Twenty years of emotional-behavioral problems of community adolescents living in Italy measured through the Achenbach system of empirically based assessment (ASEBA): a systematic review and meta-analysis.

Background: This is a systematic review and meta-analysis of emotional and behavioral problems among Italian community adolescents in the last 20 years, as assessed through the ASEBA questionnaires CBCL 6-18, YSR 11-18 and TRF 6-18. Research questions address: (1) pooled means of problems' scores in questionnaires scales; (2-3) variations in scores according to sociodemographic and time-related factors, and studies' quality; (4) trends in research with ASEBA instruments along with other outcomes, e.g., psychopathological symptoms. Methods: A systematic literature review of Scopus, EBSCO, PubMed, Web of Science, and ProQuest databases using the PRISMA 2020 guidelines was conducted on November, 2021, and of grey literature on December, 2021. The quality of studies was assessed through the Newcastle-Ottawa Scale. Results: Forty-four studies were eligible for the systematic review, of which 34 were included for meta-analysis. Results showed that: (1) emotional-behavioral problems were higher when assessed by the CBCL and lower when assessed by the YSR compared to normative data; (2) there were no gender and age differences, except for higher scores of Anxious/Depression symptoms, in girls. (3) internalizing and attention problems increased over the last two decades. (4) major trends of Italian research investigate adolescents' emotional behavioral problems concerning attachment, comorbid symptoms, especially internet addictions, and eating disorders. Discussion: Despite some limitations (e.g., low-medium quality of most studies, no data on the TRF, under-representation of some geographical areas, some search-related choices), these data provides Italian practitioners and international researchers of some parameter to evaluate Italian adolescents emotional-behavioral problems. Registered on PROSPERO N. CRD42022299999.

Families Facing Pandemic Modifications of Everyday Life: A Mixed Study on Mothers' and Children's Emotional Reactions and Regulation Strategies.

The COVID-19 pandemic caused many enduring changes in the everyday life of families, with negative effects on parents' and children's wellbeing. However, there is a lack of studies in the literature exploring the emotional reactions and coping strategies of both mothers and children of different ages. Furthermore, most studies used only self-reports. This study aimed to identify the emotions and coping strategies of children, adolescents and their mothers and to verify the association between maternal and child wellbeing. A mixed-method design using interviews and questionnaires was applied to collect information on wellbeing (emotional reactions, behavioral/emotional problems) and coping strategies of both mothers (n = 65; M age = 42.17; SD = 4.40; M age = 41.63; SD = 4.48), and their children (n = 35, 8-10 year; n = 30, 11-13 year) during the second wave of the pandemic (December 2020). No differences between the groups emerged concerning the emotional reactions reported. In contrast, mothers and children of different ages reported different self-regulation and other-regulation strategies. Moreover, maternal strategies had different effects on children's wellbeing. The integration of qualitative and quantitative results was informative to understand how families adapted to the radical changes of everyday life related to the pandemic. The implications for developing interventions in such similar stressful situations to promote family wellbeing are discussed.

Maternal mood moderates the trajectory of emotional and behavioural problems from pre- to during the COVID-19 lockdown in preschool children.

The COVID-19 outbreak and subsequent lockdown have dramatically impacted families' life, raising serious concerns about children's emotional wellbeing. However, few studies have investigated whether the impact of the COVID-19 lockdown on psychological adjustment in youngest can be moderated by maternal mood and, to our knowledge, none of them has adopted a longitudinal design. The main aim of the current study was to explore if the intensity and directionality of maternal mood symptoms moderated the trajectory of emotional and behavioural problems in Italian pre-schoolers from pre- to during the lockdown adopting a longitudinal design. To assess maternal anxiety and depression symptoms, the EPDS and the STAI-Y were filled in by 94 and 88 women before the lockdown, when their children were 1 (Wave P1) and 3 years old (Wave P2), respectively, and by 74 women during the lockdown, when their children were 4 years old (Wave L). Mothers also filled in the CBCL/1 ½-5 to assess their children's emotional and behavioural problems at each assessment wave. As a whole, children's emotional and behavioural problems significantly increased from pre- to during the lockdown. Furthermore, maternal mood moderated this trajectory. In particular, greater maternal mood symptoms were significantly associated with a greater increase in emotional reactive, anxious-depressed, withdrawn and aggressive symptoms during the lockdown. These results contribute to shed light on the role played by maternal emotional wellbeing in buffering the impact of the COVID-19 lockdown on children's behavioural development. Albeit preliminary, the current findings highlight the need to provide timely psychological interventions to distressed mothers to help their children to better cope with the effects of the pandemic.

