Italian Adolescents Research Articles

Erratum: Study protocol for a pre/post study on knowledge, attitudes and behaviors regarding STIs and in particular HPV among Italian adolescents, teachers, and parents in secondary schools

Erratum: Study protocol for a pre/post study on knowledge, attitudes and behaviors regarding STIs and in particular HPV among Italian adolescents, teachers, and parents in secondary schools

Validation of the Difficulties in Emotion Regulation Scale-Short Form in a sample of Italian adolescents.

The primary objective of the present study is to validate the Difficulty in Emotion Regulation Scale-Short Form (DERS-SF) in a sample of Italian adolescents. Additionally, we aim to evaluate its factorial structure by examining the contribution of each subscale (i.e., Nonacceptance, Clarity, Awareness, Goals, Impulse, Strategy) on the general factor using bi-factor models by replicating a past study. The sample comprises N = 704 adolescents aged 11-17 years (M = 13.38, SD = 1.37; 53.12% females). To establish external validity, correlation and path analyses were conducted between the DERS-SF sub-scales, the total score, and measures of internalizing and externalizing symptoms, as well as Problematic Smartphone Use (PSU). Measurement invariance was tested comparing males versus females and pre-adolescents and adolescents. Overall, results supported the multidimensional nature of the DERS-SF, confirming its original six-factor structure. However, bi-factor models analysis revealed that the Awareness subscale should be excluded when calculating the total score. Furthermore, findings indicated that the Strategy subscale variance is largely accounted for by the general factor rather than the specific subscale. In terms of external validity, significant positive associations between the DERS-SF sub-scales, the total score, and PSU, internalizing and externalizing symptoms were observed. Measurement invariance was supported. Altogether, findings support the validity of the DERS-SF among Italian Adolescents and provide insights relevant to the understanding of the multifaceted facets of emotion regulation, emphasizing its relevance as a transdiagnostic process.

Binge eating, social media disorder and attachment in adolescence: Gender differences in the mediating role of alexithymia

IntroductionThere is a need for research investigating factors accounting for binge eating (BE) and social media disorder (SMD) in adolescence. ObjectiveDespite studies suggesting the role of both attachment and alexithymia in these disorders, there has been no investigation into the mediating role of alexithymia in the pathways linking the different types of attachment relationships to both BE and SMD. MethodsA total of 423 Italian adolescents (32.2% males, Mage=16.88) completed self-report questionnaires investigating attachment, alexithymia, binge eating, and social media disorder levels. Hypotheses were tested with Structural Equation Modelling including multigroup analyses. ResultsAlmost all the variables showed relationships with each other. BE was explained by attachment to the mother and peers in both genders, but the mediating effect of alexithymia was significant only among girls. SMD was explained only by attachment to peers among boys but by attachment to the parents among girls. Moreover, among girls, the role of attachment to the father in SMD was fully mediated by alexithymia levels. ConclusionsAttachment and alexithymia are two explaining variables associated with BE and SMD in adolescence. However, differentiating between attachment relationships appears crucial to reaching a nuanced understanding of the dynamics underlying both BE and SMD.

A questionnaire to assess ecoanxiety and its sociodemographic determinants among Italian adolescents

