Definition and Criteria for the Assessment of Expertise in Psychotherapy: Development of the Psychotherapy Expertise Questionnaire (PEQ).

Therapist expertise is a complex, multifaceted, and continually evolving concept. Defining this construct and its constituent components can yield a substantial contribution to the field of psychotherapy, consequently enhancing the comprehension of the fundamental factors that underlie its effectiveness. Within this framework, the present research aimed at developing and assessing the psychometric properties of the Psychotherapy Expertise Questionnaire (PEQ), a self-report measure to assess therapist expertise. A sample of 260 psychotherapists of various theoretical orientations were involved in this research. They completed a survey that included the PEQ as well as other self-reported measures aimed at evaluating personality traits, self-efficacy, self-esteem, and insight orientation. The analysis provided evidence of a good fit for both a correlational model with eight factors and a higher-order model, where the eight subdimensions were grouped into subjective (performance; cognitive functioning; personal and relational qualities of the therapist; therapist self-assessment) and objective (experience; reputation with clients and colleagues; training and professional updating; deontological ethics and setting rules) factors. The eight dimensions, two higher-order factors, and total score all showed excellent levels of internal consistency. Furthermore, significant associations were found between PEQ scores and insight orientation, general self-efficacy, self-esteem, personality traits, and time exercising clinical practice. To conclude, the Psychotherapy Expertise Questionnaire (PEQ) is a valuable, theoretically guided, and psychometrically robust self-report measure designed to assess therapist expertise and its constitutive dimensions. This measure can have practical applications in guiding tailored training and customised supervision.

The relationship between social media addiction, fear of missing out and family functioning: a structural equation mediation model.

BACKGROUND: The use of social media became a daily activity for many individuals, with recreational, informational, and social purposes, to name a few. However, for some subjects, the use of these platforms may become problematic and generate functioning impairments in many life areas. Given this, the present research aimed at investigating the factor that may contribute to Social Media Addiction, by focusing on Fear of Missing Out and Family Functioning Patterns. METHODS: A sample of 303 social media users (Mage = 35.29; SD = 14.87; 65% females, 35% males) completed a survey including the Bergen Social Media Addiction Scale, Family Adaptability and Cohesion Evaluation Scales-IV, and Fear of Missing Out Scale. Data were analysed by implementing Pearson correlation and testing a mediation with the Structural Equation Model approach. RESULTS: Cohesion, flexibility, and disengagement family functioning patterns were significantly associated with the levels of social media addiction. These dimensions were inserted in the structural equation model, where the full mediation of fear of missing out in their relationship with social media addiction was shown. CONCLUSIONS: The data showed the protective effect of flexible and cohesive family functioning patterns, as well as the role of disengagement and, sequentially, fear of missing out as risk factors. These findings may provide useful indications to elaborate tailored and effective therapeutic and preventive activity.

An Integrated Approach to Addictive Behaviors: A Study on Vulnerability and Maintenance Factors.

This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial-parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.

An addictive disorders severity model: a chained mediation analysis using structural equation modeling.

BACKGROUND: The clinical relevance of the degree of severity in addiction disorders supports the need to investigate the variables underlying this aspect of the phenomenon. OBJECTIVE: This study aimed to explore the relationships between factors that may influence the severity of addiction disorder, with a particular focus on temperamental disinhibition, emotion dysregulation, interpersonal vulnerability, and their interactions. METHODS: A clinical sample of 502 (77% males and 22% females) was involved. All participants received a DSM-5 clinical diagnosis of "Substance-Related and Addictive Disorders" and were recruited from the Italian National Health System. The collected data were analyzed by implementing a chained mediation model using structural equation modeling. RESULTS: The statistical appropriateness of the hypothesized latent 4- factors model was confirmed. Specifically, temperamental disinhibition (composed of impulsiveness, compulsiveness, and obsessiveness), emotion dysregulation (composed of affect dysregulation, alexithymia, and dissociation), interpersonal vulnerability (composed of traumatic experiences, preoccupied, avoidant and unresolved attachment), and Addictive Disorders Severity (composed by substance use severity, alcohol use severity, gambling severity, and Internet use severity) were the four factors which have been identified. Furthermore, a total chained mediation model emerged, where emotion dysregulation and interpersonal vulnerability mediated the relationship between temperamental disinhibition and Addictive Disorders Severity. CONCLUSIONS: Our findings offer a better understanding of the variables associated with addictive disorder severity, providing important indications for therapeutic interventions.

The Efficacy of Parent Training Interventions with Parents of Children with Developmental Disabilities.

