Changing to Impress: Testing a Mediation Model from Instagram Self-presentation to Cosmetic Surgery.

BACKGROUND: This study examined the relationship between false self-presentation on Instagram and consideration of cosmetic surgery through the mediating role of body image control in photos (BICP), photo manipulation, and body shame. We predicted that false self-presentation on Instagram was indirectly associated with cosmetic surgery intentions through the aforementioned constructs. METHODS: A total of 504 young Italian adults (28.2% males, 18-30 years) completed an online survey. They completed a questionnaire containing the Self-presentation on Instagram Questionnaire, the Body Image Control in Photos Questionnaire-revised, the Photo Manipulation Scale, the Objectified Body Consciousness Scale, and the Acceptance of Cosmetic Surgery Scale. The pattern of associations between the constructs was analyzed via path analysis. RESULTS: The results show that false self-presentation on Instagram was associated with photo manipulation, both directly and indirectly, through BICP. Furthermore, photo manipulation was linked to body shame, but neither of them was associated with cosmetic surgery intentions. Finally, false self-presentation on Instagram was associated with the consideration of cosmetic surgery only through the mediation of BICP. CONCLUSION: Findings indicate that self-presentation styles might affect Instagram photo behaviors and individuals' cosmetic surgery intentions, suggesting that surgeons should fully examine patients' motivations before providing them with services. Furthermore, intervention programs encouraging users to present a more authentic version of themselves online might reduce the risk of self-objectification and reduce the consideration of procedures aimed at modifying one's body for purely aesthetic reasons. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Heterogeneity of smartphone impact on everyday life and its relationship with personality and psychopathology: A latent profile analysis.

BACKGROUND: The relationships between problematic smartphone use and psychological factors have been extensively investigated. However, previous studies generally used variable-centered approaches, which hinder an examination of the heterogeneity of smartphone impact on everyday life. OBJECTIVE: In the present study, we capitalized on latent profile analysis to identify various classes of smartphone owners based on the impact associated with smartphone use (e.g., unregulated usage, preference for smartphone-mediated social relationships) and to compare these classes in terms of established psychological risk factors for problematic smartphone use. METHOD: We surveyed 934 young adults with validated psychometric questionnaires to assess the impact of smartphones, psychopathological symptoms, self-esteem and impulsivity traits. RESULTS: Smartphone users fall into four latent profiles: users with low smartphone impact, users with average smartphone impact, problematic smartphone users, and users favoring online interactions. Individuals distributed in the problematic smartphone user profile were characterized by heightened psychopathological symptoms (stress, anxiety, depression, obsessive-compulsive tendencies) and impulsivity traits. Moreover, users who preferred online interactions exhibited the highest symptoms of social anxiety and the lowest levels of self-esteem. CONCLUSIONS: These findings further demonstrate the multidimensionality and heterogeneity of the impact of smartphone use, calling for tailored prevention and intervention strategies.

How Communication Technology Fosters Individual and Social Wellbeing During the Covid-19 Pandemic: Preliminary Support For a Digital Interaction Model.

The aim of the present study was to test an explanatory model for individual and social wellbeing which incorporates the advantages of using digital technologies during the COVID-19 pandemic. The study was carried out in Italy, one of the countries that has been most severely affected by the pandemic worldwide. The study was designed to include variables that might be specifically pertinent to the uniqueness of the restrictions imposed by the pandemic. Adults living in Italy (n = 1412) completed an online survey during the lockdown period in March 2020. Results showed two distinct digital interaction processes highlighted by the facilitating use of online emotions ("e-motions") and online social support ("e-support"). In short, e-motions were positively related to posttraumatic growth, which in turn was positively associated with positive mental health and higher engagement in prosocial behaviors. Moreover, individuals who perceived themselves as having greater e-support were characterized by higher levels of positive mental health, which it turn was positively associated with prosocial behaviors. Collectively, these two digital interaction processes suggest that digital technologies appear to be critical resources in helping individuals cope with difficulties raised by the COVID-19 pandemic.

The information capacity of adolescent alcohol consumption indicators along a continuum of severity: A cross-national comparison of sixteen Central and Eastern European countries.

