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Previous research on the relation between Intolerance of Uncertainty (IU) and Emotional Processing (EP) during adolescence is limited. The present study aimed to clarify how IU and EP evolve over time, to what extent they are related, and whether changes in one precede or follow changes in the other. A total of 457 Italian adolescents (53.1% girls) aged 11 to 18 years (M = 14.1 ± 2.27) completed the IU and EP scales on three separate occasions three months apart (T1, T2, and T3). Data were modeled using a Random-Intercept Cross-Lagged Panel Model (RI-CLPM) that separates individual differences between individuals from intraindividual changes. Descriptive analyses showed that IU was relatively stable between T1 and T2 and decreased slightly between T2 and T3. Consistent with the view that emotion regulation improves as adolescents develop, EP difficulties were found to decrease between T1 and T2 and between T2 and T3. The RI-CLPM revealed a strong between-person effect, showing that individual differences in IU and EP remained consistent throughout the study. In addition, significant within-person change was found, with adolescents who increased their IU at T1 and T2 also increasing their EP difficulties at T2 and T3, respectively. The opposite effect had a smaller effect size. In sum, our study showed that IU and EP are intertwined in adolescents and that changes in IU precede corresponding changes in EP. These results suggest a priority of change between IU and EP and confirm the relationship between IU and emotion regulation problems in adolescence.

A Consensus Conference of clinicians, researchers, public health specialists and users was convened in Italy to review efficacy, effectiveness, treatment appropriateness and access to care for anxiety and depression, and to consider the role of psychological therapies. Expert opinion was sought concerning identification of people requiring psychological therapies according to levels of symptom severity matched to corresponding levels of treatment intensity, suitability of psychological therapies for subclinical anxiety or depression, definition of a minimum level of information on evidence-based psychotherapies to be provided by university medical and psychology courses, initiatives to raise awareness among potential users and decision makers on the role and effectiveness of psychological therapies in healthcare. The expert jury concluded that a number of psychological therapy models endorsed by most authoritative guidelines are supported by research showing their effectiveness at least equal to the drugs used in common mental disorders (CMDs). Such therapies are under-represented in the Italian public health system, leading many people to resort to the private sector, resulting in unacceptable wealth discrimination. The difficulty of accessing psychological treatments often entails the use of drug therapies in cases where they are not indicated. Starting from these assumptions, the experts recommended the promotion of better and timely recognition of anxiety and depressive disorders and their classification in terms of symptom intensity and functional impairment, differentiating subthreshold mood swings from clinical forms, to foster outcome studies of psychotherapies in CMDs in Italy, to introduce a stepped care model structured according to levels of intensity of treatment, based on wellbeing support strategies in nonmedical contexts for subthreshold situations, self-help, support and psychoeducation as frontline interventions in mild clinical forms, evidence-based psychotherapies in moderate and severe forms, with the option of combining psychological treatment and appropriate drug therapy in the most severe cases.

The validity of self-report psychopathy assessment has been questioned, especially in forensic settings where clinical evaluations influence critical decision-making (e.g., institutional placement, parole eligibility). Informant-based assessment offers a potentially valuable supplement to self-report but is challenging to acquire in under-resourced forensic contexts. The current study evaluated, within an incarcerated sample (n = 322), the extent to which brief prototype-based informant ratings of psychopathic traits as described by the triarchic model (boldness, meanness, disinhibition; Patrick et al., 2009) converge with self-report trait scores and show incremental validity in predicting criterion measures. Self/informant convergence was robust for traits of boldness and disinhibition, but weaker for meanness. Informant-rated traits showed incremental predictive validity over self-report traits, both within and across assessment domains. These findings indicate that simple prototype-based informant ratings of the triarchic traits can provide a useful supplement to self-report in assessing psychopathy within forensic-clinical settings.

Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the Covid-19 Psychological Research Consortium longitudinal study of a representative sample of the UK adult population and data from an Italian arm of the study. We first compare data from the third wave (W3) of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample (N = 1034) and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the ecological model, predict resilient and non-resilient outcomes.We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and PTSD symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes.In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes.The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges.

