A close look at sociality in DSM criteria.

PURPOSE: The importance of sociality in psychology and psychotherapy is quite undisputed; however, this construct risks being underestimated in psychiatric nosography. The aim of the review was to assess the relevance of sociality in DSM 5 criteria. METHOD: Sociality-laden criteria of 192 selected DSM categories have been identified through a textual grid. Second, the criteria have been classified into 6 categories, i.e., (1) Affiliation and Attachment (AA), (2) Social Communication (SC), (3) Perception and Understanding of Others (PUO), (4) Culture, (5) Clinical Significance Criterion (CSC) (6), and No Specific Construct (NSC). RESULTS: 13% of all mental disorders mention AA in their criteria. 8.8% of all mental disorders mention SC; 8.8% of all mental disorders mention PUO in their criteria. 15% of all mental disorders mention culture in their criteria (exclusively ex negativo though). 40% of mental disorders mention non-specific sociality (NSC) in their criteria. CSC is mentioned in 85% of mental disorders. Personality disorders have the highest "concentration" of sociality mentions throughout the DSM categories. CONCLUSIONS: The overall results suggest that DSM criteria offer a confused account of sociality. We believe that the descriptive approach is the underlying reason. We suggest that in the long run a theory-laden approach to sociality, informed by evolutionary insights about motivations, could be of help.

The Short Version of the Italian Maastricht Vital Exhaustion Questionnaire (MVEQ): Psychometric Properties and Relationships with Anxiety, Depression, and Stress in a Community Sample of Older Adults.

Vital Exhaustion (VE) refers to a physical and mental state of excessive fatigue, feelings of demoralization, hopelessness, and increased irritability. The short form of the Maastricht Vital Exhaustion Questionnaire (MVEQ) is a widely used measure to assess VE. Despite its utility is broadly recognized, the validity and reliability of the scale have yet to be examined in the Italian context. The present study aimed to evaluate the psychometric properties of the shortened MVEQ in a community sample of Italian older adults. A total of 722 older adults (Mage = 72.97, SD = 7.71; 60.4% females) completed the MVEQ, as well as other self-report questionnaires assessing anxiety, depression and stress in order to evaluate the criterion-related validity of the scale. A confirmatory factor analysis (CFA) was conducted to examine the original MVEQ latent structure. Internal consistency was assessed through model-based omega coefficient. Test-retest reliability was examined by re-administering the MVEQ after three months to a subsample of 568 participants. Factorial invariance tests across gender were conducted by means of multi-group CFAs. The one-factor model showed an acceptable fit to the data. The MVEQ yielded a reliable total score (ω = 0.822) and showed moderate-to-large correlations with measures of anxiety, depression, and stress (r range 0.30 to 0.75, ps < 0.001). Test-retest reliability was supported by an Intraclass Correlation Coefficient (ICC) of 0.661. Lastly, the scale was factorially invariant across gender. Overall, the MVEQ provided evidence of reliability and criterion-related validity in a sample of Italian older adults and may be useful for both clinical and research practices.

Comparative efficacy of psychological interventions on immune biomarkers: A systematic review and network meta-analysis (NMA).

Psychological interventions are viable, cost-effective strategies for improving clinical and psychological impact of inflammation-related conditions. However, their efficacy on immune system function remains controversial. We performed a systematic review and frequentist random-effects network meta-analysis of randomised controlled trials (RCTs) assessing the effects of psychological interventions, against a control condition, on biomarkers of innate and adaptive immunity in adults. PubMed, Scopus, PsycInfo, and Web of Science were searched from inception up to Oct 17, 2022. Cohen's d at 95% confidence interval (CI) was calculated to assess the effect sizes of each class of intervention against active control conditions at post-treatment. The study was registered in PROSPERO (CRD42022325508). Of the 5024 articles retrieved, we included 104 RCTs reporting on 7820 participants. Analyses were based on 13 types of clinical interventions. Compared with the control conditions, cognitive therapy (d =  - 0.95, 95% CI: -1.64 to - 0.27), lifestyle (d =  - 0.51, 95% CI: -0.99 to - 0.02), and mindfulness-based (d =  - 0.38, 95% CI: -0.66 to - 0.09) interventions were associated with post-treatment reduction of proinflammatory cytokines and markers. Mindfulness-based interventions were also significantly associated with post-treatment increase in anti-inflammatory cytokines (d = 0.69, 95% CI: 0.09 to 1.30), while cognitive therapy was associated also with post-treatment increase in white blood cell count (d = 1.89, 95% CI: 0.05 to 3.74). Results on natural killer cells activity were non-significant. Grade of evidence was moderate for mindfulness and low-to-moderate for cognitive therapy and lifestyle interventions; however, substantial overall heterogeneity was detected in most of the analyses.

