The Influence of Childhood Emotional Abuse and Neglect on Love Addiction: The Indirect Effect of Vulnerable Narcissism Among Female and Male Emerging Adults.

Childhood maltreatment is a key precursor to vulnerable narcissism since it likely lead to a narcissistic injury that triggers defenses against rage and abandonment. In later life, this pattern may contribute to a maladaptive model of love relationships. The present study explored the association between different types of childhood maltreatment (i.e., emotional, physical, and sexual abuse; physical and emotional neglect) and love addiction via vulnerable narcissism in a community sample of 505 cisgender emerging adults (M = 24.90, SD = 2.67; 76.6% assigned female at birth (AFAB); 68.5% heterosexual) residing in Italy. Data collection relied on self-report questionnaires administered online through the Qualtrics platform, and study hypotheses were tested using structural equation modeling. The results showed that childhood emotional abuse and emotional neglect directly influenced love addiction, while physical and sexual abuse, as well as physical neglect, showed no significant effects. Greater childhood emotional abuse and neglect were associated with increased vulnerable narcissism, leading to higher levels of love addiction. Gender differences emerged, with the indirect effect of vulnerable narcissism on the relationship between emotional neglect and love addiction significant only for AFAB. The findings emphasize the risk of love addiction in emerging adults with a history of childhood emotional abuse and neglect, highlighting the importance of addressing childhood emotional maltreatment and vulnerable narcissistic personality traits in interventions to treat this condition.

Mentalized Affectivity, Helicopter Parenting, and Psychopathological Risk in Emerging Adults: A Network Analysis.

Emerging adulthood represents a critical stage characterized by heightened risks for anxiety, depression, and somatization symptoms development. Research has shown that difficulties in emotional identification, expression, and processing, as well as dysfunctional parenting styles, may exacerbate symptoms in emerging adults. The present study aimed at examining the interplay between mentalized affectivity (i.e., emotional identification, processing, and expression), helicopter parenting, and psychopathological risk in 913 Italian cisgender emerging adults (M = 24.34, SD = 2.81; 71.20% assigned female at birth), using network analysis. The results indicated moderate to strong associations between psychopathological symptoms, with emotional processing difficulties significantly associated with general anxiety, depression, and, to a lesser extent, somatization. Additionally, increased degrees of helicopter parenting from mothers were linked to increased psychopathology and higher emotional processing difficulties. These findings emphasize the importance of addressing the interconnection between symptoms and emotional processing to prevent and treat psychopathological risks in emerging adults. Moreover, interventions targeting intrusive and overprotecting parenting behaviors may promote well-being among emerging adults.

Attitudes and knowledge of mental health practitioners towards LGBTQ+ patients: A mixed-method systematic review.

LGBTQ+ patients exhibit higher rates of mental disorder relative to the general population. This is particularly concerning since deficiencies in mental health practitioners' skills and knowledge, along with negative attitudes and behaviors, are associated with a decreased likelihood of LGBTQ+ patients seeking mental healthcare services and an increased likelihood of reporting unmet mental healthcare needs. To address these concerns, a mixed-method systematic review was conducted to evaluate mental health practitioners' attitudes towards and knowledge of LGBTQ+ patients and the impact of these factors on service utilization. Thirty-two relevant empirical qualitative and quantitative studies were retrieved from five databases following PRISMA guidelines, for a total of N = 13,110 mental health practitioners included. The results indicated that mental health practitioners generally hold affirming attitudes towards LGBTQ+ patients. However, significant gaps in practitioners' knowledge and skills emerged, describing feelings of inadequate skill, lack of competence, low clinical preparedness in addressing specific LGBTQ+ needs, insufficient training opportunities, and desire for further education on LGBTQ+ issues. These findings underscore the need to enhance inclusivity and cultural competence at both organizational and educational levels. Such improvements are essential to better care for LGBTQ+ patients and reduce disparities in access to mental health services.

