The mediating role of narcissism in the effects of regulatory mode on positivity.

Positivity (i.e., the individual tendency to positively approach life experiences) has proven to be an effective construct applied in positive psychology. However, individuals' self-regulation may have contrasting effects on positivity. We specifically examined whether positivity could be partially explained through two aspects of motivation concerned with self-regulation: locomotion (i.e., a motivational orientation concerned with movement) and assessment (i.e., a motivational orientation concerned with comparison and evaluation). Furthermore, based on previous literature that found a link between these aspects and narcissism, we examined whether "adaptive" and "maladaptive" dimensions of narcissism could mediate the effects of locomotion and assessment on increased or decreased positivity. Narcissism was defined by previous research as adaptive or maladaptive insofar as it leads or does not lead to increased psychological well-being. We estimated a mediation model with multiple independent variables and multiple mediators in a cross-sectional study with self-reported data from 190 university students. We found that both locomotion and assessment were associated with adaptive narcissism, which in turn was positively associated with positivity. However, assessment was also associated with maladaptive narcissism, which in turn was negatively associated with positivity. Relationships between aspects of self-regulation, narcissism, and positivity can have significant implications which will be discussed.

The multifaceted nature of the response to adversity in an Italian sample of refugee community leaders.

The end of the last decade saw record numbers of refugee arrivals to Italy, straining the existing reception and integration systems. Although significant research attention has focused on the prevalence of posttraumatic stress disorder (PTSD), depression, and suicidal ideation in refugee populations, there are increasing calls to study the interactions between distress, resilience, and positive outcomes of adversity. To fully understand the complexity of the refugee experience, these voices must be heard in dialogue. Studies must be framed within a more nuanced view of refugees, characterizing them not exclusively as victims but also as advocates for their own well-being and the well-being of their communities. This exploratory study performed a thematic analysis of 15 interviews conducted with refugee community leaders in Italy, each a founder or leader of a community association and actively engaged in civil society. In keeping with Papadopoulos' (2007) construct of adversity-activated development, an inductive analysis identified three distinct patterns of positive adversity response: meaning, motivation, and mobilization. A deductive analysis identified the most appropriate theories of resilience to describe the sample, which included resilience as a dynamic positive adaptation and resilience as resistance to change in moral codes and personal value systems. The resulting image of refugee community leaders in Italy is that of individuals who are exposed to adversity and experiences of suffering and distress but safeguard their core values while positively adapting to a new country.

The role of locally-designed organizational artifacts in supporting nurses' work: an ethnographic study on the wards

INTRODUCTION: This paper aims to describe how nurses' planning and coordination work is performed through the use of locally designed tools (i.e., diaries, planners, reminders, and organizers). These tools are investigated as the materialization of organizational work, thus offering a complementary perspective on nursing practice to that proposed by the professional mandate and supported by official artifacts in use. METHOD: Ethnographic study. RESULTS: By analyzing locally designed artifacts, the rationale that enables nurses to make the flow of activities work is highlighted and explained. Evidence is provided by a description of how nurses' tacit knowledge is reified and embedded into objects produced by the nurses themselves. Implications for the design of digital systems supporting nursing practice are discussed. CONCLUSION: The analysis of these artifacts has allowed an understanding of practices used by the nurses to manage the workflow in the wards.

From service design thinking to the third generation of activity theory: a new model for designing AI-based decision-support systems.

Introduction: The rise of Artificial Intelligence (AI), particularly machine learning, has brought a significant transformation in decision-making (DM) processes within organizations, with AI gradually assuming responsibilities that were traditionally performed by humans. However, as shown by recent findings, the acceptance of AI-based solutions in DM remains a concern as individuals still strongly prefer human intervention. This resistance can be attributed to psychological factors and other trust-related issues. To address these challenges, recent studies show that practical guidelines for user-centered design of AI are needed to promote justified trust in AI-based systems. Methods and results: To this aim, our study bridges Service Design Thinking and the third generation of Activity Theory to create a model which serves as a set of practical guidelines for the user centered design of Multi-Actor AI-based DSS. This model is created through the qualitative study of human activity as a unit of analysis. Nevertheless, it holds the potential for further enhancement through the application of quantitative methods to explore its diverse dimensions more extensively. As an illustrative example, we used a case study in the field of human capital investments, with a particular focus on organizational development, which involves managers, professionals, coaches and other significant actors. As a result, the qualitative methodology employed in our study can be characterized as a "pre-quantitative" investigation. Discussion: This framework aims at locating the contribution of AI in complex human activity and identifying the potential role of quantitative data in it.