Poor sleep hygiene practices are associated with a higher increase in sleep problems during the COVID-19 pandemic: A latent change score model.

The Coronavirus 2019 (COVID-19) pandemic significantly influenced physical and mental health worldwide. The present study aimed to investigate changes in sleep problems across three waves of the COVID-19 pandemic, and to identify potential predictors of the inter-individual variability around these changes, with a particular focus on the role of detrimental sleep hygiene practices. A total of 352 participants completed an online survey of self-report questionnaires at three different waves of the COVID-19 pandemic: T1 (Spring 2020); T2 (Autumn-Winter 2020); and T3 (Spring 2021). The questionnaires collected information on socio-demographic and COVID-19-related variables, psychological distress (i.e. the Depression Anxiety Stress Scale-21), sleep hygiene (i.e. the Sleep Hygiene Index) and sleep problems (i.e. the Medical Outcomes Study-Sleep Scale). Latent change score modelling revealed an average increase in sleep problems between T1 and T2 with significant inter-individual variability. No substantial changes were observed on average between T2 and T3. Notably, poorer sleep hygiene practices were associated with a more pronounced increase in sleep problems between T1 and T2 (ß = 0.191, p = 0.013), even after controlling for relevant confounders such as demographic factors, COVID-19-related information and psychological distress. These findings expand on previous research regarding the detrimental effects of the pandemic on mental health, suggesting that interventions targeting sleep hygiene practices may be beneficial for mitigating its negative impact on sleep disruptions.

Perseverative Cognition as a Mediator Between Perceived Stress and Sleep Disturbance: A Structural Equation Modeling Meta-analysis (meta-SEM).

BACKGROUND: According to the perseverative cognition (PC) hypothesis, the repetitive chronic activation of the cognitive representations of stressors are associated with a concomitant prolonged and sustained physiological stress response, including sleep disruption. PURPOSE: We conducted a systematic review and structural equation modeling meta-analysis (meta-SEM) on PC as mediator of the association between perceived stress and subjective sleep disturbance (i.e., difficulties falling asleep or maintaining sleep). METHODS: PubMed, Scopus, Medline, CINAHL, and PsycInfo were searched up to September 2021. To test mediation, only longitudinal studies assessing the predictor (perceived stress) at T0, the mediator (PC) at T1, and the outcome (sleep disturbance) at T2, were eligible. RESULTS: Findings on 3,733 individuals (k = 8) showed a significant component effect of perceived stress on PC (ß = 0.340, p < .001), which in turn was related to sleep disturbance (ß = 0.258, p < .001). The direct effect of stress on sleep disturbance was significant (ß = 0.133, p < .001). Lastly, the indirect effect between stress and sleep disturbance via PC supported the mediation hypothesis (ß = 0.09, 95% CI 0.078-0.100). The mediation path remained significant (ß = 0.03, 95% CI 0.020-0.036) after adjusting for baseline sleep disturbance. Further leave-one-out sensitivity and control analyses confirmed that all direct and indirect effects were not driven by any single study included in the meta-analysis, as well as their robustness when controlling for sex and age, respectively. CONCLUSIONS: Overall, results of this meta-analysis indicate that PC may be one of the mechanisms explaining how perceived stressful experiences lead to subjective sleep disturbance.

The repetitive chronic activation of the cognitive representations of stressors, known as perseverative cognition (PC), is associated with a concomitant prolonged and sustained physiological stress response, with may include sleep disturbance. This study investigates the mediating role of PC in the association between perceived stress and subjective indices of sleep disturbance using structural equation modeling meta-analysis (meta-SEM). PubMed, Scopus, Medline, CINAHL, and PsycInfo were searched up to September 2021. Findings on eight studies (n = 3,733 individuals) showed a significant component effect of perceived stress on PC, which in turn was related to sleep disturbance. The direct effect of stress on sleep disturbance was significant. Finally, the indirect effect between stress and sleep disturbance via PC supported the mediation hypothesis. Results of this meta-analysis suggest that PC may be one of the mechanisms explaining how perceived stressful experiences lead to subjective sleep disturbance.