Direct and indirect effects of psychological well-being and therapeutic alliance on therapy outcome in eating disorders.

Introduction: Outcome research in eating disorders (EDs) is commonly focused on psychopathological dysfunction. However, Ryff's model of psychological well-being (PWB) has shown promising-yet preliminary-results with ED patients. Additionally, despite substantial evidence highlighting the association between the therapeutic alliance and treatment outcome, findings in ED samples remain unclear. The present study aimed at exploring the direct effect of PWB dimensions and the early therapeutic alliance on ED patients' individual treatment responses, as well as the mediating role played by the early therapeutic alliance in the relationship between PWB dimensions and overall pre-post symptom change. Methods: A sample of N = 165 ED patients assigned female at birth, who were receiving treatment in a residential program, completed the Psychological Well-Being Scale at treatment intake and the Working Alliance Inventory after the first four psychotherapy sessions. Patients also completed the Outcome Questionnaire-45.2 at the same time point and during the week prior to discharge. Results: The PWB dimensions of autonomy, positive relations, and self-acceptance were associated with clinically significant change, while the dimensions of personal growth and self-acceptance were associated with reliable change. The early therapeutic alliance showed both direct and indirect effects on therapy outcome, predicting clinically significant and reliable symptom reduction. It also emerged as a significant mediator in the relationship between all PWB dimensions and overall symptomatic change. Conclusion: The identification of individual, adaptive characteristics in ED patients that might influence their development of an early therapeutic alliance may help therapists to predict relationship ruptures and tailor their interventions to enhance treatment effectiveness.

Parental burnout, coparenting, and internalized sexual stigma during COVID-19 in parents with minoritized sexual identities.

The COVID-19 pandemic acted as a model of stressful situations for parents insofar as it led to unprecedented difficulties in childcare and caregiving, resulting in increased levels of parental burnout, worldwide. To date, research on parental burnout has mainly involved heterosexual parents. However, parents with minoritized sexual identities face partially different stressors, including internalized sexual stigma, and they also have partially different resources, including a more egalitarian division of childcare labor. Between April 2020 and February 2021, 32 lesbian mother families by donor insemination (n = 64 lesbian mothers) and 28 gay father families by gestational surrogacy (n = 56 gay fathers), all with a child aged 6-10 years and living in Italy, were recruited. In each family, both parents self-rated their parental burnout, coparenting, and internalized sexual stigma. Multilevel modeling indicated that lesbian mothers reported greater parental burnout than gay fathers. Moreover, lower coparenting quality was associated with greater parental burnout. Finally, internalized sexual stigma had a significant both direct and interactive effect on parental burnout, with higher levels of internalized sexual stigma resulting in greater parental burnout, especially in gay fathers. Considering the sexual minority stress theory and the risks and resources balance theory, the results indicate the importance of preventing and treating parental burnout in lesbian and gay parents by focusing on their internalized sexual stigma and coparenting relationship. Also, incorporating the positive psychology framework in future research would help identify in these parents the resources deriving from their minoritized sexual identities to deal with parental burnout. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The intergenerational transmission of attachment during middle childhood in lesbian, gay, and heterosexual parent families through assisted reproduction: The mediating role of reflective functioning.

The present study examined the attachment patterns distribution of 60 lesbian mothers, 50 gay fathers, and 42 heterosexual parents through assisted reproduction and their 76 children, using the Adult Attachment Interview (AAI) and the Friends and Family Interview (FFI), respectively. The study also explored the intergenerational transmission of attachment through reflective functioning (AAI-RF). All families lived in Italy and children were aged 6-12 years (Myears = 8.11, SD = 2.17; 48.68% assigned female at birth). The AAI patterns distribution was similar across family types and did not significantly differ from international and national normative data. Similarly, children's FFI attachment patterns were evenly distributed between family types, and no significant differences emerged in comparison to international and national normative data referring to middle childhood samples. Mediational models revealed that, in all three family types, parents with greater AAI coherence of mind exhibited higher AAI-RF, which, in turn, was associated with increased FFI attachment security in children. Furthermore, parents' AAI coherence of mind directly influenced children's FFI attachment security. The results support and expand hypotheses regarding the intergenerational transmission of attachment in lesbian, gay, and heterosexual parent families through assisted reproduction, while offering unique indications to support these families during middle childhood.

