COVID-19 pandemic impact among adolescents with eating disorders referred to Italian psychiatric unit.

PROBLEM: The COVID-19 pandemic has triggered or exacerbated eating disorders (EDs), especially in adolescents. This study examined the prevalence of admissions of patients with EDs at the Child and Adolescent Psychiatry Unit from the pre-COVID-19 pandemic to March 2023 and explored the differences in dimensions of ED's symptomatology according to the year of access. METHODS: We included 174 children and adolescents, 94.3% females and 5.7% males, with a diagnosis of ED (Mage = 14.87; SD = 1.72). The Eating Disorder Inventory-3 (EDI-3), the Body Uneasiness Test (BUT) and Youth Self Report ASEBA (YSR) were assessed. A one-way analysis of variance test was performed. FINDINGS: EDs' hospitalization prevalence was higher in the years 2020 and 2021 compared to pre-COVID-19 and the year 2022. Considering the ED psychopathology (EDI-3), findings showed a higher score in the dimension of the push to thinness, body dissatisfaction, asceticism, and fear of maturity in the year 2021 compared to pre-pandemic. Regarding the discomfort related to the image of one's own body (BUT), results showed an increase in the global severity index in the year 2022 compared to pre-pandemic and in weight phobia in the year 2021 compared to the year 2020. Concerning the internalizing symptoms (YSR), a tendency was found for withdrawal/depression, with higher levels in the year 2022 compared to the year 2020. CONCLUSIONS: Our study highlighted the increase of different types of EDs symptomatology related to concerns about weight, especially 2 and 3 years after the outbreak of the pandemic, on which the literature is still scarce, especially in the Italian context.

The Role of Environmental Sensitivity in the Relationship Between Childhood Maltreatment and Self-Conscious Emotions of Shame and Guilt: A Brief Report.

The association between childhood maltreatment and self-conscious emotions has been proven by the literature, but with limited attention to the specific moderating mechanisms involved. Highly sensitive individuals show emotional reactivity, ease of overstimulation, which make them more influenced by childhood maltreatment experiences. The study aims to test whether environmental sensitivity moderated the link between childhood maltreatment and self-conscious emotions of shame and guilt. The sample included 128 children referred for Oppositional Defiant Disorder (M age = 9.05; SD = 1.34). Results showed a significant interaction between maltreatment and environmental sensitivity on guilt and shame (B = 1.81, SE = .84, p < .05; B = 1.69, SE = .83, p < .05): highly sensitive children presented higher levels of shame and guilt following experiences of maltreatment as compared to low sensitive children. These findings may contribute to the literature on the role of environmental sensitivity as an individual trait moderating the effect of a contextual experience.

Cyber Dating Violence Instrument for Teens (CyDAV-T): Dimensional Structure and Relative Item Discrimination

BACKGROUND: Validated measures of cyber dating violence are scarce and have barely explored the sexual dimension. The present study advanced this line of research by developing a new instrument that differentiates between sexual, verbal and control dimensions. METHOD: The instrument was created in four phases: literature review, focus groups with young people, expert review, and creation of the final scale. This instrument was administered to 600 students from high schools in Seville and Córdoba, aged between 14 and 18 ( M = 15.54; SD = 1.22). RESULTS: A three-factor latent structure was confirmed for the aggression and victimization scales: verbal/emotional, control, and sexual. Using Item Response Theory, a refined version of the scales resulted in 19 items for both aggression and victimisation. Prevalence analysis showed that verbal/emotional forms were the most frequent, followed by control and sexual. CONCLUSIONS: The CyDAV-T instrument can be considered a valid instrument for assessing cyber dating violence in the adolescent population.

Exposure to and Speaking Up Against Online Ethnic Hate Speech: The Role of Xenophobia in a Three-Wave Longitudinal Study.