Parenting children with developmental disabilities (DD) can be generally characterized by a considerable psychological burden. The effects on parental and familial psychological well-being and, consequently, on children's developmental outcomes should not be underestimated, especially in early childhood. The current review aims to advance our understanding of the key factors (e.g., formats, sample characteristics, research design) that characterize parent training interventions, and that could be related to their outcomes, to guide researchers and clinical practitioners to develop and provide efficient programs. Studies were identified via an Internet search from three electronic databases, following PRIMSA guidelines. Studies published until November 2021 were taken into account. The initial search yielded a total of 2475 studies. Among them, 101 studies were fully reviewed. Finally, ten of the studies, which met all the inclusion criteria, formed the basis for this review. Participants' characteristics, main features of the interventions (i.e., study design, structure, and contents), outcome variables and treatment efficacy were deeply examined and discussed. Key factors of parent training interventions with parents of children affected by DD are enlightened, to guide researchers and clinicians in the design and implementation of tailored specific programs, aimed to sustain parenting and foster children's developmental outcomes, from early stages of life.

The Relationship between Attachment Styles and Compulsive Online Shopping: The Mediating Roles of Family Functioning Patterns.

The rapid expansion of e-commerce has made the buying experience faster, potentially anonymous, and without limits of space and time. While this may produce benefits, for some individuals, online shopping can become an addiction. Therefore, the present study aimed to explore the psychological factors that may be associated with Compulsive Online Shopping, with a specific focus on the role of Attachment Styles and Family Functioning patterns as risk or protective factors. The study involved a sample of 306 participants (Mage = 31.86 years, SD = 11.925) who filled out an online survey consisting of the Compulsive Online Shopping Scale, Relationship Questionnaire, Family Adaptability and Cohesion Evaluation Scales-IV, as well as a demographic questionnaire. The results showed two significant parallel mediation models. In the first one, Secure Attachment was negatively and significantly related to Compulsive Online Shopping, with the mediation of Cohesion and Enmeshed Family Functioning. In the second one, Fearful Attachment was positively and significantly related to Compulsive Online Shopping, with the mediation of Cohesion and Enmeshed Family Functioning. Important implications for preventive activity and tailored interventions may emerge from these data.

The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis.

PURPOSE: Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms. PARTICIPANTS AND METHODS: A sample of 776 Italian adults aged 19-48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms. RESULTS: After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia. CONCLUSION: The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.

Alexithymia, Dissociation, and Family Functioning in a Sample of Online Gamblers: A Moderated Mediation Study.

The diffusion of the internet and technological progress have made gambling on online platforms possible, also making it more anonymous, convenient, and available, increasing the risk of pathological outcomes for vulnerable individuals. Given this context, the present study explores the role of some protective and risk factors for problematic gambling in online gamblers by focusing on the interaction between alexithymia, dissociation, and family functioning. A sample of 193 online gamblers (Mage = 28.8 years, SD = 10.59; 17% females, 83% males) completed the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale-II, and Family Adaptability and Cohesion Evaluation Scales-IV through an online survey. MANOVA, ANOVA and moderated mediation analyses were carried out to analyse the data. Significant differences in cohesive family functioning, alexithymia and dissociation have been found between online gamblers with problematic, at-risk or absent levels of gambling disease. Furthermore, the results showed a significant and positive association between alexithymia and problematic online gambling, partially mediated by dissociation, with the moderation of cohesive family functioning. Such data may have relevant clinical implications, highlighting the interaction of some core personal and environmental variables that may be involved in the etiology of online pathological gambling and could be kept in mind to tailor preventive interventions.

Insecure Attachment Styles and Unbalanced Family Functioning as Risk Factors of Problematic Smartphone Use in Spanish Young Adults: A Relative Weight Analysis.

Young adulthood is the life stage during which people are more prone to develop problematic smartphone use (PSU). Only one study investigated the relationship among attachment styles, family functioning, and PSU, but thus far, no research has shown the relative importance that such dimensions may have on PSU. The main aim of this study was to analyze to what extent insecure attachment styles and unbalanced family functioning are related to PSU, investigating the specific weight of each dimension in a sample of young adults (N = 301; 82.7% females; Mage = 22.89; SD = 3.02). Participants completed a self-report questionnaire, including the Relationship Questionnaire, the Family Adaptability and Cohesion Evaluation Scale IV, and the Smartphone Addiction Scale. The regression and relative weight analyses results showed that preoccupied attachment style and disengaged, chaotic, and enmeshed family functioning were positively related to PSU. Implications for future research and interventions were discussed.

