The Relationships between Compulsive Internet Use, Alexithymia, and Dissociation: Gender Differences among Italian Adolescents.

Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person's functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than females. People can use the internet to avoid or alleviate negative affects; in fact, problematic internet use is associated with alexithymia and dissociation. Few studies have focused on the different stages of adolescence, gender differences, and the relationships between the aforementioned variables. This research aims to fill this gap. Five hundred and ninety-four adolescents aged between 13 and 19 filled in the Compulsive Internet Use Scale, the Toronto Alexithymia Scale, the Adolescents Dissociative Experiences Scale, and other ad hoc measures. Surprisingly, females reported higher compulsive internet use compared with males. Moreover, they referred more difficulties/symptoms and greater levels of alexithymia than males. No differences across the stages of adolescence were found. Different strengths in the relationships between variables were found according to gender. Moderated mediation analyses indicated that dissociation is an important mediator in the relation between alexithymia and Compulsive Internet Use only among females. This study shed new light on gender differences around problematic internet use and some related risk factors, in order to identify and develop prevention and treatment programs to face this topical and relevant issue.

The link between individualism-collectivism and life satisfaction among emerging adults from four countries.

The current investigation tested life satisfaction (LS), a cognitive component of subjective well-being, among emerging adults, in the context of individualism (I) and collectivism (C), by distinguishing both cultural and individual levels of analysis, considering their horizontal (H) and vertical (V) dimensions, and controlling age and gender effects. Emerging adults (N = 1760 university students, aged 18-25, Mage  = 19.46, SDag  = 1.50) located across four countries, namely China, Italy, Russia, and the USA, known to differ in the individualism index value (IDV), completed measures on the Horizontal and Vertical Individualism and Collectivism and Life Satisfaction. At the cultural level, an ANCOVA showed a significant country effects on LS. The post hoc comparisons indicated that the higher the country IDV score, the higher the average LS score, in the following order: Americans, Italians, Russians, and Chinese. At the individual level, LS was unrelated to HI and VI. Instead, it was associated with HC and VC. The positive link between LS and VC suggested an important role of family connectedness on LS across different cultures during emerging adulthood. However, contrary to previous studies, LS was unrelated to HI and VI.

The Road More Travelled: The Differential Effects of Spatial Experience in Young and Elderly Participants.

Our spatial mental representations allow us to give refined descriptions of the environment in terms of the relative locations and distances between objects and landmarks. In this study, we investigated the effects of familiarity with the everyday environment, in terms of frequency of exploration and mode of transportation, on categorical and coordinate spatial relations, on young and elderly participants, controlling for socio-demographic factors. Participants were tested with a general anamnesis, a neuropsychological assessment, measures of explorations and the Landmark Positioning on a Map task. The results showed: (a) a modest difference in performance with categorical spatial relations; (b) a larger difference in coordinate spatial relations; (c) a significant moderating effect of age on the relationship between familiarity and spatial relations, with a stronger relation among the elderly than the young. Ceteris paribus, the role of direct experience with exploring their hometown on spatial mental representations appeared to be more important in the elderly than in the young. This advantage appears to make the elderly wiser and likely protects them from the detrimental effects of aging on spatial mental representations.

Parental feeding practices across child's weight status: Evidence of the Italian validation of the Child Feeding Questionnaire.

OBJECTIVE: The main aim of this study was to assess the psychometric proprieties of the Child Feeding Questionnaire (CFQ) in Italian mothers. DESIGN: Mothers completed the Italian version of the CFQ, and children's anthropometric data were collected. Construct validity of the CFQ was assessed by comparing three different models: (a) a seven correlated factors model in which all items were analysed; (b) a seven correlated factors model with composite items based on the Restriction factor and (c) an eight correlated factors model with a separate Reward factor. Measurement invariance using BMI categories and gender was evaluated. Furthermore, discriminant validity with group comparison was performed between BMI categories and gender. SETTING: Italy. PARTICIPANTS: A total of 1253 6-year-old Italian children (53·9 % male) attending elementary school (1st grade) and their mothers (mean age = 38·22 years; sd = 4·89) participated in this study. RESULTS: The eight-factor model with a separate reward factor provided the best fit for the data. The strict invariance of the CFQ across child BMI categories and gender was confirmed. The CFQ internal consistency was acceptable for most subscales. However, two subscales showed no adequate values. As expected, the CFQ scales showed significant differences between BMI categories, while no gender-related differences were found. CONCLUSIONS: The study indicated the Italian version of the CFQ to be factorially valid for assessing parental feeding practices of 6-year-old children across BMI categories. Future research should address low internal consistency in some of the CFQ subscales.

