Association of serotonin receptor gene polymorphisms with anorexia nervosa: a systematic review and meta-analysis.

PURPOSE: Several studies have investigated the association between anorexia nervosa and polymorphisms of genes regulating serotonin neurotransmission, with a focus on the rs6311 polymorphism of 5-HTR2A. However, inconsistent results of these studies and conflicting conclusions of existing meta-analyses complicate the understanding of a possible association. We have updated these results and evaluated the involvement of other serotonin receptor gene polymorphisms in anorexia nervosa. METHODS: Adhering to PRISMA guidelines, we have searched studies on anorexia nervosa and serotonin-regulating genes published from 1997 to 2022, selected those concerning receptor genes and meta-analyzed the results from twenty candidate gene studies on the 5-HTR2A rs6311 polymorphism and the 5-HTR2C rs6318 polymorphism. RESULTS: Present analyses reveal an association for the 5-HTR2A rs6311 polymorphism, with G and A alleles, across eighteen studies (2049 patients, 2877 controls; A vs. G allele, Odds Ratio = 1.24; 95% Confidence Interval = 1.06-1.47; p = 0.009). However, after geographic subgrouping, an association emerged only in a Southern European area, involving five studies (722 patients, 773 controls; A vs. G allele, Odds Ratio = 1.82; 95% Confidence Interval = 1.41-2.37; p < 0.00001). No association was observed for the 5-HTR2C rs6318 polymorphism across three studies. CONCLUSIONS: To date, the involvement in the pathophysiology of anorexia nervosa of the 5-HTR2A rs6311 polymorphism appears limited to a specific genetic and/or environmental context, while that of the 5-HTR2C rs6318 polymorphism seems excluded. Genome-wide association studies and epigenetic studies will likely offer deeper insights of genetic and environmental factors possibly contributing to the disorder. LEVEL OF EVIDENCE: III Evidence obtained from well-designed cohort or case-control analytic studies. Clinical trial registration PROSPERO registration number: CRD42021246122.

Peripartum Depressive Symptoms in Fathers during the COVID-19 Pandemic.

Background: This research investigates peripartum depression in fathers during COVID-19, focusing on how pandemic-related distress is associated with paternal depressive symptoms and the quality of father-child feeding interactions. The primary objective was to understand if the pandemic has influenced depressive symptoms in new fathers and how these symptoms impact their interactions with their children, especially during feeding. Methods: Utilizing a cross-sectional design, the research employs online surveys and remote observation to gather data from 243 Italian fathers. The analysis involves established psychometric tools like the Symptoms Check-List/90R and the Peritraumatic Distress Index to assess the severity of depressive symptoms and their correlation with father-child interaction exchanges, observed through the SVIA. Results: The fathers' peritraumatic distress due to COVID-19 was significantly and positively associated with the level of their depressive symptoms and negatively correlated with the quality of their feeding interactions with their children. Moreover, elevated levels of peritraumatic stress were notably predictive of higher instances of depressive symptoms in the fathers. Further, higher levels of stress associated with COVID-19 were predictive of a poorer quality of father-child interactions. Conclusions: This research highlights the need for inclusive perinatal support programs, offering foundational insights into paternal mental health during pandemics.

Stability of and Change in Psychopathological Risk Levels in Pre-Early Adolescents before, during, and after Their Study Sojourns: A Descriptive Study.

BACKGROUND: Adolescents can benefit from studying abroad in terms of personal development, cross-cultural encounters, and academic enrichment. This article digs into the psychological challenges that students may face before and during their study abroad, focusing on the emotional components of their experiences. METHODS: The current descriptive study sought to assess the stability or change in levels of psychopathological risk in a sample of N = 195 adolescents before and during a study abroad sojourn. To examine psychological symptoms in pre-adolescents, teachers were asked to complete a report-form questionnaire. RESULTS: The findings of this study revealed that students' psychological functioning changed significantly after their study abroad experience. Anxious/depressed and withdrawn ratings specifically increased from the pre-sojourn assessment (T1) to the evaluation during the stay (T2), then remained consistent (T3). In addition, the scores for rule-breaking and aggressive conduct changed, increasing from T1 to T2 and then decreasing from T2 to T3. This trend implies that teenagers may struggle with behavioral challenges early in their study abroad experience, but subsequently adjust and improve their conduct as they grow more used to the new environment. CONCLUSIONS: this research offers insight into the emotional and behavioral issues that adolescents face when studying abroad, underlining the significance of treating psychopathological risk factors in this demographic.

