The role of environmental sensitivity in the mental health of Syrian refugee children: a multi-level analysis.

Individuals with high environmental sensitivity have nervous systems that are disproportionately receptive to both the protective and imperilling aspects of the environment, suggesting their mental health is strongly context-dependent. However, there have been few consolidated attempts to examine putative markers of sensitivity, across different levels of analysis, within a single cohort of individuals with high-priority mental health needs. Here, we examine psychological (self-report), physiological (hair hormones) and genetic (polygenic scores) markers of sensitivity in a large cohort of 1591 Syrian refugee children across two waves of data. Child-caregiver dyads were recruited from informal tented settlements in Lebanon, and completed a battery of psychological instruments at baseline and follow-up (12 months apart). Univariate and multivariate Bayesian linear mixed models were used to examine a) the interrelationships between markers of sensitivity and b) the ability of sensitivity markers to predict anxiety, depression, post-traumatic stress disorder, and externalising behaviour. Self-reported sensitivity (using the Highly Sensitive Child Scale) significantly predicted a higher burden of all forms of mental illness across both waves, however, there were no significant cross-lagged pathways. Physiological and genetic markers were not stably predictive of self-reported sensitivity, and failed to similarly predict mental health outcomes. The measurement of environmental sensitivity may have significant implications for identifying and treating mental illness, especially amongst vulnerable populations, but clinical utility is currently limited to self-report assessment.

A Bayesian approach for exploring person × environment interaction within the environmental sensitivity meta-framework.

BACKGROUND: For investigating the individual-environment interplay and individual differences in response to environmental exposures as captured by models of environmental sensitivity including Diathesis-stress, Differential Susceptibility, and Vantage Sensitivity, over the last few years, a series of statistical guidelines have been proposed. However, available solutions suffer of computational problems especially relevant when sample size is not sufficiently large, a common condition in observational and clinical studies. METHOD: In the current contribution, we propose a Bayesian solution for estimating interaction parameters via Monte Carlo Markov Chains (MCMC), adapting Widaman et al. (Psychological Methods, 17, 2012, 615) Nonlinear Least Squares (NLS) approach. RESULTS: Findings from an applied exemplification and a simulation study showed that with relatively big samples both MCMC and NLS estimates converged on the same results. Conversely, MCMC clearly outperformed NLS, resolving estimation problems and providing more accurate estimates, particularly with small samples and greater residual variance. CONCLUSIONS: As the body of research exploring the interplay between individual and environmental variables grows, enabling predictions regarding the form of interaction and the extent of effects, the Bayesian approach could emerge as a feasible and readily applicable solution to numerous computational challenges inherent in existing frequentist methods. This approach holds promise for enhancing the trustworthiness of research outcomes, thereby impacting clinical and applied understanding.

Moderate cardiac vagal tone predicts more cooperation in highly sensitive individuals.

Cooperation, as a mutual collaboration, is a defining feature of human social life. Individual characteristics can influence cooperation. Recent studies have shown a quadratic relationship between cardiac vagal tone (CVT), an index of self-regulation, and prosocial behaviors. Individual differences in cooperation might also vary as a function of people's environmental sensitivity (ES), i.e., may be influenced by individual differences in the perception and processing of inner and external stimuli. We tested the direct and interactive effect of CVT and ES on cooperative behaviors in two independent samples. We measured heart rate and engagement in cooperative acts in 80 young adults (M = 23.61; SD = 1.60) who were also asked to self-report on ES. We found an inverted-U relationship between CVT and cooperative behaviors. ES, on the other hand, did not predict differences in cooperative behaviors but moderated the relationships between CVT and cooperation, although the magnitude of this result was small. Specifically, only among individuals with higher ES cooperative behaviors change as a function of CVT. Highly sensitive individuals with lower or higher CVT, were less cooperative than low sensitive ones. Subsequently, we replicated the same study design in a second sample of 88 undergraduate students (M = 23.69; SD = 4.91). Once again, we found evidence supporting the presence of an inverted-U relationship between CVT and cooperative behaviors, and we also found that ES moderated the relationships between the quadratic CVT term and cooperation.

Maternal dispositional mindfulness and mother-child relationship: The mediating role of emotional control during parenting.