BACKGROUND: Because there is high variability among European countries in prevalence levels of various alcohol consumption measures, the informational value of adolescent's alcohol consumption indicators is uncertain. The present study aimed to examine information capacity and measurement invariance of different alcohol consumption indicators in adolescents from countries of the former Soviet (Eastern) Bloc in Central and Eastern Europe (CEE). METHODS: Data were collected in 16 CEE countries, as part of the 2013/2014 wave of the Health Behavior in School-aged Children study. Data from adolescents (age 15) who reported having consumed alcohol at least once in their lifetime were analyzed. Four binary items selected for analysis measured the presence or absence of alcohol consumption in the last 30 days, lifetime drunkenness, weekly drinking frequency, and binge drinking on a typical occasion. Multiple group confirmatory factor analysis and item response theory analysis were used to examine the data. RESULTS: In most of the included countries, alcohol consumption in the last 30 days and lifetime drunkenness were indicative at lower severity levels, while binge drinking and weekly drinking frequency were informative at higher levels of alcohol use severity. A low proportion of the estimated intercepts and factor loadings were noninvariant, which indicated approximate cross-national invariance of these indicators. CONCLUSIONS: Adolescent alcohol consumption indicators are informative for different severity levels and enable cross-nationally invariant measurement. However, different indicators suggested the presence of diverging drinking cultures in the CEE regions, with the highest discrimination capacity at the lower and higher ends of the continuum of alcohol use severity.

Cross-national time trends in adolescent alcohol use from 2002 to 2014.

BACKGROUND: Adolescent alcohol consumption is a major public health concern that should be continuously monitored. This study aims (i) to analyze country-level trends in weekly alcohol consumption, drunkenness and early initiation in alcohol consumption and drunkenness among 15-year-old adolescents from 39 countries and regions across Europe and North America between 2002 and 2014 and (ii) to examine the geographical patterns in adolescent alcohol-related behaviours. METHODS: The sample was composed of 250 161 adolescents aged 15 from 39 countries and regions from Europe and North America. Survey years were 2002, 2006, 2010 and 2014. The alcohol consumption and drunkenness items of the HBSC questionnaire were employed. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance. RESULTS: Data show a general decrease in all four alcohol variables between 2002 and 2014 except for some countries. However, there is variability both within a country (depending on the alcohol-related behaviour under study) and across countries (in the beginning and shape of trends). Some countries have not reduced or even increased their levels in some variables. Although some particularities have persisted over time, there are no robust patterns by regions. CONCLUSIONS: Despite an overall decrease in adolescent alcohol consumption, special attention should be paid to those countries where declines are not present, or despite decreasing, rates are still high. Further research is needed to clarify factors associated with adolescent drinking, to better understand country specificities and to implement effective policies.

Factors Associated with Providers' Work Engagement and Burnout in Homeless Services: A Cross-national Study.

The complexity of homeless service users' characteristics and the contextual challenges faced by services can make the experience of working with people in homelessness stressful and can put providers' well-being at risk. In the current study, we investigated the association between service characteristics (i.e., the availability of training and supervision and the capability-fostering approach) and social service providers' work engagement and burnout. The study involved 497 social service providers working in homeless services in eight different European countries (62% women; mean age = 40.73, SD = 10.45) and was part of the Horizon 2020 European study "Homelessness as Unfairness (HOME_EU)." Using hierarchical linear modeling (HLM), findings showed that the availability of training and supervision were positively associated with providers' work engagement and negatively associated with burnout. However, results varied based on the perceived usefulness of the training and supervision provided within the service and the specific outcome considered. The most consistent finding was the association between the degree to which a service promotes users' capabilities and all the aspects of providers' well-being analyzed. Results are discussed in relation to their implications for how configuration of homeless services can promote social service providers' well-being and high-quality care.

Goth Music and Depressive Symptoms among Adolescents: A Longitudinal Study.

Identification with Goth youth culture has been related to elevated levels of depression, self-harm and suicide ideation. However, this identification may be difficult to assess as Goth is stigmatized and adolescents may hesitate to self-identify. Conversely, adolescents readily respond to questions on their music preferences. This study addresses the potential link between liking Goth music and depressive symptoms in a four-year study among 10 to 15-year-olds (N = 940, M age = 12.4 at T1, 49% female). In this study, it was found that Goth music is only liked by a small minority of adolescents (4 to 11%). Both girls and boys who liked Goth music reported increased levels of depressive symptoms as they grew older. The findings of this study suggest that a preference for Goth music emerges as an early, sensitive marker of dormant or developing depressive symptoms in adolescents. The mechanisms through which music preferences can translate into or sustain depressive symptoms are discussed.