A dyadic approach to stress and prenatal depression in first-time parents: The mediating role of marital satisfaction.

In the field of perinatal clinical psychology, most studies focus on mothers' psychological states during pregnancy, neglecting the role of their partners. This study used an Actor-Partner Interdependence Mediation Model to evaluate the mediating role of dyadic satisfaction on the relationship between perceived stress and prenatal depressive symptomatology in both members of male-female-mixed-gender couples who were expecting their first child. One hundred thirty-eight couples in their third trimester of pregnancy were asked to complete questionnaires about perceived stress, dyadic adjustment, and depression. The model revealed that there was an intrapersonal indirect effect of fathers' perceived stress on prenatal paternal depression through their marital satisfaction. Moreover, an interpersonal indirect effect was found with mothers' perceived stress being associated with prenatal paternal depression through fathers' dyadic satisfaction. Maternal indirect effects were all non-significant, suggesting that their dyadic satisfaction and that of their partner did not mediate the relation between their perceived stress and that of their partner and their prenatal depression. Findings support the importance of assessing the dyadic satisfaction of couples during pregnancy, especially in expectant fathers, and targeting it in the psychological support offered to couples as a way of improving their prenatal distress, and consequently, their mental health.

Preoperative psychological characteristics affecting mid-term outcome after bariatric surgery: a follow-up study.

BACKGROUND: The purpose of this study was to investigate the relationship between preoperative psychological factors and percentage of total weight loss (%TWL) after laparoscopic Roux-en-Y gastric bypass (LRYGB) to identify possible psychological therapy targets to improve the outcome of bariatric surgery. METHODS: Seventy-six patients completed the Hamilton's Anxiety and Depression Scales (HAM-A, HAM-D) and Toronto Alexithymia Scale (TAS-20) the day before surgery (T0). The pre-operative body weight and the %TWL at 3 (T1), 6 (T2), and 24-30 (T3) months were collected. RESULTS: At T3, depressed and alexithymic patients showed a lower %TWL compared to non-depressed patients (p = 0.03) and to non-alexithymic patients (p = 0.02), respectively. Finally, patients who had at least one of the three analyzed psychological factors showed less weight loss, at T2 (p = 0.02) and T3 (p = 0.0004). CONCLUSIONS: Psychological factors may also affect long-term outcome of bariatric surgery. This study shows an association between alexithymia/depression pre-operative levels and the weight loss at 30 months'follow-up after bariatric surgery. LEVEL OF EVIDENCE: Level III, longitudinal cohort study.

Screening for Early Signs of Paternal Perinatal Affective Disorder in Expectant Fathers: A Cluster Analysis Approach.

Previous studies documented gender-related differences in the expression of Perinatal Affective Disorders. However, little attention has been paid to screening the male population during the perinatal period. This study was based on three aims: (1) to investigate the mental health of expectant fathers based on their levels of depression, anxiety, addiction, anger attacks/hostility, and somatization, identifying psychological profiles; (2) to analyze the association between these profiles and the individual variable of perceived stress; (3) and to examine the association between these profiles and the couple's variable of marital adjustment. A total of 350 Italian expectant fathers in the last trimester of pregnancy were asked to fill in questionnaires concerning perceived stress, dyadic adjustment, psychiatric symptomatology, and depression. Three different clusters were found: "psychologically healthy men" (68%) with low levels of symptoms on all the scales; "men at risk of externalized behavioral problems" (17.1%), characterized by one or more addictive or risky behaviors and moderate levels of scales scores; and "men experiencing psychological distress" (14.9%), with the highest scores on all the scales. A significant association emerged among the perceived stress, marital adjustment, and cluster membership. These results highlight the importance of screening fathers in perinatal health services, which are still predominantly mother-centered, and underscore the necessity to create tailored and personalized interventions.

The relationship between dyadic adjustment and psychiatric symptomatology in expectant couples: An actor-partner interdependency model approach.