BACKGROUND: The literature supports the role of parental dispositional mindfulness on parent-child relationship quality. However, little is known about the connection between these two aspects. OBJECTIVE: The aim of this study was to investigate whether emotion regulation during parenting, that is, the ability to control negative emotions, mediated the association between parental dispositional mindfulness and parent-child relationship quality. The study also explored the moderation role of child age on the association between parental dispositional mindfulness and parent's ability to control negative emotions during parenting. METHODS: Participants were 635 mothers of children aged between 12 months and 5 years. Mothers completed self-report questionnaires to measure maternal dispositional mindfulness, mother-child relationship quality and maternal control of negative emotions during parenting. RESULTS: Results showed that maternal ability to control negative emotions during parenting partially mediated the association between maternal dispositional mindfulness and mother-child relationship quality. Moreover, the moderation role of child age indicated that the association between maternal dispositional mindfulness and maternal ability to control negative emotions during parenting was stronger for older children's mothers. CONCLUSION: Dispositional mindfulness has a protective role for the quality of parenting and the mother-child relationship. Theoretical and practical implications are discussed.

Family Functioning, Identity Commitments, and School Value among Ethnic Minority and Ethnic Majority Adolescents.

Ethnic minority youth show worse school adjustment than their ethnic majority peers. Yet, it remains unclear whether this gap can be explained by differences in family functioning and consequent identity commitments. This study examined (1) whether family functioning relates to identity commitments over time and (2) whether identity commitments impact later school value (3) among minority and majority adolescents. Minority (N = 205, Mage = 16.25 years, 31.1% girls) and majority adolescents (N = 480, Mage = 15.73 years, 47.9% girls) participated in this preregistered three-wave longitudinal study (T1: March-April 2012; T2: October 2012; T3: March-April 2013). Dynamic Panel Models revealed that most within-person cross-lagged associations were not significant in the total sample. Yet, multigroup analyses revealed differences between groups: Stronger identity commitments related to lower school value among minority adolescents, but were unrelated to school value among majority adolescents over time. Additionally, higher school value increased identity commitments among minority youth, yet it decreased identity commitments among majority youth over time. The findings highlight the differential interplay between identity commitments and school adjustment for minority and majority adolescents, with important implications for their future life chances.

Longitudinal Profiles of Cultural Identity Processes and Associations with Psychosocial Outcomes Among Adolescents Participating in the Identity Project in Italy.

Cultural identity formation is a complex developmental task that influences adolescents' adjustment. However, less is known about individual variations in trajectories of cultural identity processes and how they relate to youth psychosocial outcomes. Using a person-centered approach, this study investigated patterns of change over a year in cultural identity exploration and resolution, respectively, among ethnically diverse adolescents in Italy. The sample included 173 high school students (Mage = 15 yrs, SD = 0.62, range = 14-17; 58.4% female; 26% immigrant background) who had participated in the Identity Project, a school-based intervention targeting ethnic-racial identity development. Longitudinal latent profile analysis revealed only one profile of change for exploration, whereas four unique profiles for resolution emerged ("stable low," "stable average," "increase low-to-average," "increase high-to-higher"). Overall, youth in the resolution-increase profiles reported the best outcomes. The findings highlight the heterogeneity of adolescents' resolution trajectories and the benefits of an increased sense of clarity concerning one's cultural identity for positive psychosocial functioning.

Efficacy of a cultural adaptation of the Identity Project intervention among adolescents attending multiethnic classrooms in Italy: A randomized controlled trial.

This registered report evaluated the efficacy of an Italian adaptation of the Identity Project, a school-based intervention promoting adolescents' cultural identity. Migration background and environmental sensitivity were explored as moderators. After adapting and piloting the intervention, a randomized controlled trial was conducted between October 2021 and January 2022 on 747 ethnically diverse adolescents (Mage = 15 years, 53% girls, 31% with migration background) attending 45 classrooms randomly assigned to the intervention or control condition. Bayesian analyses confirmed the efficacy of the Italian IP in enhancing exploration processes (Cohen's d = .18), whereas no cascading effect on resolution emerged. Youth with higher (vs. lower) levels of environmental sensitivity benefited more in terms of exploration. Implications for developmental theory and practice are discussed.

The interplay between parenting and environmental sensitivity in the prediction of children's externalizing and internalizing behaviors during COVID-19.

