The intergenerational transmission of attachment during middle childhood in lesbian, gay, and heterosexual parent families through assisted reproduction: The mediating role of reflective functioning.

The present study examined the attachment patterns distribution of 60 lesbian mothers, 50 gay fathers, and 42 heterosexual parents through assisted reproduction and their 76 children, using the Adult Attachment Interview (AAI) and the Friends and Family Interview (FFI), respectively. The study also explored the intergenerational transmission of attachment through reflective functioning (AAI-RF). All families lived in Italy and children were aged 6-12 years (Myears = 8.11, SD = 2.17; 48.68% assigned female at birth). The AAI patterns distribution was similar across family types and did not significantly differ from international and national normative data. Similarly, children's FFI attachment patterns were evenly distributed between family types, and no significant differences emerged in comparison to international and national normative data referring to middle childhood samples. Mediational models revealed that, in all three family types, parents with greater AAI coherence of mind exhibited higher AAI-RF, which, in turn, was associated with increased FFI attachment security in children. Furthermore, parents' AAI coherence of mind directly influenced children's FFI attachment security. The results support and expand hypotheses regarding the intergenerational transmission of attachment in lesbian, gay, and heterosexual parent families through assisted reproduction, while offering unique indications to support these families during middle childhood.

Parenting, dyadic coping, and child emotion regulation in lesbian, gay, and heterosexual parent families through assisted reproduction.

AIMS: The present study examined the associations between family structure, parenting, and dyadic coping and children's emotion regulation in lesbian, gay, and heterosexual parent families through assisted reproduction. It also explored differences in parenting dimensions and dyadic coping, based on parents' sexual orientation. METHODS: Participants were 60 lesbian mothers through donor insemination, 50 gay fathers through surrogacy, and 42 heterosexual parents through gamete donation, all with a child aged 6-12 years (M = 8.67; SD = 2.16; 48.68% females) and residing in Italy. In each family, both parents reported parenting stress, parent - child relational self-efficacy, parental control, dyadic coping, and their perception of the child's emotion regulation. RESULTS: Mixed models indicated no significant differences between family types in parenting stress and use of a controlling parenting style. However, lesbian mothers reported higher parent - child relational self-efficacy than heterosexual parents, and higher dyadic coping strategies than gay fathers. Also, children of gay fathers showed greater emotion regulation than children of heterosexual parents. Across family types, higher levels of parenting stress and dyadic coping, and lower levels of parent - child relational self-efficacy were associated with lower child emotion regulation. CONCLUSION: Given that in middle childhood, across family types, better emotional regulation was associated with lower parenting stress and dyadic coping, and greater effectiveness in the parent - child relationship clinical work should focus on the parent's and couple's ability to cooperatively manage stressors while maintaining a balanced focus on their children's resources and autonomy.

Disclosure and child exploration of surrogacy origins in gay father families: Fathers' Adult Attachment Interview coherence of mind matters.

OBJECTIVE: The present study aimed at investigating whether gay fathers' coherence of mind within the Adult Attachment Interview (AAI) moderated the influence of parental disclosure on children's exploration of their surrogacy origins during middle childhood and early adolescence. BACKGROUND: Once children of gay fathers are disclosed to about their surrogacy conception, they may start exploring the meanings and implications of their conception. Very little is known about the factors that may enhance such exploration in gay father families. METHOD: A home-visit study was conducted with 60 White, cisgender, gay fathers and their 30 children born through gestational surrogacy, all residing in Italy and with medium to high socioeconomic status. At time 1, when children were aged 6-12 years (M = 8.31, SD = 1.68), fathers were rated for AAI coherence of mind and interviewed about their disclosure of the surrogacy origins to their child. At time 2, approximately 18 months later (M = 9.87, SD = 1.69), children were interviewed about their exploration of their surrogacy origins. RESULTS: In the context of more information disclosed about the child conception, only children whose fathers showed greater AAI coherence of mind explored their surrogacy origins in more depth. CONCLUSION: Gay fathers' ability to show an internally consistent, but not emotionally overwrought, state of mind regarding their own attachment experiences impacted the extent to which their children felt safe and legitimated in sharing their curiosity about their conception.

From symptoms to subjective and bodily experiences: the contribution of the Psychodynamic Diagnostic Manual (PDM-2) to diagnosis and treatment monitoring in eating disorders.