The triarchic model of psychopathy conceptualizes variants of this clinical condition as expressions of three distinct biobehavioral dispositions, termed boldness, meanness, and disinhibition. As a trait-oriented model, the triarchic model situates psychopathy within a broader nomological network of personality and psychopathology, and has proven useful for characterizing how psychopathy relates to variables in these domains as well as to biological and behavioral variables. The current study was the first to examine sex differences in the external correlates of psychopathic traits as described by the triarchic model in a prison sample. Results were generally consistent with hypotheses: The triarchic traits related to measures of personality and psychopathology in patterns that were largely consistent across sex, but with some notable differences between males and females, in the correlates of disinhibition in particular. These included stronger associations for disinhibition with substance use problems, self-harm, and staff ratings of prison misbehavior among females compared to males. Findings from this study support the value of the triarchic model for understanding similarities and differences in the nomological network of psychopathy in incarcerated males and females.

Individuals who possess the “Looming Cognitive Style” (LCS; Riskind et al. in Journal of Personality and Social Psychology 79:837–852, 2000) are biased to perceive mental simulations of possible threats as dynamically emergent phenomena that are rapidly growing, approaching, and expanding in negative consequences. The present study aimed to evaluate whether the LCS is a cognitive risk factor for anxiety and whether it tends to more consistently predict anxiety than depression over 6-month and 12-month time windows. A cohort of Italian college students (N = 187) were administered measures of the LCS, anxiety, and depression (the BAI and BDI-II) at baseline and then at two successive follow-up assessments 6 and 12 months later. After controlling for initial symptoms, the LCS and its subscales were generally found to predict 6 months changes in anxiety symptoms but not 6 months changes in depression. In further analyses of 12 months changes, the effect sizes for LCS in predicting 12 months change were equivalent to 6 months change but attenuated in significance due to lower statistical power resulting from the exclusion of the 6 months wave of data collection. Added to this, at 12 months, the LCS physical threat subscale also emerged as a significant predictor of 12 months changes in depression symptoms. Results showed, contrary to expectations of a “positive feedback loop” hypothesis, that anxiety did not predict future increases in LCS. The LCS predicts anxiety and may do so more consistently than depression, at least in time windows of 6 months of less. The findings are discussed in terms of the potential importance of dynamic threat parameters to anxiety that are not captured by other current putative vulnerability factors.

Eating disorders are multifaceted psychopathologies and the transdiagnostic approach is currently considered a useful framework to understand their complexity. This preliminary study aimed to investigate both broad (i.e., intolerance of uncertainty and emotion dysregulation) and narrow (i.e., extreme body dissatisfaction) transdiagnostic risk factors underlying eating disorders. 50 Italian female patients seeking treatment for an eating disorder were involved (Mage = 31.6 years ± 12.8, 18–65). They completed self-report measures assessing emotion regulation difficulties, intolerance of uncertainty, extreme body dissatisfaction, general psychological distress, and eating disorder symptomatology. To explore whether the abovementioned transdiagnostic factors predicted patients’ psychological distress and eating disorder symptoms, two linear regressions were performed. Emotion dysregulation emerged as the only significant predictor of distress, while extreme body dissatisfaction was the only significant predictor of overall eating disorder symptomatology. Then, to analyze the differences between patients with anorexia nervosa and bulimia nervosa in intolerance of uncertainty and emotion regulation problems, t-tests were conducted. The two groups differed significantly in intolerance of uncertainty levels only, with higher scores obtained by patients with anorexia nervosa. Overall, our findings suggest that emotion dysregulation and extreme body dissatisfaction may be relevant constructs in eating disorders in general, while intolerance of uncertainty may be more involved in restrictive eating disorders. The clinical implications of such results are discussed.

Intolerance of Uncertainty (IU) is a transdiagnostic factor involved in several psychological disorders. Adolescence is characterized by elevated uncertainty and psychopathological vulnerability, but insufficient attention has been paid to IU at this age. This study aimed to investigate the factor structure and psychometric properties of the Intolerance of Uncertainty Scale-Revised (IUS-R) in Italian preadolescents and adolescents. 862 Italian students (57.3% girls) aged 11–17 (M = 14.8 ± 1.91) completed the IUS-R and measures of internalizing and externalizing symptoms, and psychological well-being. To test the factor structure of the IUS-R, one-factor, two-factor, and bifactor models were compared; measurement invariance, reliability, and validity were also addressed. Results showed that the bifactor model outperformed alternative factor models, and a general factor was needed to model the IUS-R. Bifactor model indices supported using the total score to assess IU reliably. Configural and metric invariance by age and sex were fully supported, while the IUS-R achieved partial scalar invariance. Significant correlations emerged for the IUS-R total score with psychopathological constructs, while no relationships with psychological well-being were found. Compared to adult normative data, higher total IUS-R scores were detected, suggesting that IU may be a phase-specific characteristic of adolescence. Our findings support using the IUS-R to measure IU across the lifespan. The recommended use of the total score and its associations with psychopathological dimensions highlight the transdiagnostic nature of IU in adolescence. Therefore, including IU when implementing interventions to prevent maladaptive outcomes in teenagers would be beneficial.