The interplay of parenting and environmental sensitivity on children's behavioral adjustment during, and immediately after, the COVID-19 lockdown restrictions was investigated in two longitudinal studies involving Italian preschoolers (Study 1, N = 72; 43% girls, Myears = 3.82(1.38)) and primary school children (Study 2, N = 94; 55% girls, Myears = 9.08(0.56)). Data were collected before and during the first-wave lockdown (Studies 1 and 2) and one month later (Study 1). Parental stress and parent-child closeness were measured. Markers of environmental sensitivity in children were temperamental fearfulness and Sensory Processing Sensitivity. Results showed little change in externalizing and internalizing behaviors over time, but differences emerged when considering parenting and children's environmental sensitivity. In preschoolers, greater parenting stress was related to a stronger increase in internalizing and externalizing behaviors, with children high in fearful temperament showing a more marked decrease in externalizing behaviors when parenting stress was low. In school-aged children, parent-child closeness emerged as a protective factor for internalizing and externalizing behaviors during COVID-19, with children high in Sensory Processing Sensitivity showing a marked decrease in internalizing behaviors when closeness was high. Implications for developmental theory and practice in times of pandemic are discussed.

Parental relationships, emotion regulation and orthorexia: A study on adolescent athletes.

Background: This study seeks to further our understanding of the factors associated with adolescent athletes and disordered eating, by expanding current research into a less-explored eating disorder known as orthorexia. Aim: The aim of the study is to explore the impact of parents' relationships and emotional regulation on the orthorexia nervosa (ON) tendencies of adolescent athletes. Methods: The participants were 303 adolescents, ranging from 15 to 17 years old, of which 139 participated in competitive sport, and 164 did not. Three self-report questionnaires were administered to assess orthorexia (ORTO-15), relationship with parents (Inventory of Parent and Peer Attachment) and emotion regulation (Emotion Regulation Questionnaire). Results: The results highlight that those who practice sports report higher levels of orthorexia, inadequate relationships with parents, as well as greater emotional regulation difficulties. Furthermore, inadequate parents' relationship predicts orthorexia while expressive emotional regulation mediates this relationship. Conclusion: These findings highlight how ON tendencies in athletes are linked to poor management of emotions combined with inadequate relationships with parents in terms of communication and affection. Implications for practice and support for athletes are discussed.

Investigating sensitivity through the lens of parents: validation of the parent-report version of the Highly Sensitive Child scale.

Children differ in their environmental sensitivity (ES), which can be measured observationally or by self-report questionnaire. A parent-report scale represents an important tool for investigating ES in younger children but has to be psychometrically robust and valid. In the current multistudy, we validated the parent-report version of the Highly Sensitive Child (HSC-PR) scale in Italian children, evaluating its factorial structure (Study 1, N = 1,857, 6.2 years, age range: 2.6-14 years) through a multigroup Confirmatory Factory Analysis in preschoolers (n = 1,066, 4.2 years) and school-age children (n = 791, 8.8 years). We then investigated the HSC-PR relationship with established temperament traits (Study 2, N = 327, 4.3 years), before exploring whether the scale moderates the effects of parenting stress on children's emotion regulation (Study 3, N = 112, 6.5 years). We found support for a bi-factor structure in both groups, though in preschoolers minor adaptations were suggested for one item. Importantly, the HSC-PR did not fully overlap with common temperament traits and moderated the effects of parenting stress on children emotion regulation. To conclude, the HSC-PR performs well and appears to capture ES in children.

The role of environmental sensitivity in the development of rumination and depressive symptoms in childhood: a longitudinal study.

Some children are more affected than others by their upbringing due to their increased sensitivity to the environment. More sensitive children are at heightened risk for the development of internalizing problems, particularly when experiencing unsupportive parenting. However, little is known about how the interplay between children's sensitivity and parenting leads to higher levels of depressive symptoms. In the current study, we investigated the interaction between early parenting and children's sensitivity on levels of depressive symptomatology in middle childhood, exploring the role of rumination as a possible mediator in a community sample. Participants included 196 USA resident families, from a middle class and mostly European-American background, and their healthy children, followed up from age 3 until 9 and 12 years. Environmental sensitivity was assessed observationally when children were 3 years old. Parenting style was based on parent-report at the age of 3 years. When children were nine, they completed questionnaires on rumination and depressive symptoms (repeated at 12 years). Analyses were run applying a Bayesian approach. Children's sensitivity interacted with permissive parenting in predicting rumination at age 9. Rumination, in turn, was associated with depressive symptoms at age 9 and, to a lesser extent, at age 12. No relevant interactions emerged for authoritative and authoritarian parenting. Sensitive children may be at heightened risk for internalizing problems when exposed to a permissive parenting style. Permissive parenting was associated with increased ruminative coping strategies in sensitive children which, in turn, predicted higher levels of depression. Hence, rumination emerged as an important cognitive risk factor for the development of depressive symptoms in sensitive children.

