QSM-detected iron accumulation in the cerebellar gray matter is selectively associated with executive dysfunction in non-demented ALS patients.

Background: This study aimed to assess whether quantitative susceptibility imaging (QSM)-based measures of iron accumulation in the cerebellum predict cognitive and behavioral features in non-demented amyotrophic lateral sclerosis (ALS) patients. Methods: A total of ALS patients underwent 3-T MRI and a clinical assessment using the ALS Functional Rating Scale-Revised (ALSFRS-R) and the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). Regression models were applied to each subscale of the cognitive section of the ECAS and the ECAS-Carer Interview to examine the effect of QSM-based measures in white and gray matter (WM; GM) of the cerebellum, separately for right, left, and bilateral cerebellar regions of interest (ROIs). These effects were compared to those of cerebellar volumetrics in WM/GM, right and left hemispheres while controlling for demographics, disease status, and total intracranial volume. Results: Higher QSM measures of the cerebellar GM on the left, right, and bilateral sides significantly predicted (ps ≤ 0.003) a greater number of errors on the executive functioning (EF) subscale of the ECAS (ECAS-EF). Moreover, higher GM-related, QSM measures of the cerebellum were associated with an increased probability of a below-cut-off performance on the ECAS-EF (ps ≤ 0.024). No significant effects were observed for QSM measures of the cerebellar WM or for volumetric measures on the ECAS-EF. Other ECAS measures showed no significant effects. Bilateral QSM measures of the cerebellar GM also selectively predicted performance on backward digit span and social cognition tasks. Discussion: Iron accumulation within the cerebellar GM, particularly in the cerebellar cortices, may be associated with executive functioning deficits in non-demented ALS patients. Therefore, QSM-based measures could be useful for identifying the neural correlates of extra-motor cognitive deficits in ALS patients.

Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis.

BACKGROUND: While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU. AIM: The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship. METHODS: A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept. OUTCOMES: Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU. RESULTS: Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (ß = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; ß = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged. CLINICAL IMPLICATIONS: Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences. STRENGTHS AND LIMITATIONS: The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors. CONCLUSION: These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.

The Mediating Role of Affect Dysregulation and Dissociation in the Relationship Between Attachment and Compulsive Online Shopping: A Path Analysis Model.

Objective: Online shopping has been described by the scientific literature both for its benefits and the potential risks when excessive usage is involved. Indeed, compulsive online shopping is commonly conceptualized as a potential behavioural addiction that substantially impacts the lives of individuals afflicted by it. In light of this, the present research aimed at exploring the association between possible risk and protective factors for compulsive online shopping, by specifically exploring the role of adult attachment, affect dysregulation, and dissociation. Method: 285 participants (75% females, 25% males; Mage = 31.57, SD = 11.379) were involved in the research and completed an online survey. The collected data was analysed implementing a path analysis model. Results: Results showed significant total effects in the relationship between secure/fearful attachment patterns and compulsive online shopping. Such associations were significantly mediated by the sequential effect of affect dysregulation and dissociation. Conclusions: The present study provides useful information to guide tailored interventions concerning both preventive activity and clinical practice.

Testing the role of extended thinking in predicting craving and problematic social network sites use.

Background and aims Problematic Social Network Sites Use (PSNSU) mirrors substance use disorders with regard to symptoms (e.g., diminished control). Recent theoretical advances in the addiction research field recognize a central role of affective and cognitive processes in the development of addictive behaviors. For example, the metacognitive model of addictive behaviors sustains that cognitive processes like extended thinking, disruption in metacognitive monitoring, and thought suppression are associated with addictive behaviors leading to increased craving. The current study aims to test the mediating role of extended thinking (i.e., worry, rumination, and desire thinking) in the relationship between psychological distress and PSNSU. Methods A community sample of 548 individuals (F = 68.5%, Mage= 29.29 ± 12.04 years) completed an online survey. Structural Equation Modeling (SEM) was utilized to analyze the relationships among the variables under study. Results The assessed structural model adequately fits the data, accounting for 89% of PSNSU variance. Psychological distress predicted PSNSU through the mediation of desire thinking and rumination and the serial mediation of (i) worry and craving (ii) desire thinking and craving The model is gender invariant. Conclusions The current findings provide preliminary evidence for the role of extended thinking in PSNSU. Worry, rumination and desire thinking may be central cognitive processes in eliciting craving and PSNSU for individuals who experience psychological distress.

