[Screens and adolescence: what issues for the Z generation?] / Écrans et adolescence : quels enjeux pour la Génération Z ?

Digital media and screens are ubiquitous in the daily lives of adolescents. The screen-addicted portrait of young people has gained public attention, and health professionals are often consulted about the impact of screen use on teenagers' physical and mental health. Scientific evidence suggests that screen use is associated with risks and benefits that need to be weighed up in a nuanced way. This paper takes a critical look at the issue of screen time and at the models for understanding a problematic screen use. These considerations underline the importance of adopting a contextual understanding of screen use in adolescence.

Les médias numériques sont omniprésents dans la vie quotidienne des adolescent-es. La figure de l'adolescent-e « addict-e ¼ aux écrans est devenue un sujet de préoccupation dans l'opinion publique et il est fréquent que les professionnel-les de la santé soient sollicité-es pour répondre aux interrogations sur l'impact de l'utilisation des écrans sur la santé mentale et physique des jeunes. Les données scientifiques indiquent que l'usage des écrans est associé à des risques et des bénéfices qu'il s'agit d'évaluer de manière nuancée. Dans cet article, nous discutons en particulier et de façon critique du temps d'écran et des modèles de compréhension de l'usage problématique de celui-ci. Ces réflexions nous amènent à souligner l'importance d'adopter une compréhension contextualisée de cet usage à l'adolescence.

Trajectories of perceived parenting across an educational transition: Associations with psychosocial adjustment and identity development among Swiss adolescents.

Educational transitions involve a number of changes for adolescents and can be challenging for adolescents and parents alike. The present study was designed to gain a better understanding as to how adolescents' perceptions of parenting evolves across a major educational transition and how the parenting perceived across this transition may facilitate adolescents' psychosocial adjustment and identity formation. Swiss adolescents (N = 483, Mage = 14.96 years old; 64.6% female) in their last year of mandatory secondary school completed self-report measures at two semiannual time points both prior to and following their educational transition. Adolescents reported on their perceptions of their parents' autonomy support and psychological control as well as their self-esteem, risk-taking behaviors, and identity processes. Group-based trajectory analyses identified three parenting trajectory classes (i.e., Highly Supportive Parenting, Decreasing Supportive Parenting, Stable Controlling Parenting), three psychosocial adjustment trajectory classes (i.e., Low Self-Esteem/Low Risk-Taking, High Self-Esteem/Low Risk-Taking, Moderate Self-Esteem/Increasing Risk-Taking), and four identity trajectory classes (i.e., Lost Searchers, Guardians, Pathmakers, Successful Searchers). These solutions support the contention that adolescents are likely to experience academic transitions differently, whether in terms of their parent-adolescent relationship, their psychosocial adjustment, or their identity. Furthermore, parenting trajectory classes were associated with specific identity and psychosocial adjustment classes. Notably, Highly Supportive Parenting was associated with the High Self-Esteem/Low Risk-Taking class and the Pathmaker identity class, whereas Stable Controlling Parenting was most strongly associated with the Low Self-Esteem/Low Risk-Taking class and the Lost Searcher identity class. These findings highlight the importance of autonomy supportive parenting for adolescent development during educational transitions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

How Do Adolescents Manage Information in the Relationship with Their Parents? A Latent Class Analysis of Disclosure, Keeping Secrets, and Lying.