Mothers with Dysregulated Eating and Their Offspring's Emotional/Behavioral Functioning during the COVID-19 Pandemic: A Descriptive Study.

OBJECTIVE: Research on the psychopathological effects of the COVID-19 pandemic has not specifically focused on mothers with dysregulated eating and their children. METHODS: This study aimed to observe whether the symptoms of mothers with binge eating episodes (assessed through the SCL-90/R and the TFEQ-R18) worsened from the pre-pandemic period (T1) to the pandemic period (T2). In addition, we sought to assess whether the levels of internalizing/externalizing and dysregulation symptoms in children (assessed through the CBCL 6-18) worsened from T1 to T2. RESULTS: Our results showed that the values obtained for mothers in the SCL-90/R were significantly higher at T2 (during the pandemic), particularly for Depression, Phobic Anxiety, Interpersonal Sensitivity, and Obsessive-Compulsive subscales. Moreover, in both the Emotional Eating and Uncontrolled Eating subscales of the TFEQ-R18, mothers at T2 scored substantially higher than mothers at T1. The emotional/behavioral functioning of children was more maladaptive at T2, according to mothers, especially for the subscales of Withdrawn, Anxious/Depressed, and Aggressive Behavior. Children also had significantly higher scores on the Internalizing and Externalizing subscales, as well as greater symptoms of dysregulation. CONCLUSIONS: This study contributes to demonstrating that the COVID-19 pandemic may have had increased maladaptive emotional/behavioral functioning in children and their mothers with dysregulated eating.

The Quality of Mother-Child Feeding Interactions Predicts Psychopathological Symptoms in Offspring and Mothers Seven Years Later: A Longitudinal Study on the General Population.

The increased risk of internalizing and externalizing symptoms in children has been observed in the presence of maternal psychopathology. This study aimed to investigate a potential pathway involving the quality of early interactions between mothers and their children. A sample of 150 mother-child dyads underwent assessment when the children were 3 years old and around the age of 10. Video recordings of feeding exchanges between mothers and children were analyzed to evaluate the quality of mother-child interactions. Maternal psychopathology and child internalizing and externalizing symptoms were measured through self-report and report-form measures completed by mothers. The quality of mother-child feeding interactions at three years of age significantly differentiated (p < 0.001), eight years later, between mothers at high and low psychopathological risk and between children exhibiting clinical and subclinical internalizing symptoms. Clinically relevant child symptoms were notably more prevalent when the mother-child interaction quality at three years of age was maladaptive, particularly in the context of concurrent high maternal psychopathological risk. The study findings underscore the importance of focusing on the early quality of mother-child feeding interactions to identify potential situations of maternal and child clinical risk for the development of psychopathological symptoms and to guide preemptive measures and policies.

Breastfeeding Apps: A Descriptive Report.

BACKGROUND: Women are increasingly using breastfeeding apps to facilitate and organize breastfeeding; however, no study has so far focused on maternal psychopathological risk and on the quality of dyadic exchanges in this field. AIM AND METHODS: This preliminary, descriptive study aimed at evaluating levels of psychopathological symptoms (through the SCL-90/R) and for the quality of the interactions they have with their children during feeding (through the SVIA) in mothers who use breastfeeding apps with different grades of engagement. RESULTS: Data analyses showed that mothers with a mild use of the apps present a higher quality of dyadic interactions during feeding and lower psychopathological risk. CONCLUSIONS: The cross-sectional and descriptive nature of this study does not allow any causal conclusions. However, results suggest that the higher the engagement and use of breastfeeding apps, the lower the quality of feeding interactions and the higher the maternal psychopathological risk.

The Role of Maternal Personality Organization and of the p Factor in Predicting Parental Distress, the Quality of Parental Care, and Offspring's Dysregulation Symptoms.

Background: It has been posited that parental distress, the quality of maternal care and offspring's dysregulation can be predicted by maternal maladaptive characteristics. However, only a few studies have considered mothers' personality organizations and features of the p factor in mothers as possible predictors of symptoms in their children. Methods: In a sample of N=524 subjects, this study evaluated the effect of mothers' personality organization and of the p factor on parental distress, parental care and offspring's dysregulation symptoms. Mothers filled out the IPO, the ASR, and the PSI-SF; children's teachers filled out the TRF; children were administered the PBI. Results: We found that different mother groups (neurotic, borderline, psychotic organization) have distinct impact on parental distress, quality of care, and children's dysregulation, mediated by the p factor. Conclusion: This study can contribute to the understanding of the key factors underpinning mothers and children's psychopathology.