Abstract Background Climate change poses serious challenges to Public Health, including mental health impacts. In Italy, few studies investigated the rise of eco-anxiety, especially among adolescents, who are the main group affected by this feeling. Specific measurement tools for this population are needed to fill this gap. The aim is to adapt the Italian version of the Climate Change Anxiety Scale (CCAS) to adolescents, and pair it with a socioeconomic and demographic questionnaire (SDQ) to assess determinants. Methods The Italian CCAS was modified for adolescents through a process involving a literature review, expert discussions, and a pretest. This adapted version (a-CCAS) was tested with individuals aged 14-18 years old, maintaining an ideal ratio of 10 respondents per item. Extant psychometric scales were utilized to assess its validity. The SDQ was developed from results of a systematic review of known associations between socioeconomic and demographic factors and eco-anxiety in youth, and expert discussions, and validated by piloting the SDQ with another sample of adolescents. Internal consistency of the a-CCAS and SDQ was assessed by Cronbach’s alpha (Cα). Results The a-CCAS kept most of its original content, comprising 13 items and 2 subscales: cognitive and functional impairment. Pilot respondents were 162; Cα coefficient was >0.7 for both subscales. Convergent and concurrent validity showed positive correlations with the extant scales. The SDQ comprised 12 items in 3 domains: family, social and political-environmental determinants. Respondents were 47 and Cα coefficient was >0.7. Conclusions The a-CCAS and SDQ are valid tools for assessing baseline eco-anxiety and its determinants in Italian adolescents and can contribute to Public Health efforts to reduce the climate-related mental health burden, by measuring the impact of specific educational interventions about climate change targeted at the young. This questionnaire was created as part of the PRIN P2022JJ3LB project. Key messages • These results contribute to filling an evidence gap on eco-anxiety and its socioeconomic and demographic determinants among Italian adolescents by providing researchers with a valid measurement tool. • This tool holds promise for assessing the impact of psychologically-informed educational interventions about climate change and adaptive coping strategies on adolescents’ eco-anxiety levels.

Differences and similarities between children and adolescent exposed to interpersonal traumas with and without Intellectual Disability: An explorative study

BackgroundIndividuals with intellectual disability (ID) are more vulnerable to traumatic and stressful events, increasing their risk of developing post-traumatic stress disorder (PTSD). AimsThis study aimed to investigate differences in psychopathology, post-traumatic symptoms, and adaptive functioning in a sample of Italian children and adolescents with and without ID. It also sought to determine whether the type of interpersonal trauma was associated with distinct psychopathological outcomes. Methods and proceduresSixty-six children and adolescents exposed to interpersonal trauma (physical/sexual abuse, domestic violence, and neglect), were selected and divided into two groups based on the presence or absence of ID. Assessment consisted of structured parent interviews and parent-reported questionnaires. For each scale, comparisons between subtests were performed. Outcomes and resultsChildren and adolescents with ID were more likely to exhibit more severe post-traumatic symptoms, anxiety issues, social problems, and poorer adaptive functioning, with the exception of the practical domain, which appeared to be equally impaired in both groups. In terms of interpersonal trauma typology, exposure to physical/sexual abuse and domestic violence led to greater post-traumatic symptoms compared to neglect. Conclusion and implicationsInterpersonal trauma significantly affects children and adolescents, with or without ID, highlighting the need for tailored treatments for both groups.

Like parents, like children… this is not always the case! Alongitudinal study on the family transmission of intergroupcontact.

During adolescence, opportunities for interethnic interactions can shape future attitudes toward diversity. However, it is unclear how family can influence adolescents' quality of contact in different life contexts. This study aims to fill this gap. A sample of 702 Italian adolescents (Mage = 15.61, SDage = 1.11, 48.58% girls) and their parents (615 mothers, Mage = 48.45, SDage = 4.34; 487 fathers, Mage = 51.22, SDage = 4.92) completed questionnaires at two time points. Cross-lagged models indicated that adolescents' intergroup contact at T1 was associated with mothers' contact over time, mainly in structured (i.e., school and work) contexts. No significant associations were found regarding fathers' intergroup contact and unstructured contexts. These results shed new light on the process of family transmission during adolescence, particularly regarding intergroup dynamics.

A Longitudinal Study on Body Image Perception and Size among Italian Early Adolescents: Changes over Time and Discrepancies between Genders.