Protective and risk activities for emotional and behavioural well-being of children and adolescents during the COVID-19 lockdown.

BACKGROUND: The lockdown imposed to contain the COVID-19 pandemic brought deep changes in the daily life of Italian children and adolescents, increasing the time spent at home. This study aims to explore how activities that children and adolescents carried out at home during the lockdown were related to their emotional and behavioural well-being. METHOD: Parents completed an anonymous online survey on how much time their children and adolescents dedicated to social networks, solitary screen time, play time and to a series of parent-child dyadic activities. They also reported on their offspring's emotional difficulties and behavioural problems. RESULTS: The use of social networks had a negative impact on children's emotional difficulties, while it promoted well-being in adolescents. Pertaining to solitary screen activities, these were associated with more behavioural problems in both children and adolescents. Regarding parent-child dyadic activities, get along with the parent was associated with less emotional difficulties and behavioural problems in children and with less behavioural problems in adolescents. Furthermore, for adolescents, the more they talked with the parent, the less behavioural problems they evidenced. CONCLUSION: The current study may help to identify activities that could be promoted and those that should be limited to effectively menage home time, in order to ultimately safeguard the emotional and behavioural well-being of children and adolescents.

Verbal - prosodic association when narrating early caregiving experiences during the adult attachment interview: differences between secure and dismissing individuals.

Previous studies reported an inconsistency between verbal extracts and emotional physiological activation in dismissing individuals when narrating their early caregiving experience at the Adult Attachment Interview (AAI). This study aimed to explore this discrepancy by analyzing the degree of concordance between verbal content and prosodic characteristics, index of physiological activation, when dismissing and secure individuals discuss negative childhood memories during the AAI. Results showed that secure participants presented a high coherence between verbal content and emotional activation, as expressed by prosody, revealing a reprocess of negative experiences that is the core feature of the development of secure working models. In contrast, dismissing participants' prosodic characteristics were discrepant with the verbal content. These individuals downplayed the nature and impact of negative experiences and emotions, but used a prosody that revealed a high emotional arousal. The difference between the two groups was more evident for participants who had experienced more rejecting parents.

Parenting Stress During the COVID-19 Outbreak: Socioeconomic and Environmental Risk Factors and Implications for Children Emotion Regulation.

The COVID-19 outbreak imposed to Italian families many changes in their daily life increasing the risk of developing psychological problems. The present study explored risk factors associated with parenting stress and implications for children's emotion regulation in families with different socioeconomic risks. Parents of 2-14 years old children completed a survey reporting difficulties experienced due to the lockdown, level of household chaos, parenting stress, parent involvement in the child's daily life, and children emotion regulation competences. The general mean levels of parenting stress and children emotion regulation abilities were not at clinical level compared with Italian norms. Household chaos predicted higher levels of parenting stress, which, in turn, was associated with less effective emotion regulation in children through the mediating role of parental involvement. More stressed parents were less involved in their children's activities, decreasing children's effective emotion regulation. Only for SES no-risk families, the lockdown constraints increased parenting stress. For SES at-risk families, the impact of parenting stress and involvement on children regulation strategies was stronger, with a protective role played by parental involvement on children's negativity not evident for SES no-risk families. Dealing with the lockdown is a stressful experience for parents who have to balance personal life, work, and children upbringing, without other help. This situation potentially impairs their ability to be supportive caregivers and is consequently detrimental for children well-being. Policies should take into consideration the implications of the lockdown for families' mental health and tailor supportive interventions according to family's risk factors.