Perseverative Cognition and Psychotic-Like Experiences in Young Adults: A Cross-Lagged Panel Model.

Psychotic-like experiences (PLEs), including persecutory ideation, bizarre experiences, and perceptual abnormalities, are considered risk factors for psychotic disorders and mental distress in the general population. The cognitive-affective mechanisms associated with PLEs remain under-investigated. We aimed to longitudinally assess the reciprocal associations between perseverative cognition (PC), an emerging transdiagnostic factor of psychopathology, and PLEs facets in young adults. Participants (n = 160) from the general population completed measures of PC and PLEs at baseline and at 2-month follow-up. A two-wave, three-variable, cross-lagged panel model was implemented controlling for well-established correlates of PC and PLEs such as depression, anxiety, and symptoms of sleep disturbance. Both PLEs and PC exhibited substantive rank-order stability (ß ranged from 0.359 to 0.657, ps < 0.001). Cross-lagged effects revealed that baseline PC was associated with bizarre experiences at 2-month follow-up (ß = 0.317; p < 0.01). This effect overcame the well-established cut-off for practical significance. In contrast, no baseline PLEs were associated with PC at follow-up. Findings suggest the presence of a monodirectional, rather than bidirectional, association between PC and bizarre experiences in young adulthood. Results should be interpreted in light of the relatively small, non-clinical, and convenient sample.

The relationship between internalized weight stigma and physical and mental health-related quality of life in a large sample of women: a structural equation modeling analysis.

PURPOSE: Health-related quality of life (HRQOL) refers to an individual's perception of their physical and mental health status over time. Although emerging evidence has documented a negative association between weight stigma (i.e., negative weight-related attitudes and beliefs towards individuals with overweight or obesity) and mental HRQOL, its influence on physical HRQOL still needs to be fully clarified. This study aims to investigate the impact of internalized weight stigma on mental and physical HRQOL by employing a structural equation modeling (SEM) approach. METHODS: The Short Form Health Survey 36 (SF-36) and the Weight Bias Internalization Scale (WBIS) were administered to a sample of 4450 women aged 18-71 (Mage = 33.91 years, SD = 9.56) who self-identified in a condition of overweight or obesity (MBMI = 28.54 kg/m2; SD = 5.86). Confirmatory factor analysis (CFA) was conducted to assess the dimensionality of the scales before testing the proposed structural model. RESULTS: After establishing the adequacy of the measurement model, SEM results revealed that internalized weight stigma was significantly and negatively associated with both mental (ß = - 0.617; p < 0.001) and physical (ß = - 0.355, p < 0.001) HRQOL. CONCLUSION: These findings offer additional support to prior research by confirming the association between weight stigma and mental HRQOL. Moreover, this study contributes to the existing literature by strengthening and extending these associations to the physical HRQOL domain. Although this study is cross-sectional in nature, it benefits from a large sample of women and the use of SEM, which offers advantages over traditional multivariate techniques, e.g., by explicitly accounting for measurement error. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.

Longitudinal association between sleep disturbance and inflammation, and the role of positive affect.

Previous longitudinal evidence suggested that sleep disturbance (i.e., difficulties in sleep onset and sleep maintenance) may be longitudinally associated with systemic inflammation, which is involved in the pathophysiology of mental and somatic illness. The mechanisms underlying this association, however, remain largely unexplored. In the context of health psychology, a substantial body of literature showed that positive affect may have a favourable impact on immune and inflammatory response and buffer the proinflammatory effects of stress. Therefore, the aim of this study was to assess whether subjective sleep disturbance is longitudinally associated with serum high sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation, and whether this association is mediated by a decrease in positive affect. The data of 1894 participants aged 64.11 ± 8.02 years from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection were analysed. Self-reported sleep disturbance was assessed in 2008-2009, (wave 4), positive affect was assessed in 2010-2011 (wave 5), and hs-CRP was assessed in 2012-2013 (wave 6). Path analysis adjusted for health-related variables including depressive symptoms, cardiovascular disease, BMI, smoking, alcohol consume, and drug intake showed a significant direct effect of sleep disturbance to positive affect; positive affect directly predicted hs-CRP. Lastly, an indirect effect between sleep disturbance to hs-CRP through the mediating role of positive affect emerged. The findings suggest that sleep onset and sleep maintenance difficulties may be associated with inflammation through the mediation of low positive affect. The clinical significance of the findings should be further explored.