Background Relationship Obsessive Compulsive Disorder (ROCD) is a presentation of OCD centering on interpersonal relationships. The aim of this Randomized Control Trial (RCT) was to assess the efficacy of short, game like, daily cognitive interventions delivered via mobile application in reducing subclinical ROCD symptoms and associated phenomena. Methods Fifty university students identified as having subclinical levels of ROCD symptoms (using the Structured Clinical Interview for DSM-5 Clinical Version) were randomized into: immediate-use group (iApp group; n = 25) and delayed-use group (dApp group; n = 25). The iApp group started using the evaluated cognitive-behavioral training application at baseline for 15 days (T0 to T1). The dApp group commenced using the application at T1 for 15 days (T1 to T2). All participants completed questionnaires at baseline (T0), 15 days from baseline (T1), and 30 days from baseline (T2). Results Repeated measure MANOVAs showed significant Group (iApp vs. dApp) × Time (T0 vs. T1) interactions. These interactions indicated greater decrease in ROCD symptoms, OCD beliefs and social anxiety symptoms, as well as a greater increase in self-esteem in the iApp group compared to dApp group at T1. Moreover, the Reliable Change Index (RCI) indicated reliable change on ROCD symptoms for a significant portion of participants (42–52%). Limitations Sample size and the use of self-report measures limits the generalizability of the results. Conclusions Short, daily cognitive training interventions delivered via mobile applications may be useful in reducing subclinical ROCD symptoms and associated features. Further testing is needed for clinical populations.

The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive instrument developed to accurately assess the main pretransplant psychosocial risk factors that may impact transplant outcomes.As neither established assessment procedures nor standardized tools designed to perform pretransplant psychosocial evaluation are currently available in Italy, the present study was designed to develop and preliminarily validate the Italian version of the SIPAT.First, our team developed the Italian version of the SIPAT, following standard forward-back translation procedures. Then, the Italian version of the SIPAT was retrospectively and blindly applied to 118 randomly selected transplant cases (40 heart, 40 lung, and 38 liver) by 2 independent examiners. Information about the patients' final transplant listing recommendation (i.e., listing vs. deferral) was independently collected from the respective transplant teams.The inter-rater reliability of the Italian version of the SIPAT scores was substantial (Cohen's kappa = 0.77; P 0.001). Moreover, the predictive value of the SIPAT ratings on the final transplant listing recommendation (i.e., listing vs. deferral) for each examiner was significant (both P 0.05).Current findings suggest that SIPAT is a promising and reliable instrument in its Italian version. Given these excellent psychometric characteristics, the use of the SIPAT as part of the pretransplant psychosocial evaluation in Italian medical settings is highly encouraged.

In research and clinical contexts, it is important to briefly evaluate perceived Psychological and Social Support (PSS) to plan psychological interventions and allocate efforts and resources. However, an appropriate brief assessment tool for PSS was lacking. This study aimed at developing a brief and accurate scale to specifically measure PSS in clinical and emergency contexts, with specific, relevant, targeted, and irredundant items. Experienced clinicians developed the perceived Psycho-Social Support Scale (PSSS) and administered it to a clinical sample (N = 112) seeking psychological help during the COVID-19 emergency. A Confirmatory Factor Analysis examined the PSSS internal structure, and a Multiple Indicator and Multiple Causes model investigated its association with the number of sessions and emotional symptoms. The PSSS showed good psychometric properties and the Confirmatory Factor Analysis provided acceptable fit indexes for a unidimensional structure. The Multiple Indicators and Multiple Causes revealed that more sessions and emotional symptoms were associated with lower PSSS scores. The PSSS is a reliable brief tool to measure PS and could be useful to individualize treatments (i.e., number of sessions) to efficiently allocate efforts and resources in clinical contexts and emergencies (e.g., earthquake, COVID-19 pandemic).The online version contains supplementary material available at 10.1007/s12144-022-03344-z.