PURPOSE: Atheoretical and descriptive conceptualizations of eating disorders (EDs) have faced substantial criticism due to their limited ability to assess patients' subjective characteristics and experiences, as needed to determine the most appropriate treatment options. The present article provides an overview of the clinical and empirical literature supporting the potential contribution of the Psychodynamic Diagnostic Manual (PDM-2) to both diagnostic assessment and treatment monitoring. METHODS: Following a discussion of the most relevant shortcomings of current diagnostic models of EDs and a description of the rationale and structure of the PDM-2, evidence supporting the core PDM-2 dimensions of ED patients' subjective experiences (i.e., affective states, cognitive processes, relational patterns, somatic/bodily experiences and states) are examined, alongside their relevance to ED diagnosis and treatment. RESULTS: Overall, the reviewed studies support the diagnostic importance of these patterns of subjective experiences in EDs, highlighting their potential role as either predisposing or maintaining factors to target in psychotherapy. A growing body of multidisciplinary evidence also shows that bodily and somatic experiences are central to the diagnosis and clinical management of ED patients. Moreover, there is evidence that a PDM-based assessment may enable closer monitoring of patient progress during treatment, with regard to both subjective experiences and symptom patterns. CONCLUSIONS: The study suggests that current diagnostic frameworks for EDs would benefit from the addition of a person-centered perspective that considers not only symptoms, but also patients' full range of functioning-including their deep and surface-level emotional, cognitive, interpersonal, and social patterns-to improve patient-tailored interventions. LEVEL OF EVIDENCE: Level V, narrative review.

Parent-Child Relationship Scale (P-CRS): A valid and clinically sensitive tool for assessing the parent-child relationship.

The present study measured the efficacy of the Parent-Child Relationship Scale (P-CRS) in assessing the relationship between parents and children. The aims of the study were to explore how the scale scores change in relation to age and sex of the children, evaluate its ability to capture relational difficulties, and investigating its usefulness to assess the parent-child relationship in the context of certain psychopathological conditions. A total of 322 clinicians rated 542 mother-child dyads (92% Italian, 8% other nationality). The clinical group was comprised of 267 children with confirmed clinical conditions. The control group was comprised of 275 children with typical development, rated by clinicians in their private offices after four to five evaluative sessions. Descriptive statistics were captured and ANOVAs and linear regression analyses were performed to investigate in both groups the efficacy of the scale in assessing the parent-child relationship. Finally, to test P-CRS accuracy, optimal cutoff scores for each subscale were computed using the ROC method. The findings provide evidence for the P-CRS ability to capture relational difficulties in both groups, showing its utility as screening tool. Thus, the results support that P-CRS can be used for exploring how different relationship patterns can occur in different clinical conditions.

El presente estudió midió la efectividad de la Escala de la Relación Progenitor-Niño (P-CRS) para evaluar la relación entre progenitores y niños. El propósito del estudio fue explorar cómo los puntajes de la escala cambian en relación con la edad y el sexo de los niños, evalúa su habilidad de captar las dificultades en la relación, e investiga su utilidad para evaluar la relación entre progenitor y niño dentro del contexto de ciertas condiciones sicopatológicas. Trescientos veintidós clínicos evaluaron 542 díadas madre-niño (92% italianas, 8 % otras nacionalidades). El grupo clínico estuvo compuesto de 267 niños con condiciones clínicas confirmadas. El grupo de control estuvo compuesto de 275 niños con un desarrollo típico, evaluados por los clínicos en sus oficinas privadas después de cuatro a cinco sesiones evaluativas. Se captaron estadísticas descriptivas y se llevaron a cabo análisis de variación (ANOVA) y análisis de regresión lineal, para investigar en ambos grupos la efectividad de la escala para evaluar la relación progenitor-niño. Finalmente, para demostrar la precisión de P-CRS, se calcularon los puntajes límites óptimos para cada subescala, usando el método ROC. Los resultados proveen evidencia de la habilidad de P-CRS de captar las dificultades de la relación en ambos grupos, demostrando su utilidad como herramienta de detección. De manera que los resultados apoyan el hecho de que P-CRS puede usarse para explorar cuán diferente los patrones de relación pueden ocurrir bajo diferentes condiciones clínicas.

