers. This study aimed at: investigating the criterion validity of the Interview of Maternal Representations During Pregnancy-Revised (IRMAG-R) and of the Interview of Paternal Representations During Pregnancy (IRPAG), using EA, parental attachment, and child attachment toward both parents, as criteria; testing the incremental validity of the IRMAG-R and IRPAG in the prediction of child attachment, controlling for other covariates, such as depressive and anxious levels during pregnancy, EA, and parental attachment; evaluating the possible mediation role of EA on the relationship between parental representations during pregnancy and child attachment. Fifty couples of primiparous parents were recruited during pregnancy, when the IRMAG-R and IRPAG were administered to mothers and fathers. At 6-9 months after childbirth, the mother-child and father-child interactions were coded by means of the EA Scales (EAS). At 14-18 after childbirth, the Adult Attachment Interview (AAI) was administered to parents, and the Strange Situation Procedure (SSP) was carried out to assess children's attachment toward mothers and fathers, respectively. The results showed significant correlations between parental pre-natal representations and EA, parental attachment and child attachment. As regards the prediction of child attachment, the IRMAG-R/IRPAG categories showed: a significant and large unique contribution for maternal representations; a close to be significant contribution for paternal representations (with a higher effect size for mothers than fathers). Moreover, while the indirect effect of pre-natal representations in the prediction of child attachment was not significant for mothers, it was instead significant for fathers. The results of this study confirmed the criterion validity of the IRMAG-R and IRPAG, and supported the incremental validity of the IRMAG-R and IRPAG in the prediction of children's attachment categories. Finally, the mediation models revealed that EA did not mediate the relationship between maternal pre-natal representations and child attachment, while it totally mediated the relationship between paternal pre-natal representations and child attachment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Tambelli, Trentini and Dentale.)

The investigation of the association between alexithymia and quality of life in infertility is a relatively neglected area of research. The aim of this study was to evaluate the association between alexithymia and infertility-related quality of life in women during Assisted Reproductive Treatment. Data were collected in a clinic in Rome, 93 infertile women completed the 20-item Toronto Alexithymia Scale (TAS-20), the Fertility Quality of Life (FertiQoL) questionnaire and a socio-demographic questionnaire. TAS-20 total and two factors-Difficulty in Identifying Feelings (DIF) and Difficulty in Describing Feelings (DDF)-showed significant negative correlations with the overall questionnaire and with both Core and Treatment modules of FertiQoL. The regression model explained the 43% variance in FertiQol overall scores (R 2 = 0.43; adjusted R 2 = .38); a significant effect was reported for the number of previous attempts (beta = 0.20; p < .04), TAS-20 DIF (beta = -0.47; p < .001) and TAS-20 Externally Orientated Thinking (EOT) (beta = 0.20; p < .04); after applying Benjamini-Hochberg correction procedure only TAS-20 DIF maintained its significance. Alexithymia is associated with a worsened quality of life in infertile women; specifically, low difficulties in identifying feelings were associated to higher quality of life. Further investigations are needed also to develop specific therapeutic interventions aimed to promote emotional abilities in infertile people., (© 2020 John Wiley & Sons, Ltd.)

Background: Maternal sub-threshold and non-clinical depression and its possible outcomes on offspring internalizing/externalizing symptoms has received growing attention in recent years because of its significant worldwide prevalence., Methods: Through a Latent State-Trait Analysis approach (LST), this longitudinal study aimed to identify a stable component of non-clinical maternal depression across a temporal interval of 6 years (measured through the Symptom Check-List-90/R) and to determine the effect of this component on children's emotional and behavioral functioning (measured through the Child Behaviour Check-List) at age 12 years., Results: LST analysis showed that maternal depressive symptoms tended to remain stable within individuals across 6 years of observation strongly contributing to children's internalizing/externalizing and dysregulation symptoms., Conclusions: The current longitudinal analysis of maternal and child data revealed that a stable component of maternal depressive symptoms reliably predicted a wide range of child emotional and behavioral symptoms at 12 years of age.