Music Playing and Interhemispheric Communication: Older Professional Musicians Outperform Age-Matched Non-Musicians in Fingertip Cross-Localization Test.

OBJECTIVE: Numerous investigations have documented that age-related changes in the integrity of the corpus callosum are associated with age-related decline in the interhemispheric transfer of information. Conversely, there is accumulating evidence for more efficient white matter organization of the corpus callosum in individuals with extensive musical training. However, the relationship between making music and accuracy in interhemispheric transfer remains poorly explored. METHODS: To test the hypothesis that musicians show enhanced functional connectivity between the two hemispheres, 65 professional musicians (aged 56-90 years) and 65 age- and sex-matched non-musicians performed the fingertip cross-localization test. In this task, subjects must respond to a tactile stimulus presented to one hand using the ipsilateral (intra-hemispheric test) or contralateral (inter-hemispheric test) hand. Because the transfer of information from one hemisphere to another may imply a loss of accuracy, the value of the difference between the intrahemispheric and interhemispheric tests can be utilized as a reliable measure of the effectiveness of hemispheric interactions. RESULTS: Older professional musicians show significantly greater accuracy in tactile interhemispheric transfer than non-musicians who suffer from age-related decline. CONCLUSIONS: Musicians have more efficient interhemispheric communication than age-matched non-musicians. This finding is in keeping with studies showing that individuals with extensive musical training have a larger corpus callosum. The results are discussed in relation to relevant data suggesting that music positively influences aging brain plasticity.

Anxiety Severity, Perceived Risk of COVID-19 and Individual Functioning in Emerging Adults Facing the Pandemic.

The COVID-19 pandemic is showing a strong impact on people in terms of uncertainty and instability it has caused in different areas of daily life. Uncertainty and instability are also emotions that characterize emerging adulthood (EA). They generate worries about the present and the future and are a source of anxiety that impacts negatively on personal and interpersonal functioning. Anxiety seems a central effect of the pandemic and recent studies have suggested that it is linked to COVID-19 risk perception. In the present study, a sample of 1045 Italian emerging adults was collected: (1) to assess anxiety severity and perceived risk related to COVID-19 and their association and (2) to compare general health and protective factors such as attitudes about security, relationships, self-esteem, and self-efficacy across anxiety severity and perceived risk categories. The findings of this study highlighted that anxiety severity categories were distributed homogeneously across the sample and that half of the participants referred to moderate-severe anxiety. A series of analysis of variances and post hoc comparisons showed that general health and all protective factors decreased according to anxiety severity. They were higher in participants with high perceived risk, with the exception of self-efficacy. Given the challenging features of the pandemic and EA, it is crucial to monitor anxiety severity in order to prevent last longing effects on mental and physical health, as well as keeping emerging adults informed about the risks related to the pandemic. Intervention and supportive programs based on improving self-esteem and self-efficacy, as well as confidence in relationships, should be offered to emerging adults over the long term, beyond the current outbreak.

Physical Activity Habits and Well-Being among 6-Year-Old Children: The "Improving Umbrian Kids' Healthy Lifestyle", an Uncontrolled Pilot Study Project.