The Link Between Problematic Instagram Use and Body-Image Investment Dimensions: The Mediating Role of Social Comparison on Instagram and the Need to Conceal Body Flaws.

Objective: The negative effects of Problematic Instagram Use (PIU) on self-evaluations of one's appearance (i.e., body-image satisfaction-dissatisfaction) are well-known, whereas less explored is its role on body-image investment dimensions. By adopting the Social Comparison and the Self-discrepancies theories as the framework, the present study hypothesized that PIU negatively affects body investment and appearance management behaviours through the serial mediating role of actual appearance comparison on Instagram (IG) and the need to conceal body flaws. Gender, age and trait appearance comparison were controlled for. Method: A convenience sample of 323 participants (F = 70.3%; M= 28.92 + 10.96) was recruited, and well-known self-report measures were administered online. Results: The structural model produced good fit indices [χ2/df = 2.36, RMSEA = 0.065 (0.053 - 0.077), CFI = 0.962, SRMR = 0.038], and the variables accounted for 79% and 32% of the variance in body investment and appearance management behaviours, respectively. PIU was associated with body investment both directly and indirectly, whereas it affected appearance management behaviours only via appearance comparison on Ig. The tested alternative model has a poorer fit than the hypothesized model, and the former fitted significantly worse than the proposed one. Conclusions: The present study represents a step toward a better understanding of the psychological mechanisms underlying the link between PIU and body image investment dimensions.

Diabetic ketoacidosis with central nervous system involvement: Conventional and advanced magnetic resonance neuroimaging findings.

Diabetic ketoacidosis (DKA) is a serious complication in children with diabetes mellitus type 1 (DM1). In rare and severe cases DKA may be complicated by cerebral edema, central brain herniation and cerebral infarctions. We present the magnetic resonance imaging findings in a child with DKA and central nervous system involvement; diffusion tensor imaging (DTI) and functional MRI (fMRI) were performed to assess the white matter integrity of sensory pathways and cortical sensory processing. Conventional imaging showed bilateral uncal herniation, effacement of the perimesencephalic cisterns, wide ischemic lesions in the posterior cerebral artery (PCA) territories, sagging brainstem and Duret's hemorrhage consistent with signs of central brain herniation and intracranial hypertension. Advanced MRI showed a possible left-sided cortical reorganization for sensory function, with underlying left cortico-talamic and cortico-spinal pathways less severely impaired. Knowledge of the full framework in these conditions is of vital importance for timely patient management; advanced neuroimaging techniques may be considered as prognostic indicators in those cases with extensive involvement of eloquent brain areas.

Perfectionistic Self-Presentation and Psychopathology: A Systematic Review and Meta-Analysis.

Decades of research implicate perfectionism as a risk factor for psychopathology. Most research has focused on trait perfectionism (i.e., needing to be perfect), but there is a growing focus on perfectionistic self-presentation (PSP) (i.e., the need to seem perfect). The current article reports the results of a meta-analysis of previous research on the facets of PSP and psychopathology outcomes (either clinical diagnoses of psychiatric disorders or symptoms of these disorders). A systematic literature search retrieved 30 relevant studies (37 samples; N = 15,072), resulting in 192 individual effect-size indexes that were analysed with random-effect meta-analysis. Findings support the notion of PSP as a transdiagnostic factor by showing that PSP facets are associated with various forms of psychopathology, especially social anxiety, depression, vulnerable narcissism and-to lesser extent-grandiose narcissism and anorexia nervosa. The results indicated that there both commonalities across the three PSP and some unique findings highlighting the need to distinguish among appearing perfect, avoiding seeming imperfect and avoiding disclosures of imperfections. Additional analyses yielded little evidence in the results across studies including undergraduates, community samples and clinical samples. Our discussion includes a focus on factors and processes that contribute to the association between PSP and psychopathology.