The discrepancy between the current perceived body image (BI) and beauty ideals leads to dissatisfaction, which is believed to be common among adolescents. This study aimed to investigate the stability in BI perceptions and dissatisfaction during early adolescence. Another aim was to highlight differences in dissatisfaction according to Body Mass Index (BMI) and inconsistencies in weight status perception. Two hundred and nine participants (mean age at first survey: 11.33 ± 0.38 years) were enrolled in this longitudinal study with three years of follow-up. Data on size and BI perceptions were collected through individual interviews. Stature and weight were directly measured. Findings indicated significant changes over three years in anthropometric traits but not in weight status prevalence or BI perception and dissatisfaction, except for the ideal figure in males and weight control in females. The results also indicated a significant difference in BI perception and dissatisfaction by BMI categories. Self-reported body measurements were found to be unreliable with a weak-to-moderate agreement between self-perceived and actual weight status. BI perception appears quite stable across the three years considered. Dissatisfaction is similar in both genders, although a tendency toward different gender aesthetic ideals is already appreciable in early adolescence. We suggest that the lower frequency of normal-weight adolescents compared with peers in previous studies is attributable to the effects of the recent pandemic. Given the growing dissatisfaction with increasing BMI and misinterpretations of weight status, school actions to promote a healthy lifestyle and positive BI should be undertaken.

COVID-19 related cognitive, structural and functional brain changes among Italian adolescents and young adults: a multimodal longitudinal case-control study

Coronavirus disease 2019 (COVID-19) has been associated with brain functional, structural, and cognitive changes that persist months after infection. Most studies of the neurologic outcomes related to COVID-19 focus on severe infection and aging populations. Here, we investigated the neural activities underlying COVID-19 related outcomes in a case-control study of mildly infected youth enrolled in a longitudinal study in Lombardy, Italy, a global hotspot of COVID-19. All participants (13 cases, 27 controls, mean age 24 years) completed resting-state functional (fMRI), structural MRI, cognitive assessments (CANTAB spatial working memory) at baseline (pre-COVID) and follow-up (post-COVID). Using graph theory eigenvector centrality (EC) and data-driven statistical methods, we examined differences in ECdelta (i.e., the difference in EC values pre- and post-COVID-19) and Volumetricdelta (i.e., the difference in cortical volume of cortical and subcortical areas pre- and post-COVID) between COVID-19 cases and controls. We found that ECdelta significantly between COVID-19 and healthy participants in five brain regions; right intracalcarine cortex, right lingual gyrus, left hippocampus, left amygdala, left frontal orbital cortex. The left hippocampus showed a significant decrease in Volumetricdelta between groups (p = 0.041). The reduced ECdelta in the left amygdala associated with COVID-19 status mediated the association between COVID-19 and disrupted spatial working memory. Our results show persistent structural, functional and cognitive brain changes in key brain areas associated with olfaction and cognition. These results may guide treatment efforts to assess the longevity, reversibility and impact of the observed brain and cognitive changes following COVID-19.

Assessment of Motor Performance and Self-Perceived Psychophysical Well-Being in Relation to Body Mass Index in Italian Adolescents.

The relationship between psychophysical self-perception (PSP), body mass index (BMI) and motor performance (MP) levels, in quantitative and qualitative terms, can be a very interesting connection to investigate. This study aimed to assess MP and PSP according to gender and weight differences (normal weight-Nw/overweight-obese-Ov-Ob) and their relationship to BMI in Italian adolescents. In total, 144 students (F = 72; M = 72) aged between 11 and 13 y.o. participated in this study. They were divided into two groups by gender and into two subgroups based on weight (Nw/Ov-Ob). Standing long jump, sit-and-reach, 10 × 5 m shuttle and sit-up tests to assess MP were carried out, and an ad hoc questionnaire to evaluate PSP was administrated. In comparing the Nw and Ov-Ob subgroups on the basis of BMI for each gender, statistically significant differences emerged in all motor skill tests administered. Regarding PSP, the Nw subgroup showed high and positive levels, while Ov-Ob showed low and negative levels, highlighting a relationship between high BMI and poor motor performance as well as negative psychophysical perception in the Ov-Ob subgroup. this study supports the importance of physical sport activity to regulate excess weight but also contribute to better psychophysical well-being.