Cette étude a mesuré l'efficacité de l'Echelle de Relation Parent-Enfant (Parent-Child Relationship Scale en anglais, soit P-CRS) en évaluant la relation entre les parents et les enfants. Les buts de l'étude étaient d'explorer comme les scores de l'échelle changement en relation à l'âge et au sexe des enfants, d'évaluer sa capacité à capturer les difficultés relationnelles, et de comprendre son utilité pour l'évaluation de la relation parent-enfant dans le contexte de certaines conditions psychopathologiques. 322 cliniciens ont évalué 542 dyades mère-enfant (92% Italiennes, 8% autre nationalité). Le groupe clinique comprenait 267 enfants avec des conditions cliniques confirmées. Le groupe de contrôle comprenait 275 enfants avec un développement typique, évalués par des cliniciens dans leurs cabinets médicaux après de trois à cinq sessions d'évaluation. Des statistiques descriptives ont été capturées et des ANOVA ainsi que des analyses de régression linéaire ont été faites afin d'établir chez les deux groupes l'efficacité de l'échelle à évaluer la relation parent-enfant. Enfin, pour tester la précision de l'a P-CRS, des scores limite optimaux pour chaque sous-échelle ont été calculés en utilisant la méthode ROC. Les résultats montrent la capacité de la P-CRS à capturer les difficultés relationnelles chez les deux groupes, montrant son utilité en tant qu'outil de dépistage. Par conséquent les résultats soutiennent que la P-CRS peut être utilisé pour explorer la manière dont des patterns de relation différents peuvent apparaître dans des conditions cliniques différentes.

Gender Identity and Non-Binary Presentations in Adolescents Attending Two Specialized Services in Italy.

BACKGROUND: Recently, the variability and heterogeneity of gender presentations in transgender youths have gained significant attention worldwide. Alongside this, specialized gender services have reported an increase in referrals of youths reporting non-binary identities. In Italy, studies investigating gender identity and expression in gender non-conforming youths are lacking, as are data regarding the non-binary population. AIM: The present study aimed at dimensionally exploring how transgender and non-binary Italian adolescents identify and express their gender. OUTCOMES: Gender expression in trans binary youths and non-binary youths. METHODS: The Gender Diversity Questionnaire (GDQ; Twist & de Graaf, 2019) was used to investigate gender identity, gender fluidity, and gender expression in a sample of 125 adolescent patients from the Gender Identity Development Service (SAIFIP) in Rome and the Gender Incongruence Unit of the Careggi Hospital in Florence, between April 2019-June 2021. RESULTS: The majority of participants (74.4%) identified as trans* binary and the remaining (25.6%) participants identified as non-binary. Trans binary participants reported a stable gender identity, whereas non-binary participants reported a more fluid gender identity across time and contexts. Almost all participants rated external appearance as important to their gender expression, yet trans binary participants attributed more importance to the body in this respect. Body discomfort and pubertal stage emerged as the most influential factors in participants' experiences of gender. Participants who were assigned male at birth expressed significantly more desire for puberty blockers, whereas those who were assigned female at birth had a stronger desire to engage in breast/chest surgery. Non-binary participants sought different medical interventions relative to trans binary participants. CLINICAL IMPLICATIONS: These results may be useful for clinicians working with transgender youths as they provide awareness regarding the features of young people who identify within and outside of binary constructions of gender. STRENGTHS & LIMITATIONS: This study provides useful data in gaining insight into understanding the variety of experiences and challenges of gender non-conforming youths. However as the sample was recruited from specialized services, it may not represent the entire gender non-conforming population in Italy. CONCLUSION: The results describe the range of gender identities and expressions among gender non-conforming youths attending gender specialized services in Italy, thereby improving our understanding of the variety of identities experienced and the specific medical needs of both trans binary and non-binary adolescents. Mirabella M, Piras I, Fortunato A, et al. Gender Identity and Non-Binary Presentations in Adolescents Attending Two Specialized Services in Italy. J Sex Med 2022;19:1035-1048.

Personality and Attachment in Transsexual Adults.