The use of disclosure and concealment strategies by adolescents in the relationship with their parents may have important implications for their adjustment. Few studies of adolescents' information management have taken a person-centered approach, yet it is a useful way to understand variations in how they regulate information shared with their parents. This study explored adolescents' information management constellations with their mothers and fathers, and how these patterns differ in terms of perceived need-supportive parenting, autonomous reasons for disclosure, and problematic alcohol use. Three hundred thirty-two Swiss adolescents (45% female; Mage = 15.01 years) reported information management strategies used with each parent (disclosure, keeping secrets, lying), perceptions of maternal and paternal need-supportive parenting (involvement, autonomy support, structure), autonomous reasons for disclosure, and problematic alcohol use. Latent class analyses revealed three classes: Reserved (37%), Communicators (36%), and Deceptive (27%). Comparisons across classes showed that adolescents in the Communicators class reported the highest levels of parental involvement and autonomy support, as well as autonomous reasons for disclosure. Adolescents in the Deceptive class reported the lowest levels of parental involvement and autonomy support, as well as autonomous reasons for disclosure. Associations between classes and problematic alcohol use were also found, such that the likelihood of problem drinking was greater for adolescents in the Deceptive class. These findings underscore the importance of continued information sharing with both parents, and underline how a need-supportive parenting context may encourage adolescents to talk voluntarily.

Putting parental overprotection into a family systems context: Relations of overprotective parenting with perceived coparenting and adolescent anxiety.

Previous research offers evidence for how overprotective parenting is related to psychosocial maladjustment among adolescents, and documents the parent-related and child-related antecedents of overprotective parenting. Using a family systems perspective, the present study aimed at extending this knowledge by looking into contextual determinants of overprotective parenting. More specifically, the goal of this study was to examine associations between adolescents' perceptions of the coparental relationship (i.e., the way parental figures relate to each other in their role as parents) and overprotective parenting, which in turn was expected to relate to more adolescent anxiety symptoms. A sample of 174 Swiss adolescents (Mage  =16.99 years, 73% girls) completed questionnaires assessing their perceptions of the coparental relationship (in terms of cooperation, conflict, and triangulation), overprotective parenting, and symptoms of anxiety. Analyses indicated that triangulation, in particular, was uniquely related to higher levels of overprotective parenting, which in turn was associated with more anxiety symptoms among adolescents. These results provide evidence for the importance of considering the larger family systems context for understanding the dynamics involved in overprotective parenting. Theoretical and clinical implications of these findings are discussed.

Existen investigaciones previas que comprueban cómo la crianza sobreprotectora está relacionada con la inadaptación psicosocial entre los adolescentes y que documentan los antecedentes de la crianza sobreprotectora relacionados con los padres y los niños. Utilizando una perspectiva de sistemas familiares, el presente estudio tuvo como finalidad ampliar estos conocimientos estudiando los determinantes contextuales de la crianza sobreprotectora. Más específicamente, el objetivo de este estudio fue analizar las asociaciones entre las percepciones de los adolescentes de la relación de cocrianza (p. ej.: la manera en la que las figuras de los padres se relacionan mutuamente en su papel como padres) y la crianza sobreprotectora, que a su vez se esperaba que se relacionara con más síntomas de ansiedad en los adolescentes. Una muestra de 174 adolescentes suizos (edad promedio =16.99 años, el 73% niñas) contestó cuestionarios que evaluaban sus percepciones de la relación coparental (desde el punto de vista de la cooperación, el conflicto y la triangulación), la crianza sobreprotectora y los síntomas de ansiedad. Los análisis indicaron que la triangulación, en particular, estuvo relacionada exclusivamente con niveles más altos de crianza sobreprotectora, la cual, a su vez, estuvo asociada con más síntomas de ansiedad entre los adolescentes. Estos resultados comprueban la importancia de tener en cuenta el contexto mayor de los sistemas familiares para comprender la dinámica que supone la crianza sobreprotectora. Se debaten las implicancias teóricas y clínicas de estos resultados.

Developmental Changes in Secrecy During Middle Adolescence: Links with Alcohol Use and Perceived Controlling Parenting.