Nowadays, adolescents have extensive access to Information and Communication Technologies, which allow them to engage in social networking activities that may expose them to Online Hate Speech (OHS). While there are few cross-sectional studies about the effects of OHS Exposure on attitudes and aggressive behavior, no study aims to analyze the tendency to Speak Up when exposed to certain content (e.g., reporting, etc.). In addition, no instruments have yet been validated to assess these constructs. The aim of the present study, focused on Online ethnic Hate Speech (OeHS), is double: (a) develop a scale to measure OeHS Exposure and the tendency to Speak Up and analyze its psychometric properties; (b) analyze the longitudinal association between Xenophobia (XEN), OeHS Exposure, and Speaking Up against OeHS, while taking into account gender differences and the nested nature of the data. Six hundred sixty-six Italian high school students (52.7 percent male; MAge = 15[0.64]), nested in 36 ninth grade classes (10 schools), took part in the longitudinal study. The first wave of data collection occurred in early 2020, before the COVID-19 pandemic. The second and third waves took place 12 and 15 months later, respectively. Findings suggest that the OeHS Scale has good psychometric properties. Moreover, according to the findings, while the three variables of interest are always cross-sectionally correlated, a longitudinal negative association have been found between XEN and both Exposure and Speaking Up. Regarding the impact of OeHS Exposure, the good news is related to the absence of a longitudinal association with both XEN and Speaking Up.

Peer victimization and developmental psychopathology in childhood and adolescence Italian psychiatric emergency unit. A single center retrospective observational study.

Peer victimization is a public health concern that affects a significant proportion of children and adolescents. The study evaluated the prevalence of peer victimization among 440 subjects referred to Emergency Department for a psychiatric consultation and analyzed the association with psychopathological symptoms. Sample was divided into two categories (6-13 and 14-18 years old). Logistics regression analysis was performed. Peer victimized were reported in 16.3% of subjects; 27.7% were younger than13 years old and 72.3% were between 14-18 years old, representing the main targets for peer victimization.A significant association was found between being peer victimized and depressive disorder (OR=4.57) in subjects younger than 13 years old and, with post-traumatic stress disorder (PTSD)(OR=6.52) in subjects older than 13 years old. Furthermore, linkage between being peer victimized and obsessive-compulsive disorder (OCD)(OR=4.45) was noted. Increased frequency of repeated hospitalizations was also documented.This is the first Italian study about children and adolescent peer victimization in psychiatric setting, showing a significant higher risk for depressive disorder in subjects younger than 13 years old and PTSD and OCD in subjects older than 13 years old. Investigating experiences of peer victimization provides an early diagnosis and a more efficient treatment plans, guaranteeing an improved clinical outcome.

Cyber Dating Violence Instrument for Teens (CyDAV-T): Dimensional Structure and Relative Item Discrimination / Escala de Violencia Online en Parejas Adolescentes (CyDAV-T): Estructura Dimensional y Análisis de Respuesta de los Ítems

Background: Validated measures of cyber dating violence are scarce and have barely explored the sexual dimension.The present study advanced this line of research by developing a new instrument that differentiates between sexual,verbal and control dimensions. Method: The instrument was created in four phases: literature review, focus groupswith young people, expert review, and creation of the final scale. This instrument was administered to 600 studentsfrom high schools in Seville and Córdoba, aged between 14 and 18 (M = 15.54; SD = 1.22). Results: A three-factorlatent structure was confirmed for the aggression and victimization scales: verbal/emotional, control, and sexual. UsingItem Response Theory, a refined version of the scales resulted in 19 items for both aggression and victimisation.Prevalence analysis showed that verbal/emotional forms were the most frequent, followed by control and sexual.Conclusions: The CyDAV-T instrument can be considered a valid instrument for assessing cyber dating violence inthe adolescent population.(AU)

Antecedentes: Las medidas validadas de violencia online en la pareja adolescente son escasas y apenas han exploradola dimensión sexual. El presente trabajo avanzó en esta línea de investigación desarrollando un nuevo instrumento quecontemplase las formas sexuales, las verbales y el control. Método: La creación del instrumento se desarrolló en cuatrofases: revisión de la literatura, grupos focales con jóvenes, revisión de expertos y creación del instrumento final. Esteinstrumento fue administrado a 600 estudiantes de institutos de Sevilla y Córdoba, con edades comprendidas entrelos 14 y los 18 años (M = 15.54; DT = 1.22). Resultados: Se confirmó una estructura de tres factores latentes para lasescalas de agresión y victimización: verbal/emocional, control, y sexual. Utilizando la Teoría de Respuesta al ítem seelaboró una versión depurada de 19 ítems para agresión y victimización. Los análisis de prevalencia mostraron que lasformas verbales/emocionales fueron las más frecuentes, seguidas del control y la sexual. Conclusiones: El CyDAV-T sepresenta como un instrumento válido para la violencia online en la pareja adolescente.(AU)

Non-Suicidal Self-Injury in Adolescence: The Role of Pre-Existing Vulnerabilities and COVID-19-Related Stress.