The main aim of this study was to investigate the associations between personality features and attachment patterns in transsexual adults. We explored mental representations of attachment, assessed personality traits, and possible personality disorders. Forty-four individuals diagnosed with gender identity disorder (now gender dysphoria), 28 male-to-female and 16 female-to-male, were evaluated using the Shedler-Westen assessment procedure-200 (SWAP-200) to assess personality traits and disorders; the adult attachment interview was used to evaluate their attachment state-of-mind. With respect to attachment, our sample differed both from normative samples because of the high percentage of disorganized states of mind (50% of the sample), and from clinical samples for the conspicuous percentage of secure states of mind (37%). Furthermore, we found that only 16% of our sample presented a personality disorder, while 50% showed a high level of functioning according to the SWAP-200 scales. In order to find latent subgroups that shared personality characteristics, we performed a Q-factor analysis. Three personality clusters then emerged: Healthy Functioning (54% of the sample); Depressive/Introverted (32%) and Histrionic/Extroverted (14%). These data indicate that in terms of personality and attachment, GD individuals are a heterogeneous sample and show articulate and diverse types with regard to these constructs.

Emerging criteria for the low-coherence cannot classify category.

As suggested by Main et al., to respond to the need for an adaptation of the existing Adult Attachment Interview (AAI) coding system, especially regarding the application to nonnormative samples, this study presents additional criteria that characterize the low-coherence cannot classify (CC) category. Three AAIs were selected from a sample of parents of maltreated children. All transcripts indicated a very low coherence, with no evidence of contradictory insecure discourse strategies. Moreover, global category descriptors were identified, together with specific indices of discourse characteristics and features that highlight the breakdown in reasoning and discourse experienced by the speakers. The aim of the study is to illustrate new criteria to identify and rate a low-coherence CC profile toward the operationalization of this pervasively unintegrated state of mind. Through the definition of additional criteria for low-coherence CC category, our study helps the AAI and its coding system be more flexible and effective when dealing with clinical samples.

Eating Disorders and Therapist Emotional Responses.

The aims of this study were to identify (a) patterns of clinicians' emotional responses to patients with eating disorders (ED); (b) patient, clinician, and treatment variables associated with therapist emotional responses; and (c) the influence of patient personality on therapist emotional responses. A random national sample of psychodynamic and cognitive-behavioral psychotherapists (N = 149) was asked to examine one patient (>18 years old) with an ED. Clinicians completed the SWAP-200, the Therapist Response Questionnaire, and the Clinical Questionnaire-Eating Disorder Form to provide general information about themselves, patients, and therapies. Results suggested a therapist pattern of emotional response in relation to different ED diagnosis and indicated meaningful influence of therapist experience and patient variables (such as sexual abuse, dissociative symptoms, and self-harm) on therapist emotional reactions. Finally, regression analysis suggested that therapist responses are more related to patient personality than ED symptoms. This study confirms the importance of patient personality in evoking specific therapists' reactions.

Change in heart rate variability after the adult attachment interview in dissociative patients.

The aim of this study was to assess heart rate variability (HRV) in individuals with dissociative disorders (DD) before and after the Adult Attachment Interview (AAI). Electrocardiograms were recorded before, during, and after the AAI in 13 individuals with DD and 13 healthy participants matched for age and gender. Significant change in HRV was observed only in the DD group. After the AAI, those with DD showed significant increases in the low frequency/high frequency ratio (pre-AAI = 1.91 ± 1.19; post-AAI = 4.03 ± 2.40; Wilcoxon test = -2.76, p = .005). Our results suggest that the retrieval of childhood attachment experiences in individuals with DD is associated with a change in HRV patterns that could reflect the emotion dysregulation of dissociative psychopathological processes.

Memories of attachment hamper EEG cortical connectivity in dissociative patients.

In this study, we evaluated cortical connectivity modifications by electroencephalography (EEG) lagged coherence analysis, in subjects with dissociative disorders and in controls, after retrieval of attachment memories. We asked thirteen patients with dissociative disorders and thirteen age- and sex-matched healthy controls to retrieve personal attachment-related autobiographical memories through adult attachment interviews (AAI). EEG was recorded in the closed eyes resting state before and after the AAI. EEG lagged coherence before and after AAI was compared in all subjects. In the control group, memories of attachment promoted a widespread increase in EEG connectivity, in particular in the high-frequency EEG bands. Compared to controls, dissociative patients did not show an increase in EEG connectivity after the AAI. Conclusions: These results shed light on the neurophysiology of the disintegrative effect of retrieval of traumatic attachment memories in dissociative patients.