The extraordinary health emergency of the COVID-19 pandemic represents a new challenge for mental health researchers and clinical practitioners. The related containment measures may be a risk factor for psychological distress and mood disorders, especially in at-risk populations. This study aims to explore the impact of COVID-19 on postpartum depressive symptoms in mothers with children below 1 year of age. An online questionnaire survey was therefore conducted in Italy between May and June 2020. The survey consisted of several self-administered questionnaires: besides some ad-hoc questionnaires, the Edinburgh Postnatal Depression Scale (EPDS), the Scale of Perceived Social Support (SPSS) and the Maternity Social Support Scale (MSSS) were used. Two hundred forty-three Italian women were included in the study. The prevalence of postpartum depression symptomatology among mothers was 44%, as measured through the EPDS (cut-off >12). Women who spent the isolation in northern Italy adopted maladaptive coping strategies significantly more than women living in areas at lower risk. The analysis highlighted a significant difference between the group that was not directly affected by the virus and women who have had a direct or indirect contact with it. Besides situational factors specific to the pandemic, the results show that there are some risk factors tied to the personal history of the mother (e.g., having had a previous abortion). These data should inform and enlighten future protocols of intervention., (Copyright © 2020 Spinola, Liotti, Speranza and Tambelli.)

The coronavirus pandemic represents a severe global crisis, affecting physical, and psychological health. Lockdown rules imposed to counteract the rapid growth of COVID-19, mainly social restrictions, have represented a risk factor for developing depressive and anxious symptoms. The research aims are to explore the effect of coping strategies and perceived social support on depressive and anxious symptomatology during the COVID-19 pandemic. Ninety-six healthy people (46 males, mean age = 39.3; SD = 16.6) completed through on-line platform: Socio-demographic questionnaire, Coping Inventory for Stressful Situations (CISS), Multidimensional Scale of Perceived Social Support (MSPSS) and Symptom Checklist-90-Revised (SCL-90-R), 3 weeks after the imposition of lockdown restrictions. SCL-90-R Depression scores showed significant positive correlation with CISS Emotion ( r = 0.85; p = 0.001) and Avoidant ( r = 0.34; p = 0.018), a significant negative correlation with MSPSS Family support ( r = -0.43; p = 0.003). SCL-90-R Anxiety scores showed a significant positive correlation with CISS Emotion ( r = 0.72; p = 0.001) and Avoidant ( r = 0.35; p = 0.016). No significant correlations between both CISS Emotion and Avoidant scales with social support emerged. Two Multiple Linear Regression analysis were performed using, respectively, SCL-90-R Depression and Anxiety scores as dependent variables, and the CISS and MSPSS scales, age, and gender as predictors. The first regression model ( R 2 = 0.78; adjusted R 2 = 0.004) had a predictive effect on SCL-90-R Depression scores. The second regression model ( p = 0.001) and MSPSS Family support (β = -0.24; p = 0.004) had a predictive effect on SCL-90-R Depression scores. The second regression model ( R = 0.001) predicted the SCL-90-R Anxiety scores. In conclusion, during the COVID-19 pandemic lockdowns, coping focus on emotions seemed to increase anxious and depressive symptoms, probably due to the uncontrollable nature of the stressful event and the high emotional response. Family support which reduces the sense of loneliness had an exclusive role in mitigating depressive symptoms. These results highlight the importance of promoting psychological strategies to improve emotional regulation skills, reducing isolation from family, to prevent mood symptomatology in healthy citizens during large-scale health crises.2 = 0.52; adjusted R 2 = 0.472) revealed that only CISS Emotion (β = 0.71; p = 0.001) predicted the SCL-90-R Anxiety scores. In conclusion, during the COVID-19 pandemic lockdowns, coping focus on emotions seemed to increase anxious and depressive symptoms, probably due to the uncontrollable nature of the stressful event and the high emotional response. Family support which reduces the sense of loneliness had an exclusive role in mitigating depressive symptoms. These results highlight the importance of promoting psychological strategies to improve emotional regulation skills, reducing isolation from family, to prevent mood symptomatology in healthy citizens during large-scale health crises., (Copyright © 2020 Mariani, Renzi, Di Trani, Trabucchi, Danskin and Tambelli.)