Intensity of Maternal Anxiety and Depressive Symptoms in Pregnancy Is Associated with Infant Emotional Regulation Problems.

This study aimed to investigate the effects of the intensity and directionality of antenatal maternal depressive and anxiety symptoms on infant negative affectivity and crying, also taking into account potential confounders. The role of socioeconomic status (SES) as a possible moderating factor of the association between antenatal maternal distress and infant negative outcomes was also explored. More than one hundred women filled in the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory to assess depressive and anxiety symptoms, respectively, during the third trimester of pregnancy and three months after delivery. Mothers also filled in the Infant Behavior Questionnaire and a parental diary to evaluate negative affectivity and crying, respectively, when their infants were 3 months old. SES was assessed through the Hollingshead classification. The intensity of antenatal maternal symptoms and SES were associated with infant negative affectivity, but not with crying. However, SES moderated the association between the intensity of maternal symptoms and infant crying. The direction of maternal symptoms (anxiety versus depression) was not associated with both infant negative affectivity and crying. Our findings contribute to elucidating the role played by the intensity of maternal stress in pregnancy-alone and in interaction with SES-in determining individual differences in infant emotional regulation, thus emphasizing the importance of timely psychological interventions for pregnant women who experience psychological distress.

Emotional Dysregulation in Adults from 10 World Societies: An Epidemiological Latent Class Analysis of the Adult-Self-Report.

Background/Objective: Emotional dysregulation (ED) is a dimensional psychological domain, previously operationalized by instruments of the Achenbach System of Empirically Based Assessment (ASEBA) for children and adolescents; however, its cross-cultural and bottom-up characteristics among adult populations are still unknown. Method: We examined scores obtained on the Adult Self-Report (ASR) by 9,238 18- to 59-year-olds from 10 societies that differed in social, economic, geographic, and other characteristics. A Latent Class Analysis was performed on the data from each society. Results: In each society, a dysregulated class (DYS) was identified, which was characterized by elevated scores on most ASR syndromes. The mean prevalence of DYS was 9.2% (6.1-12.7%). The best models ranged from three to five latent classes in the different societies. Conclusions: Although the number of identified classes and the prevalence of ED varied across societies, a DYS class was found in each society, suggesting the need to adopt a dimensional view of psychopathology and a cross cultural perspective also in adult populations.

Contexto/Objetivo: La desregulación emocional (DE) es un ámbito dimensional en Psicología, previamente operacionalizado por los instrumentos del Sistema de Evaluación Basado Empíricamente de Achenbach (ASEBA, por sus siglas en inglés) para niños y adolescentes; sin embargo, aún se desconocen sus características interculturales y su enfoque ascendente en su aplicación a la población adulta. Método: Examinamos las puntuaciones obtenidas en el Autoinforme de Adultos (ASR, por sus siglas en inglés) por 9.238 personas de 18 a 59 años de edad pertenecientes a 10 sociedades que diferían en cuanto a sus características sociales, económicas, geográficas y de otro tipo. Se realizó un Análisis de Clases Latentes con los datos de cada sociedad. Resultados: En cada sociedad se identificó una clase desregulada (DES), que se caracterizaba por puntuaciones elevadas en la mayoría de los síndromes ASR. La prevalencia media de DES fue del 9,2% (6,1-12,7%). Los mejores modelos oscilaron entre tres y cinco clases latentes en las diferentes sociedades. Conclusiones: Aunque el número de clases identificadas y la prevalencia de DE variaron entre las diversas sociedades, se encontró una clase DES en cada sociedad, lo que sugiere la necesidad de adoptar una visión dimensional de la psicopatología y una perspectiva intercultural también en las poblaciones adultas.

