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Shame may be a transdiagnostic marker of psychopathology and might potentially have a negative impact on treatment outcome. This scoping review maps the empirical literature on shame and psychotherapy, with a focus on individual therapy. Searching the terms shame and psychotherapy in PubMed and PsycInfo, we identified 2,520 unique records. After screening and selection, 46 empirical studies were included in the review and three themes were extracted from them: the impact of psychotherapy on shame, the impact of shame on psychotherapy, and additional shame-related themes. Narrative synthesis suggested that shame decreases after psychotherapy. In a subset of quantitative treatment evaluation studies, a preliminary meta-analysis indicated a medium size decrease in shame. The impact of shame on individual psychotherapy was more nuanced. Additional themes included but were not limited to shame-appropriate versus nonappropriate therapeutic interventions or investigations of therapists’ reactions to patients’ shame. Research gaps and recommendations for future investigations are outlined.

Recent empirical literature has suggested that pathological narcissism is related to paranoid presentations. However, the existing studies have focused only on cross-sectional methodology without investigating how paranoid tendencies may present in narcissists' daily lives. On the other hand, the network approach has recently emerged in psychopathology, proposing that psychopathology may be conceptualized as complex and dynamic network systems where symptoms are mutually interacting components over time. Building on these premises, the current study aimed to explore the dynamic associations between narcissistic states, paranoid states, and perception of the other using an Ecological Momentary Assessment methodology (EMA). A sample of 109 participants (females: N = 90; 82.6%) with a mean age of 23.9 years old (age range = 18 – 35, SD = ± 3.24) responded to smartphone prompts 4 times a day for 7 days. Participants were required to identify the most significant distressing interpersonal interaction and then assess their current paranoid states, narcissistic grandiose and vulnerable states, and momentary agentic/communal perceptions of the other person. Using multilevel vector autoregressive modeling (mlVAR), we examined different time-frame complementary network models (i.e., contemporaneous, cross-lagged, and between-subject models). The contemporaneous model indicated that state vulnerability and grandiosity were related to higher paranoid states simultaneously. Moreover, state vulnerability was related to a perception of the other as colder and more submissive, which, in turn, was positively related to paranoid states. According to the cross-lagged model, state vulnerability predicted higher state paranoia toward the other at the next prompt, whereas state paranoia predicted subsequently grandiose states. Surprisingly, the between-subject model showed that individuals experiencing higher grandiose and vulnerable states experienced, on average, more paranoia during t

Pathological narcissism implies a fragile self-view. The psychological effects of ego-relevant events in people high in pathological narcissism, however, are still uncertain. The study examined the effects of pathological narcissism on psychological reactions to ego-relevant events occurring in private or public settings. Participants (N = 410) completed measures of pathological narcissistic traits, and then they took part in a scenario-based experimental session. They were randomly assigned to four conditions: ego-threatening vs. ego-fostering events in public vs. private settings. Self-esteem and affective states before and after the experimental manipulation were measured. Results showed that vulnerable and grandiose manifestations of pathological narcissism affect differently psychological reactions to ego-relevant events. Vulnerable narcissism made people particularly sensitive to ego-threatening and ego-fostering events, especially when occurring in public settings. Grandiose narcissism was linked to a reduction in emotional responses to ego-relevant events. Findings suggest that self- and affective reactions to ego-relevant events depend on narcissistic prevailing manifestations, and that public exposure has a key role in vulnerable narcissism.

Background: the onset of the COVID-19 pandemic brought disruptive changes in everyone's everyday life, among which pervasive anxiety about the risk of infection, the fear of worsening physical symptoms, and the experience of isolation and loneliness due to lockdowns and other strict governments' rules. These kinds of repercussions of pandemic situations impact individuals' psychological wellbeing resulting in heightened perceived stress, anxiety, and depression. "Italia Ti Ascolto" (ITA) has been developed as an internet-based intervention to offer an online solution for psychological support needs. Methods: ITA is an app available on iOS and Android systems. Users complete a baseline assessment on emotion regulation strategies (cognitive reappraisal and expressive suppression), psychological stress, anxiety, depression, and perceived social support. Participants select between several one-hour long clinical groups held by expert psychotherapists. After every session, people are asked to complete a quick users' satisfaction survey. Discussion: Our contribution presents ITA's intervention protocol and discusses preliminary data on psychological variables collected at baseline. Data showed significant associations between emotion regulation strategies and depressive, anxious symptoms, and level of stress. Moreover, the role of perceived psychological support is considered. Future developments and implications for clinical practice and treatment are discussed.

The onset of the coronavirus disease 2019 (COVID-19) pandemic impacted individuals' psychological wellbeing resulting in heightened perceived stress, anxiety, and depression. However, a significant issue in accessing psychological care during a lockdown is the lack of access to in-person interventions. In this regard, research has shown the efficacy and utility of psychological app-based interventions. 'Italia Ti Ascolto' (ITA) has been developed as a population tailored internet-based intervention to offer an online professional solution for psychological support needs. The ITA app is available on iOS and Android systems. Users completed a baseline assessment on emotion regulation strategies (cognitive reappraisal and expressive suppression), psychological stress, anxiety, depression, and perceived social support. Participants could select among several one-hour long clinical groups held by expert psychotherapists. After every session, people were asked to complete a quick users' satisfaction survey. Our contribution presents ITA's intervention protocol and discusses preliminary data on psychological variables collected at baseline. Data showed significant associations between emotion regulation strategies, symptoms of depression and anxiety, and level of stress. Moreover, the role of perceived social support is considered. Future developments and implications for clinical practice and treatment are discussed.