For many adolescents, the COVID-19 pandemic represents a uniquely challenging period, and concerns have been raised about whether COVID-19-related stress may increase the risk for self-injurious behaviors among adolescents. This study examined the impact of pre-existing vulnerabilities on the occurrence and frequency of Non-Suicidal Self-Injury (NSSI) through COVID-19-related stress, and whether the impact of COVID-19-related stress on NSSI was buffered by the perceived social support during the pandemic. Participants were 1061 adolescents (52.40% females; Mage = 15.49 years, SD = 0.76) from a two-wave longitudinal study, which included assessments before the COVID-19 onset and one year later the declaration of the pandemic. Path analyses showed that adolescents with a prior history of NSSI, higher levels of internalizing symptoms, and poor regulatory emotional self-efficacy before the COVID-19 pandemic reported higher levels of COVID-19-related stress which in turn increased their risk to engage in NSSI. Besides, the findings did not support the role of social support as a moderator of the association between COVID-19 related stress and the occurrence/frequency of NSSI. These findings suggest that enhanced stress perception may serve as a key pathway for the continuation and development of NSSI among vulnerable adolescents facing adverse life events.

Pathways to resilience: The parallel change in children's emotional difficulties and family context during the COVID-19 lockdown in Italy.

OBJECTIVE: The study analyses which pathways to adjustment emerged at the family level during the COVID-19 containment period in Italy, during which children were locked down with their families for 56 days from March 11 to May 6. Using a longitudinal design, with data pre- and postevent, a bivariate latent change score model analyzed the covariance of the change in family well-being (FW) and in emotional difficulties (ED), testing if the longitudinal change in ED is a function of the starting level of FW, and vice-versa. Children's stress reactions to the pandemic and other related experiences were included as additional predictors. METHOD: A total of 166 middle school students (86 females) with a mean age of 11.14 (SD = .47) completed two online questionnaires, in January 2020 (T0) and in June 2020 (T1). RESULTS: Results showed that children's ED decreased significantly, on average, during the lockdown period, and FW remained constant. ED and FW change scores had a significant and negative covariation (ß = - .46; p = .01). When family well-being increased emotional difficulties decreased, and vice versa. FW at T0 predicted no change in FW, nor did T0 scores of ED predict any change in FW. CONCLUSIONS: The strong intercorrelated change between children's ED and FW during the lockdown does not seem influenced by preexisting levels of individual and family functioning. Findings supported the view that for some families, the COVID-19 lockdown was also an opportunity to experience deeper emotional connections, contributing to a decrease in ED. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The effect of the NoTrap! Antibullying program on ethnic victimization: When the peer educators' immigrant status matters.

Nowadays, an increasing number of children and adolescents living in Europe have an immigrant background. Because ethnicity is a recognizable characteristic that may become the driver of bullying, these youths are at high risk of victimization. School interventions based on peer-led approaches, assuming all the conditions postulated in contact theory, could be suitable to counteract bias-based bullying and victimization.This study aims to analyze whether the NoTrap! antibullying program, an evidence-based peer-led intervention, may also be effective in counteracting ethnic bullying and victimization when students with an immigrant background are involved as peer educators. There were 1,570 students who participated in the study: 24 control classes (N = 476) and 50 experimental classes (N = 1094). Within the last group we identified two conditions: 30 classes in which all peer educators were Italian (Experimental A, N = 661); 20 classes in which at least one of them had an immigrant background (Experimental B, N = 433). Results of two linear mixed models showed a significant interaction Time × Experimental condition for ethnic victimization, F(1, 1170) = 4.185; p = .015. Specifically, the NoTrap! is effective in reducing ethnic victimization when at least one student with an immigrant background is involved as a peer educator. Only in this condition, indeed, peer educators are directly involved in the phenomenon they counteract, and all four circumstances postulated in the contact theory are satisfied. No effects on ethnic bullying have been found, F(1, 1162) = .215; p = .806. This is in line with the activities proposed in the program, which is more focused on empowering victims than on acting directly on bullies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The longitudinal association between loneliness and depressive symptoms in the elderly: a systematic review.