Enhancing organizational processes for service innovation: strategic organizational counseling and organizational network analysis.

Previous studies have primarily focused on product innovation, overlooking the examination of organizational processes. This limited perspective poses a theoretical and practical gap as it primarily considers the external aspects of innovation. On the contrary, organizational processes play a crucial role in improving and creating internal operations necessary for product/service innovation success. To this aim, this paper presents a novel approach to enhancing service innovation within complex organizations by integrating Strategic Organizational Counseling (SOC) and Organizational Network Analysis (ONA) methodologies. More specifically, SOC supports organizations in understanding and defining the professional families that need to be triggered in the service ideation, delivery and commercialization process, especially in the case of complex organizations with multiple departments. Secondly, ONA enables the identification of the intra-organizational nodes within the professional families that, due to their social position and other personal characteristics, can be actively engaged as Ambassadors for the promotion of innovation practices. By focusing on intra-organizational processes, understanding role-related needs, and selecting influential organizational actors, this approach provides a new perspective on the service innovation process, assuming both a micro and macro viewpoint. The paper also highlights the importance of cyclically monitoring the proposed workflow to adapt to the dynamic nature of innovation.

Metabolic syndrome in psychiatrically hospitalized patients treated with antipsychotics and other psychotropics.

OBJECTIVE: We evaluated prevalence and risk factors for metabolic syndrome in inpatients treated with antipsychotics, with or without other psychotropic drugs. Although the literature on metabolic syndrome in psychiatry has expanded in recent years, we seek to elucidate some of the remaining gaps by examining a severely and chronically ill population heavily treated with pharmacological agents. METHODS: With data from medical records of 589 adults hospitalized at McLean Hospital in 2010 and 2011, we used standard statistical analyses to characterize risks and covariates of metabolic syndrome. RESULTS: With prior antipsychotic treatment, prevalence of metabolic syndrome was 29.5%. The syndrome was strongly associated with being overweight (≥25 kg/m(2) in 60.1% of subjects), older age, longer treatment-exposure, schizoaffective diagnosis (39.8%), more illness-episodes or hospitalizations, polytherapy, and higher total daily chlorpromazine-equivalent doses, but not sex. Notably, metabolic syndrome risk was greater among young, antipsychotic treated patients (15.5-fold at age ≤25 years). CONCLUSIONS: The findings extend information on the association of metabolic syndrome with antipsychotic treatment. Metabolic syndrome was found in 30% of antipsychotic-exposed inpatients. Risk was surprisingly high in young persons and after brief treatment-exposure, and psychotropic polytherapy increased risk.

Insight and awareness as related to psychopathology and cognition.

BACKGROUND: Insight affects adherence and treatment outcome and relates to cognitive impairment and psychopathology. We investigated the relationship of insight with cognition in patients with major depression, schizophrenia and bipolar disorder in acute psychiatric care, long-term inpatient, and outpatient settings. METHODS: Eighty-one patients (women, 59.5%; age, 45.9 ± 13.5 years; 27 in each setting group; 33.3% with DSM-IV bipolar disorder, 39.5% with unipolar major depression, and 27.2% with schizophrenia) underwent the Wisconsin Card Sorting Test (WCST) to test flexibility, clinician-rated Scale to Assess Unawareness of Mental Disorder (SUMD), and self-rated Insight Scale (IS) to assess insight/awareness. RESULTS: Poor performance on the WCST correlated with higher SUMD scores such as current psychiatric illness unawareness, impaired symptom attribution, unawareness of medication effect, or of social consequences, but not with IS scores. The latter correlated with days on continuous treatment. Patients receiving psycho-education showed greater symptom awareness compared to patients treated with drugs alone. Cognitive flexibility and diagnostic category did not correlate. Poor insight corresponded with severe mental illness, particularly acute psychosis. CONCLUSIONS: Treatment setting specificity reflects psychopathology and severity. Insight is inversely proportional to illness severity and cognitive flexibility, which is also affected by psychopathology. Limitations comprise group heterogeneity, cross-sectional design, and limited sample size.