There is evidence that promoting physical activity programs and decreasing sedentary behavior is a potential strategy for improving health-outcomes, peer relationships and social/emotional well-being in at-risk youth. The World Health Organization recommends enhancing physical education and school-based programs with multi-component and evidence-based assessment methodology. In Umbria (Italy) an uncontrolled pilot study project referred to as "Improving Umbrian kids' healthy lifestyle" was implemented as a systemic school-based intervention directed at 6-year-old primary school children. The intervention applied a consolidated assessment methodology developed by the C.U.R.I.A.Mo. and Eurobis projects that inserted two hours per week of physical education activity into the school curriculum, structured and supervised by specialists with Exercise and Sport Science degrees, for eight months (from October to June) of the school year. We measured anthropometric values (BMI, waist circumference, waist-to-height ratio index) with objective tools. Moreover, we evaluated physical performance variables (speed, strength, and flexibility) using standard tests. Additionally, self-report measures (measured physical activity during the week, sedentary habits, and psychological well-being) were assessed using validated questionnaires. We observed a significant decrease in waist to height ratio, and improvements in physical performance values and self-report questionnaire measures. Our study suggests that the promotion of physical activity in the school setting is likely to result in physically, mentally, and psycho-socially healthier primary-school-age children.

Age-related decline in interhemispheric transfer of tactile information: The fingertip cross-localization task.

According to the disconnection hypothesis of cognitive aging, cognitive deficits associated with brain aging could be a result of damage to connective fibres. It has been suggested that the age-related decline in cognitive abilities is accompanied by age-related changes in interhemispheric communication ensured by commissural fibres. This study aimed to contribute to this topic by investigating the effects of aging on the efficiency of interhemispheric transfer of tactile information. A total of 168 right-handed subjects, aged 20-90 years, have been tested using the fingertip cross-localization task: the subject must respond to a tactile stimulus presented to one hand using the ipsilateral (uncrossed condition) or contralateral hand (crossed condition). Because the crossed task requires interhemispheric transfer of information, the value of the difference between the uncrossed and crossed conditions (CUD) can be deemed to be a reliable measure of the efficiency of the interhemispheric interactions. The uncrossed condition was more accurate than the crossed condition for all ages. However, the degree of the CUD was significantly age-dependent. The effectiveness of the interhemispheric transfer of tactile information decreased significantly with age and may indicate the occurrence of age-related changes of the corpus callosum. Considerably, performance appears to decline around the seventh decade of life with the fastest decline in the subsequent decades. The results suggest a relationship between brain aging and the efficiency of the interhemispheric transfer of tactile information. The findings are discussed in relation to the strategic role of white matter integrity in preserving behavioural performances.

Emerging Adults and COVID-19: The Role of Individualism-Collectivism on Perceived Risks and Psychological Maladjustment.

The outbreak of the coronavirus disease 2019 (COVID-19) has dramatically changed our habits and routines. Uncertainty, insecurity, instability for the present and future, and reduced autonomy and self-directedness, are common feelings at the time of COVID-19. These aspects are very important during emerging adulthood. In spite of the fact that medical reports suggest that youth are less prone to experience COVID-19 infections, emerging adults might be at higher risk for their psychological adjustment. Emerging adults showed higher concerns about their role as a possible asymptomatic carrier than being positive with COVID-19 themselves. Both worries and concerns about COVID-19 and psychological maladjustment may be related to cultural factors. Individualism, collectivism, equality, and hierarchy seem to be meaningful perspectives to take into account. A total of 1183 Italian emerging adults were asked to fill out an online survey during the second week of the national lockdown in Italy. Results showed they reported an accurate perceived knowledge about COVID-19. At the same time, they showed higher worries and concerns about COVID-19 for their relatives, followed by more general/social worries. The lowest score included worries about COVID-19 related to themselves. State anxiety and stress levels were above the normal cutoff, confirming the challenges that emerging adults are facing during the pandemic. On one hand, emerging adults' collectivistic orientation was related to higher perceived risks of infection; on the other hand, it predicted lower psychological maladjustment, controlling for socio-demographic variables. The study suggests that to fight the COVID-19 pandemic and decrease levels of psychological maladjustment in emerging adulthood, individuals' cultural orientation such as the wish of sharing common goals with others, interdependence, and sociability, have to be emphasized and promoted as protective factors.

Protective factors for depressive symptoms in emerging adulthood.

