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Introduction: This work aims to provide an updated overview of the eating disorders (EDs) which are a widespread pathology nowadays. Informations related to the clinical-nosographic characteristics, an in-depth analysis about systemic-relational theories and historical evolution are provided. In addition, current informations about epidemiological data, recovery, treatment related implications, new neuroscientific theories and risk factors are shown. Given the complexity of these disorders, the lack of resources and the the increasing demands for treatment, the main object is related to the construction of a questionnaire to manage the waiting lists. Objectives: Building a waiting list management model for EDs, Study and compare advantages and disadvantages of the source allocation ethical models (utilitarianism, prioritarianism, egalitarianism), Analyze EDs leading experts (doctors, dietitians, psychologists, psychiatrists) and EDs patients positioning with respect to priority treatment factors. Promote constructive dialog between EDs experts from different backgrounds and EDs patients. Methods: In order to know the various treatment alternatives available, the different levels and reference structures are illustrated. In addition, it is also suggested different reasoning based on the ethical models of egalitarianism, utilitarianism and prioritarianism in order to build a waiting list management model, which is the maximum goal of this work. This model needs to be supported by a series of validated tools such as the clinical interview and self-administered questionnaires to investigate psychopathological aspects and psychiatric symptoms. Going into more details, a questionnaire is proposed to the EDs leading experts, so that they can provide their own priority factors list and related thoughts in order to build "the most ethical" waiting list. Results: It is expected that both patients and clinicians tend to give priority to patients with greater psychophysical severity, not exclusively on the basis of physical parameters. Further hypothesis related to clinicians lead us believe that they tend to use utilitarian logics, in compliance with the demonstrated efficacy of early intervention. An evaluation that could lead to a disagreement between experts and patients is related to prioritize patients in the initial phase of the disease, which could be supported by clinicians, but not by patients, probably in connection with their personal experiences. In fact, this favoritism could have a negative impact on the care of the most serious cases who risk to be left to themselves. Conclusions: This work aims to encourage a constructive dialogue between experts and patients with EDs in order to build a functional intervention model which should be "the most ethical as possible" in order to save the greatest number of lives in respect of mental suffering. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Different kinds of traumatic experiences like natural catastrophes vs. relational traumatic experiences (e.g., sex/physical abuse, interpersonal partner violence) are involved in the development of the self and PTSD psychopathological manifestations. Looking at a neuroscience approach, it has been proposed a nested hierarchical model of self, which identifies three neural-mental networks: (i) interoceptive; (ii) exteroceptive; (iii) mental. However, it is still unclear how the self and its related brain networks might be affected by non-relational vs relational traumatic experiences. Departing from this background, the current study aims at conducting a meta-analytic review of task-dependent fMRI studies (i.e., emotional processing task) among patients with PTSD due to non-relational (PTSD-NR) and relational (PTSD-R) traumatic experiences using two approaches: (i) a Bayesian network meta-analysis for a region-of-interest-based approach; (ii) a coordinated-based meta-analysis. Our findings suggested that the PTSD-NR mainly recruited areas ascribed to the mental self to process emotional stimuli. Whereas, the PTSD-R mainly activated regions associated with the intero-exteroceptive self. Accordingly, the PTSD-R compared to the PTSD-NR might not reach a higher symbolic capacity to process stimuli with an emotional valence. These results are also clinically relevant in support of the development of differential treatment approaches for non-relational vs. relational PTSD., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

This research investigates the difference between products obtained through two hydrothermal carbonization treatments. Our aim is to synthesize metal-free, carbon-based catalysts for the oxygen reduction reaction (ORR) to serve as efficient and cost-effective alternatives to platinum-based catalysts. Catalysts synthesized using the traditional hydrothermal approach exhibit a higher electrocatalytic activity for ORR in alkaline media, despite their more energy-intensive production process. The superior performance is attributed to differences in the particle morphology and the chemical composition of the particle surfaces. The presence of functional groups on the surfaces of catalysts obtained via a traditional approach significantly enhances ORR activity by facilitating deprotonation reactions in an alkaline environment. Our research aims to provide a reference for future investigations, shifting the focus to the fine-tuning of surface chemical compositions and morphologies of metal-free catalysts to enhance ORR activity.