El brote de la COVID-19 impuso a las familias italianas muchos cambios en su vida cotidiana, los cuales aumentaron el riesgo de desarrollar problemas psicológicos. El presente estudio analizó los factores de riesgo asociados con el estrés de la crianza y las consecuencias para la regulación emocional de los hijos en familias con diferentes riesgos socioeconómicos. Un grupo de padres de niños de entre dos y 14 años contestó una encuesta donde informó las dificultades vividas debido al confinamiento, el nivel de caos en el hogar, el estrés en la crianza, la participación de los padres en la vida diaria de los hijos y las competencias de los hijos para regular sus emociones. Los niveles promedio generales de estrés en la crianza y las habilidades de regulación emocional en los niños no estuvieron a nivel clínico en comparación con las normas italianas. El caos en el hogar predijo niveles más altos de estrés en la crianza, el cual, a su vez, estuvo asociado con una menor regulación emocional eficaz en los niños mediante el rol mediador de la participación de los padres. Los padres más estresados participaron menos en las actividades de sus hijos, lo cual disminuyó la regulación emocional eficaz en los niños. Solo en los casos de las familias sin riesgo socioeconómico las limitaciones del confinamiento aumentaron el estrés en la crianza. Para las familias de riesgo socioeconómico, el efecto del estrés en la crianza y la participación en las estrategias de regulación emocional de los niños fue más profundo, y en el caso de las familias sin riesgo socioeconómico, no se evidenció el papel protector desempeñado por la participación de los padres en la negatividad de los niños. Lidiar con el confinamiento es una experiencia estresante para los padres que tienen que compatibilizar la vida personal, el trabajo y la educación de los niños sin ninguna otra ayuda. Esta situación puede deteriorar su capacidad de ser cuidadores comprensivos y, como consecuencia, ser perjudicial para el bienestar de los niños. Las políticas deberían tener en cuenta las consecuencias del confinamiento en la salud mental de las familias y adaptar intervenciones de apoyo de acuerdo con los factores de riesgo de las familias.

Cognitive inflexibility and over-attention to detail: The Italian validation of the DFlex Questionnaire in patients with eating disorders.

OBJECTIVE: Cognitive inflexibility and over-attention to detail are two cognitive styles common to eating disorders (ED) and other psychopathologies characterized by rigid perfectionism. Despite many options to assess the above styles, the only self-report tool that simultaneously permits their specific assessment is the Detail and Flexibility Questionnaire (DFlex), originally developed to investigate the ED domain. The aim of this study was to validate the Italian version of the DFlex. METHOD: 170 patients (149 females) with ED and 148 controls (100 females) completed the Italian version of the DFlex. RESULTS: A Confirmatory Factor Analysis showed that the two-factor model originally proposed in the literature was a good fit to the data. Item factor loadings were largely equivalent across clinical and control groups, with intercept distributions showing higher values for the clinical group compared to controls. Both DFlex subscales showed good internal reliability and were able to predict membership to the group condition. CONCLUSIONS: The DFlex is a reliable tool for investigation in the ED population. However, because DFlex items do not explicitly assess food and body shape domains, it is possible to extend its use to other psychopathologies characterized by rigid perfectionism. We propose the use of the DFlex in research and clinical practice as a useful tool for better understanding patients' cognitive functioning and in order to support treatment planning.

Vantage sensitivity: a framework for individual differences in response to psychological intervention.

PURPOSE: People differ significantly in their response to psychological intervention, with some benefitting more from treatment than others. According to the recently proposed theoretical framework of vantage sensitivity, some of this variability may be due to individual differences in environmental sensitivity, the inherent ability to register, and process external stimuli. In this paper, we apply the vantage sensitivity framework to the field of psychiatry and clinical psychology, proposing that some people are more responsive to the positive effects of psychological intervention due to heightened sensitivity. METHODS: After presenting theoretical frameworks related to environmental sensitivity, we review a selection of recent studies reporting individual differences in the positive response to psychological intervention. RESULTS: A growing number of studies report that some people benefit more from psychological intervention than others as a function of genetic, physiological, and psychological characteristics. These studies support the vantage sensitivity proposition that treatment response is influenced by factors associated with heightened sensitivity to environmental influences. More recently, studies have also shown that sensitivity can be measured with a short questionnaire which appears to predict the response to psychological intervention. CONCLUSIONS: Vantage sensitivity is a framework with significant relevance for our understanding of widely observed heterogeneity in treatment response. It suggests that variability in response to treatment is partly influenced by people's differing capacity for environmental sensitivity, which can be measured with a short questionnaire. Application of the vantage sensitivity framework to psychiatry and clinical psychology may improve our knowledge regarding when, how, and for whom interventions work.

A matter of attachment? How adoptive parents foster post-institutionalized children's social and emotional adjustment.