Daring and Distress: Insights on Adolescent Risk Taking and Difficulties in Emotion Regulation from a Network Analysis Perspective.

We explored the interrelationships between risk-taking and self-harm in typically developing adolescents by examining various contributing factors, such as personality traits, difficulties in emotion regulation, attachment styles, and maladaptive psychological functioning. A sample of 234 Italian adolescents completed the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA), the Risk-Taking Questionnaire (RT-18), the Difficulties in Emotion Regulation Strategies (DERS), the State Adult Attachment Measure (SAAM), and the Youth Self-Report (YSR). Network analysis was used to visualize and describe the interdependencies among the variables. Risk-taking behaviors were strongly linked to rule-breaking, aggression, and risk propensity, while self-harm behaviors were connected to limited access to emotion regulation strategies and thought problems. Centrality indices indicated that variables such as anxiety/depression, limited access to emotion regulation strategies, and rule-breaking had a high influence within the network. This study provided a comprehensive understanding of the nomological network of risk-taking and self-harm behaviors among adolescents. It highlighted the relative importance of factors such as emotion regulation difficulties and maladaptive psychological functioning in influencing these behaviors. The findings could inform psychological interventions and prevention strategies targeting adolescents at risk for engaging in risk-taking or self-harm behaviors.

Epidemiology, Etiology and Intervention Strategies for Peri-Partum Depression in Mothers.

The prevalence of peri-partum depression (PPD) varies widely across countries, with rates ranging from 10% to 15% depending on the screening method used and the country studied [...].

Implementing Sensitivity and Contingency in Medical Contexts: The Case of Prematurity.

In the context of relational situations, sensitivity and contingency are identified as pivotal variables that contribute to the enhancement of patients' overall wellbeing [...].

A Psycho-Dynamically Oriented Reflection on Early Sexual Relationships in Pre-Adolescents.

Pre-adolescence is generally considered a period of change during which sexual energy remains latent before gradually beginning to express itself in adolescence and later in life [...].

Motivations, Behaviors and Expectancies of Sexting: The Role of Defensive Strategies and Social Media Addiction in a Sample of Adolescents.

Adolescents and young adults engage in sexting behaviors. Research has mainly emphasized the relationship between motivations and sexting behaviors, with little attention paid to sexting expectations and the potential role of coping strategies. This study aims to explore the measure of emotional-behavioral functioning with the Youth/Adult Self Report (based on the subject's age), the use of defensive strategies measured with the Response Evaluation Measure (REM-71), social media addiction with the Bergen Social Media Addiction Scale (BSMAS) and all dimensions of sexting: motivations, behavior and expectations measured with the Sexting Motivation Questionnaire (SMQ), Sexting Behavior Questionnaire (SBQ) and Sexpectancies Questionnaire (SQ), respectively. N = 209 adolescents and young adults were recruited from high schools and universities in Rome to complete the self-report questionnaires. Results show that males tend to have higher expectations of sexting than females. We also found that expectations play a role in determining sexting behaviors and motivations. Our hypotheses on social media addiction and sexting were confirmed, while the relationship between the defensive strategies and sexting was not significant as expected. Further studies on this topic are desirable in the future.

Psychological profiles, including emotion regulation characteristics, defence strategies and mentalisation capacity, of male adolescents involved in fights among peers.

BACKGROUND: Youth violence has become a worrying public health issue worldwide. In Europe and the USA, research has shown a prevalence of this phenomenon ranging from 30 to 70% in boys. AIMS: This descriptive study aimed to evaluate psychological profiles of male adolescents involved in fights with their peers. METHOD: Identity consolidation was evaluated with the Self-Concept and Identity Measure; defence strategies were assessed by the Response Evaluation Measure for Youth; emotion regulation was assessed with the Difficulties in Emotion Regulation Scale and mentalisation capacity was evaluated by the Reflective Functioning Questionnaire. RESULTS: Through a series of multivariate analyses of variance, our results showed that adolescents reporting four or more fights in the past year, when compared with peers reporting none or fewer than four fights, displayed lower identity consolidation, greater use of immature defence strategies, poorer emotion regulation processes and poorer mentalisation capacity. CONCLUSIONS: The results of this study could be useful for the promotion of prevention and intervention programmes to stem fights among adolescents.