How Screen Time and Social Media Hyperconnection Have Harmed Adolescents’ Relational and Psychological Well-Being since the COVID-19 Pandemic

Following the COVID-19 pandemic, the increase in screen time and hyperconnection on social media is raising significant concerns, with particular emphasis of their effects on the relational and psychological well-being of children and adolescents. The present study analyses data from two representative cross-sectional surveys conducted among Italian adolescents in 2019 and 2022. Through bivariate analyses and binary logistic regression models, the study examines changes in screen time on social media, identifies key socio-demographic predictors of hyperconnection, and explores its effects on both the relational and psychological well-being of young people. The findings reveal the profound impact of the pandemic on daily social media use, showing a significant increase across all social groups regardless of socio-demographic characteristics, with girls consistently exhibiting higher levels of hyperconnection. Additionally, the results indicate that hyperconnected individuals are 1.4 times more likely to experience negative psychological states compared to their peers. The effects of hyperconnection vary by gender, influencing both horizontal and vertical social interactions, reducing trust in adult figures, increasing the likelihood of cyberbullying victimisation, phubbing, and body image concerns, and fostering the belief that online relationships can replace offline ones. Overall, the study highlights the urgent need for more effective prevention, awareness, and educational strategies aimed at educators, parents, and adolescents.

Awareness of cholesterol levels in 46,309 Italian children and adolescents unveils the tip of the iceberg.

Cardiovascular diseases (CVD) risk factors include high cholesterol. Childrenwith total cholesterol (TC) levels ≥ 170mg/dLare usually considered hypercholesterolemic. This study aimed at investigating the awareness of TC levels in a large Italian paediatric population and at looking for a possible correlation between their TC and TC in their parents' blood. A survey was carried out in 46,309 subjects (mean age 9.7 ± 2.3years; age range 6-14years) to check the awareness of their own TC levels by using a personal and family medical history questionnaire. In 95.67% of the sample TC value was unknown. In 2.69% TC was < 170mg/dL, whereas 1.64% were hypercholesterolemic (TC ≥ 170mg/dL). A statistically significant correlation was found between children with normal TC values and physiological TC values in both parents (p < 0.0001). Again, a significant association between children with high TC and their parents with high TC was detected when parents were analysed separately (i.e. children with TC ≥ 170mg/dl vs maternal TC ≥ 200mg/dL: OR 2.01 (95% CI 1.61-2.49, p < 0.001); children with TC ≥ 200mg/dl vs maternal TC ≥ 240mg/dL: OR 3.14 (95% CI 2.14-4.6, p < 0.001); children with TC ≥ 170mg/dl vs paternal TC ≥ 200mg/dL: OR 2.39 (95% CI 1.91-2.98, p < 0.001); children with TC ≥ 200mg/dl vs paternal TC ≥ 240mg/dL: OR 3.85 (95% CI 2.70-5,.50, p < 0.001). Just a minority of the investigated young patients knew their TC. This is worrisome. Children with normal TC values are more likely to be born from healthy parents with physiological TC. In addition, high TC in the enrolled subjects is significantly associated with high TC in their parents. Overall, these findings seem to highlight the importance of health education and genetics in TC pathogenesis.

Cognitive and functional brain changes among Italian adolescents and young adults with COVID-19 infection: a longitudinal case control study

Cognitive and functional brain changes among Italian adolescents and young adults with COVID-19 infection: a longitudinal case control study

Non-suicidal self-injury trajectories among adolescents during the COVID-19 pandemic: The role of parenting dimensions and stress reactions