Emerging adulthood is characterized by pervasive changes in identity and relationships. These challenges can entail problems for subjective well-being, leading to depressive symptoms. The development of an autonomous-related self is considered crucial for emerging adults' personal growth and psychological well-being. Autonomous-related self is linked to self-esteem and secure attachment style, which are also protective factors for depression. The current research sought to investigate the relation between autonomous-related self and depressive symptoms, as well as the role of secure attachment style and self-esteem, in a sample of 356 Italian emerging adults. Gender differences were taken into account in preliminary analyses. Gender differences emerged for autonomous-related self and self-esteem, while secure attachment and depression levels were similar across gender. Our results suggest that autonomous-related self, mediated by self-esteem and secure attachment style, is a protective factor for emotional states of depression, controlling for social desirability. These findings emphasize the importance of taking autonomy and relatedness into account in emerging adulthood and represent a starting point for future studies.

Parenting Styles and Child's Well-Being: The Mediating Role of the Perceived Parental Stress.

In the last decades, consensus from laymen, scholars, and policy-makers has emphasized the role of child-parent relationships to promote child's development and positive well-being. Parenting style was claimed as one of the crucial factors for the child's positive adjustment. The main aim of the present study was to investigate the relationships between authoritative and authoritarian parenting styles and child's difficulties. The mediational role of parent's perception of a difficult child on the above mentioned relation was taken into account. The study was carried out on a sample of 459 couples including mothers (n = 459) and fathers (n = 459) of children aged 2 to 10 years old who filled in the Parenting Styles & Dimensions Questionnaire short version, the Strengths and Difficulties Questionnaire, and the Parenting Stress Index-short form. Main findings indicated that authoritative style was associated with less child's maladjustment, while the authoritarian one showed the opposite association. These relationships were partially mediated by the perception of a difficult child, which partially explained the link between parenting style and child's problems. Above and beyond the role of parent's perception as a difficult child, parenting styles had an important effect on child's difficulties. Future studies should replicate these results with other samples, use the spouse version of the parenting styles, control the effect of socio-economic status and other variables related to family functioning, as well as to consider the child's perception regarding parents' parenting style.

Personality Features in Obesity.

Obesity is a widespread and broadly consequential health condition associated with numerous medical complications that could increase mortality rates. As personality concerned individual's patterns of feeling, behavior, and thinking, it may help in understanding how people with obesity differ from people with normal-weight status in their typical weight-relevant behavior. So far, studies about personality and BMI associations have mainly focused on broad personality traits. The main purpose of this study was to explore the personality and health associations among a clinical group composed of 46 outpatients with overweight/obesity (mean age = 55.83; SD = 12.84) in comparison to a healthy control group that included 46 subjects (mean age = 54.96; SD = 12.60). Both the clinical and control groups were composed of 14 males and 32 females. Several personality and psychopathological aspects were assessed with the Personality Assessment Inventory (PAI). The results of the analysis of variance of aligned rank transformed (ART) showed that patients with overweight/obesity reported higher scores for Somatic Complaints, Depression, and Borderline Features than the control group. Logistic regression highlighted specifically that the subscales of the Borderline Features assessing the Negative Relationship contributed to the increased risk of belonging to the clinical group. For the purpose of this study, the role of gender was considered. The present findings highlight the importance of focusing on assessing personality functioning in the health context and on specific characteristics of interpersonal relationships to promote more tailored treatments.

Parental Reflective Functioning in Mothers and Fathers of Children With ADHD: Issues Regarding Assessment and Implications for Intervention.

