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ABSTRACT: The expression of early delusion and hallucination-like symptoms, known as positive schizotypy (PS), holds predictive power for later development of psychotic disorders. However, little is known about the psychological and emotional processes promoting the expression of PS during adolescent development. Our study's objective was to examine the nature of the relationships between adolescent PS and two dimensions previously identified to contribute to adult positive symptoms of psychosis, metacognitive beliefs and anxiety. Using a structural equation modeling design, data from self-report questionnaires measuring anxiety, metacognitive beliefs, and PS were collected from 179 adolescents aged 12 to 19 years. Our results indicate that although metacognitive beliefs significantly influence adolescent PS and anxiety, maladaptive contradictory metacognitive beliefs specifically potentiate positive schizotypal expression in hallucination-prone adolescents. Furthermore, we observe that PS and anxiety entertain reciprocal relationships. These findings suggest that relationships between metacognitive beliefs, anxiety, and PS can already be observed during adolescence. [ABSTRACT FROM AUTHOR]

Background: This study assessed adolescent brain-behavior relationships between large-scale dynamic functional network connectivity (FNC) and an integrated attention-deficit/hyperactivity disorder (ADHD) phenotype, including measures of inattention, impulsivity/hyperactivity and emotional dysregulation. Despite emotion dysregulation being a core clinical feature of ADHD, studies rarely assess its impact on large-scale FNC., Methods: We conducted resting-state functional magnetic resonance imaging in 78 adolescents (34 with ADHD) and obtained experimental and self-reported measures of inattention, impulsivity/hyperactivity, and emotional reactivity. We used multivariate analyses to evaluate group differences in dynamic FNC between the default mode, salience and central executive networks, meta-state functional connectivity and ADHD symptomology., Results: We present two significant group*behavior effects. Compared to controls, adolescents with ADHD had 1) diminished salience network-centered dynamic FNC that was driven by an integrated ADHD phenotype (p < .004, r = 0.57) and 2) more variable patterns of global connectivity, as measured through meta-state analysis, which were driven by heightened emotional reactivity (p < .002, r = 0.63)., Conclusions: Atypical patterns of dynamic FNC in adolescents with ADHD are associated with the affective and cognitive components of ADHD symptomology. Limitations include sample size and self-reported measures of emotional reactivity., Competing Interests: Declaration of competing interest The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2024. Published by Elsevier B.V.)

Objectives: Treatments for borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) are less effective for patients with co-occurring symptoms of both disorders, who are considered to have complex PTSD (cPTSD), compared with patients with either condition alone. Evidence suggests that co-occurrence of symptoms indicates greater impairment in mentalizing. This study examines evidence for targeting mentalizing when treating individuals with co-occurring symptoms, irrespective of their exposure to developmental trauma and, for the first time, investigates the mediational role of mentalizing in the associations between BPD symptomatology and cPTSD., Design: We identified in a routine clinical service a group of patients with BPD, with or without co-occurring symptoms of PTSD. We hypothesized that patients with co-occurring symptoms and a history of childhood maltreatment will show more severe clinical profiles and greater mentalizing problems, which in turn lead to symptoms consistent with cPTSD., Method: Clinical profiles of 72 patients with BPD (43 with and 29 without co-occurring symptoms of PTSD; mean age in both groups 28 years, 79% and 83% female, respectively) were identified using the Structured Clinical Interview for DSM-IV Axis II Disorders. Patients completed self-report measures of BPD and PTSD symptoms, well-being, dissociation and reflective functioning. Childhood trauma histories were evaluated., Results: Compared with patients with BPD-only, those with co-occurring BPD and PTSD showed greater severity in terms of BPD and dissociative symptoms, met a broader range of BPD diagnostic criteria, had a greater sense of personal worthlessness and self-evaluated their well-being as considerably diminished. This group was also more inclined to recall increased instances of childhood sexual abuse. In a mediation analysis, mentalizing acted as a partial mediator for the relationship between BPD severity and cPTSD, as well as between dissociative symptoms and cPTSD. Interestingly, mentalizing did not mediate the relationship between childhood sexual abuse and cPTSD., Conclusions: Overall, the correlational findings are consistent with an intended focus on mentalizing to treat cPTSD symptoms in individuals who also meet criteria for a diagnosis of BPD., (© 2023 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