The contribution of activity theory to modeling multi-actor decision-making: A focus on human capital investments.

Making investment decisions is usually considered a challenging task for investors because it is a process based on risky, complex, and consequential choices (Shanmuganathan, 2020). When it comes to Investments in human capital (IHC), such as startups fundings, the aspect of decision-making (DM) becomes even more critical since the outcome of the DM process is not completely predictable. Indeed, it has to take into consideration the will, goals, and motivations of each human actor involved: those who invest as well as those who seek investments. We define this specific DM process as multi-actor DM (MADM) since not a group is making decisions but different actors, or groups of different actors, who - starting from non-coinciding objectives - need to reach a mutual agreement and converge toward a common goal for the success of the investment. This review aims to give insights on psychological contributions to the study of complex DM processes that deal with IHC to provide scholars and practitioners with a theoretical framework and a tool for describing the complex socio-ecological systems involved in the DM processes. For this purpose, we discuss in the paper how the third generation of activity theory (Leont'ev, 1974, 1978;Engeström, 1987, 2001) could be used as an appropriate model to explain the specificities of MADM construct, focusing on the particular case of startup funding. Design thinking techniques will be proposed as a methodology to create a bridge between different activity systems.

Defining Adjustment to Address the Missing Link between Refugees and Their Resettlement Communities.

BACKGROUND: data from the United Nations High Commissioner for Refugees (UNHCR) show that, in 2020, among 82.4 million refugees, only 251,000 returned to their home countries, indicating the desire for refugees to stay, for the long-term, in their new homelands. The paper contributes to the scientific-psychological debate on the social representation of refugee populations, by studying this population, not simply as "foreigners", traumatized and resourceless people, but rather focusing on the factors that lead to their positive adjustments within local communities. METHOD: a scoping review was carried out to explore the phenomenon of adjustment (RQ1) and to identify the factors that foster adjustment among refugees and their resettlement communities (RQ2). A research protocol and eligibility criteria were defined prior to conducting the literature research through the Scopus database. Afterwards, data charting and items were conducted to organize the results. RESULTS: a process of data mapping outlined three dimensions of adjustment-psychological, social, and scholastic. In addition, six macro factors emerged that ease refugee adjustments-context characteristics, time, social integration markers, acculturation, social support, and psychological capital. Results show that adjustment is the result of the inter-relations among sociological and psychological factors. CONCLUSIONS: the lack of studies addressing the inner resources of refugees and community participation confirms that research in this field needs a change of paradigm, to identify the resources that refugees use to adjust to their new communities and promote their development.

Natives with a need for cognitive closure can approve of immigrants' economic effect when they trust pro-immigrant epistemic authorities.

Previous research on the need for cognitive closure (NFC), or the desire for epistemic certainty, has consistently found that it is associated with negative attitudes toward immigrants, among other outgroups, potentially because they represent agents of change and/or due to a general preference for perceived stability and certainty associated with right-wing politics. However, as individuals with this need theoretically prefer stable and certain knowledge, independent of the specific content, it is also possible that these individuals could have positive attitudes toward immigrants when they are provided with a positive source of information to which they can metaphorically "close" upon. In two studies (n = 397), controlling for participants' political orientation, we found that individuals with an NFC were more likely to accept immigrants when their positive effect was endorsed by an epistemic authority (Study 1), but only when they trusted this source (Study 2).

