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Brain arteriovenous malformations (bAVMs) are congenital defects of vasculogenesis, the natural history of which is characterized by a significant morbidity and mortality related to the risk of bleeding. Their management remains challenging, since complete eradication is often difficult. Embolization, surgery, or radiosurgery alone are safe and effective for small unruptured AVMs, while a multidisciplinary approach should be pursued for larger ones. We report a case of intracerebral haemorrhage due to the rupture of a large bAVM, for which a multidisciplinary approach was adopted: endovascular partial embolization followed by complete surgical removal.

Background: Flow diversion (FD) is an established treatment for large or giant wide-necked unruptured intracranial aneurysms. In the past few years, the use of flow diverter devices was extended to several other “off-label” indications, including solitary or adjunctive treatment to coil embolization for direct (Barrow A type) carotid cavernous fistulas (CCFs). The use of liquid embolic agents still represents the first-line treatment for indirect CCFs. Typically, the ipsilateral inferior petrosal sinus or superior ophthalmic vein (SOV) is the preferred transvenous routes to access CCFs. In some cases, vessel tortuosity or different features make the endovascular access challenging, thus requiring different approaches and strategies. The aim of the study is to discuss rational and technical aspect in treating indirect CCFs referring to the most up-to-date literature. An alternative experience-based endovascular strategy with FD is described. Methods: We report the case of a 54-year-old woman diagnosed with indirect CCF and treated with flow diverter stent. Results: After multiple unsuccessful attempts at transarterial right SOV catheterization, a right indirect CCF fed by a single trunk at the ophthalmic origin from the internal carotid artery (ICA) was treated by ICA stand-alone FD. Blood flow was redirect and successfully reduced through the fistula, with immediately postprocedure improvement of the patient’s clinical status (ipsilateral proptosis and chemosis). Ten-months radiological follow-up showed the complete obliteration of the fistula. No adjunctive endovascular treatment was performed. Conclusion: FD appears a reasonable alternative stand-alone endovascular strategy also for selected difficult-to-access indirect CCFs, when all conventional routes are judged unfeasible. Further investigations will be necessary to better define and support this potential lesson-learned application.

The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage.Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively.Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.

Blister-like aneurysms (BLA) are a rare half-dome-shaped aneurysm, with a broad-based appearance, originating more often from a non-branching site of the supraclinoid internal carotid artery (ICA). They are sometimes difficult to recognize due to their morphological changes and high tendency to rupture. BLAs are often undiagnosed and may be detected only after repeated angiograms in the case of acute subarachnoid hemorrhage (SAH). BLA are life-threatening and no consensus has so far been reached on the best management strategy. We describe a patient with a BLA in the left ICA successfully treated by flow-diverting device using intraoperative abciximab bolus, with successful results. Recently, the use of flow-diverting device (FDD), has offered a very promising option for treatment even for ruptured BLA, with high long-term occlusion and low complication rates. However, double antiplatelet therapy is required and still represents a major constraint in a case of SAH, so that standardized multicenter studies are still needed.

Background: Cancer is a major public health problem worldwide. Being the second leading cause of death in the world, this fearsome disease is a stressful event capable to cause a time of considerable upheaval in people’s lives and their loved ones. The illness condition can influence the patients’ social relationships, even reducing social involvement and fostering isolation. Hence, cancer adjustment-related variables are worth studying. Specifically, the research on coping strategies is crucial since the patients’ response style can act on the quality of the psychosocial outcomes. Objective: The aim of this study was deepening the association between coping styles and perceived social support from family, friends, and significant others among a sample of 121 cancer patients. Method: Participants were 121 cancer patients (70.2% females), aged 26 to 88 (M=61.90, SD=12.16). We assessed the adopted coping strategies by means of the Mini-Mental Adjustment to Cancer Scale (mini-MAC Scale), whereas the perceived social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS). Results: We found: (1) a positive association between fighting spirit and the perception of social support from friends; (2) the hopelessness/helplessness strategy seemed negatively related with the perception of social support, regardless of the source; (3) higher levels of fatalism were connected with higher levels of perceived social support from family; (4) both anxious preoccupation and avoidance did not show any association with perceived social support. Conclusions: Working on maladaptive coping responses might be useful for the purpose of improving the receptivity to the support from family, friends and significant others. Further research focusing on patients’ coping styles is needed to promote holistic-oriented psychological treatments., Mediterranean Journal of Clinical Psychology, Vol 9, No 1 (2021)