Impact of Maternal-Newborn Separation in Italian Women with Suspected COVID-19 Infection on Psychopathological Symptoms and Quality of Interactions during Breastfeeding.

INTRODUCTION: Before the COVID-19 pandemic, proximity between mothers and their newborn infants was at the core of sanitary guidelines. With the aim of stopping the virus transmission from mothers to infants and possible physical dangers due to the infection, some hospitals discouraged or even prohibited skin-to-skin contact and breastfeeding. METHOD: This study recruited 180 dyads in private and public hospitals in Italy with the aim of verifying whether mother-infant separation after delivery is associated with higher maternal psychopathological distress (assessed through the SCL-90-R) and poorer quality of dyadic interactions during breastfeeding (evaluated through the SVIA). RESULTS: Our results showed that mothers separated from their infants displayed more anxiety, depression, and obsessive-compulsive symptoms and a lower quality of feeding interactions on all the subscales of the SVIA (mother's affective state; interactive conflict; food refusal behavior; dyad's affective state). CONCLUSION: In light of these results, our study suggests that separating mothers from their newborns is associated with increased psychopathological symptoms in mothers and poorer feeding interactions. These issues have been posited as key predictors of maladaptive outcomes in infants' later lives; therefore, health services must fully consider the short- and long-term consequences of separating mothers and infants in their policies in the event of future pandemics.

Eating Disorders and Internalizing/Externalizing Symptoms in Adolescents before and during the COVID-19 Pandemic.

OBJECTIVE: This study aimed at assessing the prevalence of eating disorders and symptoms of dieting, food preoccupation, and oral control and internalizing/externalizing problems in a group of adolescents before and during the COVID-19 pandemic. METHODS: A sample of N = 813 adolescents (age range = 14-15 years) was recruited in the general population and administered the SCOFF, EAT-26 and YSR questionnaires at two assessment points: before the COVID-19 pandemic outbreak and during it. RESULTS: In males and females, the YSR scores at T1 were significantly lower than T2, especially for the subscales of Withdrawn, Somatic complaints, Anxious/depressed, Social problems. As for the EAT-26 scores, adolescents scored significantly lower at T1 for all four subscales of dieting, food preoccupation and oral control. The prevalence of eating disorders among males and females increased respectively from 13.2% to 18.4% and from 17.5 to 25.3 from T1 to T2. CONCLUSION: This study confirms previous research showing an increase in eating disorders prevalence and higher psychopathological symptoms both in males and females adolescents during the pandemic.

The Role of Emotional Dysregulation, Impulsivity Traits and Aggressive Behaviors in Adolescents Who Sustain Multiple Motor-Vehicle Crashes.

Adolescents tend to experience multiple motor-vehicle crashes (MVCs). Recent literature has thoroughly explored the psychological consequences following an MVC, but prior psychological functioning, the ability to regulate one's emotions and tendencies to impulsivity and aggressive behaviors have been far less explored. This study aims to explore the emotional-behavioral functioning, measured with the Youth Self-Report (YSR); emotional dysregulation, measured with the Difficulties in Emotional Regulation Scale (DERS); impulsivity traits, measured with the Barratt Impulsiveness Scale (BIS-11); and the capacity to be mindful, measured with the Mindful Attention Awareness Scale (MAAS), in adolescents that have experienced one or more MVCs in a year. N = 295 adolescents who visited an emergency department for MVCs were divided in two groups based on the number of MVCs they had sustained over the course of a year. The adolescents in Group 1 sustained more than three MVCs, and adolescents in Group 2 sustained only one. Participants were assessed through self-report questionnaires. Adolescents showed difficulties in emotional regulation, impulsivity traits, aggressive behaviors and a low capacity to be mindful. These results may be useful in the creation of intervention and prevention programs focused on emotional awareness targets for adolescents.

Deliberative and Affective Risky Decisions in Teenagers: Different Associations with Maladaptive Psychological Functioning and Difficulties in Emotion Regulation?