Background: The novel coronavirus 2019 (COVID-19) has caused severe panic among people worldwide. In Italy, a nationwide state of alert was declared on January 31st, leading to the confinement of the entire population from March 11 to May 18, 2020. Isolation and quarantine measures cause psychological problems, especially for individuals who are recognized as being vulnerable. Parental bonding and attachment styles play a role in the programming of the stress response system. Here, we hypothesize that the response to restricted social contact and mobility due to the pandemic has detrimental effects on mental-psychological health and that this relationship is, at least in part, modulated by parental bonding and attachment relationships that are experienced at an early age. Methods: A sample of 68 volunteer University students was screened for psychopathological symptoms (SCL-90-R and STAI-Y), stress perception (PSS), attachment style (RQ), and parental care and overcontrol (PBI) 6 months before the confinement. In the same subjects, psychopathological symptoms and stress perception were measured again during confinement. Results: Overall, psychological health and stress management deteriorated across the entire sample during confinement. Specifically, a significant increase in phobic anxiety, depression, psychological distress, and perceived stress was observed. Notably, parental bonding and attachment styles modulated the psychological status during the lockdown. Individuals with secure attachment and high levels of parental care (high care) showed increased levels of state anxiety and perceived stress in phase 2, compared with phase 1. In contrast, individuals with insecure attachment and low levels of parental care (low care) already showed a high rate of state anxiety and perceived stress in phase 1 that did not increase further during phase 2. Conclusion: The general deterioration of psychological health in the entire sample demonstrates the pervasiveness of this stressor, a decline that is partially modulated by attachment style and parental bonding. These results implicated disparate sensitivities to environmental changes in the high- and low care groups during the lockdown, the former of which shows the greatest flexibility in the response to environment, suggesting adequate and functional response to stress in high care individuals, which is not observable in the low care group., (Copyright © 2020 Bussone, Pesca, Tambelli and Carola.)

Background: The 2019 Coronavirus Disease (COVID-19) pandemic has become a global health emergency. The extreme actions aimed to reduce virus diffusion have profoundly changed the lifestyles of the Italian population. Moreover, fear of contracting the infection has generated high levels of anxiety. This study aimed to understand the psychological impact of the COVID-19 outbreak on sleep quality, general anxiety symptomatology, and psychological distress., Methods: An online survey collected information on socio-demographic data and additional information concerning the COVID-19 pandemic. Furthermore, sleep quality, sleep disorders, generalized anxiety symptoms, psychological distress, and post-traumatic stress disorder (PTSD) symptomatology related to COVID-19 were assessed., Results: This study included 2291 respondents. The results revealed that 57.1% of participants reported poor sleep quality, 32.1% high anxiety, 41.8% high distress, and 7.6% reported PTSD symptomatology linked to COVID-19. Youth and women, those uncertain regarding possible COVID-19 infection, and greater fear of direct contact with those infected by COVID-19 had an increased risk of developing sleep disturbances, as well as higher levels of anxiety and distress. Finally, a significant relationship between sleep quality, generalized anxiety, and psychological distress with PTSD symptoms related to COVID-19 was evidenced., Conclusions: Our findings indicate that the COVID-19 pandemic appears to be a risk factor for sleep disorders and psychological diseases in the Italian population, as previously reported in China. These results should be used as a starting point for further studies aimed to develop psychological interventions to minimize the brief and long-term consequences of the COVID-19 pandemic., Competing Interests: The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: https://doi.org/10.1016/j.sleep.2020.05.011., (© 2020 Elsevier B.V. All rights reserved.)