Background: The COVID-19 pandemic represents a global challenge which may have pervasive effects in several areas of community and individual life. Consequently, the virus could generate fear and anxiety that must be managed in a new and unknown situation, such as that of lockdown, with potential consequences for mental health outcomes. Therefore, with the theoretical guide of the Polyvagal perspective, this research aimed to analyse the mediation of social support, passive aggression, avoidance and dissociation in the relationship between fear and anxiety during the COVID-19 pandemic. Methods: During the national COVID-19 lockdown phase, a sample of 992 Italian participants with a mean age of 35.07 years (SD = 12.11) completed the Ten Penn State Worry Questionnaire, State-Trait Anxiety Inventory – Form X3, Coping Orientation to Problems Experienced and Forty Item Defense Style Questionnaire, after providing written informed consent. Results: Results showed that fear affected anxiety, both directly and indirectly, highlighting a serial multiple mediation model with two parallel chain of mediators. Social support coping strategy negatively influenced fear and passive aggression, which instead were positively associated. Furthermore, in the second chain, avoidance directly induced fear in the presence of anxiety, opposite of dissociation defense mechanism. Conclusions: Such findings highlighted some possible answers that could be implemented as a consequence of the fear perception during the COVID-19 lockdown, according to the framework of the Polyvagal Theory. These data could provide an important contribution in shedding light on mechanisms put in place during the pandemic, promoting valuable information for a more effective clinical practice., Mediterranean Journal of Clinical Psychology, Vol 9, No 1 (2021)

Background: Eating disorders (ED) can be considered in terms of affective disorders. In this perspective, abnormal eating behaviors would be dysfunctional defensive behaviors related to difficulties to recognize and modulate traumatic emotional experiences. The aim of this study is to explore the associations between alexithymia, boredom, impulsiveness, and desire thinking in subjects with eating disorders. Methods: 45 patients with ED and 45 healthy controls completed the following questionnaires: Toronto Alexithymia Scale, Barratt Impulsiveness Scale, Multidimensional State Boredom Scale, Desire Thinking Questionnaire, Body Uneasiness Test and Somatoform Dissociation Questionnaire. Results: Our results seem to confirm that alexithymia, boredom, impulsivity, and desire thinking are strictly related in ED. In particular, difficulties in identifying feelings contribute to determine boredom experiences which, in turn, contribute significantly to structure body image disorders. Conclusions: This study adds new insights into the associations between alexithymia, boredom, impulsiveness, and desire thinking in subjects with eating disorders. Future areas of investigation could better explore the role of boredom experiences in structuring body image dissatisfaction and its relationship with alexithymia., Mediterranean Journal of Clinical Psychology, Vol 8, No 3 (2020)