Emotional Dysregulation in Adults from 10 World Societies: An Epidemiological Latent Class Analysis of the Adult-Self-Report

AbstractBackground/Objective: Emotional dysregulation (ED) is a dimensional psychological domain, previously operationalized by instruments of the Achenbach System of Empirically Based Assessment (ASEBA) for children and adolescents; however, its cross-cultural and bottom-up characteristics among adult populations are still unknown. Method: We examined scores obtained on the Adult Self-Report (ASR) by 9,238 18- to 59-year-olds from 10 societies that differed in social, economic, geographic, and other characteristics. A Latent Class Analysis was performed on the data from each society. Results: In each society, a dysregulated class (DYS) was identified, which was characterized by elevated scores on most ASR syndromes. The mean prevalence of DYS was 9.2% (6.1-12.7%). The best models ranged from three to five latent classes in the different societies. Conclusions: Although the number of identified classes and the prevalence of ED varied across societies, a DYS class was found in each society, suggesting the need to adopt a dimensional view of psychopathology and a cross cultural perspective also in adult populations.

ReportResumenAntecedentes/Objetivo: La desregulación emocional (DE) es un ámbito dimensional en Psicología, previamente operacionalizado por los instrumentos del Achenbach System of Empirically Based Assessment (ASEBA) para niños y adolescentes; sin embargo, aún se desconocen sus características interculturales y su enfoque ascendente en su aplicación a la población adulta. Método: Examinamos las puntuaciones obtenidas en el Adult Self-Report (ASR) por 9.238 personas de 18 a 59 años pertenecientes a diez sociedades que diferían en cuanto a sus características sociales, económicas, geográficas y de otro tipo. Se realizó un análisis de clases latentes con los datos de cada sociedad. Resultados: En cada sociedad se identificó una clase desregulada (DES), que se caracterizaba por pun-tuaciones elevadas en la mayoría de los síndromes ASR. La prevalencia media de DES fue del 9,2% (6,1-12,7%). Los mejores modelos oscilaron entre tres y cinco clases latentes en las diferentes sociedades. Conclusiones: Aunque el número de clases identificadas y la prevalencia de DE variaron entre las diversas sociedades, se encontró una clase DES en cada sociedad, lo que sugiere la necesidad de adoptar una visión dimensional de la psi-copatología y una perspectiva intercultural también en las poblaciones adultas.

Respiratory Sinus Arrhythmia (RSA) stress response in preschool age varies by serotonin transporter polymorphism (5-HTTLPR): A preliminary report.

The serotonin transporter promoter region polymorphism (5-HTTLPR) has been implicated in stress regulation, with increased stress reactivity often being found in carriers of the low-expressing short (S) allele. Nevertheless, the role of the 5-HTTLPR in influencing parasympathetic stress reactivity, as indexed by Respiratory Sinus Arrhythmia (RSA), is still unknown. This study examined, for the first time, whether the 5-HTTLPR was associated with variations in RSA response to maternal separation in a sample of 69 healthy 5-year-old children. Preschoolers' RSA was measured during an age-adapted version of the Strange Situation Procedure (SSP). The 5-HTTLPR polymorphism was tested as a predictor of RSA dynamic response to the SSP through multilevel models. A significant interaction between 5-HTTLPR and SSP episodes was found. In particular, whereas a significant decrease in RSA levels was observed during the stranger episode in the whole sample, S allele carriers showed a significant decrease in RSA levels from the stranger episode to the first separation episode, followed by an increase for the rest of the procedure. Albeit preliminary, data support the view that the 5-HTTLPR may contribute to individual differences in RSA stress reactivity from preschool age.

Older adult psychopathology: international comparisons of self-reports, collateral reports, and cross-informant agreement.