BACKGROUND: Many researchers who evaluated psychological distress during the transition to parenthood agree in identifying pregnancy as the most sensitive period for the onset of psychiatric symptomatology for both parents. Furthermore, research highlights a correlation between symptoms experienced by fathers in relation to those experienced by mothers. OBJECTIVE: The aim of this study was to investigate whether dyadic functioning influences the level of psychiatric symptomatology in couples expecting their first child. Participants were 137 couples expecting their first child; they were recruited at the San Filippo Neri and the Santo Spirito hospitals in Rome (ASLROMA1). We used an Actor-Partner Interdependence Model (APIM) to test the interdependence of both partners and the effect of dyadic relationships on psychiatric symptoms in the couple. RESULTS: The overall test of distinguishability yielded a chi square value of 122.167 (23 df; p < .001). The actor-partner interdependence model showed significant paths between couple coping and psychiatric symptomatology. Specifically, we found that the quality of couple coping perceived by the mother negatively predicted maternal psychiatric symptomatology, and the quality of couple coping perceived by the father negatively predicted paternal psychiatric symptomatology. Furthermore, the quality of couple coping perceived by the father negatively predicted maternal psychiatric symptomatology. CONCLUSIONS: The results of this study confirm that dyadic adjustment is an important element for the development of effective interpersonal relationships. These data highlight the importance of promoting psycho-educational and clinical courses and programs for the development of social support with future parents.

Psychopathological features in a sample of substance-abusing individuals with criminal history: Towards a definition of a personality prototype of an 'Addict with Criminal Conduct'.

BACKGROUND: The relationship between substance use disorders and criminal activity is strong, and one that is not easily resolved in the criminal justice system. A better understanding of personality traits among substance misusers who commit offences could support better treatment efforts. AIMS: The aim of this study is to explore associations between the psychopathology of people addicted to substances who have also committed crimes. METHODS: We recruited 263 substance-dependent individuals (80% male, 20% female) from a cohort of people attending regional community services in Italy. They all completed an extensive evaluation of their current mental health and personality traits. Their official criminal records were obtained, and the psychopathology of those who had a criminal record compared with those who did not. RESULTS: The criminal group was more likely to perceive the external world as hostile and to consider others as responsible for their own problems and difficulties; in addition, substance-dependent individuals with criminal records showed more personality traits within the psychopathy range and fewer in the dependent personality range than the substance abusers who had never committed crimes. CONCLUSIONS: These findings allow us to hypothesise that substance abusers who also have criminal convictions may have a specific personality profile. If further research were to confirm this, then it could have important implications for identifying people for particular treatment pathways and developing more effective treatments. Copyright © 2016 John Wiley & Sons, Ltd.

Are There Similar or Divergent Transitions to Adulthood in a Mediterranean Context? A Cross-National Comparison of Italy and Spain.

The purpose of this study was to examine the differences and similarities between Italy and Spain in regard to emerging adults' perceptions of identity status, autonomy, attachment, and life satisfaction. The goal was to verify whether a Mediterranean model of transitions from adolescence to adulthood exists. Three hundred and forty undergraduate students (171 Italians and 169 Spanish) ranging in age from 19 to 22 completed measures of identity status, emotional autonomy, attachment style, and life satisfaction. Multiple correspondence analyses provided a graphic synthesis of results. The results indicate that no common model of young adult development exists in Spain and Italy and that Italian youth have a more complex quality of development compared to their Spanish peers.

The relationships between self-efficacy, internet addiction and shame.

BACKGROUND: Internet addiction (IAD) is one of the most diffuse mental disorders among adolescents. AIMS: The aim of our study was to evaluate the relationships between shame, self-efficacy and Internet addiction. MATERIALS AND METHODS: We recruited a total of 670 college students (males = 164, 24.5%; females = 506, 75.5%). The subjects were aged between 18 and 36 years (M = 20.93, SD = 2.52; males: M = 21.43, SD = 2.95; females: M = 20.76, SD = 2.35). We administered the following instruments: Experience of Shame Scale; Perceived Social Self-Efficacy Scale - Adult Version; Perceived Self-Efficacy in Handling Negative Emotions Scales; Internet Addiction Test. STATISTICS ANALYSIS: We applied multivariate analyses of variance (MANOVA), Pearson's correlation indices and linear regression analysis. RESULTS AND CONCLUSION: We found a significant inter-relation between Internet addiction and shame. Shame could be a good predictor of Internet addiction.

The moderating role of father's care on the onset of binge eating symptoms among female late adolescents with insecure attachment.

The present study examined the association between quality of attachment, perception of the father's bond, and binge eating symptoms in a sample of female late adolescents. In total, 233 female students aged between 18 and 20 years completed measures on binge eating, quality of attachment and parent-child relationship. Data showed that respondents with binge symptoms reported lower scores on secure attachment and father's care, and higher scores on preoccupied and fearful attachment. Binge eating symptoms were associated with father's care, but not with father's overprotection. Also, binge symptoms were negatively associated with secure attachment styles, and positively with preoccupied and fearful attachment. The data, finally, provided evidence that at higher levels of preoccupied attachment, the impact of binge symptoms tended to be lower when father's care was high.