Background: The syndromic diagnosis of major depressive disorder (MDD) is associated with individual differences in prognosis, course, treatment response, and outcome. There is evidence that patients with a history to adverse childhood experiences (ACEs) may belong to a distinct clinical subgroup. The combination of data on ACEs and blood biomarkers could allow the identification of diagnostic MDD subgroups., Methods: We selected several blood markers (global DNA methylation, and VEGF-a, TOLLIP, SIRT1, miR-34a genes) among factors that contribute to the pathogenetic mechanisms of MDD. We examined their level in 37 MDD patients and 30 healthy subjects. ACEs were measured by the Parental Bonding Instrument and the Childhood Trauma Questionnaire., Results: We found significant differences between patients and healthy subjects in three biomarkers (TOLLIP, VEGF-a, and global DNA methylation), independently from the confounding effect of parental care received. By contrast, SIRT1 differences were modulated by quality of parental care. The lowest levels of SIRT1 were recorded in patients with active symptoms and low maternal/paternal care. miR-34a and SIRT1 levels were associated with MDD symptoms especially in early-life stressed patients., Limitations: Small sample size, no information on personality comorbidity and suicidal history, cross-sectional definition of remission, and lack of follow-up., Conclusions: Our findings suggest that the levels of global DNA methylation, TOLLIP, and VEGF-a reflect pathophysiological changes associated with MDD that are independent from the long-term effects of low parental care. This study also suggests that SIRT1 may be an additional variable distinguishing the ecophenotype that includes MDD patients with exposure to ACEs., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Chemsex is a novel phenomenon referring to the consumption of illicit drugs to facilitate, enhance, and prolong the sexual experience in men who have sex with men (MSM)., Aim: The present study aims to investigate contexts, patterns of substance use, first chemsex experience, and harm reduction in a group of MSM practicing chemsex in Italy., Methods: Thirty MSM involved in chemsex activities were interviewed between February and July 2019., Outcomes: The interviews were conducted using an ad hoc grid exploring general characteristics of Italian chemsex, patterns of substance use, first chemsex experience, and harm reduction opinions., Results: Chemsex in Italy showed important peculiarities and patterns because of sociocultural background. Chemsex was mainly reported in private venues within couple and group sexual activities. Most participants attended chemsex sessions about 1-2 times per month often concurring with men-only club events. Freebase cocaine emerged among the most relevant substances consumed together with gamma-hydroxybutyrate/gamma-butyrolactone, crystal methamphetamine, and mephedrone. A rare use of injected substances compared with other European Union countries was shown. Given the high prevalence of erectile problems, a large use of phosphodiesterase type 5 inhibitors was reported, and noncoital sexual activities were usually preferred (eg, oral sex, fist fucking). The first chemsex experiences were usually accessed by geolocation-based dating apps and sexual partners and were generally described as positive experiences, with some negative consequences at the end of the session (dysphoric mental states, guilt, craving). Taking part in international gay events seems to favor the first experience of chemsex for some participants. Moreover, some MSM practiced chemsex only abroad or in other cities in Italy so as not to be recognized as chem users in their daily environment., Clinical Translation: Implications for ad hoc harm reduction programs are discussed., Strengths & Limitations: Despite the methodological limitations due to participants' number and the absence of interviews audio recording, results highlighted some relevant characteristics of chemsex in Italy, such as freebase cocaine use, attitudes regarding slamming, geographical movements, and secrecy., Conclusion: The results revealed a need for greater scientific and public attention on chemsex to act with the most specific and effective prevention and harm reduction tools. Nimbi FM, Rosati F, Esposito RM, et al. Chemsex in Italy: Experiences of Men Who Have Sex With Men Consuming Illicit Drugs to Enhance and Prolong Their Sexual Activity. J Sex Med 2020;17:1875-1884., (Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)