OBJECTIVES: To conduct international comparisons of self-reports, collateral reports, and cross-informant agreement regarding older adult psychopathology. PARTICIPANTS: We compared self-ratings of problems (e.g. I cry a lot) and personal strengths (e.g. I like to help others) for 10,686 adults aged 60-102 years from 19 societies and collateral ratings for 7,065 of these adults from 12 societies. MEASUREMENTS: Data were obtained via the Older Adult Self-Report (OASR) and the Older Adult Behavior Checklist (OABCL; Achenbach et al., ). RESULTS: Cronbach's alphas were .76 (OASR) and .80 (OABCL) averaged across societies. Across societies, 27 of the 30 problem items with the highest mean ratings and 28 of the 30 items with the lowest mean ratings were the same on the OASR and the OABCL. Q correlations between the means of the 0-1-2 ratings for the 113 problem items averaged across all pairs of societies yielded means of .77 (OASR) and .78 (OABCL). For the OASR and OABCL, respectively, analyses of variance (ANOVAs) yielded effect sizes (ESs) for society of 15% and 18% for Total Problems and 42% and 31% for Personal Strengths, respectively. For 5,584 cross-informant dyads in 12 societies, cross-informant correlations averaged across societies were .68 for Total Problems and .58 for Personal Strengths. Mixed-model ANOVAs yielded large effects for society on both Total Problems (ES = 17%) and Personal Strengths (ES = 36%). CONCLUSIONS: The OASR and OABCL are efficient, low-cost, easily administered mental health assessments that can be used internationally to screen for many problems and strengths.

Mirroring, monitoring, modelling, belonging, and distancing: Psychosocial processes in an online support group of breast cancer patients.

Breast cancer patients are primary users of Internet Health Forums, virtual self-help communities where they find and share information, preoccupations, and support. Previous literature has mainly focused on analysing the contents and the outcomes of breast cancer forums' participation. In light of the Community of Practice theoretical model, our research investigated the psychosocial processes that build and shape patients' experience and participation in the forum. We conducted 16 semi-structured email interviews with breast cancer patients recruited within a well-established online community. Thematic analysis identified five processes-mirroring, monitoring, modelling, belonging, and distancing-that marked three phases of users' experience: initiation, participation, detachment. An interactive dynamic characterised the identified processes: the disease's experience was shaped by and, in turn, it crafted this virtual community. These community processes contributed to participants' empowerment at practical, informative, and emotional levels through the development of a shared repertoire of resources, stories, and ways of dealing with patients' recurring problems.

Maternal caregiving moderates the impact of antenatal maternal cortisol on infant stress regulation.

BACKGROUND: Emerging evidence suggests that antenatal exposure to maternal stress signals affects the development of the infant stress response systems. Animal studies indicate that maternal sensitive caregiving can reverse some of these effects. However, the generalizability of these findings to humans is unknown. This study investigated the role of maternal caregiving in the association between multiple markers of maternal antenatal stress and infant stress regulation. METHODS: The sample consisted of 94 mother-infant (N = 47 males, mean postnatal weeks = 12; SD = 1.84) dyads. Maternal levels of Interleukin-6, C-Reactive Protein (CRP), diurnal cortisol and alpha amylase, depressive and anxiety symptoms were assessed in late pregnancy (mean gestational age = 34.76; SD = 1.12), whereas postnatal symptomatology, caregiving, and infant cortisol response to the inoculation were evaluated at 3 months. RESULTS: Hierarchical linear models (HLMs) showed a significant interaction between maternal antenatal cortisol, caregiving, and time on infant cortisol reactivity, while controlling for gender, maternal age, and postnatal depression. Specifically, higher levels of maternal antenatal cortisol were associated with greater cortisol response only among infants of less emotionally available mothers. All other markers of antenatal stress were not significantly associated with infant cortisol reactivity either independently or in interaction with maternal caregiving. CONCLUSIONS: Albeit preliminary, results provide the first evidence in humans that maternal sensitive caregiving may eliminate the association between antenatal maternal cortisol and infant cortisol regulation.

Assessing stress variations in children during the strange situation procedure: comparison of three widely used respiratory sinus arrhythmia estimation methods.