Modification of EEG power spectra and EEG connectivity in autobiographical memory: a sLORETA study.

The aim of the present study was to explore the modifications of scalp EEG power spectra and EEG connectivity during the autobiographical memory test (AM-T) and during the retrieval of an autobiographical event (the high school final examination, Task 2). Seventeen healthy volunteers were enrolled (9 women and 8 men, mean age 23.4 ± 2.8 years, range 19-30). EEG was recorded at baseline and while performing the autobiographical memory (AM) tasks, by means of 19 surface electrodes and a nasopharyngeal electrode. EEG analysis was conducted by means of the standardized LOw Resolution Electric Tomography (sLORETA) software. Power spectra and lagged EEG coherence were compared between EEG acquired during the memory tasks and baseline recording. The frequency bands considered were as follows: delta (0.5-4 Hz); theta (4.5-7.5 Hz); alpha (8-12.5 Hz); beta1 (13-17.5 Hz); beta2 (18-30 Hz); gamma (30.5-60 Hz). During AM-T, we observed a significant delta power increase in left frontal and midline cortices (T = 3.554; p < 0.05) and increased EEG connectivity in delta band in prefrontal, temporal, parietal, and occipital areas, and for gamma bands in the left temporo-parietal regions (T = 4.154; p < 0.05). In Task 2, we measured an increased power in the gamma band located in the left posterior midline areas (T = 3.960; p < 0.05) and a significant increase in delta band connectivity in the prefrontal, temporal, parietal, and occipital areas, and in the gamma band involving right temporo-parietal areas (T = 4.579; p < 0.05). These results indicate that AM retrieval engages in a complex network which is mediated by both low- (delta) and high-frequency (gamma) EEG bands.

Parental burnout, coparenting, and internalized sexual stigma during COVID-19 in parents with minoritized sexual identities.

The COVID-19 pandemic acted as a model of stressful situations for parents insofar as it led to unprecedented difficulties in childcare and caregiving, resulting in increased levels of parental burnout, worldwide. To date, research on parental burnout has mainly involved heterosexual parents. However, parents with minoritized sexual identities face partially different stressors, including internalized sexual stigma, and they also have partially different resources, including a more egalitarian division of childcare labor. Between April 2020 and February 2021, 32 lesbian mother families by donor insemination (n = 64 lesbian mothers) and 28 gay father families by gestational surrogacy (n = 56 gay fathers), all with a child aged 6-10 years and living in Italy, were recruited. In each family, both parents self-rated their parental burnout, coparenting, and internalized sexual stigma. Multilevel modeling indicated that lesbian mothers reported greater parental burnout than gay fathers. Moreover, lower coparenting quality was associated with greater parental burnout. Finally, internalized sexual stigma had a significant both direct and interactive effect on parental burnout, with higher levels of internalized sexual stigma resulting in greater parental burnout, especially in gay fathers. Considering the sexual minority stress theory and the risks and resources balance theory, the results indicate the importance of preventing and treating parental burnout in lesbian and gay parents by focusing on their internalized sexual stigma and coparenting relationship. Also, incorporating the positive psychology framework in future research would help identify in these parents the resources deriving from their minoritized sexual identities to deal with parental burnout. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Heterotypic and homotypic continuity in psychopathology: a narrative review.

Psychopathology is a process: it unfolds over time and involves several different factors. To extend our knowledge of such process, it is vital to understand the trajectories that lead to developing and maintaining a specific disorder. The construct of continuity appears very useful to this aim. It refers to the consistency, similarity, and predictability of behaviors or internal states across different developmental phases. This paper aims to present a narrative review of the literature on homotypic and heterotypic continuity of psychopathology across the lifespan. A detailed search of the published literature was conducted using the PsycINFO Record and Medline (PubMed) databases. Articles were included in the review based on the following criteria: (1) publication dates ranging from January 1970 to October 2022; and (2) articles being written in the English language. To ensure a thorough investigation, multiple combinations of keywords such as "continuity," "psychopathology," "infancy," "childhood," "adolescence," "adulthood," "homotypic," and "heterotypic" were used. Articles were excluded if exclusively focused on epidemiologic data and if not specifically addressing the topic of psychopathology continuity. The literature yielded a total of 36 longitudinal studies and an additional 190 articles, spanning the research published between 1970 and 2022. Studies on continuity focus on the etiology of different forms of mental disorders and may represent a fundamental resource from both a theoretical and clinical perspective. Enhancing our understanding of the different trajectories beneath psychopathology may allow clinicians to implement more effective strategies, focusing both on prevention and intervention. Since literature highlights the importance of early detection of clinical signs of psychopathology, future research should focus more on infancy and pre-scholar age.