Testing the Italian version of the Cyberchondria Severity Scale and a metacognitive model of cyberchondria.

Cyberchondria refers to the tendency to excessively and compulsively search for online medical information despite the distress experienced, with consequent impairment of daily-life activities. The current two studies sought to explore (i) the factor structure of the Italian version of the Cyberchondria Severity Scale (CSS) and (ii) a metacognitive model of cyberchondria. Participants were Italian community adults who reported using the Internet to search for health-related information (Study 1: N = 374, Study 2: N = 717). Results from Study 1 supported the Italian version of the CSS exhibiting a five-factor structure, with the resulting scales demonstrating good internal consistency, 5-week test-retest reliability, and generally strong correlations with indices of health anxiety. In Study 2, results of a path analysis showed that the negative metacognitive belief domain ("thoughts are uncontrollable") shared the strongest direct association with each of the five dimensions of cyberchondria, followed by beliefs about rituals. Consistently, the strongest indirect associations were found between "thoughts are uncontrollable" and all the five cyberchondria dimensions via beliefs about rituals. These results provide support for an Italian version of the CSS and the metacognitive conceptualization of cyberchondria.

[Work-related stress of providers in homelessness services: a comparison among workers in traditional services and housing first]. / Lo stress lavorativo negli operatori dei servizi dedicati alle persone senza dimora: confronto tra operatori di servizi tradizionali e di servizi di Housing First.

SUMMARY: Burnout has recently been identified as a disorder by the World Health Organization. Although helping professions are the most exposed to burnout, there is a lack of research on work-related stress in social service workers, such as frontline workers in homeless services. The aim of this study is to evaluate burnout in a sample of Italian providers working in homelessness services, exploring the differences between traditional services and Housing First. Burnout was measured through the Link Burnout Questionnaire, consisting of four dimensions investigating Psychophysical exhaustion, Depersonalization, Professional inefficacy and Disillusion. A total of 69 participants (40 social providers and 29 educators of both types of service) responded to the survey. The results show similar levels of burnout in providers and educators working in the two types of services.

Emotion Regulation and Desire Thinking as Predictors of Problematic Facebook Use.

Research evidence suggests that problematic Facebook use (PFU) affects large numbers of people worldwide. A variety of studies have investigated the relationship between PFU and psychological dysfunction, revealing that negative mood and cognitive self-regulation are common among problematic Facebook users. The aim of the present study was to examine the role of craving, emotion regulation and desire thinking in predicting PFU. An online survey was administered to 750 participants (Mage = 23.38 years; SDage = 5.72). Correlation analyses indicated that all predictor variables were positively associated with PFU. Path analysis showed that imaginal prefiguration was associated with craving, which, in turn, was associated with verbal prefiguration that was directly linked to PFU, beyond the direct effect of emotion regulation. These findings provide further support for the importance of desire thinking in predicting problematic behaviours. Desire thinking and emotion regulation should be considered in the modification of problematic Facebook use.

Overweight and lower age at menarche: evidence from the Italian HBSC cross-sectional survey.

BACKGROUND: A unique standardized national dataset on adolescent girls (21 regions) participating in the Italian Health Behaviour in School-aged Children Study (HBSC) was used to investigate the correlation between body mass index (BMI) and age at menarche. METHODS: Two independent nationally representative survey datasets: one on 15-year-olds (n = 6907, in 21 regions, year 2013/2014) and one on 11-year-olds (n = 10,128, in 20 regions, year 2009/2010) were analysed. The survey instrument was a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated by means of Kaplan-Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). "Region-level obesity" was measured as the prevalence of overweight/obesity (%) in each region. RESULTS: Region-level median age at menarche ranged between 12 years/3 months and 13 years/4 months. Region-level prevalence of overweight among 15-year-old girls ranged between 4 and 19%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = - 0.70; 95% CI, - 0.84 to - 0.56). Individual- and class-level measures of BMI accounted for 50% of the region-level variance in age at menarche. CONCLUSIONS: The results show that overweight in childhood is in relation with the early puberty in girls. Future surveys may take into account this report to clarify if overweight is the cause or consequence of early menarche.

Sociopolitical Control for Immigrants: The Role of Receiving Local Contexts.