Background and Purpose: To evaluate outcome and safety of endovascular treatment beyond 6 hours of onset of ischemic stroke due to large vessel occlusion in the anterior circulation, in routine clinical practice. Methods: From the Italian Registry of Endovascular Thrombectomy, we extracted clinical and outcome data of patients treated for stroke of known onset beyond 6 hours. Additional inclusion criteria were prestroke modified Rankin Scale score ≤2 and ASPECTS score ≥6. Patients were selected on individual basis by a combination of CT perfusion mismatch (difference between total hypoperfusion and infarct core sizes) and CT collateral score. The primary outcome measure was the score on modified Rankin Scale at 90 days. Safety outcomes were 90-day mortality and the occurrence of symptomatic intracranial hemorrhage. Data were compared with those from patients treated within 6 hours. Results: Out of 3057 patients, 327 were treated beyond 6 hours. Their mean age was 66.8±14.9 years, the median baseline National Institutes of Health Stroke Scale 16, and the median onset to groin puncture time 430 minutes. The most frequent site of occlusion was middle cerebral artery (45.1%). Functional independence (90-day modified Rankin Scale score, 0–2) was achieved by 41.3% of cases. Symptomatic intracranial hemorrhage occurred in 6.7% of patients, and 3-month case fatality rate was 17.1%. The probability of surviving with modified Rankin Scale score, 0–2 (odds ratio, 0.58 [95% CI, 0.43–0.77]) was significantly lower in patients treated beyond 6 hours as compared with patients treated earlier No differences were found regarding recanalization rates and safety outcomes between patients treated within and beyond 6 hours. There were no differences in outcome between people treated 6-12 hours from onset (278 patients) and those treated 12 to 24 hours from onset (49 patients). Conclusions: This real-world study suggests that in patients with large vessel occlusion selected on the basis of CT perfusion and collateral circulation assessment, endovascular treatment beyond 6 hours is feasible and safe with no increase in symptomatic intracranial hemorrhage.

Cerebral Amyloid Angiopathy (CAA) is characterized by deposit of β-amyloid protein in the cortical and leptomeningeal arteries. It tends to increase in prevalence with advancing age and seems to have slight predilection for temporal, parietal and occipital lobes. It has recently been identified an inflammatory form of this angiophaty. This report describes a case presenting as an inflammatory vasculitis-perivasculitis form successfully treated with steroids and discuss about typical features and findings of this condition.

In patients with ischemic stroke, endovascular treatment results in a higher rate of recanalization of the affected cerebral artery than systemic intravenous thrombolytic therapy. However, comparison of the clinical efficacy of the two approaches is needed.We randomly assigned 362 patients with acute ischemic stroke, within 4.5 hours after onset, to endovascular therapy (intraarterial thrombolysis with recombinant tissue plasminogen activator [t-PA], mechanical clot disruption or retrieval, or a combination of these approaches) or intravenous t-PA. Treatments were to be given as soon as possible after randomization. The primary outcome was survival free of disability (defined as a modified Rankin score of 0 or 1 on a scale of 0 to 6, with 0 indicating no symptoms, 1 no clinically significant disability despite symptoms, and 6 death) at 3 months.A total of 181 patients were assigned to receive endovascular therapy, and 181 intravenous t-PA. The median time from stroke onset to the start of treatment was 3.75 hours for endovascular therapy and 2.75 hours for intravenous t-PA (P0.001). At 3 months, 55 patients in the endovascular-therapy group (30.4%) and 63 in the intravenous t-PA group (34.8%) were alive without disability (odds ratio adjusted for age, sex, stroke severity, and atrial fibrillation status at baseline, 0.71; 95% confidence interval, 0.44 to 1.14; P=0.16). Fatal or nonfatal symptomatic intracranial hemorrhage within 7 days occurred in 6% of the patients in each group, and there were no significant differences between groups in the rates of other serious adverse events or the case fatality rate.The results of this trial in patients with acute ischemic stroke indicate that endovascular therapy is not superior to standard treatment with intravenous t-PA. (Funded by the Italian Medicines Agency, ClinicalTrials.gov number, NCT00640367.).