Adolescence is a developmental period characterized by fundamental transformations in parent-child communication. Although a normative shift in adolescents' secrecy seems to occur in parallel to changes in their drinking behaviors and in their perceptions of the relationship with their parents, relatively little attention has been paid to their associations over time. The present longitudinal study examined the associations between developmental changes in adolescents' secrecy, alcohol use, and perceptions of controlling parenting during middle adolescence, using a latent growth curve approach. At biannual intervals for two consecutive years, a sample of 473 Swiss adolescents (64.7% girls) beginning their last year of mandatory school (mean age at Time 1 = 14.96) completed self-report questionnaires about secrecy, alcohol use, and perceived controlling parenting. The results of the univariate models showed mean level increases in secrecy and alcohol use, but stable levels in controlling parenting over time. The results of a parallel-process model indicated that higher initial levels of secrecy were associated with higher initial levels of alcohol use and perceived controlling parenting, while an increase in secrecy was associated with an increase in alcohol use and an increase in perceived controlling parenting over time. In addition, adolescents who reported the lowest initial levels of perceived controlling parenting showed a greater increase in secrecy over time and those with high initial levels of secrecy reported a relative decrease in perceived controlling parenting. Finally, adolescents with the lowest initial levels of alcohol use experienced a greater increase in secrecy. Overall, these results indicate that the development of adolescents' secrecy is associated with the development of their drinking habits and perceptions of family relationships in dynamic ways.

Assessing Online and Offline Adolescent Social Skills: Development and Validation of the Real and Electronic Communication Skills Questionnaire.

Studies examining the associations between Internet use and social skills are increasingly frequent. However, most of them only evaluate offline social skills and consider them as equivalents to online social skills. So far, no instrument allowed differentiating social skills depending on online versus offline contexts. This study aimed to develop and validate the Real and Electronic Communication Skills questionnaire (RECS), a new measure evaluating several dimensions of social skills in two different contexts (i.e., face-to-face and computer-mediated communication). Results of exploratory and confirmatory factor analyses among a sample of 657 adolescents and young adults (mean age = 17.68 years; 67% female) showed that the best fitting model for each context is a bifactor solution, with one general factor (Social Competence) and four specific factors (Sociability, Emotion Decoding, Disclosure, and Assertiveness). Each specific factor was differentially correlated with theoretically relevant subscales of the Social Skills Inventory, confirming the external validity of the RECS. The RECS is the first instrument allowing not only to assess social competence in online settings but also to quantify the relationships between offline social skills and their online counterpart. Given its ease of use and brevity, the RECS is a useful and promising instrument to capture social skills in both online and offline contexts.

Further insight into adolescent personal identity statuses: Differences based on self-esteem, family climate, and family communication.

INTRODUCTION: During adolescence, youngsters are faced with the challenging task of forming an identity. This process can be either supported or hindered by adolescents' family context. The present study used a six-process model of personal identity including the five identity processes described by the dual-cycle model of identity (exploration in breadth, commitment making, exploration in depth, identification with commitment, and ruminative exploration) as well as a sixth identity process of reconsideration of commitment, commonly described in the three-factor model of identity. In the current investigation, we sought to evaluate how adolescents in identity statuses derived from this six-process model differed based on psychological adjustment, perceived family climate, and family communication. METHOD: A total of 1105 Swiss adolescents (Mage = 15.08; 51% female) completed self-report questionnaires at one time point. Using a person-centered approach, identity statuses were empirically derived and unique profiles for each identity status were identified. RESULTS: We identified six identity statuses: Achievement, Foreclosure, Ruminative Moratorium, Reconsidering Achievement, Troubled Diffusion, and Carefree Diffusion. Statuses with the highest degree of commitment showed the most optimal profiles of psychological adjustment and perceived family climate, whereas those with the lowest levels of commitment demonstrated the least optimal profiles. Adolescents in the Reconsidering Achievement status, however, reported high levels of both parental support and psychological control. CONCLUSION: The use of the six-process model of identity allowed for the derivation of six identity statuses and provided further insight into how adolescents in different identity statuses confront identity-related issues in the context of their family.

Daily internet time: towards an evidence-based recommendation?