At present, suicidal patients are still hospitalized to reduce their risk of committing a life-threatening act. Yet suicide research, long dominated by the ambition to identify people at risk, shows that the prediction model is largely ineffective. The time has come for a paradigm shift to: give up categorizing patients according to their risk; recognize that hospitalization, if not accompanied by a well-defined purpose, can become iatrogenic; formulate achievable short-term objectives, guiding such hospitalizations on the basis of a reproducible empirical model and demonstrating its benefits beyond keeping the patient alive. Interventions aim thus to reduce distress, personalize care and promote the change required by the suicidal crisis., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Pathological narcissism (PN) is a common psychopathological issue leading to maladaptive strategies to cope with self-esteem threats, including self-enhancement and exploitation (grandiose strategies) or internalized shame, depression, and social withdrawal (vulnerable strategies). Mentalizing is a key process for regulating self and other representations and their associated emotions. Patients with PN further struggle with emotion dysregulation (ED), which during development is intertwined with the growing capacity to mentalize. We seek to contribute to emerging empirical data documenting the associations between PN and ED and between PN and mentalizing, and to provide information on the nature of their mutual relationships. In the present study, we assessed PN, ED, and three mentalizing dimensions (mentalizing self, other, and motivation to mentalize) in 183 patients consulting in our outpatient unit specialized in ED. We found that narcissistic vulnerability was negatively associated with self-mentalizing and positively associated with overall ED, both even after adjustment for borderline and attention deficit hyperactivity disorder (ADHD) symptoms. However, the association with ED was not maintained after further adjustment for self-mentalizing or overall-mentalizing, which suggests that mentalizing may play a mediating role in this relationship. On the other hand, narcissistic grandiosity was positively associated with other-mentalizing and ED and negatively associated with self-mentalizing in bivariate analyses, but these last two associations were not maintained after adjustment for comorbid borderline and/or ADHD symptomatology. This study provides new information on the link between PN and ED and on key mentalizing dimensions meaningfully relating to PN, notably through a potential role of self-mentalizing processes between PN and ED., (© 2024 John Wiley & Sons Ltd.)

Background: The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression., Method: The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used., Results: The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life., Limitations: Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance., Conclusion: The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Adult attention deficit hyperactivity disorder (ADHD) is often associated with personality pathology. However, only few studies have been conducted on the link between ADHD and pathological narcissism (PN), with or without a diagnosis of narcissistic personality disorder (NPD). In order to fill this gap, PN and NPD were assessed in 164 subjects suffering from ADHD, with several other measures including ADHD severity, quality of life, depression, anxiety, impulsivity, and emotion dysregulation (ED). We found that a significant proportion of ADHD patients suffered from NPD, and that both narcissistic grandiosity and vulnerability were associated with ADHD hyperactivity and impulsivity symptoms, but not with inattentive symptoms. These two dimensions seemed to be negatively associated with well-being and positively associated with most of the other studied psychiatric dimensions except ED, the latter being only associated with vulnerability, even after adjustment on borderline symptoms. Overall, despite important limitations that limit the generalizability of our findings to the overall ADHD population (notably linked to selection bias), we believe that this exploratory study sheds light on the potential clinical relevance of narcissistic pathology in adult ADHD patients., Competing Interests: Declaration of Competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Following experts' recommendations for a phenomenological approach to suicidal behavior, this study opted to focus on the life-protecting beliefs and values expressed by people in acute suicidal crisis., Method: 61 adults hospitalized in psychiatric emergency for suicidal crises were assessed in terms of reasons for living (RFL) and suicidality. Multiple correspondence analysis was used to discern groups of patients based on their RFL profiles. Group differences on suicidality were further examined., Results: 4 groups of patients were observed, emerging from RFL differences in "Survival and Coping Beliefs", "Fear of Social Disapproval", "Responsibility to Family" and "Child-Related Concerns". Profiles varied by gender but not age. We further observed that "Survival and Coping Beliefs" and "Moral Objections" are weakened during an acute suicidal crisis., Conclusions: These findings underline the clinical utility of evaluating RFL during a suicidal crisis, and that RFL may be useful to personalize case formulation during an emergency intervention. They could further increase therapeutic communication by connecting the individual to key psychological resources. Longitudinal studies are necessary to evaluate how the different groups identified in this study may yield specific post-emergency trajectories connected to specific clinical needs.