OBJECTIVE: Loneliness and the onset of depression in old age are growing problems related to the greater life expectancy nowadays. This review investigated the longitudinal association between loneliness and depressive symptoms in the elderly. DESIGN: A comprehensive search was conducted using three databases (Scopus, PsycInfo, and PubMed) combing for empirical studies published up until July 2020. A total of 4.549 abstracts and 221 full-text articles were assessed. Three authors independently reviewed titles and abstracts; disagreements were resolved by consensus. RESULTS: Ten studies were included in the final review. We identified two categories of studies based on the outcome considered in each article: 1) the longitudinal effect of loneliness on depressive symptoms and 2) the clinical course of depression and its association with loneliness. All the articles reported a significant and positive association between loneliness and depressive symptoms in their longitudinal design research, ranging from an odds ratio of 0.41 to 17.76. The heterogeneity regarding the effect size in the analyses can be explained by the multifactorial design implemented by most of the studies included. CONCLUSIONS: Future research should investigate the moderators' role and how it may influence the longitudinal association between loneliness and depression over the years.

Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Scale in a Sample of Italian Students.

This study aimed to further validate the self-reported version of the Proposed Specifiers Conduct Disorder (PSCD) scale, testing the associations between the PSCD with a scale that measures emotional/behavioral difficulties and prosocial behaviors (Strength and Difficulties Questionnaire, SDQ). A total of 536 Italian students (47.76% male; 11-14 years) completed the PSCD, while their caregivers and teachers completed the SDQ. A series of confirmatory factor analyses to test the best fitting model were run. The internal consistency of the PSCD was evaluated, and the correlations between the PSCD self-reported scores and SDQ Parent and Teacher report scores were examined. A bi-factor model was fitted with a refined 19-item version of the scale, which showed adequate fit indices. The PSCD total score was strongly associated with higher parent- and teacher-rated conduct problems, hyperactivity, and lower prosocial behavioral symptoms. In conclusion, this study indicated that the self-report PSCD shows preliminary promise as a reliable, easy-to-use tool, for measuring psychopathic traits in Italian children and young adolescents.

Victimization among children and adolescents accessing the Meyer pediatric hospital: A retrospective study.

PROBLEM: The consistent prevalence and occasionally severe consequences of bullying and victimization suggest the need to include a more accurate assessment of these episodes within the Emergency Departments (ED). However, the literature on mental health related symptoms of bullying/victimization treated in the ED is still scarce. The aim of this study is to assess the prevalence of peer victimization amongst children and adolescents referred to an Italian Pediatric Emergency Department. Differences between Hospital Departments, type of victimization and ages are tested. METHODS: A retrospective observational study was conducted with 705 subjects. The age range was from 6 to 18 years old (M = 13.09; SD = 3.048). FINDINGS: 15.3% of the sample reported to be victimized (8.2% occasionally; 7.1% systematically). For the Child and Adolescent Psychiatry Unit, we found a significant association between peer victimization and being adolescent (Fisher's p = 0.003). In addition, a significant association was found between verbal victimization and Child and Adolescent Psychiatry Unit (Fisher's p = 0.02) and physical victimization and Child Abuse Department (Fisher's p < 0.001). CONCLUSION: Findings suggest the importance of an accurate assessment of victimization experiences of children and adolescents with access to ED, to prevent future re-victimization and crystallization of symptoms across time.

Positive and Negative Experiences of Living in COVID-19 Pandemic: Analysis of Italian Adolescents' Narratives.