Associations between orthorexia, disordered eating, and obsessive-compulsive symptoms: A systematic review and meta-analysis.

OBJECTIVE: Orthorexia nervosa (ON) is defined as an unhealthy obsession with healthy eating, focusing on concerns regarding food quality and composition. Currently, there is still a lack of consensus about a clear definition of the construct. Specifically, it has yet to be clarified whether ON pertains to eating disorders (EDs) or obsessive-compulsive disorder (OCD) spectrum. Hence, we conducted a systematic review and meta-analysis addressing the magnitude of the association between these groups of symptoms. METHOD: PubMed, Medline, SCOPUS, PsychINFO, CINAHL, and Web of Science were searched from inception up to February 2021. Data from individual studies were pooled using a random-effects model. Pearson's r was used as the effect size metric. Subgroup analyses were conducted exploring the role of ON-related instruments, body mass index, study quality, and cultural context. RESULTS: Thirty-six studies met the eligibility criteria and were included in the meta-analysis. Random-effects model yielded a moderate association between ON and EDs symptoms with an overall effect size of r = .36 (p < .001; 95% confidence interval [CI] = 0.30-0.43). On the other hand, the results showed a small association between ON and OCD symptoms with a mean effect size of r = .21 (p < .001; 95% CI = 0.15-0.27). DISCUSSION: Meta-analytic findings showed that ON symptoms are more associated to EDs compared to OCD. Despite the similarities, the nonhigh magnitude of the pooled correlations suggests that ON might be different from pre-existing EDs and OCD. Hence, ON might be treated as a stand-alone ED and included as an emerging syndrome in the DSM classification.

OBJETIVO: La ortorexia nerviosa (ON) se define como una obsesión poco saludable con la alimentación saludable, centrándose en las preocupaciones con respecto a la calidad y composición de los alimentos. Actualmente, todavía hay una falta de consenso sobre una definición clara del constructo. Específicamente, aún no se ha aclarado si la ON se refiere al espectro de los trastornos de la conducta alimentaria (TCAs) o al trastorno obsesivo-compulsivo (TOC). Por lo tanto, se realizó una revisión sistemática y un metanálisis que abordaron la magnitud de la asociación entre estos grupos de síntomas. MÉTODO: Se realizaron búsquedas en PubMed, Medline, SCOPUS, PsychINFO, CINAHL y Web of Science desde su inicio hasta febrero de 2021. Los datos de los estudios individuales se agruparon mediante un modelo de efectos aleatorios. Se utilizó la r de Pearson como métrica del tamaño del efecto. Se realizaron análisis de subgrupos que exploraron el papel de los instrumentos relacionados con ON, el índice de masa corporal, la calidad del estudio y el contexto cultural. RESULTADOS: Treinta y seis estudios cumplieron los criterios de elegibilidad y se incluyeron en el metanálisis. El modelo de efectos aleatorios produjo una asociación moderada entre los síntomas de ON y EDs con un tamaño del efecto general de r = 0,36 (p<0,001; IC del 95% = 0,30 a 0,43). Por otro lado, los resultados mostraron una pequeña asociación entre los síntomas de ON y TOC con un tamaño medio del efecto de r = 0,21 (p<0,001; IC del 95% = 0,15 a 0,27). DISCUSIÓN: Los hallazgos metaanalíticos mostraron que los síntomas de ON están más asociados a los TCAs en comparación con el TOC. A pesar de las similitudes, la magnitud no alta de las correlaciones agrupadas sugiere que la ON podría ser diferente de los TCA y el TOC preexistentes. Por lo tanto, la ON podría tratarse como un trastorno de la conducta alimentaria independiente e incluirse como un síndrome emergente en la clasificación del DSM.

Italian adaptation of the Düsseldorf Orthorexia Scale (I-DOS): psychometric properties and prevalence of orthorexia nervosa among an Italian sample.