Using network analysis, we investigated the relationships between maladaptive psychological functioning, difficulties in emotion regulation, and risk-taking in deliberative and affective behavioral decisions. Participants (103 adolescents aged between 13 and 19 years, 62% boys) took the Cold (deliberative) and Hot (affective) versions of the Columbia Card Task and completed the Youth Self-Report (YSR) and the Difficulties in Emotion Regulation Scale (DERS). In contrast to the view that risk propensity increases from preadolescence to middle adolescence and decreases at later ages, our study revealed no age-specific trend. YSR syndrome scales were significantly correlated with risk propensity, but only in the Cold version. The YSR Thought Problems scale was the most central node in the network, linking internalizing and externalizing problems with risk propensity in the Cold CCT. Lack of emotional Clarity was the only DERS consistently linked with risk-taking both in correlation and network analyses. Maladaptive psychological functioning and difficulties in emotion regulation were linked with risk propensity in affective risky decisions through deliberative processes. The statistical significance of direct and indirect effects was further examined using nonparametric mediation analyses. Our study highlights the role of cognitive factors that in each variable set might account for risk-taking in teenagers.

Observational Tools Using Video Recordings of Parent-Child Feeding Interactions: A Narrative Review.

Current research has confirmed that the quality of the caregiver-child relationship influences the child's emotional and behavioral development. Play and feeding contexts, for example, are the best contexts to observe mother-child or father-child interaction. The observation of feeding interaction establishes involvement on the part of both parties and identifies relationship characteristics. The purpose of this study is to select and describe the most frequently used observational methods during feeding interactions in the first three years of a child's life. Instruments that employ video recordings of mealtimes will be detailed to highlight the relevance that specific tools have nowadays. Finally, the SVIA (Scala di Valutazione delle Interazioni Alimentari), a technique for analyzing food interactions by observation that has also been utilized remotely, will be offered. This is intended to provide practitioners and researchers with an overview of tools while also taking into consideration the present scenario in which digital tools are increasingly being employed in health and clinical settings. Furthermore, the purpose of this paper is to review the various observational methods of the parent-child relationship to assist future practitioners and researchers in the field in making an accurate assessment of caregiver-child interaction and selecting a valid tool for the early recognition of problematic relationships and identifying the most appropriate treatment modalities.

Internet Addiction among Young Adult University Students during the COVID-19 Pandemic: The Role of Peritraumatic Distress, Attachment, and Alexithymia.

The literature focused on the effect of the COVID-19 pandemic on young adult university students' mental health shows a significant increase in psychopathological symptoms and Internet Addiction (IA). The key role played by attachment and alexithymia has also been suggested, but no study has explored the possible dynamic relationship between these variables. We recruited a sample of n = 410 young adult university students online. We assessed the attachment to parents and peers (through IPPA), alexithymia (through TAS-20), peritraumatic distress symptoms due to COVID-19 (through CPDI), and IA (through IAT). The results showed that the relationship between the attachment to mothers and IA was partially mediated by alexithymia and by the serial mediation of alexithymia and peritraumatic distress, whereas the influence of the attachment to fathers on IA was fully mediated by peritraumatic distress. The direct effects of the attachment to peers on alexithymia, peritraumatic distress, and IA were all significant, as were the indirect paths via the simple mediation of both alexithymia and peritraumatic distress and the multiple serial mediation of alexithymia and peritraumatic distress. Our findings suggested that the relationship between attachment, alexithymia, and psychopathological risk is dynamic in predicting IA during the pandemic among young adult university students and that the different attachment figures exert a peculiar contribution to these processes.

Sensor Technology and Intelligent Systems in Anorexia Nervosa: Providing Smarter Healthcare Delivery Systems.

Ubiquitous technology, big data, more efficient electronic health records, and predictive analytics are now at the core of smart healthcare systems supported by artificial intelligence. In the present narrative review, we focus on sensing technologies for the healthcare of Anorexia Nervosa (AN). We employed a framework inspired by the Interpersonal Neurobiology Theory (IPNB), which posits that human experience is characterized by a flow of energy and information both within us (within our whole body), and between us (in the connections we have with others and with nature). In line with this framework, we focused on sensors designed to evaluate bodily processes (body sensors such as implantable sensors, epidermal sensors, and wearable and portable sensors), human social interaction (sociometric sensors), and the physical environment (indoor and outdoor ambient sensors). There is a myriad of man-made sensors as well as nature-based sensors such as plants that can be used to design and deploy intelligent systems for human monitoring and healthcare. In conclusion, sensing technologies and intelligent systems can be employed for smarter healthcare of AN and help to relieve the burden of health professionals. However, there are technical, ethical, and environmental sustainability issues that must be considered prior to implementing these systems. A joint collaboration of professionals and other members of the society involved in the healthcare of individuals with AN can help in the development of these systems. The evolution of cyberphysical systems should also be considered in these collaborations.