Relationship between Executive Functions, Social Cognition, and Attachment State of Mind in Adolescence: An Explorative Study.

BACKGROUND: The passage from pre-adolescence to adolescence is presented as a turning point for the achievement of those abilities in social understanding as they commonly appear in adulthood. Developmental perspectives point to the possible role of neuro-cognitive maturation and social experiences to facilitate this growth. This paper has the goal to goalsto propose a valid and reliable measure of the new quantitative and qualitative advancements in social understanding occurring in the adolescent passage; relying on this, the research has two main objectives (a) to establish the associations between the advancements in social understanding and the executive functions held responsible for the neuro-cognitive rearrangements of adolescence; (c) to evidence the significant associations between attachment models and the development of social understanding in this phase of life. METHODS: 100 subjects (50 boys and 50 girls, aged 11-15) were administered with AICA, SCORS, CNT, Stroop Color-Word Test, and WISC-III. RESULTS: Advancements in the complexity of self-other representations and mentalization of interpersonal exchanges significantly occurs in the passage from pre-adolescence to adolescence and seem to be promoted by increased performances in executive control and cognitive shifting. Dismissing state of mind with respect to attachment is associated with lower development of social understanding in adolescence. The neurocognitive reorganization that underlies the passage from pre-adolescence to adolescence seems to provide the scaffolding for more sophisticated interpretations of the social world. Past and current affective experience can boost or hinder the full deployment of such human maturational potential. Given the importance of social cognition for adjustment and psychopathology, clinical intervention should target the amelioration of individual and family abilities in social reasoning and mentalization.

Attachment-Related Representations and Suicidal Ideations in Nonsuicidal Self-Injury Adolescents with and without Suicide Attempts: A Pilot Study.

OBJECTIVES: Consistent with the debate surrounding the association between nonsuicidal self-injury (NSSI), suicidal intent, and suicidal behavior, and between NSSI and dysregulation processes, we attempted to analyze suicide intent and emotion dysregulation in NSSI adolescents, in the framework of the attachment representations and exploring these clues of emotion dysregulation characteristics of insecure attachment. Furthermore, we intended to focus on these attachment-related segregated systems regarding death and suicidal ideations, to explore how differently they would characterize self-injuring adolescents with and without suicide attempts. METHODS: Thirty-four NSSI inpatient adolescents, 17 with suicide attempts, 17 without suicide attempts, and 17 healthy controls (age 11-17) were assessed using Adult Attachment Projective, which allows for the classification of attachment status and related emotion dysregulation and segregated systems. RESULTS: The majority of the NSSI group with and without suicide attempts showed unresolved (disorganized) attachment-related representations and clues of damaged reflective functions, whereas only the NSSI with suicide attempts showed clues of impaired interpersonal relationships. The two clinical groups used words expressing suicidal intent, whereas the healthy group did not. CONCLUSIONS: Therapists are encouraged not to underestimate suicidal ideation in NSSI regardless of whether or not they have already attempted suicide.

DSM-5 personality domains as correlates of non-suicidal self-injury severity in an Italian sample of adolescent inpatients with self-destructive behaviour.

To evaluate the associations between DSM-5 alternative model of personality disorder dysfunctional personality domains and the clinician's ratings of non-suicidal self-injury (NSSI) severity, a sample of consecutively admitted Italian adolescent inpatients (N = 100) were administered the Italian translations of the DSM-5 Clinician Rating Scale-NSSI (CRS-NSSI), the Personality Inventory for DSM-5 (PID-5), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0 (SCID-II) and the Children's Depression Inventory (CDI). Bivariate association analyses showed that PID-5 negative affectivity scores and CDI total score were significantly associated with CRS-NSSI ratings. PID-5 negative affectivity score proved to be a significant predictor of the CRS-NSSI score even when the effect of the CDI total score was held constant. Our results highlighted that specific risk factors for NSSI severity may be identified even among NSSI adolescents. © 2019 John Wiley & Sons, Ltd.