Prosocial and externalizing behaviors in children raised by different-and same-gender parent families: new directions in parenting research.

Introduction: Limited research focused on the association between parenting practices and children's prosocial and externalizing behaviors comparing same- and different-gender parent families. The present study considered 76 Italian families (73% same-gender and 27% different-gender parent families) with 8-year-old (SD = 2.17; 49% assigned female at birth) children born through assisted reproductive techniques, to explore parenting practices and children's prosocial and externalizing behaviors. Method: We ran a Multiple-group-by-couple Structural Equation Model in which we estimated the predictive role of parenting on children's behaviors, controlling for age, gender, and family socioeconomic status using the Maximum Likelihood estimation. Results: Results showed that both same- and different-gender parent families reported high levels of parental warmth and very low levels of hostility and rejection; regarding children's behaviors, both same- and different-gender parent families reported high levels of prosociality and low levels of externalizing behaviors. In addition, same-gender parents reported significantly higher levels of children's prosociality and parental warmth than different-gender parents. Regarding associations between parenting practices and behaviors, we found a positive association between positive parenting practices and increasing children's prosocial behaviors and decreasing children's externalizing behaviors, in both same- and different-gender families, controlling for family background characteristics. Conclusion: The present study encourages future research to investigate how specific parenting practices can influence behavioral adjustment in children, focusing on same-gender parent families.

Exploring Gender Diversity in Transgender and Non-Binary Adults Accessing a Specialized Service in Italy.

In Italy, studies investigating gender identity and expression in gender non-conforming adults are lacking, as well as data regarding the non-binary population. The present study aimed at dimensionally exploring how transgender and non-binary Italian adults identify and express their gender. The Gender Diversity Questionnaire (GDQ) was administered to a sample of 112 adult subjects aged 18-60 years accessing a gender-specialized service in Rome. The majority of the participants were aged 18-24 years (53.6%), whereas fewer subjects were aged 25-35 years (32%) and 35 years and older (14.3%). Most participants (83.9%) identified themselves as trans binary, while the remaining (16.1%) identified as non-binary. Trans binary participants reported a stable gender identity, whereas non-binary participants reported a more fluid gender identity over time and across contexts. Younger subjects recognized the use of chosen names, pronouns, and clothes as important for their gender expression, whereas older subjects attributed more importance to physical appearance and emotions. Differences regarding gender-affirmative interventions emerged between non-binary and transbinary participants. Findings evidence that gender non-conforming adults accessing gender-specialized services have unique needs and features, thus it is essential to shed light on this population by providing greater visibility and recognition.

Psychodynamic university counseling: which factors predict psychological functioning after intervention?

Introduction: University counseling centers represent important resources for personal development, and students are increasingly turning to them for help. The present study aimed at, first, evaluating changing in psychological functioning before and after a university counseling intervention and, second, exploring which psychological variables predicted the intervention outcome. Methods: For this purpose, 122 students who attended university counseling services were administered measures to assess personality traits, and measures to assess state variables - intended as contextual, rather than stable, alterations in functioning - such as anxiety, hopelessness and depression. Several Linear Mixed Models were performed to measure the differences between OQ-45 scores before and after the intervention (one for each OQ dimension and OQ total score); then, two steps of multiple regression analyses were performed. Results: Significative reductions between pre-test and post-test OQ-45 scores were found, highlighting increased levels of well-being; personality traits seem not to be predictive of the intervention outcome, while state variables significantly contribute to the psychological wellbeing improvement after counseling intervention. Discussion: Our findings highlight the importance of paying attention to the role of affective difficulties in predicting the counseling effectiveness.