Background: Since 2001, a recommendation of no more than 2 h per day of screen time for children 2 years of age or older was adopted in many countries. However, this recommendation was rarely examined empirically. The goal of the present study was to question this recommendation in today's connected world. Methods: We used data from the ado@internet.ch survey (spring 2012), a representative sample of 8th graders in the Canton of Vaud, Switzerland (n = 2942, 50.6% female). Internet use, health outcomes, substance use, well-being and socio-demographic characteristics were considered. Bi-variate statistical analyses were performed. Results: All outcomes were significantly associated with the time spent on internet, more time being associated with a higher prevalence of adverse consequences. Youth spending on average one more hour on Internet per day than the reference category (1.5-2.5 h) did not differ in terms of adverse health outcomes. Differences began to appear on sleeping problems, tobacco use, alcohol misuse, cannabis use and sport inactivity with youth spending between 3.5 h and 4.5 h per day on internet. Conclusions: This study demonstrates the absence of justification for setting a limit to only 2 h of screen time per day. Significant effects on health seem to appear only beyond 4 h per day and there may be benefits for those who spend less than an hour and a half on internet.

When Do Adolescents Accept or Defy to Maternal Prohibitions? The Role of Social Domain and Communication Style.

Drawing upon both Social-Cognitive Domain Theory and Self-Determination Theory, the goal of the present multi-informant study was to test whether the correlates of maternal prohibitions depend on what is prohibited (i.e., the content of the social domain involved), thereby contrasting moral with friendship prohibitions, as well on how the prohibition is communicated, thereby contrasting an autonomy-supportive with a controlling communication style. In a sample of adolescents (N = 196; mean age = 13.9 years; 63 % female) and their mothers (N = 185; mean age = 44 years), we first examined mean-level differences between the two domains in terms of mothers' degree and style of prohibition, as well as on a number of developmental outcomes (i.e., adolescents' legitimacy perceptions, internalization, and oppositional defiance). Both adolescents and mothers reported more maternal involvement in the moral domain (e.g., higher scores for degree of prohibition and controlling communication style). In addition, adolescents reported greater perceived legitimacy and less oppositional defiance in the moral domain (as compared to the friendships domain). Second, we tested whether associations between degree and style of prohibition and the developmental outcomes were moderated by social domain. Whereas associations between degree of prohibition and developmental outcomes either were non-significant or moderated by domain, the associations with communication style were more domain-invariant, with an autonomy-supportive style generally yielding an adaptive pattern of correlates and with a controlling style relating to maladaptive outcomes. The discussion focuses on similarities and differences in the characteristics and correlates of both types of prohibitions.

Thought-shape fusion in young healthy females appears after vivid imagination of thin ideals.

BACKGROUND AND OBJECTIVES: It has been shown that exposure to female thin ideals in media has minimal to moderate direct effects on body image satisfaction (BIS), mood and dysfunctional eating in healthy young women. Evidence has been found for several intervening variables such as social comparison processes. Accordingly it is assumed, that cognitive processing (rather than mere media exposure) is crucial. Consequently, vivid imagination of thin ideals after exposure to a fashion magazine was induced in order to trigger cognitive processes. Changes in mood, BIS and resulting bodyrelated cognitive distortions (Thought-Shape Fusion Body, TSF-B) were assessed. METHODS: A total of 91 healthy women (mean age 21.9 years, SD = 2.0) were exposed to either a fashion magazine (thin-ideal group) or a nature magazine (control group) in a waiting room design. Afterwards they were instructed to vividly imagine either the thin ideals or landscapes. RESULTS: When exposed to thin ideals, a significant decrease in mood and BIS emerged after vivid imagination, but not after mere magazine exposure. Imagining thin ideals triggered body-related cognitive distortions (TSF-B). A higher degree of eating disorder (ED) symptomatology amplified this effect. LIMITATIONS: These findings apply to young healthy females and cannot be generalized to samples with obesity, EDs or males. Internal validity is limited since the intensity of the exposure has not been systematically controlled. CONCLUSIONS: Vivid imagination of thin ideals promoted by magazines results in impaired mood and BIS and moreover in body-related cognitive distortions (TSF-B) in healthy women, especially, for those with stronger ED symptomatology.