Parental factors contribute to ADHD, partly in an etiological way and partly as moderators and mediators of child outcomes and treatment effects. An important aspect of parenting seems to be parental reflective functioning (PRF), defined as the parent's capacity to reflect upon his own and his child's internal mental experience. The studies on parenting factors linked to ADHD have not extensively investigated the role of PRF. Recent findings on interventions have begun to consider mentalization to promote empathy and emotion regulation in parents, but empirical studies assessing PRF are still scarce. The aim of this cross-sectional study was to compare specific familial and parental functioning characteristic between parents of children with attention deficit/hyperactivity disorder (ADHD) and parents of controls without ADHD. A clinical sample of 41 children with ADHD aged 8-11 years and their parents was compared with a matched, non-clinical sample of 40 children. Three aspects of parental functioning were investigated: parental symptomatology, parental alliances and PRF; children's differences in strength and difficulty profiles were also assessed. The results showed that families of children with ADHD had lower socioeconomic status, and both mothers and fathers of the same families reported higher scores for depression and lower PRF than did the control group; only mothers showed lower parental alliance. Logistic regression highlighted the fact that several of these familial and parental factors contributed to the increased risk of belonging to the clinical group, specifically both mothers' and fathers' depressive symptoms and lower PRF. These data represent new findings with potentially meaningful clinical implications for both assessment and intervention.

Childhood obesity and parental reflective functioning: Is there a relation?

BACKGROUND/OBJECTIVE: In recent decades, the prevalence of childhood obesity has increased, with the major implications for public health. However, the factors that contribute to obesity in children are still poorly understood. The present study aimed to investigate the role of parental reflective functioning (PRF) in childhood obesity. METHOD: In a cross-sectional design, 120 sets of parents of 60 children (n = 30 with obesity, age range 6-11) were recruited by local paediatricians. Parents completed the Parental Reflective Functioning Questionnaire. Children's and parents' weight (assessed by BMI), as well as their socio-economic status (SES), were assessed to explore the contribution of PRF in the prediction of children's weight, controlling for parents' weight and SES. RESULTS: t-test showed significant differences with medium effect sizes in BMI, SES and PRF between parents of children with and without obesity. The best model resulted from hierarchical multiple regression analyses and showed that mothers' PRF predicted children's BMI above and beyond the prediction by parents' BMI and SES. CONCLUSIONS: Low maternal PRF could be an important target for intervention strategies, highlighting the need to consider parental responses to children's emotions in the treatment of childhood obesity, particularly in parents with low SES and high BMI.

ANTECEDENTES/OBJETIVO: En las últimas décadas la prevalencia de la obesidad infantil ha aumentad, teniendo implicaciones relevantes por la salud pública, pero hay todavía poca comprensión de los factores que contribuyen a la misma. La finalidad del estudio es investigar el papel de la función reflectiva parental (PRF) en la obesidad infantil. MÉTODO: En un estudio transversal, 120 parejas de padres de 60 niños (30 con obesidad, con edades entre 6 y 11 años) fueron reclutados por pediatras locales. Los padres tuvieron que rellenar el Parental Reflective Functioning Questionnaire. El peso de los niños y de los padres (BMI), así como el estado socio-económico (SES) fueron evaluados para explorar la contribución del PRF a la predicción del peso de los niños, en relación al peso parental y al SES. RESULTADOS: El t-test ha mostrado diferencias significativa entre padres de niños con y sin obesidad en BMI, SES y PRF. El mejor modelo resultado de los análisis de regresión múltiple jerárquica ha mostrado que el PRF materno puede predecir el BMI de los niños más que el BMI paterno y el SES. CONCLUSIONES: Un PRF materno bajo podría representar una diana importante para estrategias de intervención.

Hospitalized Children: Anxiety, Coping Strategies, and Pretend Play.

The aim of this paper was to assess strengths and fragilities in children aged 6 to 10 who suffered one or more hospitalizations. State and trait anxiety, coping abilities, and cognitive and affective functioning through play were assessed using a triangulation approach. Fifty hospitalized children aged 6-10 were compared to 50 non-hospitalized children, and children at first admission were compared with children with more than one hospitalization experience. The State-Trait Anxiety Scales Inventory for Children was administered for assessing trait and state anxiety, and the Children's Coping Strategies Checklist (Revision 1) was administered to assess coping dimensions. The Affect in Play Scale - Preschool - Brief (Extended version) was used to assess cognitive and affective dimensions of play. No significant differences were found for trait anxiety between hospitalized vs. non-hospitalized children. Instead, as expected, state anxiety was significantly higher in hospitalized childen than in the non-hospitalized children. Hospitalized children reported higher scores than non-hospitalized children in support-seeking strategies. As for pretend play, hospitalized children showed significantly higher cognitive scores than non-hospitalized children. However, hospitalized children appeared significantly more restricted in their affect expressions. No significant differences were found for play and anxiety scores between children admitted for the first time in the hospital ward and children with more than one admission. However, children at first admission scored higher in coping and positive cognitive restructuring and in avoidance-coping strategies than children with more than one admission. The initial assessment of the interplay of key variables such as anxiety, coping and play can inform healthcare professionals by serving as a guide in order to determine a child's risk for negative psychological outcomes due to hospitalization, to plan appropriate interventions and to provide substantial assistance to hospitalized children in the future.