Objective.The respiratory sinus arrhythmia (RSA) is a well-known marker of vagal activity that can be exploited to measure stress changes. RSA is usually estimated from heart rate variability (HRV). This study aims to compare the RSA obtained with three widely adopted methods showing their strengths and potential pitfalls.Approach.The three methods are tested on 69 healthy preschoolers undergoing a stressful protocol, the strange situation procedure (SSP). We compare the RSA estimated by the Porges method, the univariate autoregressive (AR) spectral analysis of the HRV signal, and the bivariate AR spectral analysis of HRV and respirogram signals. We examine RSA differences detected across the SSP episodes and correlation between the estimates provided by each method.Main results.The Porges and the bivariate AR approaches both detected significant differences (i.e. stress variations) in the RSA measured across the SSP. However, the latter method showed higher sensitivity to stress changes induced by the procedure, with the mean RSA variation between baseline and first separation from the mother (the most stressful condition) being significantly different among methods: Porges, -17.5%; univariate AR, -18.3%; bivariate AR, -23.7%. Moreover, the performances of the Porges algorithm were found strictly dependent on the applied preprocessing.Significance.Our findings confirm the bivariate AR analysis of the HRV and respiratory signals as a robust stress assessment tool that does not require any population-specific preprocessing of the signals and warn about using RSA estimates that neglect breath information in more natural experiments, such as those involving children, in which respiratory frequency changes are extremely likely.

Antenatal maternal anxiety, maternal sensitivity and toddlers' behavioral problems: An investigation of possible pathways.

BACKGROUND: While evidence exists of an association between maternal antenatal anxiety and offspring's behavioral outcomes, the role played by maternal care in explaining this link has been poorly investigated. AIM: The current study aimed to investigate the mediating/moderating role of maternal sensitivity in the association between maternal antenatal trait anxiety and toddlers' behavioral problems and temperament, taking also into account potential confounders. Analyses were also replicated for maternal antenatal state anxiety and depression. METHODS: Ninety women filled in the State-Trait Anxiety Questionnaire and the Edinburgh Postnatal Depression Scale to assess anxiety/depressive symptoms during the third trimester of pregnancy (34-36 weeks of gestation) and 14 months post-partum. They also filled in the Child Behavior Checklist and the Infant Behavior Questionnaire to evaluate their 14-month-olds' behavioral problems and negative affectivity, respectively. Maternal sensitivity was assessed through the Emotional Availability Scales. RESULTS: Maternal antenatal trait anxiety was associated with internalizing, but not externalizing, problems. Interestingly, maternal sensitivity moderated the association between antenatal trait anxiety and externalizing problems. Conversely, antenatal maternal depression was significantly associated with toddlers' negative affectivity. CONCLUSIONS: Our findings contribute to shed light on the association between maternal antenatal anxiety and child behaviors, as well as on the role played by parenting in moderating this link, with promising implications for targeted interventions.

Quality of life in patients with primary biliary cholangitis: A cross-geographical comparison.

BACKGROUND & AIMS: Several symptoms impair the quality of life (QoL) of patients with primary biliary cholangitis (PBC). They are reported to vary significantly in different countries. Aim of our study was to explore whether there is a geographical clustering that accounts for symptoms in PBC. METHODS: Data was analysed from four cohorts of PBC patients from the UK, Spain, Japan and Italy using the PBC-27 scale. RESULTS: Overall, 569 patients from four cohorts were identified, including 515 females (90.5%) with a mean age of 61 years. The analysis provided evidence for strict factorial invariance of the scale, a robust indicator of its validity for cross-cultural research. The mean of the fatigue domain of British patients was significantly greater than that of the Japanese (p â€‹< â€‹0.05), Italian (p â€‹< â€‹0.05), and Spanish patients (p â€‹< â€‹0.001). The mean of the cognitive domain after 54 years of age, was significantly greater in the British patients than in the Japanese (p â€‹< â€‹0.05) and Spanish patients (p â€‹< â€‹0.01). However, after 69 years of age, there were not significant differences between countries. The mean of the emotion domain after 54 years of age, was greater in the British that in the Spanish (p â€‹< â€‹0.01) and Italian patients (p â€‹< â€‹0.01). CONCLUSIONS: Differences in the four countries concerning fatigue, cognitive and emotional dysfunction were found. The association of latitude and symptoms might provide new insights into the role of sun exposure, genetics and/or cultural component into disease phenotype in PBC.