Brief report: Academic amotivation in light of the dark side of identity formation.

The study intended to determine motivational profiles of first-year undergraduates and aimed their characterization in terms of identity processes. First, a cluster analysis revealed five motivational profiles: combined (i.e., high quantity of motivation, low amotivation); intrinsic (i.e., high intrinsic, low introjected and external regulation, low amotivation); "demotivated" (i.e., very low quantity of motivation and amotivation); extrinsic (i.e., high extrinsic and identified regulation and low intrinsic and amotivation); and "amotivated" (i.e., low intrinsic and identified, very high amotivation). Second, using Lebart's (2000) methodology, the most characteristic identity processes were listed for each motivational cluster. Demotivated and amotivated profiles were refined in terms of adaptive and maladaptive forms of exploration. Notably, exploration in breadth and in depth were underrepresented in demotivated students compared to the total sample; commitment and ruminative exploration were under and overrepresented respectively in amotivated students. Educational and clinical implications are proposed and future research is suggested.

National and Gender Measurement Invariance of the Utrecht-Management of Identity Commitments Scale (U-MICS): A 10-Nation Study With University Students.

The purpose of this study was to examine the psychometric properties of the Utrecht-Management of Identity Commitments Scale (U-MICS), a self-report measure aimed at assessing identity processes of commitment, in-depth exploration, and reconsideration of commitment. We tested its factor structure in university students from a large array of cultural contexts, including 10 nations located in Europe (i.e., Italy, the Netherlands, Poland, Portugal, Romania, and Switzerland), Middle East (i.e., Turkey), and Asia (i.e., China, Japan, and Taiwan). Furthermore, we tested national and gender measurement invariance. Participants were 6,118 (63.2% females) university students aged from 18 to 25 years (Mage = 20.91 years). Results indicated that the three-factor structure of the U-MICS fitted well in the total sample, in each national group, and in gender groups. Furthermore, national and gender measurement invariance were established. Thus, the U-MICS can be fruitfully applied to study identity in university students from various Western and non-Western contexts.

Testing new identity models and processes in French-speaking adolescents and emerging adults students.

Developing a sense of identity is a crucial psychosocial task for young people. The purpose of this study was to evaluate identity development in French-speaking adolescents and emerging adults (in France and Switzerland) using a process-oriented model of identity formation including five dimensions (i.e., exploration in breadth, commitment making, exploration in depth, identification with commitment, and ruminative exploration). The study included participants from three different samples (total N = 2,239, 66.7 % women): two samples of emerging adult student and one sample of adolescents. Results confirmed the hypothesized five-factor dimensional model of identity in our three samples and provided evidence for convergent validity of the model. The results also indicated that exploration in depth might be subdivided in two aspects: a first form of exploration in depth leading to a better understanding and to an increase of the strength of current commitments and a second form of exploration in depth leading to a re-evaluation and a reconsideration of current commitments. Further, the identity status cluster solution that emerged is globally in line with previous literature (i.e., achievement, foreclosure, moratorium, carefree diffusion, diffused diffusion, undifferentiated). However, despite a structural similarity, we found variations in identity profiles because identity development is shaped by cultural context. These specific variations are discussed in light of social, educational and economic differences between France and the French-speaking part of Switzerland. Implications and suggestions for future research are offered.

Is Internet use unhealthy? A cross-sectional study of adolescent Internet overuse.