The self is the core of our mental life which connects one's inner mental life with the external perception. Since synchrony is a key feature of the biological world and its various species, what role does it play for humans? We conducted a large-scale psychological study (n = 1072) combining newly developed visual analogue scales (VAS) for the perception of synchrony and internal and external cognition complemented by several psychological questionnaires. Overall, our findings showed close connection of the perception of synchrony of the self with both internal (i.e., body and cognition) and external (i.e., others, environment/nature) synchrony being associated positively with adaptive and negatively with maladaptive traits of self. Moreover, we have demonstrated how external (i.e., life events like the COVID-19 pandemic) variables modulate the perception of the self's internal-external synchrony. These findings suggest how synchrony with self plays a central role during times of uncertainty., 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 The Author(s). Published by Elsevier Inc. All rights reserved.)

Abstract: Emotion dysregulation is considered a core feature of borderline personality disorder (BPD). The role of dissociation in BPD has been discussed from different perspectives. Nevertheless, implications of dissociation for BPD features are not clear. The current study estimated mediation effects of dissociative dimensions on the relationships between several emotion regulation strategies (ERSs) and BPD features among 281 adults recruited from the general population. The online survey administered a comprehensive self-report battery for the assessment of maladaptive and adaptive ERSs together with dissociative dimensions. Borderline personality disorder features were also self-report screened. Results showed significant indirect effects of dissociation on the relationships between ERSs and BPD features. Dissociation was a full mediator of the relationship between deficits with problem-solving skills and BPD criteria. The study confirmed that emotion dysregulation is a core feature of BPD and that the dissociative dimensions should be included as relevant maladaptive mechanisms sustaining BPD emotional difficulties., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

The COVID-19 pandemic has had a profound impact on individuals' sense of self perturbating the sense of connectedness with the others, touching upon deep existential fears and deep intersubjective and cultural layers, emphasizing the importance of a neuro-socio-ecological alignment for the sense of security of psychological self. We can still observe after years how social distancing measures, quarantines, and lockdowns have disrupted social connections and routines, leading to feelings of isolation, anxiety and depressive symptomatology. Furthermore, from a physiological perspective, some people continue to experience health problems long after having COVID-19, and these ongoing health problems are sometimes called post-COVID-19 syndrome or post-COVID conditions (PASC). In this complex scenario, through the operationalization of the sense of self and its psychological and physiological baseline, our aim is to try to shed some new light on elements of resilience vs. vulnerability. Here we intend the self and its baseline as the crossroads between psychology and physiology and we show how COVID-19 pandemic, especially in post-COVID-19 syndrome (PACS), left traces in the mind-body-brain system at a neuro-socio-ecological and inflammatory level., Competing Interests: Competing interests: None., (© 2023 Giovanni Fioriti Editore s.r.l.)

Aim: Departing from existing neurobiological models of dissociation, the current study aims at conducting a quantitative meta-analytic review of neural responses to emotional stimuli among individuals ascribed to the dissociative spectrum (DS). Accordingly, the study explored common and specific brain mechanisms across borderline personality disorder, conversion/somatoform disorders, posttraumatic stress disorder, posttraumatic stress disorder related to repeated interpersonal traumatic experiences, and dissociative disorders., Methods: The meta-analysis included studies that administered emotional stimuli during functional magnetic resonance imaging acquisition among individuals included in the DS. There were two conducted meta-analytic procedures: (i) a Bayesian network meta-analysis for a region-of-interest-based approach; and (ii) robust voxel-based approach., Results: Forty-four independent studies were included for a total of 1384 individuals (DS = 741 patients). The network meta-analysis showed specific patterns of neural activity considering an extended brain network involved in emotion regulation for each condition ascribed to the DS. The voxel-based meta-analysis highlighted an increased activity of dorsal anterior cingulate cortex as a common neurological signature of the DS., Conclusion: The common neural feature of the DS captures an implicit appraisal of emotion-eliciting stimuli as threatening and/or noxious for mental and physical integrity of the individual together with painful subjective experiences associated with physiological emotional reactions. Specific brain responses across the DS suggested the engagement in different mechanisms to address emotional stimuli, including implicit avoidance reactions and attempts to overcontrol of affective states together with a disruption of integrative processes of emotional mind-body features., (© 2023 The Authors Psychiatry and Clinical Neurosciences © 2023 Japanese Society of Psychiatry and Neurology.)