Problematic Social Media Use in Young Adults: A Mixed Serial-Parallel Mediation Model Involving Alexithymia, Defense Mechanisms, and Fear of Missing Out.

Problematic social media use (PSMU) can have profound and detrimental effects across various domains of life. As a result, scientific investigations into the risk factors associated with this phenomenon can hold substantial practical implications within the clinical and preventive realms. Consistently with this framework, this study aimed to examine the relationship between certain variables and PSMU, with a specific focus on alexithymia, defense mechanisms, and fear of missing out (FoMO). A sample of 340 young adults (Mage = 26.42 years; SD = 3.689) completed an online survey, including the Bergen Social Media Addiction Scale, FoMO scale, 40-Item Defense Style Questionnaire, and 20-Item Toronto Alexithymia Scale. Results showed a statistically significant mixed serial-parallel mediation model. A significant total effect in the association between alexithymia and FoMO emerged. Furthermore, defense mechanisms and FoMO significantly and totally mediated this relationship. These findings have the potential to provide valuable insights in the field of clinical research on PSMU, and can offer practical information for enhancing clinical practice.

The Application of the Metacognitive Model of Desire Thinking and Craving in Problematic Social Networking Sites Use.

Cognitive models of addictive behaviours have highlighted the central role of Desire Thinking (DT) - a conscious and voluntary cognitive process orienting to prefigure images and information about a positive target-related experience - in increasing craving and maintaining addictive behaviors. The metacognitive model of DT and craving posits that metacognition plays a central role in understanding dysregulation in DT. The current study aims to test the role of metacognitions about DT, DT, and craving in the relationship between Fear of Missing Out (FoMo), boredom proneness, negative emotional reactivity and Problematic Social Network Sites Use (PSNSU). A sample of 529 participants (Mage= 32.45 ± 13.33; F = 62.9%) completed an online survey. The hypothesised model produced an adequate fit to the data and accounted for 86% of PSNSU variance. FoMO predicted positive metacognitions about DT (PMDT), which predicted DT that, in association with craving, predicted PSNSU. Boredom proneness positively predicted PSNSU directly and indirectly through the serial mediation of PMDT, DT, and craving. A direct path between negative emotional reactivity and PSNSU was found. The current findings provide preliminary evidence for applying the metacognitive model of DT and craving in PSNSU. PMDT and DT may be central cognitive processes in craving and PSNSU for individuals who experience boredom proneness and FoMo.

Interpersonally-Based Fears and Feelings During the Covid-19 Pandemic Revisited: Research Findings and Further Reflections on Fear of Missing out and Feelings of not Mattering.

Much has transpired since severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) began spreading throughout the world in 2020. In our previous commentary, we focused on the significance of two specific fears with an interpersonal basis (i.e. the fear of missing out, FoMO, and the fear of not mattering) during a period in which daily routines were disrupted and physical distancing or "social distancing" was implemented as a crucial important public health intervention in response to the coronavirus. In the current article, we examine the current context and review what has been learned about the similarities and differences among people during the pandemic with a particular emphasis on research during the pandemic on the fear of missing and feelings and fears of not mattering to other people. The nature of these constructs as revealed during the pandemic is discussed with a focus on how these attributes reflect insecurity and doubts about the self that heighten susceptibility to external feedback. Key themes include the need to consider FoMO from a broad perspective that includes actual lost opportunities during the pandemic and how individual differences in mattering have been reflected in coping and adaptability and related outcomes. It is clear from our analysis that FoMO and mattering are highly salient and relevant constructs with clear ecological validity in terms of accounting for individual differences in the costs and consequences of the pandemic.