OBJECTIVE: To assess whether problematic internet use is associated with somatic complaints and whether this association remains when checking for internet activity among a random sample of adolescents living in the canton of Vaud, Switzerland. METHODS: Cross-sectional survey of 3,067 8th graders (50.3% females) divided into average (n = 2,708) and problematic (n = 359) Internet users and compared for somatic complaints (backache, overweight, headaches, musculoskeletal pain, sleep problems and sight problems) controlling for sociodemographic and internet-related variables. Logistic regressions were performed for each complaint and for all of them simultaneously controlling variables significant at the bivariate level. RESULTS: At the multivariate level, when taken separately, problematic internet users were more likely to have a chronic condition (adjusted odds ratio [aOR] with 95% CI: 1.58 [1.11:2.23]) and to report back pain (aOR: 1.46 [1.04:2.05]), overweight (aOR: 1.74 [1.03:2.93]), musculoskeletal pain (aOR: 1.36 [1.00:1.84]) and sleep problems (aOR: 2.16 [1.62:2.88]). When considered in the full model, only sleep problems remained significant (aOR: 2.03 [1.50:2.74]). CONCLUSIONS: Our results confirm that problematic internet users report health problems more frequently, with lack of sleep being the most strongly associated and seeming to act as mediator regarding the other ones. Clinicians should remember to screen for excessive internet use their patients complaining of sleep-related problems, back or musculoskeletal pain or overweight. Clinicians should advise parents to limit the amount of time their adolescent children can spend online for leisure activities. Furthermore, limiting the number of devices used to connect to the internet could help warrant enough sleeping time.

Implicit attitudes and self-concepts towards transgression and aggression: differences between male community and offender adolescents, and associations with psychopathic traits.

Research suggests that implicit attitudes play a key role in the occurrence of antisocial behaviours. This study assessed implicit attitudes and self-concepts related to aggression and transgression in community and offender adolescents, using a new set of Implicit Association Tests (IATs), and examined their association with of psychopathic traits. Thirty-six offenders and 66 community adolescents performed 4 IATs assessing 1) implicit attitudes about a) aggression and b) transgression as good, and 2) implicit self-concepts about a) aggression and b) transgression as self-descriptive. They filled in self-report questionnaires: the Youth Psychopathic Traits Inventory, the Child Behaviour Checklist, and explicit measures of their attitudes and self-concepts towards transgression and aggression. Results showed few differences between community and offender adolescents on implicit attitudes and self-concepts, and unexpected negative associations between some implicit attitudes and psychopathic traits, while the association was positive for the corresponding explicit attitudes. Possible explanations of these findings are discussed.

Meta-analysis of the effects of MI training on clinicians' behavior.

MI-based interventions are widely used with a number of different clinical populations and their efficacy has been well established. However, the clinicians' training has not traditionally been the focus of empirical investigations. We conducted a meta-analytic review of clinicians' MI-training and MI-skills findings. Fifteen studies were included, involving 715 clinicians. Pre-post training effect sizes were calculated (13 studies) as well as group contrast effect sizes (7 studies). Pre-post training comparisons showed medium to large ES of MI training, which are maintained over a short period of time. When compared to a control group, our results also suggested higher MI proficiency in the professionals trained in MI than in nontrained ones (medium ES). However, this estimate of ES may be affected by a publication bias and therefore, should be considered with caution. Methodological limitations and potential sources of heterogeneity of the studies included in this meta-analysis are discussed.

Brief report: The Identity Style Inventory (ISI-3) and the Utrecht-Management of Identity Commitments Scale (U-MICS): factor structure, reliability, and convergent validity in French-speaking university students.

The purpose of this study was to evaluate the factor structure and the reliability of the French versions of the Identity Style Inventory (ISI-3) and the Utrecht-Management of Identity Commitments Scale (U-MICS) in a sample of college students (N = 457, 18-25 years old). Confirmatory factor analyses confirmed the hypothesized three-factor solution of the ISI-3 identity styles (i.e. informational, normative, and diffuse-avoidant styles), the one-factor solution of the ISI-3 identity commitment, and the three-factor structure of the U-MICS (i.e. commitment, in-depth exploration, and reconsideration of commitment). Additionally, theoretically consistent and meaningful associations among the ISI-3, U-MICS, and Ego Identity Process Questionnaire (EIPQ) confirmed convergent validity. Overall, the results of the present study indicate that the French versions of the ISI-3 and UMICS are useful instruments for assessing identity styles and processes, and provide additional support to the cross-cultural validity of these tools.