Different epistemic stances for different traumatic experiences: implications for mentalization.

Traumatic experiences may impair reflective functioning (RF), making it difficult for individuals to understand their own and others' mental states. Epistemic trust (ET), which enables evaluating social information as reliable and relevant, may vary in association with RF. In this study, we explored the implications of different ET stances (i.e., trust, mistrust, and credulity) in the relation between different childhood traumatic experiences (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and different types of RF impairments (uncertainty and certainty about mental states). A non-clinical community sample of 496 cisgender emerging adults (mage = 24.91, standard deviation = 2.66, 71.85% assigned female at birth, 63.63% heterosexual) reported on their childhood traumatic experiences, ET, and RF. We used structural equation models to examine direct and indirect associations. The results showed significant indirect effects between emotional abuse and uncertainty about mental states through credibility. We also observed significant indirect effects between emotional abuse and certainty about mental states through mistrust and credibility. The findings suggest that a lack of discrimination when evaluating knowledge from others (i.e., credulity) might promote increased uncertainty in RF when emerging adults have experienced emotional abuse in their childhood. Conversely, a tendency to view all information sources as unreliable or ill-intentioned (i.e., mistrust) may foster greater certainty in RF as a protective mechanism against an unreliable and potentially harmful world when combined with childhood emotional abuse. The implications for clinical practice and intervention are discussed.

European gay fathers via surrogacy: Parenting, social support, anti-gay microaggressions, and child behavior problems.

The present study investigated child behavior problems, parenting styles, coparenting, and couple relationship satisfaction in 67 European gay father families via surrogacy and 67 European heterosexual parent families via unassisted conception, all with children aged 1.5-10 years (M = 3.57 years, SD = 2.09). The two family groups were matched for child age and gender. In the gay father group only, the associations between family anti-gay microaggressions, family/friend support, and other main variables also were explored. Children of gay fathers had fewer externalizing and internalizing problems compared to children of heterosexual parents. Also, gay fathers reported more effective parenting styles, greater coparenting quality, and higher couple relationship satisfaction compared to heterosexual parents. Overall, child externalizing problems (i.e., aggression, rule-breaking) and internalizing problems (i.e., anxiety, depression) were more strongly associated with being raised in a heterosexual parent family, more authoritarian parenting, and lower positive coparenting. Specific to the gay father sample, anti-gay microaggressions experienced by family members were associated with more child internalizing problems, lower positive coparenting, and lower social support from family and friends. These results refute concerns about possible detrimental effects on child development of surrogacy conception or of being raised by gay fathers. The results further suggest that family therapists treating child behavior problems should focus mainly on improving the coparenting relationship, reducing authoritarian/punitive parenting styles, and (for gay father families specifically) coping with anti-gay microaggressions and lack of social support outside the nuclear family.

Problematic internet use in emerging adulthood to escape from maternal helicopter parenting: defensive functioning as a mediating mechanism.