BACKGROUND Body dysmorphic disorder (BDD) is characterized by concerns for perceived defects in physical appearance that appear to others as mild or unobservable. Individuals with BDD frequently refer concerns with their physical appearance being 'not right' (not just right experiences; NJREs), and BDD-related behaviours may be performed until their appearance is perceived as 'right'. The aim of the study was to explore the relationship between BDD and NJREs in cosmetic surgery and aesthetic medicine settings. METHODS Individuals requesting cosmetic procedures with BDD symptoms (BDD-symptoms group; n = 24), without BDD symptoms (cosmetic intervention [CI] group; n = 45), and individuals that have never required these procedures (no cosmetic intervention [NCI] group; n = 53) entered the study. RESULTS Results showed a greater number of past-month NJREs, higher NJREs severity, higher drive for thinness, and greater general distress in the BDD-symptoms group. Pertaining to features associated with NJREs (perfectionism and obsessive-compulsive disorder symptoms) and ED core features, the BDD-symptoms group scored higher only with respect to NCI. Regression analyses showed that BDD symptoms were predicted by age, NJREs severity, and drive for thinness above and beyond general distress, perfectionism, obsessive-compulsive disorder symptoms, bulimia, and body dissatisfaction related to weight and shape in the BDD-Symptoms group (in comparison with the CI and NCI groups). CONCLUSIONS NJREs may represent a potential vulnerability factor for BDD symptoms in cosmetic settings.

Objective To explore the direct and indirect associations between intolerance of uncertainty, health anxiety (HA), and psychological distress through problematic internet use (PIU) and cyberchondria, both before and during the first months of the COVID-19 pandemic. Design Two Italian samples were enrolled via an online questionnaire. Sample 1 (N = 556; 69.3% females, Mage 29.6 years, SD = 13.2) was recruited in non-pandemic times, whereas Sample 2 (N = 575; 74% females, Mage 31.9 years, SD = 13.4) was recruited during the COVID-19 lockdown. Main outcome measures Self-report measures assessing HA and psychological distress. Results Two distinct path analyses showed that intolerance of uncertainty was directly associated with HA and psychological distress in both samples. Moreover, cyberchondria partially mediated the relationship between intolerance of uncertainty and HA and PIU partially mediated the relationship between intolerance of uncertainty and psychological distress in both samples. The link between cyberchondria and psychological distress was significant in Sample 2 but non-significant in Sample 1. The model accounted for a substantial variance of HA and psychological distress in both samples. Conclusion Our findings suggest that problematic online behaviors might exacerbate the negative consequences of intolerance of uncertainty in terms of higher levels of HA and psychological distress both in pandemic and non-pandemic contexts.

Studies pertaining to muscle dysmorphia (MD) have concentrated the most on males. However, a new body ideal for women is emerging: a very toned, athletic body with flat, smooth muscles. The emphasis on the level of muscularity represents a contribution to the growth of MD symptoms in women. The aim of this study was to evaluate the factorial structure and psychometric properties of the muscle dysmorphic disorder inventory (MDDI) in two samples of physically active Italian women. One-hundred and sixty-five women practicing non-competing bodybuilding/powerlifting and 353 women practicing physical exercise completed the MDDI and measures of features associated with MD. Findings of the confirmatory factor analysis showed a three-factor structure with acceptable fit and invariant across groups. Omega coefficients revealed adequate internal consistency for all the scales and for the total score of the MDDI. Furthermore, convergent and divergent validity as well as retest reliability emerged to be good. MDDI represents a reliable measure of MD symptoms in physically active Italian women.

The triarchic model of psychopathy posits that three distinct trait dispositions-disinhibition, meanness, and boldness-contribute to the interpersonal, affective, and impulsive-unrestrained features of this condition and is represented to varying degrees in all conceptualizations and measures of psychopathy. Using data for incarcerated males (

Body dissatisfaction has been related to Body Image Disorders (BIDs) such as Eating Disorders (EDs) and Body Dysmorphic Disorder (BDD). This study investigates the efficacy of a mHealth app in reducing body dissatisfaction, BDD/ED symptoms and related features. Ninety-five women who were identified as high-risk of developing BIDs (using the Structured Clinical Interview for DSM-5) were randomized into: immediate-use App (iApp group; n = 47) and delayed-use App (dApp group; n = 48). The iApp group started using the app at baseline for 16 days (T1). The dApp group started using the app at T1 for 16 days. Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Multivariate Analysis of Variance (MANOVA) showed Group (iApp vs. dApp) × Time (T0 vs. T1) interactions indicating decrease in BDD symptoms and body dissatisfaction related to EDs in the iApp group at T1. The Reliable Change Index indicated changes on extreme body dissatisfaction/BDD symptoms for 34.74% of participants. Although preliminary, these findings highlight that a mHeatlh app might reduce BDD symptoms and body dissatisfaction related to EDs in women at high-risk for BIDs. Effects on ED symptoms and associated features seem more limited.