Mattering, substance use, and addictive behaviors: review, analysis, and implications for treatment and prevention.

In the current article, we examine mattering to others as a relational resource and discuss how feelings of not mattering are uniquely implicated in addiction and substance use. We describe the mattering construct and how it is conceptualized, and we comprehensively review existing evidence based primarily on research with adolescents that links feelings of not mattering with addictive tendencies in general, and specific tendencies (e.g., excessive drinking and drug use and excessive social media use). A central premise of this article is the need to take race and ethnicity into account when considering the potential link between feelings of not mattering and substance use among young people with minority status and various ethnicities who may be especially prone to feeling marginalized and insignificant as a result of adverse experiences reflecting being ostracized and not socially accepted. Potential models of drinking and addictive tendencies that can easily incorporate the mattering construct are also outlined to underscore the conceptual relevance of feelings of not mattering to others. Mattering is also considered in terms of how internalization (i.e., not mattering to oneself) potentiates impulsive and risky behavior. Our article concludes with discussion of the implications for treatment and prevention in addiction and substance use and directions for future research that should further illuminate the role of feelings of not mattering to others and not mattering to oneself.

Amyotrophic lateral sclerosis with upper motor neuron predominance: diagnostic accuracy of qualitative and quantitative susceptibility metrics in the precentral gyrus.

OBJECTIVE: The study aims at comparing the diagnostic accuracy of qualitative and quantitative assessment of the susceptibility in the precentral gyrus in detecting amyotrophic lateral sclerosis (ALS) with predominance of upper motor neuron (UMN) impairment. METHODS: We retrospectively collected clinical and 3T MRI data of 47 ALS patients, of whom 12 with UMN predominance (UMN-ALS). We further enrolled 23 healthy controls (HC) and 15 ALS Mimics (ALS-Mim). The Motor Cortex Susceptibility (MCS) score was qualitatively assessed on the susceptibility-weighted images (SWI) and automatic metrics were extracted from the quantitative susceptibility mapping (QSM) in the precentral gyrus. MCS scores and QSM-based metrics were tested for correlation, and ROC analyses. RESULTS: The correlation of MCS score and susceptibility skewness was significant (Rho = 0.55, p < 0.001). The susceptibility SD showed an AUC of 0.809 with a specificity and positive predictive value of 100% in differentiating ALS and ALS Mim versus HC, significantly higher than MCS (Z = -3.384, p-value = 0.00071). The susceptibility skewness value of -0.017 showed specificity of 92.3% and predictive positive value of 91.7% in differentiating UMN-ALS versus ALS mimics, even if the performance was not significantly better than MCS (Z = 0.81, p = 0.21). CONCLUSION: The MCS and susceptibility skewness of the precentral gyrus show high diagnostic accuracy in differentiating UMN-ALS from ALS-mimics subjects. The quantitative assessment might be preferred being an automatic measure unbiased by the reader. CLINICAL RELEVANCE STATEMENT: The clinical diagnostic evaluation of ALS patients might benefit from the qualitative and/or quantitative assessment of the susceptibility in the precentral gyrus as imaging marker of upper motor neuron predominance. KEY POINTS: • Amyotrophic lateral sclerosis diagnostic work-up lacks biomarkers able to identify upper motor neuron involvement. • Susceptibility-weighted imaging/quantitative susceptibility mapping-based measures showed good diagnostic accuracy in discriminating amyotrophic lateral sclerosis with predominant upper motor neuron impairment from patients with suspected motor neuron disorder. • Susceptibility-weighted imaging/quantitative susceptibility mapping-based assessment of the magnetic susceptibility provides a diagnostic marker for amyotrophic lateral sclerosis with upper motor neuron predominance.

Has the prevalence of problematic social media use increased over the past seven years and since the start of the COVID-19 pandemic? A meta-analysis of the studies published since the development of the Bergen social media addiction scale.