Objective: The main purpose of the current study is to examine the factorial structure of the Psychological Problems (PP) scale, which is an inventory used for assessing anxious and depressive symptoms. No previous studies were found in which the dimensionality of the measure has been examined. Method: In order to test the underlying factorial structure of the scale, we performed both exploratory principal axis factor analysis and maximum likelihood robust confirmatory factor-analytic analysis on a sample of 266 international students. Parallel analysis was also computed to identify the number of factors to take into account. Multigroup confirmatory factor analyses were performed to evaluate the factorial invariance of the scale across gender. Results: Our results yield a bifactorial structure. One item is removed due to its double-loading, resulting in a 14-item scale. Both of the subscales’ alpha coefficients are good, with satisfying levels of adjusted item-scale correlations. Findings from the measurement invariance indicate adequate configural, metric, scalar and strict invariance across gender. Conclusion: We conceptualize the two scales emerged from our factor analysis studies in terms of affective and psychosomatic domains of psychological problems. Despite some limitations, our findings may add new theoretical and practical implications, which are discussed also providing directions for future research.

Evidence suggests that incidental modulation of affective states affects the ability to keep track of time. Alexithymia represents an ideal condition to further address the emotion-time processing link, as it refers to a trait characterized by a deficit of affective processing. 31 healthy participants completed an online version of the TAS-20 scale, which measures alexithymia, and a time reproduction task of visual stimuli related to positive (i.e., happiness) and negative (i.e., anger) facial expressions. Results documented a positive correlation between TAS-20 score and the variability in reproducing sub-second durations of the anger expression stimuli We also found an overestimation of sub-second durations of non-affective expressions in borderline/alexithymic participants. Finally, in line with the literature, we confirmed the overall tendency to overestimate the duration of anger expression stimuli. These findings, which can be interpreted in terms of abnormal scalar timing property in alexithymia, expand previous investigations linking this personality trait with abnormal processing of negative emotions. The evidence that alexithymia predicts the reproduction variability of sub-second durations of negative affective stimuli corroborates previous neuroimaging studies documenting cerebellar deficits in these individuals.

Background: This study aimed to identify clusters of long COVID-19 symptoms using latent class analysis and investigate the psychological factors involved in the onset of this syndrome. Method: Five hundred and six subjects recovering from COVID-19 completed a series of standardized questionnaires to evaluate the personality traits, alexithymia, and post-traumatic stress. Results: Five classes were identified: Brain fog (31.82%), No symptoms (20.95%), Sensory disorders (18.77%), Breath impairment (17.59%), and Multiple disorders (10.87%). Women reported post-COVID-19 respiratory symptoms and multiple disorders to a greater extent than men. Hospitalized subjects were more likely to report persistent symptoms after COVID-19 than asymptomatic or home-treated subjects. Antagonism, hyperarousal, and difficulty identifying emotions significantly predicted post COVID-19 symptoms. Conclusions: These findings open new questions for research on long COVID-19 and how states of emotional dysregulation can alter the physiological processes of the body and contribute to the onset of organic pathologies.

Palmira Faraci, Rossella Bottaro, Giusy Danila Valenti, Giuseppe Craparo Faculty of Human and Social Sciences - University of Enna “Kore”, Enna, ItalyCorrespondence: Palmira Faraci, Faculty of Human and Social Sciences, University of Enna “Kore”, Cittadella Universitaria, Enna, 94100, Italy, Tel +39 0935 536536, Email palmira.faraci@unikore.itIntroduction: The outbreak of the COVID-19 has largely impacted individuals’ health and lifestyles. This study aimed to investigate people’s psychological well-being during the second phase of the COVID-19 pandemic.Methods: We selected six indicators of psychological well-being: fear of COVID-19, loneliness, social interaction anxiety, generalized anxiety, PTSD, and depression. A sample of 231 Italian participants (56.3% women), with a mean age of 32.7 (SD=12.61), completed an online survey from February to March 2021, during the so called “second wave”. It included the Fear of COVID-19 Scale (FCV-19S), the UCLA Loneliness Scale- Version 3, the Generalized Anxiety Disorder 7-item Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Impact of Event Scale–Revised (IES-R), and the Social Interaction Anxiety Scale (SIAS).Results: Apart from loneliness, women reported lower levels of psychological well-being than men. Fairly good associations between all the detected variables were found. Based on a mediation model evaluation (in which generalized anxiety was introduced as a mediator in the relationship between fear of COVID-19, PTSD, loneliness, social interaction anxiety, and depression), except for social interaction anxiety, total and partial mediation effects suggested that generalized anxiety played a crucial role in exacerbating depressive symptoms during the pandemic.Conclusion: Our outcomes may expand the knowledge about the psychological well-being during the pandemic experience, with a focus on the mediating role of generalized anxiety.Keywords: pandemic, psychological well-being, mediation model, fear, loneliness, generalized anxiety