Prenatal IL-6 levels and activation of the tryptophan to kynurenine pathway are associated with depressive but not anxiety symptoms across the perinatal and the post-partum period in a low-risk sample.

Depression and anxiety symptoms are highly prevalent among women during pregnancy and post-partum. Previous studies suggest that one of the pathophysiological underpinnings could be an enhanced metabolism of tryptophan (Trp) into kynurenine (Kyn) due to increased inflammation. However, the longitudinal changes in the Kyn pathway and the complex interplay with inflammation and stress in women with perinatal depressive or anxiety symptoms are incompletely understood. We examined a cohort of healthy women at 34-36 gestational weeks. One hundred and ten women were assessed for salivary cortisol and 97 participants were also assessed for serum levels of Trp, Kyn and Interleukin 6 (IL-6). Women filled in two screening questionnaires for depressive (Edinburgh Postnatal Depression Scale (EPDS)) and anxiety (State Trait Anxiety Inventory subscale (STAI-S)) symptoms at 34-36 gestational weeks, delivery, 3 and 12 months postpartum. Unexpectedly, lower prenatal Kyn levels were associated with higher depressive symptoms in late pregnancy. Furthermore, prenatal Trp levels and the Kyn/Trp ratio moderate the association between IL-6 levels and depressive symptoms during the perinatal and the post-partum period. We found no interactions between Trp and Kyn biomarkers and cortisol on depressive symptoms. The observed associations were more robustly found for depressive symptoms, whereas weak and non-significant effects were found for the trajectory of anxiety symptoms. Overall, our data support the involvement of the Trp to Kyn pathway and inflammation in the course of depressive but not anxiety symptoms in women from late pregnancy until one-year post-partum, providing new evidence on the mechanisms regulating emotions during pregnancy and after delivery in a low-risk sample.

Neuroendocrine and immune markers of maternal stress during pregnancy and infant cognitive development.

Antenatal exposure to maternal stress is a factor that may impact on offspring cognitive development. While some evidence exists of an association between maternal antenatal depressive or anxiety symptoms and infants' cognitive outcomes, less is known about the role of biological indices of maternal antenatal stress in relation to infant cognitive development. The current study investigated the association between maternal depressive and anxiety symptoms, stress and inflammatory markers during pregnancy and infant's cognitive development in a sample of 104 healthy pregnant women (mean gestational age = 34.76; SD = 1.12) and their 12-week-old infants (mean postnatal weeks = 11.96; SD = 1.85). Maternal depressive and anxiety symptoms were evaluated during pregnancy, alongside measurements of serum Interleukin-6 (IL-6), C-Reactive Protein (CRP), salivary cortisol, and alpha amylase (sAA) concentrations. Infant cognitive development, maternal caregiving and concurrent anxiety or depressive symptoms were assessed 12 weeks after delivery. Hierarchical linear regressions indicated that higher maternal diurnal cortisol and CRP levels were independently associated with lower infant cognitive development scores, while adjusting for infant gender and gestational age, maternal IQ, caregiving, depressive, or anxiety symptoms. Though correlational, findings seem suggestive of a role for variation in maternal biological stress signals during pregnancy in influencing infants' early cognitive development.

The generalizability of Older Adult Self-Report (OASR) syndromes of psychopathology across 20 societies.

OBJECTIVES: As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies. METHODS/DESIGN: The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes. RESULTS: In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies. CONCLUSIONS: The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.

The programming role of maternal antenatal inflammation on infants' early neurodevelopment: A review of human studies: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD.