The increasing use of the Internet has raised concerns about its problematic use, particularly among emerging adults who grew up in a highly digitalized world. Helicopter parenting, characterized by excessive involvement, overcontrol, and developmentally inappropriate behavior, has been identified as a potential factor contributing to problematic Internet use (PIU). Under these circumstances, considering that emerging adults navigate their adult lives and strive to reduce their sense of being in-between, implicit emotion regulation strategies, such as defense mechanisms, may help comprehend PIU. The present questionnaire-based study investigated the associations between maternal and paternal helicopter parenting and PIU through defensive functioning among a community sample of 401 cisgender emerging adults (71.82% females; 82.04% heterosexuals; Mage=24.85, SD=2.52) living in Italy. About one-fourth (25.19%) reported PIU. Greater maternal, B=0.904, SE=0.235, p<.001, but not paternal, B=0.343, SE=0.188, p=.068, helicopter parenting was significantly associated with PIU through a less mature defensive functioning. Conversely, neither maternal, B=1.158, SE=0.722, p=.109, nor paternal, B=0.355, SE=0.731, p=.628, helicopter parenting had a direct association with PIU. The results suggest the importance for psychotherapists to incorporate individuals' defense mechanisms and parent-child relationship history when designing tailored interventions for effective treatment of PIU. This emphasis is crucial because, in the context of a developmentally appropriate parenting style, relying on more mature defenses after psychotherapeutic intervention can lead to healthier adjustment among emerging adults.

Parenting, dyadic coping, and child emotion regulation in lesbian, gay, and heterosexual parent families through assisted reproduction.

AIMS: The present study examined the associations between family structure, parenting, and dyadic coping and children's emotion regulation in lesbian, gay, and heterosexual parent families through assisted reproduction. It also explored differences in parenting dimensions and dyadic coping, based on parents' sexual orientation. METHODS: Participants were 60 lesbian mothers through donor insemination, 50 gay fathers through surrogacy, and 42 heterosexual parents through gamete donation, all with a child aged 6-12 years (M = 8.67; SD = 2.16; 48.68% females) and residing in Italy. In each family, both parents reported parenting stress, parent - child relational self-efficacy, parental control, dyadic coping, and their perception of the child's emotion regulation. RESULTS: Mixed models indicated no significant differences between family types in parenting stress and use of a controlling parenting style. However, lesbian mothers reported higher parent - child relational self-efficacy than heterosexual parents, and higher dyadic coping strategies than gay fathers. Also, children of gay fathers showed greater emotion regulation than children of heterosexual parents. Across family types, higher levels of parenting stress and dyadic coping, and lower levels of parent - child relational self-efficacy were associated with lower child emotion regulation. CONCLUSION: Given that in middle childhood, across family types, better emotional regulation was associated with lower parenting stress and dyadic coping, and greater effectiveness in the parent - child relationship clinical work should focus on the parent's and couple's ability to cooperatively manage stressors while maintaining a balanced focus on their children's resources and autonomy.

Donor sibling relations among adult offspring conceived via insemination by lesbian parents.