"The Flow in the Funnel": Modeling Organizational and Individual Decision-Making for Designing Financial AI-Based Systems.

Nowadays, the current application of artificial intelligence (AI) to financial context is opening a new field of study, named financial intelligence, in which the implementation of AI-based solutions as "financial brain" aims at assisting in complex decision-making (DM) processes as wealth and risk management, financial security, financial consulting, and blockchain. For venture capitalist organizations (VCOs), this aspect becomes even more critical, since different actors (shareholders, bondholders, management, suppliers, customers) with different DM behaviors are involved. One last layer of complexity is the potential variation of behaviors performed by managers even in presence of fixed organizational goals. The aim of this study is twofold: a general analysis of the debate on implementing AI in DM processes is introduced, and a proposal for modeling financial AI-based services is presented. A set of qualitative methods based on the application of cultural psychology is presented for modeling financial DM processes of all actors involved in the process, machines as well as individuals and organizations. The integration of some design thinking techniques with strategic organizational counseling supports the modeling of a hierarchy of selective criteria of fund-seekers and the creation of an innovative value proposition accordingly with goals of VCOs to be represented and supported in AI-based systems. Implications suggest that human/AI integration in the field can be implemented by developing systems where AI can be conceived in two distinct functions: (a) automation: treating Big Data from the market defined by management of VCO; and (b) support: creating alert systems that are coherent with ordered weighted decisional criteria of VCO.

A Multilevel Analysis of the Impact of Unit Tightness vs. Looseness Culture on Attitudes and Behaviors in the Workplace.

This study examines the impact of work unit-level perceived Tightness vs. Looseness (T-L) culture on individual-level perceived stress, intention to leave, organizational deviance, job satisfaction, effort investment, and organizational commitment. Using quantitative cross-sectional data (N=417) collected from preexisting work units (N=57) in different organizations in Italy, multilevel analysis results revealed that a perceived cultural tightness at the unit level was significantly and positively related to individual-level job satisfaction, effort investment, and organizational commitment and significantly and negatively related to individual-level stress, intention to leave, and organizational deviance. The findings suggest that organizations should promote a culture of tightness to positively influence employee attitudes and behaviors. Limitations and recommendations for future research are discussed.

At Home: Place Attachment and Identity in an Italian Refugee Sample.

The central tenet of Place Attachment theory states that an individual has an inborn predisposition to form strong bonds with places as well as with people. Our qualitative study applies this theory to understand how, despite loss and adversity, refugees are able to reconstruct a sense of identity, community, and "home". Participants included 15 forcibly displaced people from different countries of origin. Semistructured interviews explored factors that facilitate participants' integration in a new context and the impact of this context on their sense of identity. Data were analysed using Consensual Qualitative Research Methodology to identify recurrent themes and their frequencies within interview transcripts. Within the relational dimensions of place attachment, affiliation, and seeking help from others, the study explores the factors that facilitate the integration of refugees in a new context and the impact of this context on their sense of identity, identifying recurrent themes and their frequencies within interview transcripts. The most frequent resulting themes were (a) a sense of identity and (b) expectations toward the resettlement country. Additional, though less frequent, themes included: (c) sense of belonging, (d) community integration, (e) trust, (f) opportunity seizing, (g) being a point of reference for others, (h) sense of community, (i) positive memories, (j) refusal. These results begin to describe the ways by which Place Attachment, toward both birth and resettlement countries, contributes to a restructured identity and sense of "feeling at home" for refugees.

The Emergency Department's management of a severe acute psychomotor agitation: a rare case of an adult presentation of Rasmussen's Syndrome?

We report a severe acute psychomotor agitation treated in the Emergency Department. We hypothesized to be a rare case of an adult presentation of Rasmussen's Syndrome.

Changes in medication practices for hospitalized psychiatric patients: 2009 versus 2004.