Objective: This study aims to longitudinally investigate the effects of individual's factors on subsequent burn-out/psychological distress in a sample of mental health practitioners, testing if higher attachment anxiety and avoidance and lower reflective functioning (i.e., certainty and uncertainty of mental states) and well-being at baseline may lead to a greater psychological distress and burn-out 1 year later., Methods: The sample consisted of 40 experienced psychotherapists (females: 72.5%; mean age: 47.40 ± 9.48 years) who completed a battery of questionnaires at baseline and 1 year later. Statistical analyses were conducted with Bayesian multiple linear regressions., Results: Greater attachment anxiety and certainty about mental states and lower individual's well-being at baseline predicted greater burn-out 1 year later. Similarly, greater attachment anxiety and lower individual's well-being at baseline predicted psychological distress at 1 year follow-up. Of note, uncertainty of mental states and avoidant attachment were not associated with outcomes., Conclusion: These findings suggest that the levels of burn-out and psychological distress among psychotherapists may be alleviated with interventions targeting attachment insecurity, specific aspects of reflective functioning (i.e., certainty about mental states) and well-being., (© 2023 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.)

The sense of self has always been a topic of high interest in both psychoanalysis and most recently in neuroscience. Nowadays, there is an agreement in psychoanalysis that the self emerges from the relationship with the other (e.g., the caregiver) in terms of his/her capacity to attune, regulate, and synchronize with the emergent self of the infant. The outcome of this relational/intersubjective synchronization is the development of the sense of self and its regulatory processes both in dynamic psychology and neuroscience. In this work, we propose that synchrony is a fundamental biobehavioral factor in these dialectical processes between self and others which shapes the brain-body-mind system of the individuals, including their sense of self. Recently in neuroscience, it has been proposed by the research group around Northoff that the self is constituted by a brain-based nested hierarchical three-layer structure, including interoceptive, proprio-exteroceptive, and mental layers of self. This may be disrupted, though, when traumatic experiences occur. Following the three levels of trauma theorized by Mucci, we here suggest how different levels of traumatic experiences might have an enduring effect in yielding a trauma-based topographic and dynamic re-organization of the nested model of self featured by dissociation. In conclusion, we propose that different levels and degrees of traumatic experience are related to corresponding disruptions in the topography and dynamic of the brain-based three-layer hierarchical structure of the self., 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., (Copyright © 2022 Scalabrini, Mucci and Northoff.)

Trait empathy is an essential personality feature in the intricacy of typical social inclinations of individuals. Empathy is likely supported by multilevel neuronal network functioning, whereas local topological properties determine network integrity. In the present functional MRI study (N = 116), we aimed to trace empathic traits to the intrinsic brain network architecture. Empathy was conceived as composed of two dimensions within the concept of pre-reflective, intersubjective understanding. Vicarious experience consists of the tendency to resonate with the feelings of other individuals, whereas intuitive understanding refers to a natural awareness of others' emotional states. Analyses of graph theoretical measures of centrality showed a relationship between the fronto-parietal network and psychometric measures of vicarious experience, whereas intuitive understanding was associated with sensorimotor and subcortical networks. Salience network regions could constitute hubs for information processing underlying both dimensions. The network properties related to empathy dimensions mainly concern inter-network information flow. Moreover, interaction effects implied several sex differences in the relationship between functional network organization and trait empathy. These results reveal that distinct intrinsic topological network features explain individual differences in separate dimensions of intersubjective understanding. The findings could help understand the impact of brain damage or stimulation through alterations of empathy-related network integrity.