This study examines the individual and contextual factors associated with sociopolitical control expressed by immigrants in southern Spain. We used hierarchical linear modeling to evaluate the relations between individual (community participation, social connectedness, and perceived cultural competence of receiving community services) and municipality characteristics (city community participation, city social connectedness, and city community services' cultural competence) and immigrants' feelings of sociopolitical control. Data were analyzed using a two-level model based on 707 Moroccan immigrants in 25 municipalities. After adjusting for gender, educational level, and psychosocial confounding factors, we observed a positive association between social connectedness and sociopolitical control at the individual level. At the contextual level, we observed a positive association between (a) city community participation, (b) city social connectedness, and (c) city community services' cultural competence, and sociopolitical control. Indeed, living in a municipality where there are community services with high levels of cultural competence and where, on average, many people participate in organizations and neighbors are connected, was associated with higher levels of perceived control in the sociopolitical domain for immigrants. We also discuss implications for community-based research and practice.

Is Medicine Use for Nervousness Associated with Adolescent At-Risk or Problem Gambling?

OBJECTIVE: To examine the association between adolescent at-risk or problem gambling (ARPG) and medicine used to treat nervousness in a large-scale nationally representative sample of Italian adolescents. STUDY DESIGN: Data from the 2013/2014 Health Behaviour in School-aged Children Survey was used for cross-sectional analyses (a sample of 20,791 15-year-old students). Self-administered questionnaires were completed by a representative sample of high-school students. Respondents' ARPG, use of medicine for nervousness and potential confounding factors were assessed. Multilevel logistic regression analyses were used to test the association between medicine use to treat nervousness and ARPG. RESULTS: The overall prevalence of adolescents reporting medicine use for nervousness in the last month was 6.3%. The odds of ARPG were 3 times higher among adolescents who used medicine for nervousness compared to that among adolescents who did not take such medicine (OR 2.96, 95% CI 2.07-4.25). Importantly, the association between medicine used to treat nervousness and ARPG did not vary significantly when viewed in light of psychological symptoms. CONCLUSIONS: Medicine use to treat nervousness is associated with increased risk of gambling-related harm.

"I Am Becoming More and More Like My Eldest Brother!": The Relationship Between Older Siblings, Adolescent Gambling Severity, and the Attenuating Role of Parents in a Large-Scale Nationally Representative Survey Study.

The present study examined the association between having older siblings who gamble and adolescent at-risk/problem gambling and how parents (i.e., parental knowledge of their whereabouts) and peers might moderate such effects. Data were drawn from the ESPAD®Italia2012 survey (European School Survey Project on Alcohol and Other Drugs) comprising a nationally representative Italian sample of adolescents. The analysis was carried out on a subsample of 10,063 Italian students aged 15-19 years (average age = 17.10; 55 % girls) who had at least one older sibling and who had gambled at some point in their lives. Respondents' problem gambling severity, older gambler sibling, gambler peers, parental knowledge, and socio-demographic characteristics were individually assessed. Multinomial logistic regression analyses including two- and three-way interactions were conducted. The odds of being an at-risk/problem gambler were higher among high school students with older siblings that gambled and those with peers who gambled. Higher parental knowledge (of who the adolescent was with and where they were in their leisure time) was associated with lower rates of at-risk/problem gambling. There was also an interaction between gamblers with older siblings and parental knowledge. The combination of having siblings who gambled and a greater level of parental knowledge was associated with lower levels of problem gambling. The present study confirmed the occurrence of social risk processes (older siblings and peers who gambled) and demonstrated that gambling among older siblings and peers represents an important contextual factor for increased at-risk/problem gambling. However, parental knowledge appears to be sufficient to counterbalance the influence of older siblings.

School Sense of Community, Teacher Support, and Students' School Safety Perceptions.

This study examined the association between two characteristics of school climate (sense of community and teacher support, measured both at the individual and at the school level) and students' feelings of being unsafe at school. The study involved a sample of 49,638 students aged 10-18 years who participated in the 2010-2012 California Healthy Kids Survey. Using hierarchical linear modeling (HLM), our findings revealed that, at the individual level, students perceiving higher levels of sense of community and teacher support at school were less likely to feel unsafe within the school environment. At the school level, sense of community was negatively associated with unsafe feelings, whereas there was no association between school-level teacher support and feelings of being unsafe at school.

Adolescent Gambling-Oriented Attitudes Mediate the Relationship Between Perceived Parental Knowledge and Adolescent Gambling: Implications for Prevention.