BACKGROUND: We tested the hypothesis that combinations and total daily doses of psychotropics for hospitalized patients diagnosed with major psychiatric disorders are rising. METHODS: We evaluated McLean Hospital records of 481 consecutive inpatients with DSM-IV schizophrenia, schizoaffective, or bipolar disorders in 2004 (n = 278) or 2009 (n = 203) to compare characteristics and treatments. RESULTS: In 2009, Clinical Global Impression (CGI)-severity scores were 6% lower at intake and improved 1.7 times more than in 2004, as hospitalization-length decreased by 12%. Polytherapy (> or = 2 psychotropics) increased in 2009 (affective or schizoaffective disorders > schizophrenia). Total psychotropics/patient (3.1-3.2) remained stable but mood-stabilizers/patient increased markedly and antipsychotics/patient decreased somewhat in 2009. Antipsychotic-choice (2009) ranked: quetiapine, aripiprazole, risperidone, and others; mood-stabilizers ranked: lamotrigine, valproate, lithium, and others (1/4 off-label). In 2009, final total antipsychotic doses (mg/day) increased by 97%, and mood-stabilizers by 75%. Adverse-effect rates fell by half. Factors differing independently for 2009 versus 2004 ranked: (a) more CGI improvement, (b) more mood-stabilizers/patient, (c) lower admission CGI scores, and (c) higher total antipsychotic dose. COMMENT: Combinations and doses of antipsychotic and mood-stabilizing drugs for inpatients increased markedly (2004 vs. 2009) without consistent correspondence of agents/person and doses, without apparent increase in major adverse effects, and with possibly superior clinical improvement.

Social and Psychological Capital for the Start-Up of Social Enterprises With a Migratory Background.

The highest number of forcibly displaced people has been currently recorded due to war, poverty, and climate change. Recently, a process that recognizes refugees as reliable interlocutors for the improvement of reception policies has started. Refugees are therefore encouraged to start up social enterprises aimed at fostering newcomers' social integration to participate to such a phenomenon. Positive Psychology, with its focus on human strengths, allows to identify the resources that pushed refugees to turn the difficulties they faced during the journey and the resettlement process into resources for themselves and for the resettlement community. The following paper explores in particular the interplay between social and psychological capital that is at the base of a similar social entrepreneurship project through a case study. A qualitative research has been carried out within a social enterprise with a migratory background to analyze the internal and relational resources that brought founders to start up the venture. Results show that while social and psychological capital were independently activated to start from scratch in the resettlement community, they occurred in interrelation in a subsequent phase when participants transformed their direct experiences related to migration into the human capital of their enterprise.

Vitamin D and N-Acetyl Cysteine Supplementation in Treatment-Resistant Depressive Disorder Patients: A General Review.

Major Depressive Disorder (MDD) is often a lifetime disabling mental illness as individuals with MDD might not benefit from standard-therapy, including both pharmacological and psychosocial interventions. Novel therapies are, therefore, required. It was shown by recent preclinical and clinical studies that the dysfunction of glutamatergic neurotransmission might be involved in the pathophysiology of MDD. Furthermore, neuroimmune alterations could have a significant role in the pathogenesis of MDD. Vitamin D is a neurosteroid hormone essential for several metabolic processes, immune responses, and for regulating neurotrophic-neuroprotective processes, neurotransmission and synaptic plasticity. Recent studies have also shown Vitamin D deficiency in patients with severe psychiatric disorders, including MDD. Lately, clinical studies have shown the neuroprotective action of N-acetyl cysteine (NAC) through the modulation of inflammatory pathways and via the modulation of synaptic release of glutamate in cortico-subcortical brain regions; the cysteine-glutamate antiporter. This paper reviews the therapeutic use of Vitamin D and NAC and among individuals with refractory MDD to the first- line pharmacological interventions, reviewing the clinical studies published in the last decade. A detailed summary of the current evidence in this area aims to better inform psychiatrists and general practitioners on the potential benefits of Vitamin D and NAC supplementation for this disorder. Nutraceutical supplementation with Vitamin D and NAC in treatment-resistant MDD patients may be important not only for improving depressive clinical manifestations but also for their safety and tolerability profile. This is of great interest, especially considering the need for treating special populations affected by MDD, such as youngsters and elders. Finally, the nutraceutical approach represents a good choice, considering its better compliance by the patients compared to traditional psychopharmacological treatment.