BackgroundThe literature on the trajectories of NSSI behavior during the pandemic is scarce and mainly short-term. Furthermore, studies have not explored the buffering mechanisms that may have altered risk trajectories during this vulnerable period. This study aims to analyze the univariate change of NSSI during adolescence and to examine the alteration of the univariate growth due to the time-varying effect of COVID-19-related stress, parenting dimensions (i.e., positive and negative parenting), and their interaction. MethodsParticipants included 830 Italian adolescents (44.2 % females; Mage = 14.52; SD = 0.80), who participated in at least one time point of data collection, from a three-wave longitudinal study (T1: from December 2019 to January 2020; T2: December 2020; T3: December 2021). ResultsThe Latent Growth Curve Analyses show a linear increase in NSSI over time. In regards to time-varying, at T1, the results highlight that higher levels of negative parenting are associated with higher levels of NSSI at the same time point. Instead, at T2, results show that pandemic stress is associated with higher levels of NSSI at T2. Regarding the interaction effect, positive parenting significantly buffered the effect of COVID-19 stress on NSSI at both T2 and T3. LimitationsOnly some dimensions of parenting style (i.e., positive and negative parenting) are included. ConclusionsThis study attempts to deepen the trajectory of NSSI behavior during the two years of the pandemic and examine the changes caused by the time-varying effects, thus providing suggestions for designing programs to prevent engagement in NSSI.

Living in Italian residential care under COVID-19 restrictions. A survey on adolescents’ perspectives over their psychosocial wellbeing

COVID-19 lockdown has been worldwide considered one of the major collective traumatic experiences for everyone, vulnerable adolescents included. Surprisingly, however, research on the experiences of adolescent living in residential care (RC) – considered it to be particularly exposed to traumas and developmental challenges – has been underdeveloped in the pandemic scenario. Bridging this gap and drawing on a national survey with Italian adolescents living in RC, the current study examines their psychosocial wellbeing, i.e., their perceived subjective and relational wellbeing, during lockdown. In terms of subjective wellbeing, results show increased irritability, but, differently from general population, no sleep quality deterioration. In terms of relational wellbeing, we document a general sense of safeness and protection in RC, a significant sense of being listened to by caregivers, and continuity of care with professionals and keypersons. We confirm and display two distinctive effects as well: a) the “gender effect” – i.e., compared to boys, girls reported higher irritability, and b) the “length of placement in RC” effect – i.e., adolescents living in RC for more than 3 years reported increased irritability and a lower relational wellbeing, counterbalanced by a higher competence in keeping their contact with their schoolmates outside RC. Proposals for targeted psychosocial interventions, limitations and implications for future research in the developmental areas are discussed in the conclusions.

Sleep Disturbances and Co-sleeping in Italian Children and Adolescents with Autism Spectrum Disorder.

The current study aimed (1) to provide an analysis of the frequency and prevalence of sleep disturbances in a large Italian sample of children and adolescents with ASD, detecting specific predictors of the presence/absence of sleep disorders, (2) to examine the phenomenon of co-sleeping within a subgroup of participants with ASD. A total of 242 children and adolescents with ASD (194 males, mean age 5.03 ± 3.15years) were included. After the diagnostic procedure, caregivers were requested to complete the Sleep Disturbance Scale for Children (SDSC) to assess sleep disorders among participants. The presence of co-sleeping was investigated in a subgroup of 146 children and adolescents with ASD. An elevated or clinically relevant global score for sleep disorders (≥ 60) was found in 33% of participants. The most prevalent sleep disorder in our group was related to difficulties with sleep onset and sleep maintenance (~ 41% of cases). Sleep disturbances were predicted by higher intelligence quotient (IQ)/developmental quotient (DQ), increased internalizing problems, and elevated parental stress. The subgroup of participants engaged in co-sleeping (N = 87) were younger and had lower IQ/DQ scores, reduced adaptive functioning, and diminished psychological wellbeing than the non-co-sleeping group. Our findings are consistent with the current literature highlighting that insomnia is the most widespread sleep problem associated with ASD. The relationship between IQ/DQ and sleep alterations is a crucial topic that deserves additional research. Future studies should assess sleep by objective measures such as EEG topography to better understand the mechanisms underlying sleep alterations in this neurodevelopmental disorder.