Problematic Social Media Use (PSMU) has been defined as the lack of regulation of one's use of social media associated with negative outcomes in everyday functioning. Previous meta-analyses reported PSMU prevalence before the beginning of the COVID-19 pandemic and based the estimates on the cut-off scores, which are debatable in the current fields. The present meta-analysis aims to explore whether PSMU, as assessed by the most used self-report scale (i.e., the Bergen Social Media Addiction Scale; BSMAS), increased across the world (i) since the first published study on this topic (i.e., in the last seven years), (ii) since the beginning of the COVID-19 pandemic, and (iii) depending on age, gender and the income level of the countries. The meta-analysis involved 139 independent samples with 133,955 respondents from 32 countries spanning seven world regions. The results show that PSMU: (i) is significantly higher in low-income countries (LIC); (ii) did not increase in the last 7 years overall and after the beginning of the COVID-19 pandemic, except for LIC; (iii) did not vary depending on age and gender. The higher prevalence of PSMU reported during the COVID-19 pandemic by some single studies may have been a transient phenomenon to cope with physical distances in some countries, whilst, in others, an overall increase of PSMU occurred. High levels of PSMU in LIC might be explained based on socio-cultural differences between countries, but also with the higher prevalence of mental disorders in LIC since PSMU might be a symptom of other, more primary psychiatric disorders.

Banks of the Superior Temporal Sulcus in Alzheimer's Disease: A Pilot Quantitative Susceptibility Mapping Study.

BACKGROUND: Brain iron homeostasis is disrupted in neurodegeneration and areas of iron overload partially overlap with regions of amyloid and tau burden in Alzheimer's disease (AD). Previous studies demonstrated alterations in brain iron accumulation in AD using quantitative susceptibility mapping (QSM). OBJECTIVE: Here, we investigate brain alterations of QSM values in AD and non-AD patients as compared to healthy controls (HC) in the superior temporal sulcus and its banks (BANKSSTS), one of the top AD-affected regions. METHODS: Thirty-four patients who underwent brain MRI including a multi-echo gradient-echo sequence were subdivided into AD (n = 19) and non-AD (n = 15) groups according to their clinical profile, CSF (Aß42/40) and/or amyloid-PET status. Ten HC were also included. QSM values were extracted from left and right BANKSSTS and compared among groups. Correlation and binomial regression analyses between QSM values and CSF-AD biomarkers were conducted. RESULTS: QSM in left BANKSSTS was significantly different among groups (p = 0.003, H = 11.40), being higher in AD. QSM values in left BANKSSTS were correlated with Aß42 (rho -0.55, p = 0.005), Aß42/40 (rho -0.66, p < 0.001), pTau (rho 0.63, p < 0.001), tTau (rho 0.56, p = 0.005), tTau/Aß42 (rho 0.68, p < 0.001) and pTau/Aß42 (rho 0.71, p < 0.001). No correlations between QSM values and amyloid-PET SUVR in the left BANKSSTS were found. QSM values in left BANKSSTS showed good accuracy in discriminating AD (AUC = 0.80, CI95 % [0.66-0.93]). Higher QSM values were independent predictors of Aß42 (B = 0.63, p = 0.032), Aß42/40 (B = 0.81, p = 0.028), pTau (B = 0.96, p = 0.046), tTau (B = 0.55, p = 0.027), and tTau/Aß42 (B = 1.13, p = 0.042) positivity. CONCLUSION: Our preliminary data support the potential role of increased QSM values in the left BANKSSTS as an auxiliary imaging biomarker in AD diagnosis.

The relationship between problematic Instagram use and eating disorders psychopathology: an explanatory structural equation model.