PURPOSE: Orthorexia Nervosa (ON) is described as an extreme level of preoccupation around healthy eating, accompanied by restrictive eating behaviors. During the years, different assessment instruments have been developed. The aim of the study is to adapt into Italian the Düsseldorf Orthorexia Scale (I-DOS) and to test its psychometric properties. METHOD: A total sample of 422 volunteer university students (mean age = 20.70 ± 3.44, women 71.8%) completed a group of self-report questionnaires in large group sessions during their lecture time. The scales assessed ON (the I-DOS and the Orhto-15), disordered eating (Disordered Eating Questionnaire, DEQ), depressive symptoms (Beck Depression Inventory-II, BDI-II), obsessive and compulsive symptoms (Obsessive Compulsive Inventory-Revised, OCI-R), and self-reported height and weight. RESULTS: The fit of the unidimensional structure and reliability of the I-DOS was tested trough Confirmatory Factor Analysis (CFA) as well as its criterion validity computing correlation coefficients among Ortho-15, DEQ, BDI-II, OCI-R, BMI. Analyses confirmed the unidimensional structure of the I-DOS with acceptable or great fit indices (CFI = 0.984; TLI = 0.978; SRMR = 0.043; RMSEA = 0.076) and the strong internal consistency (α = 0.888). The correlations path supported the criterion validity of the scale. The estimated total prevalence of both ON and ON risk was 8.1%. CONCLUSIONS: This 10-item scale appears to be a valid and reliable measure to assess orthorexic behaviors and attitudes. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.

A consensus document on definition and diagnostic criteria for orthorexia nervosa.

PURPOSE: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with "correct" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. METHODS: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. RESULTS: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. CONCLUSIONS: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. LEVEL OF EVIDENCE: Level V: opinions of expert committees.

Insomnia symptoms as long-term predictors of anxiety symptoms in middle-aged and older adults from the English Longitudinal Study of Ageing (ELSA), and the role of systemic inflammation.

Insomnia, i.e., difficulties in sleep onset and sleep maintenance, may increase the risk of anxiety symptoms, although long-term follow-up studies are rarely reported. Here, we examined whether insomnia symptoms may predict anxiety symptoms in a 9-year follow-up, and whether inflammation may play a mediating role. Data from 1355 participants (63.44 ± 7.47 years, 55.1 % females) from the English Longitudinal Study of Ageing (ELSA) were analysed. Insomnia symptoms were assessed in 2012/13. High-sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation, was measured in 2016/17. Anxiety symptoms were assessed in 2020/21. After adjusting for confounders and baseline levels, structural equation modelling (SEM) revealed that insomnia symptoms significantly predicted anxiety symptoms (ß = 0.357, p < .001) but not hs-CRP (ß = -0.016, p = .634). Similarly, hs-CRP was not related to anxiety symptoms (ß = -0.024, p = .453). The hs-CRP mediation hypothesis was therefore rejected (ß = 0.0004; 95 % BCI -0.001 to 0.005), and multi-group SEM showed that sex did not moderate these paths. However, baseline diagnoses of anxiety disorders prospectively predicted higher hs-CRP (B = 0.083, p = .030). Results of the current study suggest that individuals with baseline anxiety disorders may be at higher risk of developing low-grade chronic inflammation. Several alternative psychophysiological mechanisms linking insomnia and anxiety symptoms should be explored, including autonomic and cortical pre-sleep arousal, cortisol reactivity, and pro-inflammatory cytokines. Finally, insomnia symptoms may be a treatment target to lower the risk of anxiety symptoms in elderly.

Factor Structure, Construct Validity, and Measurement Invariance of the Neuroception of Psychological Safety Scale (NPSS).

Psychological safety has recently emerged as a central construct, strictly implicated in mental health and emotional well-being. The Neuroception of Psychological Safety Scale (NPSS) is the first scale designed to assess feelings of psychological safety from a multidimensional perspective. However, the robustness of its factorial structure requires further examination in large community samples, and evidence of construct validity along with measurement invariance across genders is scarce. The present study aimed to address these gaps through a comprehensive cross-validation approach. A community sample of 660 Italian adults, aged 18-65, completed self-report questionnaires including the NPSS, the Compassionate Engagement and Action Scale (CEAS), the Sussex-Oxford Compassion for Others (SOCS), and the Body Perception Questionnaire (BPQ). A three-factor model, i.e., Social Engagement, Compassion, and Bodily Sensations, demonstrated a good fit to the data in two random subsamples. Moreover, the measurement model was factorially invariant across genders. Model-based omega coefficients supported the internal consistency of the NPSS scores (ω ranged between 0.879 and 0.918). Zero-order correlations between NPSS subscales and CEAS, SOCS, and BPQ provided construct validity evidence. Additionally, inter-correlations between latent factors and Harman's single-factor test supported the discriminant validity of the NPSS dimensions. Overall, this study provided compelling evidence regarding the psychometric properties of the NPSS, demonstrating for the first time the invariance of its factorial structure across gender.