Self-consciousness is neuronally associated with the brain's default mode network as its "neuronal baseline" while, psychologically the self is characterized by different thought modes and dynamics. We here raise the question whether they reflect the "psychological baseline" of the self. We investigate the psychological relationship of the self with thought modes (rumination, reflection) and mind-wandering dynamics (spontaneous, deliberate), as well as with depressive symptomatology. Our findings show a relationship between self-consciousness and i) mind-wandering dynamics, and ii) thought functional modes, in their respective forms. At the same time, self-consciousness is more related to spontaneous mind-wandering than deliberate and to rumination than reflection. Furthermore, iii) rumination acts as a mediator between self-consciousness and spontaneous mind-wandering dynamics; and iv) the relationship between high levels of self-consciousness and depressive symptoms is mediated by ruminative modes and spontaneous mind-wandering dynamics. Together, these findings support the view of the self as "psychological baseline"., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: Clinical and neurobiological models posited that dissociative mechanisms might affect processes involved in emotional generation and regulation. However, there is a lack of a comprehensive theoretical framework that systematically includes dissociation within emotional functioning., Methods: The current study aims at conducting a meta-analytic review on the relationship between dissociation and emotion regulation in order to empirically estimate to what extent dissociation is related to emotion regulation processes. The meta-analysis was based on r coefficient as effect size measure, using a random-effect approach., Results: The meta-analysis included 57 independent studies for a total of 11596 individuals. Findings showed an overall moderate relationship between dissociation and emotion regulation (r w  = .32; p < .05). The association between dissociation and emotion regulation was the same among clinical samples than non-clinical ones. Furthermore, dissociation showed moderate to large relationships with maladaptive domains of emotion regulation, namely disengagement (r w  = 0.34; p < .01) (i.e., behavioral avoidance, experiential avoidance, thought and emotional suppression) and aversive cognitive perseveration (r w  = 0.38; p < .001) (i.e., rumination, worry and nonacceptance). The analysis did not find significant relationship between dissociation and adaptive domain of emotional regulation (i.e., problem solving, mindfulness)., Conclusion: Dissociation in the context of emotion regulation might be viewed as a basic neuro-mental mechanism that automatically contribute to the over-modulation of emotional states through avoidance reactions from internal and external reality. Future longitudinal studies are needed to clarify the causal relationships between dissociation and emotion regulation., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Starting with Freud and Jung, dreams have always been considered a core source of information for psychoanalysis. Nowadays, neuroscientific findings suggest that dreams are related especially to limbic and right emotional brain circuit, and that during REM stages they engage self-related and visual internally generated processing. These neuroscientific findings together with contemporary psychoanalysis suggest that dreams are related to the sense of self and serve the purpose of re-integrating and re-structuring the integrity of the psyche. However, while dreams are still viewed as 'the via regia to the unconscious', it is the unconscious that has been reconsidered. The repressed unconscious seems to be related with left brain activity while the unrepressed unconscious based on dissociation seems to be associated with limbic and cortical areas of the right hemisphere. This notion of the unconscious might be seen as an implicit self-system encoded in the right brain that evolves in the interaction with a primary caregiver developing through preverbal and bodily stages of maturation enhanced by signals of dual communication. What kind of dreams for which unconscious? What are the differences regarding the capacity to dream for neurotic and borderline personality organizations? Our research aims to integrate psychodynamics, infant research, and neuroscientific findings to better understand the role of dreams in the assessment and treatment of, especially, traumatized and borderline patients. The capacity to dream is here proposed as a sort of enacted manifestation of emotional memories for the development of a more cohesive, coherent and symbolic vs fragmented, diffuse and alexithymic sense of self., Competing Interests: Conflict of interests: the authors declare no potential conflict of interests., (©Copyright: the Author(s).)