Introduction: Growing, albeit heterogenous evidence questions whether attention deficit/hyperactivity disorder (ADHD) is associated with socio-cognitive impairments, especially beyond childhood. This study focuses on mentalizing - the socio-cognitive ability to attribute and reason in terms of mental states. We aimed to characterize mentalizing performance in terms of correct scores and types of errors in adolescents and young adults with ADHD., Methods: Forty-nine adolescents and adults with ADHD and 49 healthy controls matched for age and gender completed a computerized naturalistic mentalizing task, the Movie for Assessment of Social Cognition (MASC). Repeated measures analyses of variance examined the effects of age group and ADHD diagnosis on MASC performance. Additionally, associations between mentalizing scores, the severity of attention problems, and the presence of comorbidity were explored in the ADHD group., Results: Results showed an increased prevalence of hypomentalizing errors in adolescents with ADHD. Lower mentalizing scores in adolescents with ADHD were correlated with indices of inattentiveness, impulsivity, and vigilance problems. Hypomentalizing errors in adolescents showed to be particularly associated with inattentiveness, after controlling for age and comorbidity. In contrast, adults with ADHD performed similarly to controls and their scores on the mentalizing task were not correlated to attention problems., Conclusion: These findings highlight potential developmental differences in mentalizing abilities in ADHD youths and their association with attentional impairments., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Background: Depression symptoms and mood disorders constitute one of the major public health challenges among youths. Thus, early prevention and intervention for depression should be a priority. The main goal of the present study was to validate the Patient Health Questionnaire-9 (PHQ-9) scores in a school-based sample of non-clinical adolescents., Method: Stratified random sampling was conducted. Participants were 2235 students (M = 14.49, SD =1.76, range= 12-18 years), 52.9 % were female, from 34 secondary schools in Spain. Several previously validated self-reported questionnaires of mental health and psychopathology were administrated., Results: The unidimensional factorial model of the PHQ-9 items showed adequate goodness of fit indices. Strong measurement invariance across gender was found. Omega for the PHQ-9 total score was 0.87. The PHQ-9 total score was positively associated with anxiety symptoms and emotional and behavioral problems, and negatively associated with prosocial behavior and quality of life., Conclusions: The PHQ-9 is a brief, easy, and reliable tool for assessing self-reported depressive symptoms in both clinical and school settings. PHQ-9 may be used as a screening tool for universal early detection and monitorization of depression symptoms during adolescence., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Objective: Schizotypal traits and disturbances in mentalizing (the capacity to understand the mental states driving one's own and others' behaviors) have been implicated in increased vulnerability for psychosis. Therefore, we explored the associations linking schizotypal traits, mentalizing difficulties and their interactions to clinical high-risk for psychosis (CHR-P), as captured by the Basic Symptoms (BS) approach, during adolescence and young adulthood., Methods: Eighty-seven adolescents and young adults from the general population (46% male, 44% female; age: 14-23 years) were assessed with the Schizophrenia Proneness Interview (SPI-CY/A) for 11 perceptive and cognitive BS, with the Schizotypal Personality Questionnaire (SPQ) for schizotypal traits, and with the Reflective Functioning Questionnaire (RFQ) for self-reported mentalizing abilities. The RFQ evaluates the level of certainty (RFQc scale) and uncertainty (RFQu scale) with which individuals use mental state information to explain their own and others' behaviors., Results: Logistic regression models showed significant positive effects of the SPQ disorganization scale on perceptive BS and of the SPQ interpersonal scale on cognitive BS. Post-hoc analyses revealed that schizotypal features pertaining to odd speech and social anxiety, respectively, were associated with perceptive and cognitive BS. Furthermore, higher scores on the RFQu scale and lower scores on the RFQc scale independently explained the presence of cognitive BS. Finally, significant interaction effects between RFQc and SPQ odd speech on perceptive BS, and between RFQc and SPQ social anxiety on cognitive BS were found., Conclusion: Our findings suggest that schizotypal traits and mentalizing significantly relate both independently and through their interactions to the presence of cognitive and perceptive BS included in CHR-P criteria. Furthermore, mentalizing dysfunction may contribute in the relation between schizotypal traits and early state signs of CHR-P. Mentalizing may support both detection and early treatment of CHR-P among adolescents and young adults who present with trait risk for psychosis., 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 author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Salaminios, Sprüngli-Toffel, Michel, Morosan, Eliez, Armando, Fonseca-Pedrero, Derome, Schultze-Lutter and Debbané.)