STUDY QUESTION: How do adult offspring in planned lesbian-parent families feel about and relate to their donor (half) sibling(s) (DS)? SUMMARY ANSWER: A majority of offspring had found DS and maintained good ongoing relationships, and all offspring (regardless of whether a DS had been identified) were satisfied with their knowledge of and contact level with the DS. WHAT IS KNOWN ALREADY: The first generation of donor insemination offspring of intended lesbian-parent families is now in their 30s. Coincident with this is an increased use of DNA testing and genetic ancestry websites, facilitating the discovery of donor siblings from a common sperm donor. Few studies of offspring and their DS include sexual minority parent (SMP) families, and only sparse data separately analyze the offspring of SMP families or extend the analyses to established adult offspring. STUDY DESIGN, SIZE, DURATION: This cohort study included 75 adult offspring, longitudinally followed since conception in lesbian-parent families. Quantitative analyses were performed from online surveys of the offspring in the seventh wave of the 36-year study, with a 90% family retention rate. The data were collected from March 2021 to November 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were 30- to 33-year-old donor insemination offspring whose lesbian parents enrolled in a US prospective longitudinal study when these offspring were conceived. Offspring who knew of a DS were asked about their numbers found, characteristics or motivations for meeting, DS terminology, relationship quality and maintenance, and impact of the DS contact on others. All offspring (with or without known DS) were asked about the importance of knowing if they have DS and their terminology, satisfaction with information about DS, and feelings about future contact. MAIN RESULTS AND THE ROLE OF CHANCE: Of offspring, 53% (n = 40) had found DS in modest numbers, via a DS or sperm bank registry in 45% of cases, and most of these offspring had made contact. The offspring had their meeting motivations fulfilled, viewed the DS as acquaintances more often than siblings or friends, and maintained good relationships via meetings, social media, and cell phone communication. They disclosed their DS meetings to most relatives with neutral impact. The offspring, whether with known or unknown DS, felt neutral about the importance of knowing if they had DS, were satisfied with what they knew (or did not know) of the DS, and were satisfied with their current level of DS contact. This study is the largest, longest-running longitudinal study of intended lesbian-parent families and their offspring, and due to its prospective nature, is not biased by over-sampling offspring who were already satisfied with their DS. LIMITATIONS, REASONS FOR CAUTION: The sample was from the USA, and mostly White, highly educated individuals, not representative of the diversity of donor insemination offspring of lesbian-parent families. WIDER IMPLICATIONS OF THE FINDINGS: While about half of the offspring found out about DS, the other half did not. Regardless of knowing of a DS, these adult offspring of lesbian parents were satisfied with their level of DS contact. Early disclosure and identity formation about being donor-conceived in a lesbian-parent family may distinguish these study participants from donor insemination offspring and adoptees in the general population, who may be more compelled to seek genetic relatives. The study participants who sought DS mostly found a modest number of them, in contrast to reports in studies that have found large numbers of DS. This may be because one-third of study offspring had donors known to the families since conception, who may have been less likely to participate in commercial sperm banking or internet donation sites, where quotas are difficult to enforce or nonexistent. The study results have implications for anyone considering gamete donation, gamete donors, donor-conceived offspring, and/or gamete banks, as well as the medical and public policy professionals who advise them. STUDY FUNDING/COMPETING INTEREST(S): No funding was provided for this project. The authors have no competing interests. TRIAL REGISTRATION NUMBER: N/A.

Sperm donor relations among adult offspring conceived via insemination by lesbian parents.

AIM: The present study examined how adult offspring of lesbian parents relate to their anonymous, open-identity, or known donors. DESIGN: An online survey of 75 donor-conceived offspring of lesbian parents, aged 30-33 years, participating in Wave 7 of a U.S. 36-year longitudinal study of planned lesbian-parent families was conducted. Offspring were asked about donor type, motivations for contacting the donor, terminology for the donor, relationship quality, means of relationship maintenance, impact of donor contact on offspring's other family members, and their feelings about the donor. RESULTS: Twenty offspring with anonymous donors and 15 with open-identity donors whom they had not contacted felt comfortable not knowing their donors. Forty offspring knew their donors - anonymous, contacted through an online registry (n = 7), open-identity, contacted (n = 9), or known since childhood (n = 24). Offspring who had contacted their donor since age 18 had their motivations fulfilled after contact, got along well with him, did not view him as a relative, and had told most family members about their contact, without detriment. Whether the donor was unknown or known at this stage of their lives, most offspring were satisfied with their contact level. CONCLUSION: This cohort of donor-conceived offspring of lesbian parents was among the first to reach adulthood during a time of technological advances in DNA testing, giving access to anonymous donors via online registries. The results inform donors, families, mental health providers, medical providers and public policymakers, on whether, how, and to what degree donor-conceived offspring optimally make donor contact.

Disclosure and child exploration of surrogacy origins in gay father families: Fathers' Adult Attachment Interview coherence of mind matters.