Unwanted mental intrusions (UMIs) with contents related to Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Illness Anxiety Disorder (IAD), and Eating Disorders (EDs) are highly prevalent, independently of the cultural and/or social context. Cognitive-behavioral explanations for these disorders postulates that the escalation from common UMIs to clinically relevant symptoms depends on the maladaptive consequences (i.e., emotions, appraisals, and control strategies) of experiencing UMIs. This study examines, from a cross-cultural perspective, the cognitive-behavioral postulates of the maladaptive consequences of having UMIs.Non-clinical 1,473 participants from Europe, the Middle-East, and South America completed the Questionnaire of Unpleasant Intrusive Thoughts to assess the maladaptive consequences of experiencing highly disturbing OCD, BDD, IAD, and EDs-related UMIs.Findings revealed main effects for both the country and the consequences associated with the four UMI contents. Interaction effects between the consequences of each UMI content and the sample location were also observed.Cognitive-Behavioral models for OCD, BDD, IAD, and EDs should be implemented along with socio-cultural variables that increase the understanding of the role of these variables in the phenomenology of UMIs and their associated consequences.Las intrusiones mentales no deseadas (IM) de contenidos relacionados con el Trastorno Obsesivo-Compulsivo (TOC), el Trastorno Dismórfico Corporal (TDC), la Ansiedad por la Enfermedad (AE), y los Trastornos Alimentarios (TAs) son muy prevalentes, independientemente de la cultura y/o el contexto social. Las explicaciones cognitivo-conductuales de esos trastornos postulan que la escalada de IM normales a síntomas clínicamente relevantes depende de las consecuencias desadaptativas (i.e., emociones, valoraciones y estrategias de control) de las IM. Este estudio examina los planteamientos sobre dichas consecuencias desde una perspectiva transcultural.1.473 participantes de Europa, Oriente Medio y Suramérica completaron el Inventario de Pensamientos Intrusos Desagradables para evaluar las consecuencias desadaptativas de experimentar IM muy molestas con contenidos de TOC, TDC, AE y TAs.Se obtuvieron efectos principales tanto para el país como para las consecuencias asociadas con los cuatro contenidos de IM, así como efectos de interacción entre las consecuencias de cada modalidad de IM y la localización de la muestra.Los modelos cognitivo-conductuales sobre el TOC, el TDC, la AE y los TAs deben complementarse con variables socioculturales que aumenten la comprensión del papel de esas variables en la fenomenología de las IM y sus consecuencias asociadas.

Although “not just right experiences” (NJREs) and disgust proneness (DP) have been increasingly implicated in the development and maintenance of obsessive–compulsive disorder (OCD), no studies to date have examined their conjoint effect. In the present study, structural equation modeling was used to examine the extent to which NJREs and DP were associated to OC symptoms in a sample composed of college students in a model which also included OC-related beliefs and negative affect. The results showed that NJREs and OC-beliefs, but not DP, were related to overall OC symptoms severity. Moreover, NJREs were associated to all the main OC symptoms dimensions (washing, checking, ordering, obsessing, and mental neutralization) whereas DP was associated with obsessing symptoms and, negatively, with mental neutralization. These findings underscore the importance of the continued examination of vulnerability factors such as NJREs and DP in enhancing our understanding of OCD.

This study extended recent research showing that perceptions of disease risk are associated with emotional well-being during COVID-19 by examining how psychopathic traits of boldness, meanness, and disinhibition influence these perceptions and psychological outcomes. During the Italian national lockdown, a large community sample (Mage = 31.3 years) completed online questionnaire measures of the triarchic psychopathic traits, perceptions of disease susceptibility and danger, and recent well-being. Path analyses revealed differing roles for the triarchic traits: boldness and meanness predicted greater well-being (lower stress, higher positive affect) and disinhibition predicted lower well-being. Further, boldness and meanness were linked to well-being through distinct indirect pathways of low perceived susceptibility to infection (boldness) and low perceived dangerousness of COVID-19 (boldness and meanness). Findings speak to the triarchic model's utility in explaining socioemotional phenomena during times of crisis and support the distinct biobehavioral conceptualizations of boldness as low threat sensitivity, meanness as low affiliative capacity, and disinhibition as deficient affective and behavioral control.