Reliability and clinical usefulness of the personality inventory for DSM-5 in clinically referred adolescents: A preliminary report in a sample of Italian inpatients.

BACKGROUND: The DSM-5 Alternative Model of Personality Disorders (AMPD) provides the opportunity to integrate the needed developmental perspective in the assessment of personality pathology. Based on this model, Krueger and colleagues (2012) developed the Personality Inventory for DSM-5 (PID-5), which operationalizes the proposed DSM-5 traits. METHODS: Eighty-five consecutively admitted Italian adolescent inpatients were administered the Italian translation of the PID-5, in order to obtain preliminary data on PID-5 reliability and clinical usefulness in clinically referred adolescents. RESULTS: With the possible exception of the PID-5 Suspiciousness scale, all other PID-5 scales evidenced adequate internal consistency reliability (i.e., Cronbach's α values of at least .70, most being greater than .80). Our data seemed to yield at least partial support for the construct validity of the PID-5 scales also in clinical adolescents, at least in terms of patterns of associations with dimensionally assessed DSM-5 Section II PDs that were also included in the DSM-5 AMPD (excluding Antisocial PD because of the participants' minor age). Finally, our data suggested that the clinical usefulness of the PID-5 in adolescent inpatients may extend beyond PDs to profiling adolescents at risk for life-threatening suicide attempts. In particular, PID-5 Depressivity, Anhedonia, and Submissiveness trait scales were significantly associated with adolescents' history of life-threatening suicide attempts, even after controlling for a number of other variables, including mood disorder diagnosis. DISCUSSION: As a whole, our study may provide interesting, albeit preliminary data as to the clinical usefulness of PID-5 in the assessment of adolescent inpatients.

Theory of mind in non-suicidal self-injury (NSSI) adolescents.

UNLABELLED: The aim of the present study is to investigate different facets of the theory of mind (ToM), i.e. first vs. third-person, first vs. second-order ToM, egocentric vs. allocentric perspective, in a clinical sample of 20 non-suicidal self-injury (NSSI) adolescent inpatients and 20 healthy controls. METHODS: We investigated whether performance in ToM tasks was related to both the type and frequency of self-injuring behavior and attitude toward life and death, using a semi-structured interview and different self-report questionnaires. RESULTS: NSSI participants performed less well than the control group in all the ToM dimensions investigated. Furthermore, ToM performance was negatively related to Attraction to Death, in terms of both the type and frequency of self-injuring behavior, and it was positively related to Attraction to Life. CONCLUSIONS: These preliminary findings have interesting implications for future clinical investigations, in that they provide previously unavailable information regarding the association between ToM and NSSI behavior.

A biomonitoring study on blood levels of beta-hexachlorocyclohexane among people living close to an industrial area.

BACKGROUND: A chemical plant manufacturing pesticides has been operating since the 1950's in the Sacco River Valley (Central Italy). In 2005, high beta-hexachlorocyclohexane (Beta-HCH) concentrations were found in milk of cows raised and fed near the river. We report the results of a biomonitoring study conducted in this region to evaluate the body burden of Beta-HCH and to identify the determinants of the human contamination. METHODS: We defined four residential areas by their distance from the chemical plant and the river, and selected a stratified random sample of 626 people aged 25-64 years. We evaluated the association, in terms of the geometric mean ratio (GMR), between several potential determinants and Beta-HCH serum concentrations using multivariate linear regression analysis. RESULTS: Two hundred forty-six serum samples were analysed to assess Beta-HCH levels (mean concentration: 99 ng/g lipid; Standard Deviation: 121; Geometric Mean: 60.6; Geometric Standard Deviation: 2.65). We found a strong association between Beta-HCH and living in the area close to the river (GMR: 2.00; 95%CI: 1.36-2.94). Beta-HCH levels were also associated with age, level of education, use of private wells and consumption of local food. CONCLUSIONS: The results suggest that people living close to the river may have been contaminated by Beta-HCH, most likely through water from private wells and privately grown food. A programme of epidemiological and clinical surveillance is on-going on this population.

