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Metacognition among those reporting psychotic symptoms is associated with a distortion in the way they understand their own and others' mental states. Recent advances suggest that distortion in the form of self-criticism may activate a threat response and fuel symptom expression. At high level of self-criticism metacognition may reduce its protective role towards psychosis. Here, we explored whether the associations between impaired self-reflectivity and delusional ideation would decrease in the presence of self-criticism. A moderated regression model confirmed our hypothesis in a large sample of healthy young adults (N = 2065) even when controlled for sex, education, and family income. Our findings suggest how interventions aimed at reducing symptoms and promoting metacognition should always be interconnected with those targeting self-criticism., Author(s): Simone Cheli [sup.1] [sup.2] , Veronica Cavalletti [sup.2] , Francesco Mancini [sup.3] [sup.4] , Gil Goldzweig [sup.5] Author Affiliations: (1) grid.8404.8, 0000 0004 1757 2304, School of Human Health [...]

Background: There is a growing interest in the early assessment and treatment of maladaptive forms of personality traits in adolescents, though little is known about effective interventions. This case series aims to present the adaption of a therapy specifically tailored on schizotypal traits to adolescents. The treatment – Evolutionary Systems Therapy for Schizotypy – integrates evolutionary psychopathology, metacognitively oriented psychotherapy and compassion focused therapy. Methods: Five adolescents attended 6-months of individual psychotherapy. All participants were diagnosed with schizotypal personality disorder in accordance with the DSM-5 Alternative Model of Personality Disorders. Primary outcome was remission from diagnosis. Secondary outcomes were a reliable change in personality pathology and distress and the acceptability of the intervention. Results: Four out of five patients showed remission from diagnosis. All the participants showed reliable changes in personality pathology and distress whether comparing initial and final assessments or investigating monthly variations. Changes were maintained at 1-month follow-up. No adverse events were reported, and intervention was described as satisfactory and sustainable. Discussion: Further research is needed to confirm the feasibility of the proposed treatment. This study suggests the importance of developing effective interventions for adolescents with personality disorder, especially for those at risk for severe manifestations. [ABSTRACT FROM AUTHOR]

This article introduces a measure of self-condemnatory internal dialogue as an element of the relationship with the self: The Automatic Self-Recrimination Scale (ASRS). Using the construct validation approach to test construction, we describe the initial development of items and report on findings from a clinical and nonclinical sample showing the ASRS is best understood as a multidimensional measure of self-critical internal dialogue composed of one higher-order factor and four lower-order facets: Not Mattering, Self as Failure, Undeserving Self, and Loathsomeness. The overall scale and four subscales demonstrated acceptable internal consistency and test-retest reliability. Moreover, there was evidence of good convergent and incremental validity of the ASRS subscales with measures of perfectionism, self-criticism, and dysfunctional attitudes. Overall, the ASRS appears to be a reliable and valid measure of an automatic self-recriminatory internal dialogue. [ABSTRACT FROM AUTHOR]

Little is known about effective psychosocial treatments for paranoid personality disorder. This study explores the feasibility of a novel treatment, namely Evolutionary Systems Therapy, in supporting individuals diagnosed with paranoid personality disorder. Seven patients attended 10 months of individual therapy without receiving any psychopharmacological treatment. The primary outcome was the feasibility of the intervention, while the secondary outcomes were remission from the diagnosis and reliable changes in personality pathology and paranoid ideation. All recruited patients completed the intervention and did not report any adverse events. Six out of seven patients experienced remission from the diagnosis of paranoid personality disorder. All participants showed reliable changes in personality pathology and paranoid ideation, which were maintained at the 1-month follow-up. Further research is needed to confirm these encouraging results. [ABSTRACT FROM AUTHOR]

The aim of this work is to contribute to the ongoing debate on the Consensus Conference on Psychological Therapies for Anxiety and Depression. Taking a scientific approach to implement the guidelines of the Istituto Superiore di Sanità, I will frame my reflections in a peer-review format identifying five areas that might benefit from the review. Obviously, the opinions I express here may be faulty opinions that I will attempt to justify from the standpoint of existing scientific literature. [ABSTRACT FROM AUTHOR]

We explored the role of criticism of self and of others, and metacognitive abilities in hearing voices that may refer to god or a divine presence, and qualitatively compared differences and similarities between persons who were diagnosed with psychosis and those who were not. We recruited two samples of persons who heard divine voices: six were diagnosed with brief psychotic disorder (sub-sample A) and six were not (sub-sample B). All participants were interviewed according to a mixed-method design that integrated content analysis and phenomenological procedures. The narratives of sub-sample A showed higher levels of self-criticism and other-criticism and lower levels of narrative coherence than those of sub-sample B. The latter showed an intention of the voices characterized by compassion and connectedness. This qualitative study highlighted the importance of considering criticism and metacognition as central mechanisms in understanding the distress of persons hearing divine voices. [ABSTRACT FROM AUTHOR]

Objective: This mixed-methods study aimed to explore the role of externalizing traits in moderating the relationship between COVID-19 risk perception and vaccine hesitancy in patients diagnosed with cancer. A community-based participatory approach - comprising a preliminary qualitative inquiry and a subsequent crosssectional research - was used to promote effective vaccination campaigns. Method: 12 people diagnosed with cancer and 7 cancer professionals were recruited for the qualitative inquiry, 356 people either under cancer treatment or in follow-up care for the cross-sectional research. A phenomenological analysis explored the transcripts of two focus groups. The cross-sectional research tested the hypothesis emerged during the previous qualitative inquiry through self-reported questionnaires and moderated regression. Results: Phenomenological analysis suggested a pivotal role of externalizing traits in vaccine hesitancy. Moderated regression revealed how the association between risk perception and vaccine hesitancy is moderated by externalizing traits, even when controlled for treatment adherence. Conclusions: In the present study we found a stronger relationship between risk perception and vaccine hesitancy for patients with higher levels of externalizing traits. We suggest that vaccination campaigns should be personality-informed to offer individualized and effective solutions. Patients with externalizing traits may cope dysfunctionally with vaccination campaigns. [ABSTRACT FROM AUTHOR]

The tendency to hide and mask suffering and one's perceived imperfections is one of the biggest obstacles in treating those with prominent perfectionistic traits. In this single case, we present an integrative form of psychotherapy for patients with recurrent strategies aimed at neither displaying nor disclosing their perfectionism. Emily was a 26‐year‐old woman diagnosed with Major Depressive Disorder and reported a personality pathology as diagnosed through the Alternative Model of Personality Disorders. The intervention comprised of a 4‐month individual therapy and 2‐month group therapy. The former is based on Metacognitive Interpersonal Therapy protocol for personality disorders. The latter is a protocol that integrates the Dynamic Relational Treatment for Perfectionism and Compassion Focused Therapy. At the end of this integrative treatment, Emily remitted from Major Depressive Disorder and personality pathology. Further studies should confirm our promising results in larger samples. [ABSTRACT FROM AUTHOR]