INTRODUCTION: Despite a growing interest in the field, scarce narrative studies have delved into adolescents' psychological experiences related to global emergencies caused by infective diseases. The present study aims to investigate adolescents' narratives on positive and negative experiences related to COVID-19. METHODS: Italian adolescents, 2,758 (females = 74.8%, mean age = 16.64, SD = 1.43), completed two narrative tasks on their most negative and positive experiences during the COVID-19 emergency. Data were analyzed by modeling an analysis of emergent themes. RESULTS: "Staying home as a limitation of autonomy," "School as an educational, not relational environment," the impact of a "new life routine," and experiencing "anguish and loss" are the four emergent themes for negative experiences. As for positive experiences, the four themes were "Being part of an extraordinary experience," "Discovering oneself," "Re-discovering family," and "Sharing life at a distance." CONCLUSION: Authors discuss the impact of COVID-19 on adolescents' developmental tasks, such as identity processes and autonomy acquisition.

Mapping community, social, and economic risks to investigate the association with school violence and bullying in Italy.

BACKGROUND: School violence and bullying are a pandemic issue. The academic literature underlined the need to investigate social-contextual risk factors. The United Nations called for more comprehensive and disaggregated data to inform prevention strategies. OBJECTIVE: The present study comprises a set of secondary analyses on Italian data from the International Civic and Citizenship Study 2016. We adopted an innovative 'bottom-up' approach to identify the level of disaggregation for national data. The researchers focused on community, social, and economic risk indicators at school-level, and investigated whether it was possible to aggregate schools in different classes, depending on their risk profile. PARTICIPANTS AND SETTINGS: Analyses were implemented on a nationally representative sample of 170 Principals of lower secondary schools, 2,527 teachers and 3,766 students at grade 8. METHODS AND ANALYSES: A Latent Class Analyses was conducted on risk indicators and four classes of risk were identified: No Risk, Community Risk, Socio-economic Risk, Multi-Risk (entropy = .786). No significant differences were found across classes in relation to urban/rural location, school size, and geographical macro-partition. On the contrary, significant differences emerged when considering teachers' perception of bullying, social problem, and students' behavior at school. Furthermore significant differences were found for the quality of relationship with teachers as reported by students. CONCLUSIONS: Results a) suggested a potential gradient of increasing risk moving across the classes; b) provided a contribution to address the gap in the investigation of contextual factors and bullying; c) offered a new lens to tailor interventions to prevent school violence and bullying.

Voluntary Vs Nominated Peer Educators: a Randomized Trial within the NoTrap! Anti-Bullying Program.

There is a debate in scientific literature about the effectiveness of a peer-led approach to anti-bullying interventions. In order to understand which circumstances and for whom these approaches work best, the present study was carried out within the NoTrap! anti-bullying program. Using a cluster design, classes were randomly assigned into two different peer educator recruitment strategies: volunteering (N = 500; 48% females; mean age = 13.5 years, ds = 1.3) vs peer nominated (N = 466; 38% females; mean age = 13.9 years, ds = 1.3). Results showed that voluntary peer educators suffered a higher level of victimization, while the nominated ones tended to be more popular and likable. Furthermore, a set of linear mixed-effect models showed that the program was effective in reducing bullying and victimization, and in increasing defending behaviour only in the voluntary recruitment condition. On the contrary, in classrooms under the peer nominated recruitment condition, bullying and victimization remained stable, and defending behaviour increased only for peer educators, but not for their classmates. This implies that the step of peer selection and recruitment must be kept into consideration in developing and validating an intervention, because of its possible impact on the effectiveness of the whole intervention.

Distinguishing spontaneous from deliberate mind wandering in adolescents: The role of attentional control and depressive symptoms.