Body shaming and internalized weight bias as potential precursors of eating disorders in adolescents.

Introduction: Body shaming (BS) is a growing phenomenon within the school context, especially among adolescents. Recently, it has been described as an unrepeated act in which a person expresses unsolicited, mostly negative comments about an individual's body. The targeted person perceives these comments as negative, offensive or body shame-inducing. Empirical evidence also suggests that body weight is the most common reason that youths are teased and bullied. Indeed, weight stigma, described as bias or discriminatory behaviors, attitudes, feelings, and thinking about individuals, because of their weight, can lead to weight-based discrimination and victimization. Preliminary evidence suggests that BS and weight stigma have negative effects on psychological health both in the short and long term. In the delicate stage of adolescence development and pubertal maturation, BS experiences can be highly prevalent and it can lead to adverse outcomes such as eating disorders (ED). However, prevalence data in the Italian context are still lacking. Methods: The study aims to estimate weight-related BS perceived by different sources (i.e., peers and family members) and their associations with public and internalized weight bias, body mass index (BMI), body dissatisfaction, and ED symptoms. A sample of 919 high school students (Mage = 15.97, SD = 1.58; 57.1% boys) completed a battery of self-report questionnaires assessing these variables. Results: One in four students reported experiences of weight-related BS by peers or family members. A total of 37% reported having at least one BS experience in a lifetime. Higher scores of ED symptoms, body dissatisfaction, and weight bias were reported by adolescents who experienced BS, especially females. Among overweight participants, results showed that internalized weight bias partially mediated the relationship between BS by family members and ED symptoms and fully mediated the relationship between BS by peers and ED symptoms, after controlling for age, sex and BMI. Discussion: These findings, despite their cross-sectional nature, add an important contribution to the creation of quantitative empirical evidence on the phenomenon of BS. Its role in explaining eating disorders, both alone and with the mediation of internalized weight stigma has been first proved and needs to be confirmed by longitudinal results.

A Brief Online Intervention Based on Dialectical Behavior Therapy for a Reduction in Binge-Eating Symptoms and Eating Pathology.

Dysregulated eating behaviors, comprising subthreshold and clinical binge-eating disorder (BED) and bulimia nervosa (BN), are increasing among the general population, with a consequent negative impact on one's health and well-being. Despite the severity of these outcomes, people with BED and BN often face a delay in receiving a diagnosis or treatment, often due to difficulties in accessing care. Hence, evidence-based and sustainable interventions for eating symptomatology are needed. The present study aims to assess the effectiveness of a web-based 10-session multidisciplinary group intervention based on Dialectical Behavior Therapy (DBT) for BED and BN, aimed at reducing psychological distress and binge-eating-related symptomatology in a sample of patients with dysregulated eating behaviors and including one session of nutritional therapeutic education. A total of 65 participants (84.6% F; age M = 38.5 ± 13.2; experimental group, N = 43; treatment-as-usual group, TAU, N = 22) took part in the study. The results show, after the 9 weekly sessions, a significant reduction in binge-eating-related symptomatology and general psychopathology and an increased self-esteem and eating self-efficacy in social contexts in the experimental group compared to the treatment-as-usual group (T0 vs. T1). Improvements in the experimental group were significantly maintained after one month from the end of the intervention (T2) in terms of binge-eating symptoms, general psychopathology, and eating self-efficacy in social contexts. This study supports the effectiveness of a brief web-based multidisciplinary group intervention in reducing eating symptomatology and psychological distress and enhancing self-esteem and eating self-efficacy in a group of people with dysregulated eating behaviors. Brief web-based interventions could represent an accessible and sustainable resource to address binge-eating-related symptomatology in public clinical settings.

Maladaptive daydreaming and problematic online behaviors: A network analysis approach.