Eating disorder risks and psychopathological distress in Italian high school adolescents

BackgroundPsychopathological disorders are often comorbid diagnosis in eating disorders (EDs). We aimed to assess the presence of psychopathological traits and symptoms associated with EDs in an Italian high school adolescent population.MethodsA sample of high school adolescents was enrolled, and demographic and clinical data were collected. Two self-report questionnaires, the Eating Disorder Inventory-3 (EDI-3) and the Questionnaire for the Assessment of Psychopathology in Adolescence (Q-PAD), were administered.Results548 adolescents (333 F/215 M; 16.89 ± 0.85 years) were included. Symptoms associated with EDs of clinical or high clinical concern were prevalent in a range of individuals, with percentages varying from 26.82% for body dissatisfaction to 51.83% for Interoceptive Deficits. The findings from the Q-PAD assessment indicated the presence of psychological distress, leading to discomfort or challenging situations requiring potential intervention in a percentage of adolescents ranging from 2.93% for psychosocial risks to 23.77% for anxiety. These percentages showed differences between genders (F > M, p < 0.001). Our study also highlighted an association between symptoms of EDs and lifestyle factors within families. We observed correlations between Q-PAD measures and EDI-3 scores, including a positive correlation between Q-PAD and EDI-3 body dissatisfaction (r = 0.7), Q-PAD interpersonal conflicts and EDI-3 interpersonal problems (r = 0.6) and a negative correlation between Q-PAD self-esteem and well-being and EDI-3 ineffectiveness Composite (r=-0.7).Conclusionsa substantial prevalence of ED symptoms and psychological distress among high school adolescents were recorded. These conditions are interrelated, suggesting the importance of addressing them comprehensively. Early detection is essential to improve treatment outcomes and to implement preventive strategies.

Adverse childhood experiences and psychological maladjustment in adolescence: The protective role of epistemic trust, mentalized affectivity, and reflective functioning.

Adverse childhood experiences (ACEs) are psychosocial factors acknowledged as significant contributors to health consequences later in adolescence, including psychological maladjustment. The research suggests that, at a transdiagnostic and transtheoretical level, working on restoring epistemic trust (ET), mentalized affectivity (MA), and reflective functioning (RF) in adolescents with ACEs assumes a central role in the therapeutic process. However, there are still few studies that attempted to investigate the specific role of these sociocognitive factors in the detrimental positive association between levels of experienced ACEs during childhood and psychological maladjustment in nonclinical adolescents. A community sample of 306 Italian cisgender adolescents (61.4% assigned females at birth; age range 13-19 years old; Mage = 16.1, SD = 1.64) self-reported ACEs (Childhood Trauma Questionnaire-Short Form), psychological maladjustment (Strengths and Difficulties Questionnaire), ET (Epistemic Trust, Mistrust and Credulity Questionnaire), MA (Brief-Mentalized Affectivity Scale for Adolescence), and RF (Reflective Functioning Questionnaire). A multiple mediation regression analysis has been performed to explore the association between ACEs and psychological maladjustment through the interaction with socio-cognitive factors. ACEs are positive predictors of psychological maladjustment later in adolescence. Regardless of gender differences, epistemic mistrust and credulity, processing and expressing emotions, and uncertainty about mental states mediated this association, while epistemic trust, identifying emotions, and certainty about mental states did not configure as significant mediators. Findings suggest that ET disruptions and deficits in RF are risk factors, while MA is a protective factor within the link between ACEs and psychological maladjustment in adolescence. These links help to specify the role of sociocognitive factors in the development of mental problems in adolescents who have been exposed to adverse experiences in childhood.