Recent research on trauma, attachment and neuroscience point at a clear divide in psychopathology between disorders based on repression, (as in Freud's repression model) and psychopathologies structured on dissociative mechanisms, a response to severe interpersonal trauma. Pathologies based on repression are typical of a neurotic structure, (with better developmental outcome), while pathologies based on dissociation are of more severe, often borderline nature, as in Otto Kernberg's borderline organization (1975). Neurobiology of attachment and affect regulation theory (Allan Schore), developmental psychopathology (Giovanni Liotti) and contemporary relational psychoanalysis (Philip Bromberg), all provide clinical evidence that the most severe psychopathology is of dissociative structure. This paper clarifies the after-effects of first level of traumatization of human agency (i.e., lack of attunement) and of the second level as in cases with actual abuse, maltreatment or incest (Mucci, 2013), with the internalization of a dyad victim/persecutor within the self of the survivor, as seen in borderline psychopathology (Mucci, 2018).

Major depressive disorder (MDD) is a psychiatric disorder characterized by abnormal resting state functional connectivity (rsFC) in various neural networks and especially in default-mode network (DMN). However, inconsistent findings, i.e., increased and decreased DMN rsFC, have been reported, which raise the question for the source of DMN changes in MDD. Testing whether the DMN abnormalities in MDD can be traced to either a local, i.e., intra-network, or a global, i.e., inter-network, source, we conducted a novel sequence of rsFC analyses, i.e., global FC, intra-network FC, and inter-network FC. Moreover, all analyses were conducted without global signal regression (non-GSR) and with GSR in order to identify the impact of specifically the global component of functional connectivity on within-network functional connectivity within specifically the DMN. In MDD our findings demonstrate (i) increased representation of global signal correlation (GSCORR) in DMN regions, as confirmed independently by degree of centrality (DC) and by an independent DMN template, (ii) increased within-network DMN rsFC, (iii) highly increased inter-network rsFC of both lower- and higher order non-DMN networks with DMN, (iv) high accuracy in classifying MDD vs. healthy subjects by using GSCORR as predictor. Further supporting the global, i.e., non-DMN source of within-network rsFC of the DMN, all results were obtained only when including the global signal, i.e., non-GSR, but not when conducting GSR. Together, we show for the first time increased global signal representation within rsFC of DMN as stemming from inter-network sources as distinguished from local sources, i.e., within- or intra-DMN.

The goal of this study was to test in a clinical sample the interrater reliability and convergent validity of the Differentiation-Relatedness Scale (D-RS), a measure that evaluates mental representations based on open-ended descriptions of self and significant others. The study also investigated the ability of the D-RS to predict personality disorders (PDs) from Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the dysfunctional trait domains presented in the Alternative DSM-5 Model for Personality Disorders Criterion B in Section III of the DSM-5. We also evaluated if the D-RS predicts observed Section II PDs over and above Criterion B of the Alternative DSM-5 Model for Personality Disorders. We found that the interrater reliability of the D-RS was good on the basis of the mean scores of 6 independent raters and that it showed moderate convergent validity. Results of dominance analyses indicated that the D-RS is a significant predictor of Section II borderline PD and of the overall number of DSM-5 PDs. When we considered the Section III Criterion B for PDs, the D-RS was not able to predict any of the Personality Inventory for DSM-5 domains, suggesting that the D-RS may be more related to personality functioning behind mental representations than to maladaptive personality traits. Finally, results of hierarchical regression analyses suggested that the D-RS produced a significant but modest increase in the prediction of borderline PD traits and the overall number of PDs traits even when the effect of the Personality Inventory for DSM-5 domains were controlled for.