[Epidemiologic studies on the health status of the population living in the Sacco River Valley]. / Indagini epidemiologiche sullo stato di salute della popolazione residente nell'area della Valle del Sacco.

UNLABELLED: OBIETTIVO: to analyze the health status of the population living in an area close to the Colleferro industrial plant. SETTING AND PARTICIPANTS: the area of the Sacco River Valley, Central Italy nearby Rome, has been heavily polluted over the years by industrial wastes deriving from the chemical industrial plant in Colleferro. In 2006, it was discovered that the herds of livestock were contaminated by beta-hexachlorocycloexane (ß-HCH, an industrial waste belonging, as well as lindane, to the group of hexachlorocycloexane isomers). MAIN OUTCOME MEASURES: the analyses of mortality and morbidity were carried out for the 1998-2007 period (calculation of standardized mortality ratios, SMR), and for the period 2003-2007 (calculation of standardized hospitalization ratios, SHR), respectively. The general population in the Lazio Region has been considered as reference. In addition, a biomonitoring study was conducted on a sample of the population living in 4 areas of the Sacco River Valley with different levels of exposure and the following persistent organic pollutants were measured in the blood (α, ß and γ-HCH, HCB p,p'-DDT and p,p'- DDE, 6 NDL-PCB congeners and 12 DL-PCBs, PCDDs and PCDFs), and heavy metals (Cd, Hg, Pb). RESULTS: cancer mortality in men was increased in the area (SMR=1.20), especially for specific cancer sites (stomach, larynx, lungs, pleura, myeloma); in women an excess of mortality from diabetes was detected (SMR=1.44). The analysis of morbidity indicated an excess of hospitalization for various cancers (larynx, myeloma) in men, for respiratory illness and asthma in both genders and for thyroid disease in women. The biomonitoring study found high mean concentration of ß-HCH (mean: 99.05 ng/g fat, SD=121.3), with higher levels in the population living along the river (mean=150 ng/g fat; SD=153.5), likely occurred through water and local food. CONCLUSION: the area of Colleferro has been polluted by multiple sources and the human population has been exposed to industrial chemicals, toxic substances in the workplace, and to the cumulative accumulation of organic pesticides especially through water and food.

Mortality in a cohort of cement workers in a plant of Central Italy.

PURPOSE: Workers of cement production are exposed to alkaline dust with irritant effects on the respiratory system. Most previous studies have examined workers in cement/asbestos factories, but there is limited information of the effects of exposures to Portland cement alone. The present study examines the effects of cement dust in a cohort of Portland cement workers through the analyses of their mortality records. METHODS: Using the records of a cement plant, we reconstructed the work history of all 748 male employees between 1956 and 2006. SMRs were computed for overall mortality and for specific causes of death for the cohort compared with the reference population. The analysis was also performed by subdividing the cohort in low- and high-exposure groups on the basis of the task of the worker and the length of his exposure. RESULTS: The overall mortality of the cohort (SMR = 0.87) as well as the mortality from all cancers (SMR = 0.64) and from cancers of the respiratory system (SMR = 0.56) was significantly lower compared to the reference population. Workers of the cement plant with higher exposures did not have an increased mortality risk from any cause. The only significantly elevated risk observed among these workers was for cancer of the respiratory system (SMR = 2.86), exclusively in the small subgroup of 39 workers with previous exposure to a cement/asbestos plant. CONCLUSIONS: Portland cement workers had a statistically significant reduced risk of overall mortality and of all cancers mortality probably due to the healthy workers effect. The study confirmed an increased risk of respiratory system cancer only in the subgroup with previous work exposure in a cement/asbestos plant.