BACKGROUND: Maternal inflammation during pregnancy is a frequently proposed mechanism underlying the link between maternal antenatal physical (e.g. infections, immune disease, obesity) and/or psychological (e.g. depression, anxiety) conditions and child outcomes. However, the extent to which maternal inflammation is directly associated with offspring's early development and health in humans remains largely unknown. METHODS: In this review, empirical findings on the prospective association between maternal prenatal levels of inflammatory markers and infants' neurodevelopmental outcomes are summarized. Fifteen studies were included with sample sizes ranging from 36 to 6016 mother-infant dyads and average overall quality score 9.53 (range 6-12). RESULTS: Findings concerning the link between maternal antenatal inflammation and, respectively, infants' health and birth outcomes, stress reactivity or cognitive development are mixed. However, it is noteworthy that all higher quality studies (scores >10) reviewed here do find evidence of an association between levels of inflammation, mostly as indexed by Interleukin-6 (IL-6), in healthy women across the whole gestation and offspring's neurodevelopmental outcomes, including structural and functional brain alterations. LIMITATIONS: The correlational nature of the findings and conspicuous methodological heterogeneity across studies make drawing strong conclusions premature. CONCLUSIONS: Findings, albeit preliminary, are consistent with animal studies and speak in favor of a role of maternal antenatal inflammation in shaping fetal development with possible long-term effects.

Emotional Availability in Samples of Mothers at High Risk for Depression and With Substance Use Disorder.

Background: Maternal substance use disorder (SUD) and depression have been extensively associated with dysfunctions in parent-child interactions. However, few studies have compared caregiving behaviors of these mothers. The current study aims to explore maternal emotional availability (EA) in mothers with maternal SUD and depressive symptoms in order to investigate whether these conditions represent a different risk gradient for early parenting. Methods: Mother-infant relationship was investigated in 18 mothers with SUD, 11 mothers at risk for depression, and 39 mothers from general population. The dyads were videotaped during a free-play session and the quality of parent-child interactions was assessed using the EA Scales (EAS) and the Emotional Attachment and EA Clinical Screener (EA2-CS). Results: Mothers with SUD scored lower on sensitivity, non-intrusiveness, and non-hostility with respect to the low-risk sample, whereas mothers at risk for depression scored lower on sensitivity and non-hostility compared to the latter. No significant differences between mothers with SUD and mothers at risk for depression emerged on the EAS, whereas different specific classifications on the EA Clinical Screener were found for the SUD (i.e., Complicated), depression (i.e., Detached), and low-risk (i.e., Emotionally Available) samples. Conclusion: If the current findings are replicated, they might have significant implications for selecting targets of early mother-infant interventions.

Testing Syndromes of Psychopathology in Parent and Youth Ratings Across Societies.

As societies become increasingly diverse, mental health professionals need instruments for assessing emotional, behavioral, and social problems in terms of constructs that are supported within and across societies. Building on decades of research findings, multisample alignment confirmatory factor analyses tested an empirically based 8-syndrome model on parent ratings across 30 societies and youth self-ratings across 19 societies. The Child Behavior Checklist for Ages 6-18 and Youth Self-Report for Ages 11-18 were used to measure syndromes descriptively designated as Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior. For both parent ratings (N = 61,703) and self-ratings (N = 29,486), results supported aggregation of problem items into 8 first-order syndromes for all societies (configural invariance), plus the invariance of item loadings (metric invariance) across the majority of societies. Supported across many societies in both parent and self-ratings, the 8 syndromes offer a parsimonious phenotypic taxonomy with clearly operationalized assessment criteria. Mental health professionals in many societies can use the 8 syndromes to assess children and youths for clinical, training, and scientific purposes.

Differentiating PNES from epileptic seizures using conversational analysis.

We applied conversation analysis in an unselected continuous series of 70 patients to discriminate patients with psychogenic nonepileptic seizures (PNES) from patients with epilepsy. Two psychologists examined the patients' recorded reports. Patients were also submitted to an extensive neuropsychological battery in order to verify whether specific cognitive deficits or mental health problems are typical of patients with PNES and whether some cognitive deficits could prevent the correct diagnosis. The results showed a good percentage of correct diagnosis, with a sensitivity of 0.795 and a specificity of 0.83, while no difference in the cognitive profile was found between patients with PNES and patients with epilepsy. The results also suggest that psychologists can apply the conversation analysis as well as linguists, which is an important finding since psychologists are employed in specialized centers, while linguists in general are not part of the team.