High rates of post-traumatic stress disorder (PTSD) symptoms have been found among patients with more severe COVID-19-related symptoms, and hospitalization is generally recognized as a risk factor for developing PTSD. Furthermore, other personality characteristics may increase the risk of developing post-traumatic stress symptoms following a COVID-19 infection. This study aimed to assess personality traits, alexithymia, dissociation, anxiety, and depression in patients who have recovered from COVID-19 and the impact of these variables on the presence of post-traumatic stress symptoms. Five hundred and six participants completed a battery of standardized questionnaires. All the scales used in this study are valid and reliable measures of their respective constructs. Results showed that high levels of alexithymia, dissociation, anxiety, and depression statistically significantly predicted the three main clusters of PTSD symptoms (avoidance, intrusion, and hyperarousal) in individuals who have recovered from COVID-19. Furthermore, negative affectivity and psychoticism significantly predicted PTSD symptoms in our sample. Finally, individuals hospitalized by COVID-19 are more at risk of developing intrusion and hyperarousal symptoms than those who never needed hospital care. Our findings are a valuable contribution in identifying the main risk factors of psychological distress related to COVID-19 to address the long-term mental health needs of people who have experienced the disease.

Background/aim Medulloblastoma is a rare tumor of adult age, while it occurs more frequently in children. Given the rarity, there is a lack of evidence for the treatment of recurrent disease. Few data are available about salvage re-irradiation collecting very heterogeneous series. Case report A 51-year-old male presented with headache, nausea, double vision, and gait disorders. A contrast-enhanced brain-MRI showed the presence of multifocal medulloblastoma. After surgery, adjuvant craniospinal radiotherapy was performed, chemotherapy was stopped due to toxicity. After 27 months, a new MRI and a Methionine-PET revealed a late pontocerebellar relapse; multidisciplinary board decided for a SBRT treatment. The second course of RT was well tolerated and 14 months later, the patient is alive in good general conditions, with no evidence of disease. Conclusion Our experience supports the use of salvage stereotactic radiotherapy as a safe and effective treatment option.

Purpose: Intracranial carotid artery occlusion represents an underinvestigated cause of acute ischemic stroke as well as an indication for mechanical thrombectomy. We investigated baseline and procedural characteristics, outcomes and predictors of outcome in patients with acute ischemic stroke secondary to intracranial carotid artery occlusion. Methods: A retrospective analysis of the Italian Registry of Endovascular Treatment in Acute Stroke was performed. Patients with intracranial carotid artery occlusion (infraclinoid and supraclinoid) with or without cervical artery occlusion but with patent intracranial arteries were included. The 3‑month functional independence, mortality, successful reperfusion and symptomatic intracranial hemorrhage were evaluated. Results: Intracranial carotid artery occlusion with patent intracranial arteries was diagnosed in 387 out of 4940 (7.8%) patients. The median age was 74 years and median baseline National Institute of Health Stroke Scale (NIHSS) was 18. Functional independence was achieved in 130 (34%) patients, successful reperfusion in 289 (75%) and symptomatic intracranial hemorrhage in 33 (9%), whereas mortality occurred in 111 (29%) patients. In univariate analysis functional independence was associated with lower age, lower NIHSS at presentation, higher rate of successful reperfusion and lower rate of symptomatic intracranial hemorrhage. Multivariable regression analysis found age (odds ratio, OR:1.03; P = 0.006), NIHSS at presentation (OR: 1.07; P < 0.001), diabetes (OR: 2.60; P = 0.002), successful reperfusion (OR:0.20; P < 0.001) and symptomatic intracranial hemorrhage (OR: 4.17; P < 0.001) as the best independent predictors of outcome. Conclusion: Our study showed a not negligible rate of intracranial carotid artery occlusion with patent intracranial arteries, presenting mostly as severe stroke, with an acceptable rate of 3‑month functional independence. Age, NIHSS at presentation and successful reperfusion were the best independent predictors of outcome. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