The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2), but previous studies have typically relied solely on confirmatory factor analysis (CFA) to understand IES-2 dimensionality. In contrast, a bifactor exploratory structural equation modelling (B-ESEM) framework offers a more realistic account of IES-2 multidimensionality. Here, we assessed the psychometric properties of a novel Italian translation using a combination of exploratory factor analysis and B-ESEM. A total of 950 adults completed the IES-2 alongside measures of positive body image, disordered eating, and psychological well-being. Results indicated that a 4-factor B-ESEM model had adequate fit to the data and that fit was improved when the correlated uniqueness of seven negatively worded IES-2 items was accounted for. This model of IES-2 scores showed adequate internal consistency and good test-retest reliability up to three weeks. Evidence of construct validity was good in terms of a global IES-2 factor, and broadly supported in terms of its specific-factors. These results highlight the utility of a B-ESEM framework for understanding the dimensionality of IES-2 scores and may help scholars better understand the extent to which the IES-2 adequately operationalises the construct of intuitive eating.

Background/Objective Not Just Right Experiences (NJREs) are currently considered as one of the motivators of Obsessive-Compulsive Disorder (OCD), but the ways through which NJREs affect OCD symptoms remains unclear. The aim of the present study was to examine the putative mediational role of Intolerance of Uncertainty (IU) in the association between NJRE severity and OCD symptoms in patients with OCD. Method Sixty-two patients with OCD completed self-report measures of NJREs, OCD symptoms, and IU. Results IU mediated the relationship between NJRE severity and OCD symptoms. Furthermore, NJRE severity emerged as moderator of the path, suggesting that the mediational role of IU is stronger when the severity of NJREs increases. Conclusion Findings support the importance of NJREs in OCD, as well as the specific contribution of IU in the maintenance of this disorder.

This study sought to evaluate the specificity of health anxiety, relative to other forms of psychopathology, in perceptions of COVID-19 as dangerous. Measures of health anxiety, COVID-19 perceived dangerousness, negative affect, anxiety, depression, stress, contamination-related obsessions and compulsions, and intrusive illness-related thoughts were administered online to 742 community individuals during the Italian national lockdown. Results showed that, after controlling for demographic variables and other internalizing problems, health anxiety was the single most important factor associated with the perceived dangerousness of COVID-19. Moreover, a comparison between the current sample’s scores on various symptom measures and scores from prepandemic Italian samples revealed that, whereas other internalizing symptoms increased by a large or very large magnitude during the pandemic, levels of health anxiety and negative affect increased by a medium amount. This result may indicate that health anxiety is relatively trait-like, increasing the likelihood that our correlational data support the model of health anxiety as a vulnerability rather than an outcome. Together, these results indicate that health anxiety may be a specific risk factor for COVID-related maladjustment and support the distinction of health anxiety from other psychological problems.

The aim of the current study was to investigate the intersecting roles of dysfunctional personality traits and coping styles in relation to psychological distress during the Italian national lockdown caused by the COVID-19 pandemic. Participants included 633 adults who completed questionnaires of maladaptive personality traits, coping styles, and psychological distress. Results indicated that all the maladaptive traits were associated with psychological distress with magnitude of associations strongest for Negative Affect and weakest for Antagonism. Maladaptive traits were also generally positively associated with avoidant/maladaptive and negatively associated with acceptance and positive reframing, forms of coping. A series of path analyses further demonstrated that coping strategies partially explained associations between maladaptive personality traits and psychological distress. All told, results suggest that during an unprecedented stressful time, associations between maladaptive personality traits and psychological distress may be, at least in part, explained by maladaptive coping strategies.

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.