An emerging body of research has evidenced the negative influence of using and being exposed to social networking sites (SNSs) on body image. Furthermore, it has been postulated that SNS use might be related with onset and persistence of eating disorders (EDs) psychopathology. The aim of the present study is to evaluate the complex interplay between problematic Instagram use (PIU) (conceptualized as a potential behavioral addiction comprising withdrawal, conflict, tolerance, salience, mood modification and relapse) and ED psychopathology, by means of an explanatory structural equation model. We hypothesized that PIU would be associated with ED symptoms through the mediating role of appearance comparison, individual psychological investment in physical appearance, and body uneasiness. A sample of 386 young female participants (Mage = 26.04 ± 6.73) was recruited, of which 152 had received a diagnosis of ED. ED patients used Instagram more than the control group and showed higher levels of PIU. Results from structural equation modeling (fit indices: χ2 = 44.54, df = 19, p < 0.001; RMSEA = 0.059; CFI = 0.98; SRMR = 0.02) showed that PIU predicted appearance comparison and psychological investment in physical appearance, which in turn predicted body uneasiness. In turn, body uneasiness predicted ED psychopathology and interpersonal difficulties. Our model provides a useful account of how eating disorder symptoms could be triggered and maintained by an addictive use of Instagram.

Stigmatizing attitudes toward Internet gaming disorder, Problematic smartphone use and Problematic social networking site use: An experimental vignette study.

Public stigma on substance and gambling disorders have been well documented. Negative effects of stigma include shame, embarrassment, fear being judged and the determent of help-seeking behaviors among stigmatized individuals. Less is known about the public perception toward Internet gaming disorder (IGD) and other widespread problematic behaviors that share some characteristics with established behavioral addictions, such as Problematic smartphone use (PSU) and Problematic social networking sites use (PSNSU). The purpose of this study is to compare the public perception of problematic Internet gamers, problematic smartphone users and problematic social networking sites users using an experimental within-group vignette study design. A sample of 280 adults (F = 72.1%; Mage = 32.84, SD = 13.85) was recruited and completed the study online. Participants were presented with male OR female vignettes (i.e. the gender of the target in the vignette was randomized) describing an individual with IGD, PSU, and PSNSU. A repeated-measures ANOVA followed by post hoc tests using Bonferroni's correction was used. IGD was seen as more serious, more noticeable, and less understandable than both PSU and PSNU. Moreover, participants' emotional reaction (e.g., anger and sadness) and desired social distance were significantly stronger toward IGD. However, vanity attributions were higher for individuals with PSNSU, which were also more blamed compared to both IGD and PSU. PSU was seen as more controllable than both IGD and PSNSU. The results, taken together, suggest that IGD is perceived as more inherently problematic, but PSNSU also seem to deserve scientific attention as individuals showing symptoms of PSNSU are blamed more than problematic Internet gamers. Our findings provide initial information that can be used when developing interventions to impact stigma toward technological addictions.

Childhood adversity, symptoms, and cortisol in first episode psychosis: a cross-sectional, secondary, observational analysis of a subsample of FEP patients.

BACKGROUND: Although it has been proposed that childhood adversities (CAs) may affect the hypothalamic-pituitary-adrenal (HPA) axis activity and psychotic symptoms severity, these associations have not been fully confirmed in first-episode psychosis (FEP). This study explored the association between CA, cortisol and psychotic symptoms in FEP patients. METHODS: 81 FEP patients were enrolled. CAs were evaluated by the Childhood Experience of Care and Abuse Questionnaire and a semi-structured interview. Psychotic symptoms were evaluated by the Positive and Negative Syndrome Scale. Cortisol level was collected using saliva samples. ANCOVA and partial correlation analyses were run. RESULTS: FEP patients with childhood abuse reported severe positive symptoms than those without CA. FEP patients with at least one CA had higher levels of cortisol awaking, cortisol at 12 a.m., and cortisol at 8 p.m. Morning cortisol levels were negatively correlated with the severity of negative symptoms and positively correlated with the severity of general psychopathology. Evening cortisol levels were positively correlated with severity of general psychopathology. CONCLUSION: FEP patients with CAs, compared with those without CA, might report more severe positive symptoms and higher cortisol, even though these findings as prone to bias due to the small sample size, and should be seen in the larger perspective of conflicting evidence in the field.