In questo capitolo si presenta una sintesi dei risultati ottenuti dall'indagine svolta dall'unità di ricerca "La condizione delle vittime della criminalità organizzata nel meridione: approfondimenti e confronti tra mafia, camorra e 'ndrangheta nell'ambito di un progetto PRIN (Progetti di rilevante interesse nazionale), cofinanziato dall'Università degli studi di Palermo e dal MIUR.

Lo stalking descrive una varietà di comportmanti di minaccia e di controllo, messi in atto intenzionalmente dall'autore allo scopo di provocare paura nella propria vittima. Nel corso degli ultimi vent'anni questa condizione è diventata oggetto di attenzione giuridica e clinica. é noto che più della metà degli stalker afferenti ai servizi psichiatrici e giudiziari è affetta da almeno un disturbo psichiatrico in comorbilità, tuttavia ad oggi non esiste un inquadramento diagnostico univoco del fenomeno che viene di volta in volta accostato alle esperienze psicotico, ai disturbi ossessivo-compulsivi ed alla psicopatia.

Introduction Given the centrality of insight in promoting change, the relevance of measures for assessing this construct has become increasingly clear. This paper describes a new self-report measure for assessing some of the characteristics of insight, the insight orientation scale (IOS). Aims In study 1, we evaluated the factor structure and the reliability of the scale. In study 2, we analyzed the concurrent and discriminant validity of the scale in patients with different clinical diagnoses. Methods In study 1 participants were 600 individuals (41.1% male, 58.9% female) with a mean age of 33.95 years (SD = 13.04). In study 2 participants were 136 individuals divided into the following groups: 1) schizophrenia spectrum and other psychotic disorders ( n = 26); 2) substance-related disorders ( n = 55); 3) depressive disorders ( n = 27); and 4) personality disorders ( n = 28). Instruments Instruments are the insight orientation scale (IOS) and the Beck cognitive insight scale. Results The goodness-of-fit indices showed a satisfactory fit of a one factor model. We found also a good internal consistency (α = .77). Conclusions These findings support the dimensionality of the IOS and suggest that it may be useful as an assessment tool for use in guiding psychotherapy.

Objective: the main purpose of this study is to investigate the emotional and temperamental characteristics associated with gambling in Italy and to compare different groups of people on the basis of their risk of gambling: low-risk gamblers, problem gamblers, and pathological gamblers. Particularly, we examined the possible discriminant functions of perception of control, locus of control (whether internal or chance-based; that is, devoted to fate), and emotion-regulation strategies (cognitive reappraisal and expressive suppression). Method: a total of 251 adult regular gamblers (142 males and 109 females) recruited from different betting and bingo halls completed self-report questionnaires on gambling behaviors, lack of control as temperamental dimension, locus of control and emotional regulation strategies. Results: pathological gamblers, in comparison to low-risk gamblers, had lower levels of internal locus of control and cognitive reappraisal and higher levels of chance locus of control. Results from a discriminant function analysis have underlined the presence of two distinct functions: the former, named “unmanageable and stressful fate,” describes an egosyntonic position to gambling; the latter, named “I’d like to resist,” describes the egodystonic position to gambling. Conclusions: findings suggest considering regular gamblers as a heterogeneous group with respect to their attitudes towards their addiction. This can have important implications for their treatment.