We used structural equation modeling to assess the role of impaired emotional awareness and clarity (Impaired Awareness/Clarity) and inability to control behaviors when experiencing emotional distress (Inability to Control Behaviors) as an account for the relationship between intolerance of uncertainty (IU) and negative affect (NA) in individuals with Substance Use Disorders (SUDs) and healthy controls (HCs) used for comparison. One-hundred and thirty-one individuals with SUDs (42.75% female; mean age = 39.74 ± 11.83) and 131 sex-matched HCs (mean age = 40.02 ± 12.34) entered the study. Participants completed questionnaires assessing the constructs of interest. Single-group analyses aimed to identify a baseline model for each group and test the hypothesized direct/indirect relations’ overall significance. Then, a multigroup analysis tested the invariance of model parameters between SUD and HC groups. The model in which IU had both direct and indirect relationships with NA through Impaired Awareness/Clarity and Inability to Control Behaviors was a good fit to the data. The indirect relationship of IU with NA through Inability to Control Behaviors was significant and moderate-sized. The relationship involving Impaired Awareness/Clarity and Inability to Control Behaviors was small-sized and significant in single group analysis only. The multigroup analysis supported the association of IU with NA through Inability to Control Behaviors in the SUD group. Overall, our study highlights the crucial role of the Inability to Control Behaviors in SUDs and suggests that its association with IU might fuel NA in this population.

The paper forms part of a series of papers outlining the theoretical framework for a new model of uncertainty distress (this paper), treatment implications arising from the model, and empirical tests of the model. We define uncertainty distress asthe subjective negative emotions experienced in response to the as yet unknown aspects of a given situation. In the first paper we draw on a robust body of research on distinct areas including: threat models of anxiety, perceived illness uncertainty and intolerance of uncertainty. We explore how threat and uncertainty are separable in anxiety and how we can understand behaviours in response to uncertainty. Finally, we propose a clinically, theoretically and empirically informed model for uncertainty distress, and outline how this model can be tested. Caveats, clinical applications and practitioner key points are briefly included, although these are more fully outlined in the treatment implications article. While we outline this model in the context of novel coronavirus (COVID-19), the model has broader applications to both mental and physical health care settings.Key learning aims(1)To define the concept of uncertainty distress.(2)To understand the role of threat, over-estimation of threat, perceived uncertainty, actual uncertainty, and intolerance of uncertainty in distress maintenance.(3)To understand how people may behave in response to uncertainty distress.(4)To describe a model of uncertainty distress.

Intolerance of Uncertainty (IU) is an individual´s "tendency to be bothered or upset by the (as yet) unknown elements of a situation, whether the possible outcome is negative or not." This construct, originally proposed in the context of Generalised Anxiety Disorder (GAD), is now considered a transdiagnostic construct. The Intolerance of Uncertainty Scale (IUS; Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994) has been the gold standard measure for IU, both the original 27-item and the 12-item (IUS-12; Carleton, Norton, & Asmundson, 2007) versions. The present study, conducted in the context of a broader research project about IU and the COVID-pandemic by the UNiCORN team, aims to develop an even shorter version of the IUS, both psychometrically sound and quicker to administer, which would increase its utility in research studies with an elevated number of measures. Initial analyses conducted in currently available data from four countries (UK, Italy, Spain and Greece) suggest that it is possible to reduce the IUS-12 to 5 items, including two items measuring desire for predictability, one item assessing uncertainty paralysis, and two items describing aversiveness of uncertainty. The five-item version of the questionnaire (IUS-5) showed adequate internal consistency across languages (English, Italian, Spanish, Greek) and across situations (e.g., before and during COVID-19), and its total score is highly correlated with the total score of the IUS-12. Overall, preliminary results suggest that the IUS-5 may represent a valid and reliable measure of IU to be used across samples, languages, and countries.

Investigating whether intolerance of uncertainty interacts with difficulties in emotion regulation and negative affect in Italian individuals with borderline personality disorder compared to health...

Worry is frequently observed in undergraduates, especially in female students who usually show a lower adjustment to college life than male ones. The current study explored gender differences in worry and its associated cognitive features in a large sample of Italian university students and assessed whether different mechanisms may occur in the path from Intolerance of Uncertainty (IU) to worry according to gender. A sample made up of 243 male and 406 female undergraduates entered the study. Comparisons on measures assessing worry, IU, Positive Beliefs about Worry (PBW), Negative Problem Orientation (NPO), and Cognitive Avoidance (CA) were performed. Furthermore, two moderated mediation models (one for each sample) wherein IU was the independent variable, worry the dependent variable, PBW, NPO, and CA parallel mediators, were tested. Females showed higher levels of worry, NPO, and CA than males, but effects were small. Whilst PBW and NPO, but not CA, mediated the relationship between IU and worry in both samples, IU moderated the mediations only in females. Overall, results suggest the existence of a differential interplay between worry and associated cognitive features according to gender in Italian undergraduates.