Research on individual differences in mind wandering (MW) in healthy adults has supported the separation of spontaneous and deliberate MW given their different association with a number of psychological traits. This study aimed to further test this distinction by investigating the associations of the two types of MW with attentional control and depressive symptomatology in adolescents. Data were collected on 439 9-10th graders, who completed measures of spontaneous and deliberate MW, distractibility, difficulty in attentional shifting, and depressive symptomatology. A multivariate three-level multiple regression revealed that distractibility was a significant predictor of only spontaneous MW, whereas difficulties in attentional shifting and depressive symptoms were significant predictors of both types of MW. However, the last two variables were stronger predictors for spontaneous than for deliberate MW. These findings provide support for the distinction, beyond their theoretical and empirical overlap, between the two types of MW also in adolescents and suggest the independent contribution of cognitive functioning and depressive symptoms. Statement of contribution What is already known? Studies on mind wandering (MW) in adults have shown that spontaneous and deliberate MW reflect dissociable cognitive experiences. In adults, trait-level tendency to spontaneous MW seems to reflect difficulties in controlled attentional processing. The majority of studies on MW in adolescents have treated this phenomenon as unitary and found a relation with negative affect, stress, and self-esteem. What does this study add? This is the first study to examine cognitive functioning and depressive symptoms as correlates of spontaneous and deliberate MW in adolescents. We found that distractibility is a significant predictor of only spontaneous MW. Difficulties in attentional shifting and depressive symptoms are significant predictors of both types of MW, although stronger for spontaneous MW. The findings support the distinction, beyond their theoretical and empirical overlap, between the two types of MW also in adolescents and call for future studies on the function of deliberate and spontaneous MW across development.

Coping Power Universal for middle school students: The first efficacy study.

INTRODUCTION: The present study examined the efficacy of the universal prevention version of the Coping Power Program in reducing behavioral and emotional problems and in promoting prosocial behaviors in middle-school classrooms. METHODS: The study used a randomized control study design; and the sample included 839 middle-school Italian youths (411 males), attending 40 middle-school classrooms. The students were in seventh or eighth grade, and they had an average age of 13.24 years (SD = .65; range 12-14 years). Ninety students were Africans, the rest were Caucasian. Teachers and parents completed the Strengths and Difficulties Questionnaire, before and after intervention. We used the 24-session universal prevention adaptation of Coping Power, which aims to improve children's emotional regulation and social problem-solving skills. RESULTS: Linear mixed models and effect sizes indicated that behaviors improved as a result of the Coping Power intervention. Specifically, the program was effective in reducing internalizing problems and increasing prosocial behaviors. CONCLUSIONS: The Coping Power Universal effectively adapts an existing evidence-based program, and is believed to be a useful strategy also to improve social emotional skills in middle-school students.

Effects of a universal prevention program on externalizing behaviors: Exploring the generalizability of findings across school and home settings.

Universal prevention approaches have significantly reduced children's conduct problems and aggressive behavior in the school setting, but it has not been clear whether the effects generalize into children's behavior in home and community settings in later elementary school years. The present study examined this issue using a classroom-randomized design, with 1030 students in 70 fourth and fifth grade Italian classes. The intervention model is the Coping Power Universal and the classroom teachers delivered it. Coping Power Universal produced a significant reduction in both parents' and teachers' rated conduct problems, relative to control classes, indicating that universal prevention can produce significant reductions in children's conduct problems that generalize into the home and community settings. The intervention also increased children's prosocial behaviors in school and home settings. The Coping Power Universal is a short intervention model that is believed to be a useful strategy for children's behavioral problems in the broad population.

The Teacher's Role in Preventing Bullying.

The teacher plays an important role in the management of classroom bullying (Yoon and Bauman, 2014). Therefore, understanding and fostering teachers' characteristics able to predict successful responses to bullying and victimization is a priority for prevention programs. The aim of this study was to evaluate whether the association between the teacher's individual characteristics, such as her/his competence in regard to the phenomenon, job satisfaction, and self-efficacy, and the school level of bullying/victimization was mediated by the teacher's intervention when an episode of bullying occurred. The study included 120 teachers (17.5% boys; 79.2% girls), between the ages of 25 and 66 (mean age = 48.21; SD = 9.22), and 1,056 students (40.3% boys; 59.6% girls), between the ages of 11 and 17 (mean age = 13.09; SD = 1.46). A total of 57% of the students were attending secondary middle school and 42.2% were in secondary high school. Path analyses showed that for perpetrated behaviors, teachers' competence on bullying affects students report of bullying through a higher likelihood of teachers' intervention after a bullying episode occurred. The indirect effect resulted significant. Lower levels of bullying and victimization were associated with teacher job satisfaction, thus indicating how professional fulfillment can influence the classroom climate. The model for victimization was the same, except that the indirect path was not significant. Findings are discussed in terms of teachers' involvement in bullying intervention and prevention.