Il Cyberstalking è una forma diffusa di molestia effettuata tramite l'utilizzo delle nuove tecnologie, come e-mail, chat e social network. Si stima che tra il 2-13% e l'8-32% delle donne negli Stati Uniti è vittima di cyberstalking. Il crescente interesse per questo nuovo crimine informatico è testimoniato dal recente adeguamento del sistema legislativo italiano (art. 612-bis del Codice Penale). Le azioni dei cyberstalker potrebbero essere mosse dal desiderio di vendetta, da un'ossessione d'amore o dalla ricerca di intimità.

Emilio Franzoni,1 Stefano Gualandi,1 Vincenzo Caretti,2 Adriano Schimmenti,3 Elena Di Pietro,1 Gaetano Pellegrini,1 Giuseppe Craparo,3 Arianna Franchi,1 Alberto Verrotti,4 Alessandro Pellicciari11Child Neuropsychiatry Unit, University of Bologna, Italy; 2Department of Psychology, University of Palermo, Italy; 3Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy; 4Department of Pediatrics, University of Chieti, ItalyBackground: The connections between eating disorders (EDs) and alexithymia have not been fully clarified. This study aims to define alexithymia's connections with shame, trauma, dissociation, and body image disorders.Methods: We administered the Dissociative Experience Scale-II, Trauma Symptom Inventory, Experience of Shame Scale, Toronto Alexithymia Scale-20, and Body Uneasiness Test questionnaires to 143 ED subjects. Extensive statistical analyses were performed.Results: The subjects showed higher scores on alexithymia, shame, dissociation, and traumatic feelings scales than the nonclinical population. These aspects are linked with each other in a statistically significant way. Partial correlations highlighted that feelings of shame are correlated to body dissatisfaction, irrespective of trauma or depressed mood. Multiple regression analysis demonstrates that shame (anorexic patients) and perceived traumatic conditions (bulimic and ED not otherwise specified) are associated with adverse image disorders.Conclusion: Shame seems to hold a central role in the perception of an adverse self-image. Alexithymia may be interpreted as being a consequence of previous unelaborated traumatic experiences and feelings of shame, and it could therefore be conceptualized as a maladaptive–reactive construct.Keywords: eating disorders, trauma, alexithymia, shame, body image

All forms of addiction (drug addiction, food addiction, sexual addiction, technological addiction, work addiction) are syndromic conditions characterized by a recurrent and reiterated search for pleasure derived from a specific dependence behavior, associated with abuse, craving, clinically significant stress, and compulsive dependence actions despite the possible negative consequences. The purpose of this article is to propose a new diagnostic criteria of addiction.

The evaluation of alcohol use disorder is the important first stage of interven- tions and treatments. The S.A.I.D. is an auto-evaluation test built on the assumption that alcoho- lism is close connected to the other person’s life problems that may have contributed to rouse, exacerbate or maintain alcoholism. The test is composed of 39 items, presented as auto-descriptions, that provide patient’s diagnostic profile articulated in two specific areas (social area and psycho- logical area), each divided in 9 scales (work/study; relationships; social relation- ship; cure/physical health; depression; hostility; inattention, anxiety,alexitimya) investigated through specific behavioural indexes that are noticeable in alcoholists. 219 subjects were examined, 122 with alcohol dependence diagnosis in ac- cordance with DSM-IV-TR and 97 non alcoholics not in treatment at psychiatric services, that form the control sample. The statistical analysis by Student’s t test showed that instrument is able to discriminate between alcoholists and healthy control subjects and Cronbach’s Alpha analysis noticed a good internal validity in two main areas in which dependence indexes are assembled, but a substantial unhomogeneity about singles subscales. These results indicate that the instrument can be useful for the general evaluation of social and psychological impairment in alcoholism but also suggest the need for a revision of the instrument aiming to a better internal consistency of subscales. Key words: Alcohol, alcoholism, screening, evaluation scale.