Previous evidence showed that Maladaptive Daydreaming (MD) is positively associated with different Problematic Online Behaviors (POBs). This study aimed to investigate the mutual relationship between MD and several POBs. Data were collected from 1209 participants, aged 18-73 (M = 30.59, SD = 12.26), through self-report questionnaires assessing MD and POBs, including problematic online gambling, problematic online gaming, problematic cybersex, Problematic Social Media Use (PSMU), problematic online shopping, and cyberchondria. Two psychometric network analyses were performed to examine the associations between all POBs at item levels, and between MD and POBs at construct levels. Results revealed six distinct communities, supporting the specificity of each POB. Furthermore, MD was found to be more strongly associated with PSMU and cyberchondria, and weakly associated with problematic online gaming, problematic cybersex, and problematic online shopping. The mutual relationships between MD and POBs might have relevant implications for the assessment and treatment of these clinical conditions.

Inflammation as a mediator between adverse childhood experiences and adult depression: A meta-analytic structural equation model.

Exposure to adverse childhood experiences (ACEs) confers a higher risk of developing depression in adulthood, yet the mediation of inflammation remains under debate. To test this model, we conducted a systematic review and two-stage structural equation modelling meta-analysis of studies reporting correlations between ACEs before age 18, inflammatory markers and depression severity in adulthood. Scopus, Pubmed, Medline, PsycInfo, and CINAHL were searched up to 2 October 2023. Twenty-two studies reporting data on C-reactive protein (CRP, n = 12,935), interleukin-6 (IL-6, n = 4108), tumour necrosis factor-α (TNF-α, n = 2256) and composite measures of inflammation (n = 1674) were included. Unadjusted models revealed that CRP (ß = 0.003, 95 % LBCI 0.0002 to 0.0068), IL-6 (ß = 0.003, 95 % LBCI 0.001 to 0.006), and composite inflammation (ß = 0.009, 95 % LBCI 0.004 to 0.018) significantly mediated the association between ACEs and adult depression. The mediation effects no longer survived after adjusting for BMI; however, a serial mediation model revealed that BMI and IL-6 sequentially mediated the association between ACEs and depression (ß = 0.002, 95 % LBCI 0.0005 to 0.0046), accounting for 14.59 % and 9.94 % of the variance of IL-6 and depressive symptoms, respectively. Due to the cross-sectional nature of assessment of inflammation and depression findings should be approached with caution; however, results suggest that complex interactions of psychoneuroimmunological and metabolic factors underlie the association between ACEs and adulthood depression.

Parental quality of life, child adjustment and adult attachment in parents of children and adolescents with Autism Spectrum Disorder.

BACKGROUND: Parents of children and adolescents with Autism Spectrum Disorder (ASD) may experience a lower quality of life (QoL) than parents of offspring with typical development. However, factors associated with parental QoL are not yet fully understood. AIMS: This study aimed to investigate the relationships between parental QoL, child adjustment and adult attachment among parents of children and adolescents with ASD. METHODS AND PROCEDURES: One hundred and eighty-eight parents of children and adolescents diagnosed with ASD completed a group of self-report questionnaires on sociodemographic variables, QoL (i.e., overall QoL and ASD symptoms-related parental QoL), child adjustment (i.e., offspring's total problems and prosocial behaviors) and adult attachment. OUTCOMES AND RESULTS: Structural equation modeling revealed that the overall parental QoL was negatively related to children's total problems and positively associated with prosocial behaviors, as well as with higher levels of secure attachment and lower levels of fearful attachment styles. Additionally, ASD symptoms-related parental QoL was negatively associated with the offspring's total problems. CONCLUSIONS AND IMPLICATIONS: This suggests that child characteristics may interact with parental characteristics to either enhance or compromise the QoL of parents of children and adolescents with ASD. Implications of these findings for promoting parental QoL are discussed.

Predictors of suicidal ideation in Italian veterinarians.

Suicide represents a significant problem for healthcare professionals such as veterinarians. Previous studies showed that contextual and individual risk factors can contribute to suicidality among veterinarians. In the present study, self-report measures on exposure to animal euthanasia, substance abuse, reflective functioning, and suicidal ideation were administered to 1556 Italian veterinarians aged 24-74 years old. Structural equation modelling revealed that failures in reflective functioning and substance abuse were associated with suicidal ideation. Prevention programs focusing on improving reflective functioning and decreasing substance abuse might reduce suicide risk among veterinarians.