Resilience predictors in the post-pandemic era: A study on Italian adolescents

Resilience is the ability to emerge strengthened from adversity. Recently, as the Covid-19 pandemic has impacted adolescents' growth processes, investigating which psychosocial variables make adolescents resilient has become essential. The aim of the study is to investigate which are the significant predictors of resilience in a sample of Italian adolescent students (N = 1266, 47% male, mean age = 14.96 years) one year after the end of the pandemic. Participants responded to a battery of tests, administered online, that included measures of: resilience, ad hoc items on meditation frequency, self-compassion, self-efficacy in managing positive and negative emotions, and coping. The results of a linear regression model revealed that the predictors of resilience in adolescents in the post-pandemic period were: frequency of meditation (ß =.61, p &amp;lt;.01), self-efficacy in regulating positive and negative emotions (ß =. 41, p 001; ß = 19, p 001), self-reliance (ß = .11, p 001), mindfulness (ß = .11, p 01), low over-identification (ß = -.06, p 05), future perspective (ß = .11, p 001) and problem orientation (ß = .17, p 001). These findings emphasize the importance of cultivating these psychosocial variables to promote adolescents resilience in the face of adversity. The implications of the present study are discussed.

Sex-specific associations of a ferroalloy metal mixture with motor function in Italian adolescents.

Motor function is critical for children's health, yet remains an understudied neurodevelopmental domain. Exposure to metals has been linked with motor function, but no study has examined the joint effects of metal mixtures. We evaluated cross-sectional associations between a metal mixture and motor function among 569 adolescents (10-14 years old) living near the ferroalloy industry. Concentrations of blood lead, hair manganese, hair copper, and hair chromium were quantified using inductively coupled plasma mass spectrometry. Neuropsychologists administered multiple fine motor function assessments: pursuit aiming, finger tapping, visual reaction time (VRT), and subtests from the Luria Nebraska battery. We estimated associations between motor function and the metal mixture using quantile-based g-computation and multivariable linear regression, adjusting for child age, sex, and socioeconomic status. We explored sex-specific associations in stratified models. Associations between the metal mixture and motor function were mostly null but were modified by sex. We observed a beneficial association among females: a quartile increase in all metals in the mixture was associated with a 2.6% faster average response time on the VRT (95% confidence interval [CI] = -4.7%, -0.5%), driven by Cu and Cr. In contrast, this association was adverse among males (ß = 1.5% slower response time [95% CI = -0.7%, 3.9%]), driven by Cu and Mn. Results suggest that males may be more susceptible to the adverse effects of metal exposure on motor function during adolescence than females. Future studies, particularly prospective study designs, are warranted to further understand the associations of metal mixtures with motor function.

P.A.V.I.A. Study: Pervasiveness and Associated Factors of Video Slot Machine Use in a Large Sample of Italian Adolescents.

Video slot machines (VSM) are considered a particularly harmful gambling format; however, scant data is available on their use among underage Italian individuals. Two surveys were conducted in 2018 and 2022 involving 7,959 underage high school students (57.8% female) in Pavia, Northern Italy. We estimated adjusted odds ratios (aOR) and corresponding 95% confidence intervals (CI) for lifetime experience and current regular (at least monthly) use of VSM, according to family, educational and behavioral factors. Overall, participants reporting lifetime VSM experience were 13.2% (95% CI: 12.5 - 13.9), 15.2% (95% CI: 14.0-16.4%) in 2018, and 12.0% (95% CI: 11.1-13.0%) in 2022. Current regular VSM users were 1.4% (95% CI: 1.1-1.7) in total, 1.2% (95% CI: 0.8-1.6%) in 2018 and 1.5% (95% CI: 1.1-1.8%) in 2022. VSM lifetime experience and current regular use were significantly more frequent in males (aORs: 1.55 and 4.81, respectively), students who failed a year (aORs: 2.07 and 3.44), or with daily gambling parents/siblings (aORs: 2.83 and 4.86). Lifetime use of alcohol, tobacco, or illicit substances was significantly directly associated with lifetime VSM use (aORs between 2.64 and 4.75); monthly alcohol, tobacco, or illicit substances use was significantly directly associated with current regular VSM use (aORs between 4.47 and 18.21). Sexting and voluntary self-injury were significantly more frequent among VSM lifetime/current regular users. VSM use, which is directly associated with other risky behaviors, may be pervasive among Italian minors. Such public health concern calls for legislative enforcements and integrated multidisciplinary health promotion and prevention strategies.