Childhood obesity and parental reflective functioning: Is there a relation? / ¿Existe relación entre la obesidad infantil y la función reflectiva parental?

Background/Objective: In recent decades, the prevalence of childhood obesity has increased, with the major implications for public health. However, the factors that contribute to obesity in children are still poorly understood. The present study aimed to investigate the role of parental reflective functioning (PRF) in childhood obesity. Method: In a cross-sectional design, 120 sets of parents of 60 children (n = 30 with obesity, age range 6-11) were recruited by local paediatricians. Parents completed the Parental Reflective Functioning Questionnaire. Children's and parents’ weight (assessed by BMI), as well as their socio-economic status (SES), were assessed to explore the contribution of PRF in the prediction of children's weight, controlling for parents’ weight and SES. Results: t-test showed significant differences with medium effect sizes in BMI, SES and PRF between parents of children with and without obesity. The best model resulted from hierarchical multiple regression analyses and showed that mothers’ PRF predicted children's BMI above and beyond the prediction by parents’ BMI and SES. Conclusions: Low maternal PRF could be an important target for intervention strategies, highlighting the need to consider parental responses to children's emotions in the treatment of childhood obesity, particularly in parents with low SES and high BMI

Antecedentes/Objetivo: En las últimas décadas la prevalencia de la obesidad infantil ha aumentad, teniendo implicaciones relevantes por la salud pública, pero hay todavía poca comprensión de los factores que contribuyen a la misma. La finalidad del estudio es investigar el papel de la función reflectiva parental (PRF) en la obesidad infantil. Método: En un estudio transversal, 120 parejas de padres de 60 niños (30 con obesidad, con edades entre 6 y 11 años) fueron reclutados por pediatras locales. Los padres tuvieron que rellenar el Parental Reflective Functioning Questionnaire. El peso de los niños y de los padres (BMI), así como el estado socio-económico (SES) fueron evaluados para explorar la contribución del PRF a la predicción del peso de los niños, en relación al peso parental y al SES. Resultados: El t-test ha mostrado diferencias significativa entre padres de niños con y sin obesidad en BMI, SES y PRF. El mejor modelo resultado de los análisis de regresión múltiple jerárquica ha mostrado que el PRF materno puede predecir el BMI de los niños más que el BMI paterno y el SES. Conclusiones: Un PRF materno bajo podría representar una diana importante para estrategias de intervención

Immune tolerance induced using plasma exchange and rituximab in an infantile Pompe disease patient.

Infantile Pompe disease, resulting from deficiency of lysosomal acid α-glucosidase, requires enzyme replacement therapy with recombinant human acid α-glucosidase. Most patients develop antirecombinant human acid α-glucosidase antibodies, leading to reduced response to enzyme therapy in a subgroup of them. Aiming to improve treatment response, several immune tolerance induction strategies have been explored. We describe a patient with life-threatening infusion-associated reactions presenting anti-recombinant human acid α-glucosidase antibodies. He was successfully treated with an immune tolerance induction protocol, consisting of plasma exchange combined with a single dose of rituximab. Immediate reduction of antibody titer was obtained and enzyme therapy was resumed without infusion-associated reactions. Twenty-two months later, immunoglobulin G titer remained below 1:100. In conclusion, we applied a short-course immune tolerance induction strategy in a patient with severe infusion-associated reactions and anti-recombinant human acid α-glucosidase antibodies, leading to early and persisting reduction of antibody titer, in the absence of significant adverse events.