OBJECTIVE: The present study aimed at investigating whether gay fathers' coherence of mind within the Adult Attachment Interview (AAI) moderated the influence of parental disclosure on children's exploration of their surrogacy origins during middle childhood and early adolescence. BACKGROUND: Once children of gay fathers are disclosed to about their surrogacy conception, they may start exploring the meanings and implications of their conception. Very little is known about the factors that may enhance such exploration in gay father families. METHOD: A home-visit study was conducted with 60 White, cisgender, gay fathers and their 30 children born through gestational surrogacy, all residing in Italy and with medium to high socioeconomic status. At time 1, when children were aged 6-12 years (M = 8.31, SD = 1.68), fathers were rated for AAI coherence of mind and interviewed about their disclosure of the surrogacy origins to their child. At time 2, approximately 18 months later (M = 9.87, SD = 1.69), children were interviewed about their exploration of their surrogacy origins. RESULTS: In the context of more information disclosed about the child conception, only children whose fathers showed greater AAI coherence of mind explored their surrogacy origins in more depth. CONCLUSION: Gay fathers' ability to show an internally consistent, but not emotionally overwrought, state of mind regarding their own attachment experiences impacted the extent to which their children felt safe and legitimated in sharing their curiosity about their conception.

Long-Term Effects of Family Resilience on the Subjective Well-Being of Offspring in the National Longitudinal Lesbian Family Study.

The current study used a family resilience approach to investigate why some offspring of sexual minority parents thrive despite homophobic stigmatization while others do not. Specifically, the study explored the role of two specific family functioning mechanisms (i.e., during adolescence, disclosure of offspring's personal life to their parents, and family compatibility) in the association between experienced homophobic stigmatization at age 17 and subjective well-being at age 25, among 71 offspring (37 females and 34 males, all cisgender) of the National Longitudinal Lesbian Family Study (NLLFS). The results showed that, overall, the offspring reported healthy subjective well-being as emerging adults. However, among NLLFS offspring with less family compatibility as adolescents, homophobic stigmatization was related to higher scores on negative affect when they were emerging adults. Psychological counseling that supports adolescent-parent communication may help prevent the negative effect of homophobic stigmatization on the subjective well-being of offspring with sexual minority parents.

Mental Health Disparities Between Lesbian Mothers and Heterosexual Parents: the Mediating Role of Positivity.

Introduction: Previous evidence has shown better mental health outcomes for lesbian mothers, in comparison with heterosexual parents. The present study explored the mediating role of positivity (i.e., the tendency to view life with a positive outlook) in determining these mental health differences. Methods: Seventy-two Israeli lesbian mothers by donor insemination (from 36 families) were compared with 72 Israeli heterosexual parents by assisted reproduction (without donated gametes; from 36 families) on positivity, life satisfaction, and depressive symptomatology. All parents were cisgender and had at least one child born through assisted reproduction, aged 3-10 years. Data were collected between December 2019 and February 2021. Results: Mediational analyses indicated that lesbian mothers reported greater positivity, which was, in turn, associated with greater life satisfaction and less depressive symptomatology. Conclusions: The results pinpoint the possible protective and strengthening role of positivity for lesbian mothers in the pronatalist and familistic environment of Israel. The research contributes to the literature on the mental health of parents with diverse sexual orientations living outside of the USA and Europe. Policy Implications Policymakers and mental health professional should be knowledgeable about the importance of improving positivity as a strategy for reducing depressive symptomatology and promoting life satisfaction among lesbian mothers. Moreover, policy makers and legislators are called to ease the access of sexual minority individuals to parenthood, as in this population parenthood associates with heightened mental health outcomes.

Stress and Resilience Experiences during the Transition to Parenthood among Belgian Lesbian Mothers through Donor Insemination.

The present research explored parenting, stress, and resilience experiences among 16 Belgian, lesbian, first-time parental couples with donor-conceived children aged 3-72 months. In each couple, both mothers participated in a conjoint, semi-structured interview focused on their parenthood desire; the impact of stigmatization and social support from families of origin, friends, and institutions; and couple and family resources. Interviews were audio recorded, transcribed, and analyzed using Braun and Clarke's reflective thematic analysis. Four themes were identified: (1) "The precious baby": Realizing the parenthood project; (2) "Can we show ourselves in public without prying eyes?": Family social visibility; (3) "It's complicated!": Parental legal recognition and role imbalance; and (4) "How can we handle this?": Family resilience. The themes indicated that the child's donor conception, the parents' coming out, the non-gestational mother's role, the legal obstacles encountered, and the need to find a balance between the two mothers in childcare tasks generated stress and required mothers to develop resilience strategies. The results suggest several potential areas for mental health practitioners to explore in clinical contexts when supporting intended lesbian mothers in their transition to parenthood through donor insemination.

eCONNECT Parent Group: An Online Attachment-Based Intervention to Reduce Attachment Insecurity, Behavioral Problems, and Emotional Dysregulation in Adolescence.