Fear and anxiety at the basis of adolescent externalizing and internalizing behaviors: a case study.

Juvenile delinquency is rarely associated with success in psychotherapeutic treatment. Up until now, few data have been recorded regarding possible overlaps or common features of conduct disorders with anxiety disorders. This case report of a delinquent adolescent's presenting an obsessive-compulsive disorder discusses possible underlying common features of externalizing and internalizing disorders, mainly in terms of fear and anxiety regulation. The successful psychotherapy is discussed with regard to efficient psychological assessment and treatment of delinquent adolescents, and it underlies the importance of detailed analysis of psychopathology in cases of juvenile delinquency.

The Beck Cognitive Insight Scale in outpatients with psychotic disorders: further evidence from a French-speaking sample.

OBJECTIVE: The Beck Cognitive Insight Scale (BCIS) evaluates patients' self-report of their ability to detect and correct misinterpretation. Our study aims to confirm the factor structure and the convergent validity of the original scale in a French-speaking environment. METHOD: Outpatients (n = 158) suffering from schizophrenia or schizoaffective disorders fulfilled the BCIS. The 51 patients in Montpellier were equally assessed with the Positive and Negative Syndrome Scale (PANSS) by a psychiatrist who was blind of the BCIS scores. RESULTS: The fit indices of the confirmatory factor analysis validated the 2-factor solution reported by the developers of the scale with inpatients, and in another study with middle-aged and older outpatients. The BCIS composite index was significantly negatively correlated with the clinical insight item of the PANSS. CONCLUSIONS: The French translation of the BCIS appears to have acceptable psychometric properties and gives additional support to the scale, as well as cross-cultural validity for its use with outpatients suffering from schizophrenia or schizoaffective disorders. The correlation between clinical and composite index of cognitive insight underlines the multidimensional nature of clinical insight. Cognitive insight does not recover clinical insight but is a potential target for developing psychological treatments that will improve clinical insight.

Eating and weight related cognitions in people with Schizophrenia : a case control study.

BACKGROUND: Patients with antipsychotic-induced weight gain (WG) regularly report on unsuccessful dietary trials, which suggests strong biological weight gain drive that is extremely hard to overcome with thoughts, such that behaviour doesn't change despite some intent to change. The purpose of the present study was to assess cognitions specifically related to restrained eating in severely overweight patients with schizophrenia treated with antipsychotic drugs. METHODS: Forty outpatients with schizophrenia and 40 controls without psychiatric disability were included. Both groups were composed of one subgroup severely overweight (defined as a BMI > 28), and a comparison sample (BMI<28). The revised version of the Mizes Anorectic cognitive questionnaire (MAC-R) was used in this cross-sectional case-control study. RESULTS: Gender was significantly related to eating disorders cognition, women scoring higher than men. Patients with schizophrenia in general scored higher on the MAC-R total scale and on the MAC-R subscale 2, the latter score representing rigid weight regulation and fear of weight gain. When comparing the two groups of subjects with BMI < 28, it appeared that patients with schizophrenia also scored higher on MAC-R total scale, the subscales 2 and 3, the latter subscale 3, indicating altered self control and self-esteem. CONCLUSION: As is the case in weight gain of subjects without schizophrenia, the present results suggest that the cognitive distortions, as assessed by the MAC-R, may play an important role in weight gain also in patients with schizophrenia, and in weight gain associated with antipsychotic pharmacotherapy. Particular attention to these processes may help to improve the management of antipsychotic drugs induced weight gain.