Unpacking trust: The Italian validation of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ).

The construct of epistemic trust has received much consideration in recent psychological literature, even though mainly from a theoretical perspective. The overall aim of this study was to validate the first self-report measure of epistemic trust-the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ)-in an Italian sample. Our primary goal was to test the factorial validity of the instrument, also exploring the influence of age, gender, and level of education on epistemic trust (Study 1, n = 843). Secondarily, we investigated the associations between epistemic trust, mistrust, credulity, and other aspects of psychological functioning, as well as with the presence of adverse childhood experiences in a smaller number of participants (Study 2, n = 445). Besides the ETMCQ, the survey included an ad hoc questionnaire investigating socio-demographic characteristics and self-report measures of reflective functioning, mentalized affectivity, traumatic experiences, attachment, and psychological symptoms. Statistical analysis showed a three-factor hierarchical structure similar to the model proposed in the original validation, with some differences that suggest an influence of cultural factors in determining individuals' epistemic stance. Our results corroborate previous theoretical contributions regarding the association between epistemic trust and psychological wellbeing, and between epistemic disruptions and higher levels of psychological suffering. Both Mistrust and Credulity were significantly related to the presence of childhood traumatic experiences, attachment avoidance and anxiety, lower levels of mentalization, lower abilities in emotional regulation, and higher levels of psychopathological symptoms. The ETMCQ represents an easily administered and time-effective tool. Its use could pave the way for interesting clinical and theoretical findings.

Free-Association Session Scale: factor structure and preliminary validity test.

One of the main concepts of the psychoanalytic method postulated by Freud in 1912 is the fundamental rule, which involves asking the patient to say whatever comes to mind as the analyst follows the patient's speech with fluctuating attention. Despite different theoretical models, this concept has remained an invariant element that characterizes the psychoanalytic method. For this reason, the purpose of the current study is to present a new instrument that measures this process based on the clinician's assessment. The Free-Association Session Scale (FASS) has been designed according to the psychoanalytic framework. Study 1 presented the preliminary validation of the FASS factor structure. Experienced Italian psychoanalysts (N = 281; 196 women) completed the FASS and sociodemographic questionnaire. The following two factors were identified using exploratory factor analysis: (1) Perturbing, and (2) Associativity. Study 2 cross-validated the two factors using an independent sample (N = 259; 187 women) of experienced psychoanalysts and confirmatory factor analysis (CFA). The FASS has been tested for concurrent validity using the Session Evaluation Questionnaire (SEQ) and Linguistic measures of the Referential process. The two-factor model achieved a close-fit test, and the FASS items were found to measure the corresponding factors with good reliability. The Perturbing factor is negatively associated with three SEQ factors (Depth, Smoothness, and Positivity) and negatively correlated with symbolization (IWRAD and IWRAD_IWRRL), confirming a more complex and unexpected session. The Associativity factor is positively associated with all four SEQ factors (Depth, Smoothness, Positivity, and Arousal). In conclusion, the FASS is a promising new questionnaire for assessing psychoanalytic session quality processes with satisfactory validity and reliability.

Psychological Counseling among University Students Worldwide: A Systematic Review.

University counseling services (UCSs) are actively involved in mental health assessment and in supplying interventions aimed at preventing, facing and possibly overcoming psychological problems. However, we do not have a global overview of psychological counseling among universities. This systematic review aims at reviewing the literature on university psychological counseling, including articles documenting: (1) mental health and attitudes regarding help-seeking behaviors and UCSs among university students or counselors, (2) the description of protocols/services among UCSs, (3) the efficacy of psychological counseling/interventions among university students (both face-to-face and internet-delivered interventions). The study followed PRISMA guidelines and was registered on PROSPERO. After defining inclusion and exclusion criteria, a literature search was conducted, identifying 7085 records. Finally, 152 articles met the review eligibility criteria and were included in the qualitative synthesis. Results are divided into seven thematic topics that emerged during the analysis of the literature. The results mainly showed that face-to-face and web-based counseling/psychological interventions improve university students' mental health. Cross-sectional studies showed that many biases exist toward help-seeking behaviors, especially among international students. Both students and counselors must strive to overcome cultural barriers. Available resources for UCSs are scarce and need to be strengthened, as well as efficacy studies through randomized clinical trials.