During adolescence, a secure parent-adolescent relationship promotes youths' adjustment and psychological well-being. In this scenario, several studies have demonstrated the effectiveness of the CONNECT program, a 10-session, attachment-based parenting intervention that helps parents understand and reframe their parent-adolescent interactions, reducing adolescents' insecure attachment and behavioral problems. Furthermore, recent years have witnessed a significant increase in the implementation of effective online versions of psychological interventions, emphasizing the opportunity for more agile and easier dissemination of evidence-based protocols. Therefore, this study aims to identify changes in adolescents' attachment insecurity, behavioral problems, and parent-child affect regulation strategies, providing preliminary findings on an online, 10-session, attachment-based parenting intervention (eCONNECT). A total of 24 parents (20 mothers, 4 fathers; Mage = 49.33, SD = 5.32) of adolescents (Mage = 13.83 years, SD = 1.76, 45.8% girls) were assessed on their adolescents' attachment insecurity (avoidance and anxiety) and behavioral problems (externalizing and internalizing), and on their affect regulation strategies in the parent-child interaction (adaptive reflection, suppression, and affect dysregulation) at three time points: before intervention (t0), after intervention (t1), and at a 2-month follow-up (t2). Mixed-effects regression models highlighted a reduction in adolescents' internalizing problems (d = 0.11), externalizing problems (d = 0.29), and attachment avoidance (d = 0.26) after the intervention. Moreover, the reduction in externalizing problems and attachment avoidance remained stable at follow-up. Additionally, our findings highlighted a reduction in parent-child affect dysregulation. Results add preliminary evidence on the implementation suitability of an online attachment-based parenting intervention to change at-risk adolescents' developmental trajectories by reducing attachment insecurity, behavioral problems, and parent-child affect regulation.

Patient personality dimensions, relational patterns and therapeutic alliance in clinical practice: An empirical investigation.

INTRODUCTION: Transference (meant in this context, as the patient relational patterns expressed towards the clinician) and therapeutic alliance play a crucial role in the treatment of personality pathology. To date, no empirical study examined the association between these two dimensions of the clinical relationship and patients' personality maladaptive traits in psychotherapy. METHODS: A national sample of therapists (N = 100) of different theoretical orientations assessed dysfunctional personality features of a patient in their care using a comprehensive and empirically grounded dimensional diagnostic approach from the Shedler-Westen Assessment Procedure-200 (SWAP-200). Moreover, they filled in the Psychotherapy Relationship Questionnaire (PRQ) to identify interpersonal patterns expressed early in treatment by the patients and the Working Alliance Inventory (WAI-T) to evaluate quality of therapeutic alliance. RESULTS: Overall, the most severe and maladaptive dimensions of patients' personality were associated with more negative clinician-patient dynamics and poorer levels of therapeutic alliance in statistically significant and clinically relevant ways. Notably, the hostile transference was predicted by both SWAP Hostility and Psychopathy, whereas the SWAP Narcissism was the strongest predictor of the special/entitled transference. The latter was also predicted by SWAP Emotional Dysregulation; conversely, the SWAP Dysphoria was the most robust predictor of anxious/preoccupied pattern. The SWAP Schizoid Orientation and Psychopathy predicted avoidant/dismissing attachment pattern; moreover, they were strongly and negatively related to the SWAP Psychological Health that was the best predictor of positive transference and alliance. CONCLUSIONS: Findings support that therapists' careful understanding of patients' interpersonal ways during early treatment stages may meaningfully inform diagnostic and therapeutic processes.