The Role of Attachment in Gambling Behaviors and Gambling Disorder: A Systematic Review.

In recent years, a growing number of attachment-based studies have contributed to the understanding of both substance and behavioral addictions. Although gambling is a form of addictive behavior widespread all over the world, both among young people and adults, the evidence on the association between attachment-related phenomena and gambling has not yet been systematized in literature. The aim of the present study, therefore, is to provide a systematic literature review aimed at summarizing the empirical evidence on this topic. Following the updated 2020 PRISMA guidelines, a systematic search in four electronic scientific databases (Scopus, PubMed, PsycInfo and Web of Science) was conducted. After removing duplicates, 146 records were double-screened, with 12 articles meeting the inclusion criteria. Additionally, by means of a backward search a further article was selected. Altogether, 13 articles were selected for the present systematic review. With few exceptions, the results underline the significant role played by attachment-related phenomena in gambling behaviors, highlighting that specific attachment contexts have a different influence on gambling, also depending on whether gamblers are youths or adults. In particular, while secure attachment has proven to be a protective factor for the onset of gambling behavior, insecure attachment has emerged to be a vulnerability factor in two ways. On the one hand, it directly favors gambling behaviors; on the other, it affects coping strategies and the individual's ability to identify and regulate emotions, which in turn predict gambling. Limitations, strengths, and implications of the present systematic review are discussed.

Effects of the COVID-19 pandemic on psychological health in a sample of Italian adults: A three-wave longitudinal study.

The COVID-19 pandemic and the resulting societal restrictions have had negative implications for mental health in the general population. The aims of the present longitudinal study were (i) to investigate changes in psychopathological symptoms and psychological well-being in a sample of Italian individuals surveyed at different points of the pandemic and (ii) to evaluate the potential risk and protective factors associated with the psychopathological outcomes. Self-reported data on psychiatric symptoms, and psychological well-being were collected in March 2020 (T0, the lockdown phase), in May 2020 (T1, the end of the lockdown phase), and in November 2020 (T2, the second wave of COVID-19 infection). 1258 participants (Mage=23.43, SDage=6.45; 75.4% female) were recruited at T0. Of these, 712 also completed the T1 survey, and 369 also completed the T2 survey. A significant decrease in anxiety, depressive, posttraumatic, and obsessive-compulsive symptoms and a significant increase in psychological well-being were observed from T0 to T1. All psychopathological symptoms increased, and psychological well-being decreased significantly from T1 to T2. Several demographic, psychological and COVID-19-related factors emerged as predictors over the course of the pandemic. The current findings indicated that psychological health covaried with the intensity of the COVID-19 pandemic and the associated societal restrictions.

A trauma model of substance use: Elaboration and preliminary validation.

The current study expands on and integrates previous theoretical models concerning the pathways that link child maltreatment to substance use disorder. The proposed model, based on the self-medication hypothesis, suggests that experiences of neglect and abuse during childhood can lead to substance use and abuse both directly and indirectly, via dissociation resulting from failed attempts to integrate experiences of maltreatment in childhood. The model was tested on ten substances (painkillers, stimulants, sedatives, marijuana, cocaine, ecstasy, hallucinogens, heroin, inhalants, and methamphetamine) via structural equation modeling (SEM) in a sample comprising 1040 community-dwelling adults (67 % women) aged between 18 and 78 (M = 29.55, SD = 11.37). Fit indexes of the SEM were good, thus supporting the hypothesized model. Specific forms of child maltreatment were related to increased use of specific substances; however, experience of childhood neglect (both physical and emotional) was found to have a central role in predicting use of most substances. Although no single pathway can fully explain the origins of substance abuse, the current study provides evidence of a critical developmental pathway to it, with implications for theory and clinical practice.