The current study investigates the contribution of children's age at adoption (M = 46.52 months, SD = 11.52 months) and parents' attachment on post-institutionalized children's attachment and social-emotional adjustment. A total of 132 subjects, 48 post-institutionalized children aged 3-5 years, and their adoptive parents, took part in the study. One year from adoption, children's attachment distribution was as follows: 31% secure, 42% disorganized, and 27% insecure. Parents' secure attachment increased children's probability of presenting a secure attachment pattern; specifically, mothers' attachment patterns were most strongly associated with those of their adopted children, with fathers' making an additional contribution. Two years from adoption, secure children showed more adequate social competences than their insecure and disorganized peers and presented better emotional comprehension. The effect of age at adoption was delimited to a marginal association with behavioral problems. This pattern of associations suggests that attachment - both of adoptive parents and of children - substantially fosters social-emotional adjustment of post-institutionalized children who have experienced a period in emotionally neglecting environments beyond their first year of life, regardless of their age at adoption. Implications for policies and practices are discussed.

What promotes secure attachment in early adoption? The protective roles of infants' temperament and adoptive parents' attachment.

Life before adoption is characterized by the lack of sensitive and stable caregiving, putting infants at risk for non-secure attachment patterns. What leads to adoptees' attachment security in their adoptive families has not been conclusively determined. We investigated the roles of children's temperament and adoptive parents' attachment on adoptees' attachment security. The variables were studied in a sample of 30 early-placed adoptees (age at adoption placement M = 5.37 months, SD = 4.43) and their adoptive mothers and fathers. Attachment patterns were investigated by means of the Strange Situation Procedure and the Adult Attachment Interview, and temperament via the Infant Behavior Questionnaire. Results showed that mothers' secure attachment, but not fathers' attachment or adoptees' temperament, increased the chance of secure attachment in adoptees. Temperament moderated the mother-child attachment match.

The role of environmental sensitivity in the experience and processing of emotions: implications for well-being.

Several theories suggest that people differ significantly in their environmental sensitivity, defined as the capacity to perceive and process information about the environment. More sensitive people, who make up between 25% and 30% of the population, are not only more negatively affected by adverse experiences but also benefit disproportionately from positive ones, in line with differential susceptibility theory. Heightened emotional reactivity has been identified as one of the key markers of sensitivity. However, the current understanding of the relationship between sensitivity and the experience and processing of emotions remains limited. In the current paper we propose a new conceptual framework for the multiple ways in which environmental sensitivity may impact on different aspects of the experience and processing of emotions. This includes heightened perception of emotions, increased emotional reactivity, as well as the important role of emotion regulation for the well-being of highly sensitive people. In addition, we also consider rearing experiences in shaping sensitivity and emotion regulation. The reviewed empirical studies largely support the conceptual model but more research is needed to explore the dynamics between sensitivity and emotions further. Finally, we discuss several implications for well-being before making a case for the inclusion of individual differences in environmental sensitivity in affective science. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

The Role of Psychological Parental Control and Internalizing Problems in the Etiology of Vigorexia and Orthorexia in Adolescence.

The present study aims to explore the forms of psychological parental control that are interconnected with dysfunctional emotional states (i.e., anxiety and depression), and how these internalizing problems may manifest as distorted behaviors (i.e., vigorexic and orthorexic behaviors) during adolescence. Participants included 403 Italian adolescent athletes (231 boys and 172 girls) aged 14 to 18 years. The participants completed self-report questionnaires designed to assess psychological parental control oriented towards dependence and achievement, anxiety and depression, and vigorexia and orthorexia. The results highlight how both forms of psychological parental control predict anxiety and depression. Furthermore, anxiety was found to be linked to both vigorexic and orthorexic behaviors, while depression is connected only to vigorexia. This study delves into the intricacies of parental influence on adolescents, revealing that both dependency-oriented and success-oriented psychological parental control have notable implications for the mental well-being of adolescents. The findings underscore the interconnectedness of these factors, demonstrating that anxiety can set off a chain reaction, leading to engagement in vigorexic and orthorexic behaviors. On the other hand, depression appears to be uniquely associated with vigorexia. These insights contribute to our understanding of the complex dynamics between parental control and adolescent mental health. The implications of this research extend to both theoretical frameworks and practical interventions, emphasizing the need for a nuanced approach to supporting adolescents in navigating these challenges.