Although substantial research has provided support for the association between parental practices and adolescent gambling, less is known about the role of adolescent attitudes in this relationship. The primary purpose of this study was to test an integrative model linking perceived parental knowledge (children's perceptions of their parents' knowledge of their whereabouts and companions) with adolescent gambling while evaluating the mediating effects of adolescents' own gambling approval, risk perception of gambling, and descriptive norms on gambling shared with friends. The data were drawn from the ESPAD® Italia 2012 (European School Survey Project on Alcohol and Other Drugs) study, which is based on a nationally representative sample of Italian adolescent students aged 15-19. The analysis was carried out on a subsample of 19,573 subjects (average age 17.11, 54 % girls). Self-completed questionnaires were administered in the classroom setting. The results revealed that adolescents who perceived higher levels of parental knowledge were more likely to disapprove of gambling and show higher awareness of its harmfulness, which were in turn negatively related to gambling frequency. They were also less likely to perceive their friends as gamblers, which was also negatively related to gambling frequency. These findings suggest that gambling prevention efforts should consider perceived parental knowledge and gambling-oriented attitudes (self-approval, risk perception, and descriptive norms) as factors that may buffer adolescent gambling behavior in various situations.

Social Capital and Fear of Crime in Adolescence: A Multilevel Study.

Hierarchical linear modeling was used to examine the relationships between social capital (at the individual, the neighborhood, and the regional levels) and adolescents' fear of crime, while controlling for the main individual (sociodemographics, television viewing, and bullying victimization), neighborhood (neighborhood size and aggregated victimization), and regional (crime rate and level of urbanization) variables. Data were analyzed using a three-level model based on 22,639 15.7-year-old (SD = 0.67) students nested within 1081 neighborhoods and 19 Italian regions. The findings revealed that individual and contextual measures of social capital, modeled at the individual, neighborhood, and regional levels simultaneously, showed negative associations with adolescents' fear of crime. Males and participants with higher family affluence were less likely to feel fear of crime, whereas victimization, both at the individual and neighborhood levels, had a positive association with fear of crime. Strengths, limitations, and potential applications of the study are discussed.

Well-being in 15-year-old adolescents: a matter of relationship with school.

BACKGROUND: Psychosomatic health complaints are significant indicators of adolescent well-being. The aim of this study is to describe the full set of interactions between health complaints and the presence of subjective resources, represented by the quality of relationships with parents and peers and by a positive school perception, in a population of 15-year-old adolescents. Smoking and alcohol consumption were also included in the analyses. METHODS: Bayesian networks were built for males and females separately, in order to understand the interactions among all considered variables in a representative sample of 16 018 Italian adolescents participating in the Health Behaviour in School-Aged Children survey 2009-10. RESULTS: The resulting networks show that school is the crucial node linking adolescents' well-being with parents and peer relationships, as well as with smoking and alcohol consumption. CONCLUSIONS: Adolescents' well-being, as well as the prevalence of typical risk behaviours, such as smoking and alcohol consumption, is mediated by the adolescents' academic stress. Therefore, public health interventions, to be effective, should consider addressing the school environment by making it a more inclusive environment promoting critical thinking and sense of belonging rather than just focusing on personal behaviours.

Cybervictimization and somatic and psychological symptoms among Italian middle school students.

BACKGROUND: Existing literature clearly documents the association between cybervictimization and psychological symptoms; less clear is the association between cybervictimization and somatic symptoms. This study aims to verify the association between cybervictimization and both psychological and somatic symptoms on a representative sample of Italian early adolescents. METHODS: This study used data from 24 099 students aged 13 years participating in the 2009/2010 Health Behaviour in School-aged Children Survey. Self-completed questionnaires, devised by the HBSC international group, were administered in classrooms. Multilevel models of logistic regression (controlling for traditional bullying victimization, computer use and demographics) were used to investigate the association between cybervictimization and psychological and somatic symptoms. RESULTS: Overall, 3.1% of the students reported having been bullied frequently electronically and 8.7% occasionally (compared, respectively, to 4.0 and 9.2% victims of traditional forms of bullying). Overall, prevalence of students reporting psychological and somatic symptoms was 32.5 and 12.0%, respectively. Being victims of cyberbullying was positively associated to students' psychological and somatic symptoms, after controlling for traditional bullying victimization and computer use. CONCLUSION: Cybervictimization has similar psychological and somatic consequences for boys and girls, thus suggesting that intervention and prevention efforts should focus on both gender groups.