Diagnostic and therapeutic challenges in neuroleptic malignant syndrome: a severe medical case.

Neuroleptic malignant syndrome (NMS) is a rare, idiosyncratic medical emergency usually associated with the use of dopamine antagonists, commonly typical antipsychotic drugs. However, it has been observed that it can occur with atypical antipsychotics as well. NMS is characterized by altered consciousness, fever, rigidity, autonomic instability and high creatine phosphokinase (CPK) blood levels. Here, we report a case of a 44-year-old female patient with history of a treatment-resistant bipolar disorder. She was admitted to our psychiatric ward for severe psychomotor agitation and treated with a therapy based on typical and atypical antipsychotics. During the course of the hospitalization she developed NMS. In this case, the diagnosis was delayed due to the slow and insidious symptom presentation, therefore requiring a differential diagnosis. Autoimmune NMDA receptor encephalitis, catatonic syndrome and malignant catatonia have been excluded. The patient met all the DSM-5 criteria for NMS: exposure to dopamine-blocking agent, severe muscle rigidity, fever, diaphoresis, dysphagia, altered level of consciousness, mutism, tremors, tachycardia, high or labile blood pressure, leukocytosis, high creatine phosphokinase. Since robust evidence-based protocols are lacking, here we discuss the relevance of this case in order to highlight the hurdles of a prompt diagnosis, clinical management of associated complications and treatment possibilities for such emergency.

The Influence of Vitamin D on Neurodegeneration and Neurological Disorders: A Rationale for its Physio-pathological Actions.

Vitamin D is a steroid hormone implicated in the regulation of neuronal integrity and many brain functions. Its influence, as a nutrient and a hormone, on the physiopathology of the most common neurodegenerative diseases is continuously emphasized by new studies. This review addresses what is currently known about the action of vitamin D on the nervous system and neurodegenerative diseases such as Multiple Sclerosis, Alzheimer's disease, Parkinson's disease and Amyotrophic Lateral Sclerosis. Further vitamin D research is necessary to understand how the action of this "neuroactive" steroid can help to optimize the prevention and treatment of several neurological diseases.

Health and economic burden of metabolic comorbidity among individuals with bipolar disorder.

OBJECTIVES: To compare the prevalence and health care costs of metabolic conditions in patients with bipolar disorder to age- and sex-matched control patients using a large insurance claims database. METHODS: A retrospective analysis of medical service and prescription claims from the Thomson Reuters (Healthcare) MarketScan Commercial Database (which includes claims information on >12 million employees with employer-based insurance and their dependents in the United States) was conducted. Claims data for 28,531 patients with bipolar disorder were compared for 1 year with data for 85,593 age- and sex-matched control patients with no mental health disorders and no psychotropic medication use. RESULTS: Patients with bipolar disorder had a significantly higher prevalence of metabolic comorbidities than the general population (37% vs 30%, P < 0.0001), and annual medical service treatment costs for metabolic conditions were twice that of the control cohort (531 dollars vs 233 dollars, P < 0.0001). The bipolar cohort had significantly higher overall medical service and prescription drug costs than those of the control cohort (12,764 dollars vs 3,140 dollars, P < 0.0001). Prescription medication costs for metabolic conditions were higher as well, with bipolar cohort per-patient costs of 571 dollars versus 301 dollars for the control cohort (P < 0.0001). CONCLUSIONS: Patients with bipolar disorder have significantly more metabolic comorbidities and higher medical costs than age- and sex-matched controls. Studies that link claims data with medical records or primary data collection pertaining to metabolic conditions may overcome limitations in the diagnostic information and outcome predictors. To reduce the medical and economic burden of bipolar disorder, strategies should be identified to prevent the development of metabolic comorbidities and improve medication adherence.