Psychopathological Problems Research Articles

Study of a brief online and group focusing intervention: a protocol for a randomised clinical trial

IntroductionEmotion dysregulation is a transdiagnostic characteristic that affects many people with many psychopathological problems. Two mechanisms that have been frequently associated with emotional regulation are immersion and distancing. Focusing is...

The Frequency of Health Anxiety, Coronavirus Anxiety and Anxiety Disorder in Patients With Tinnitus During the COVID-19 Pandemic and the Impact of Pandemic on Tinnitus.

This study aimed to examine the frequency of anxiety disorder, coronavirus anxiety and health anxiety in tinnitus patients during the pandemic and also, determined the psychophysiological impact of COVID-19 on tinnitus. This cross-sectional study was conducted in a tertiary central pandemic hospital from 15 July 2021 to 15 December 2022. In total, 124 patients with tinnitus and 77 healthy controls participated in the study. The sociodemographic data, a set of valid and reliable assessment instruments were used to measure outcomes of anxiety disorder, coronavirus anxiety, health anxiety and severity of tinnitus. Patients with tinnitus were found to experience higher levels of coronavirus anxiety, health anxiety and anxiety disorder than controls (p < 0.05). In tinnitus patients, the frequency of coronavirus anxiety was 22.6% and anxiety disorder was 18.5%. Notably, the levels of tinnitus severity were moderate to severe in more than half of the patients (51.6%) and also most of them (81.3%) reported that the severity of tinnitus during the pandemic was higher compared with the pre-pandemic. Tinnitus patients had high levels of anxiety disorder, coronavirus anxiety and health anxiety. In line with these findings, it was evaluated that there was a relationship between the COVID-19 pandemic with psychological problems and tinnitus. Therefore, the predominance of tinnitus symptoms at presentation should not lead the clinician to neglect the underlying psychopathological problems in these patients.

The Mediating Role of Social Interactions and Early Psychopathological Symptoms in the Relationship Between Empathy and Prosociality in Young Children with ASD and Neurotypical Peers.

This study examined the relationship between empathy, prosocial behaviour, social interactions and early psychopathological symptoms (internalising and externalising behaviours) in children with autism spectrum disorder (ASD) and typically developing (TD) children. A total of 506 parents of children aged 18-48 months participated in this study. The parents of 92 children with ASD and 414 neurotypical children completed the Empathy Questionnaire, the Child Prosocial Behaviour Questionnaire, and the Emotional and Social Development Questionnaire. The results confirmed the direct relationship between empathy and prosocial behaviour in both groups. However, the findings showed a different pattern of the indirect relationship between empathy and prosociality through the social dimensions in the children with ASD compared to their typically developing peers. In the children with ASD, there was only one significant indirect path from empathy to prosocial behaviour - through internalising behaviours (anxiety). Anxiety also played a moderating role in this relationship. The higher the anxiety, the stronger the relationship between empathy and prosociality. In the neurotypical group, social interactions were a significant mediator, strengthening the relationship between empathy and prosocial behaviour. Externalising behaviours weakened this relationship. Intergroup and gender differences were also examined. These findings may have practical implications for social skills training programmes based on behavioural interventions by highlighting the importance of prosocial behaviour for social interaction and protection against psychopathological problems in children with autism and typically developing children.

Adolescent Emotional Reactivity in Family and School Contexts: Prospective Links to Adolescent Psychopathology.

Emotional reactivity has been linked to adolescent psychopathology and mental health problems. However, limited research has investigated the distinct associations between emotional reactivity in multiple interpersonal contexts and the development of adolescent psychopathology. The current study examined emotional reactivity to interparental conflict, parent-adolescent conflict, and school problems as predictors of adolescent internalizing problems, depressive symptoms, and anxiety symptoms six months later. The sample included 139 adolescents (54% girls; Mage = 13.30, SDage = 0.73) and their parents who completed 10-day daily reports and 6-month follow-up assessments in Taiwan. Results showed that negative emotional reactivity to interparental conflict was associated with increased internalizing problems, depressive symptoms, and anxiety symptoms, after controlling for emotional reactivity to parent-adolescent conflict and school problems, outcomes at baseline, mean negative emotions, and sex. Furthermore, the associations between both positive and negative emotional reactivity to interparental conflict and adolescent anxiety symptoms was stronger for girls than boys. Findings suggested that heightened emotional reactivity to interparental conflict is a risk factor for predicting adolescent psychopathology, especially for girls' anxiety symptoms. Results highlight the importance of emotional reactivity across multiple interpersonal contexts in adolescence.

Psychometric properties of the Ten-Item Personality Inventory for Children and Adolescents (TIPI-CA) in a Spanish sample

BackgroundThe Ten-Item Personality Inventory (TIPI) is a non-commercial very brief Five-Factor Model (FFM) measure widely em-ployed in research. Its use has been extended to children and adolescents, without exploring the suitability of its employ-ment for these early ages. The present study aimed to examine the psychometric properties of an adaptation of this ques-tionnaire (the Ten-Item Personality Inventory for Children and Adolescents, TIPI-CA).Participants and procedureThe sample comprised 2428 children and adolescents (Mage = 12.65, SD = 2.41, 47.16% girls). The psychometric properties of the TIPI-CA were explored in terms of factor validity (including measurement invariance across gender), as well as conver-gent and divergent validities in a subsample of 800 participants (Mage = 12.50, SD = 1.96, 49.1% girls). Furthermore, criterion validity was also tested by exploring associations with prosocial behavior and psychopathological problems in another sub-sample of 618 participants (Mage = 11.97, SD = 2.70, 53.2% girls). Finally, internal consistency and temporal stability were estimated too.ResultsThe TIPI-CA presented reasonably appropriate psychometric properties, although weaker discriminant validity was found among children and adolescents compared to TIPI adult versions.ConclusionsThe instrument emerges as a useful tool to obtain a suitable approximation of the Big Five personality trait measures when time and/or space are scarce at early and young ages.

Identifying Subgroups of Youth Suicide Decedents Based on Clinical Profiles of Psychiatric and Medical Diagnoses: A Latent Class Analysis

PurposeTo identify risk subgroups of youth suicide decedents using demographic and clinical psychiatric and medical diagnostic profiles to inform tailored youth suicide prevention efforts. MethodsThis study linked Ohio Medicaid and death certificate data for Medicaid enrolled youth aged 8–25 years who died by suicide between January 1, 2010, and December 31, 2020 (N = 511). Latent class analysis was used to identify distinct clinical risk subgroups. ResultsThree latent classes were identified. Internalizing problems were common across all classes, but especially prevalent in class 1, the High Internalizing + Multiple Comorbidities group (n = 152, 30%). A prior history of suicidal behavior was confined to class 1 decedents, who were otherwise characterized by substance misuse, and multiple psychiatric and medical comorbidities. Class 2 decedents, the Internalizing + Externalizing group (n = 176, 34%), were more often younger, male, Black, and unlikely to have a history of substance misuse. Decedents in class 3, the Internalizing + Substance Misuse group (n = 183, 36%), were more often older and likely to have a history of substance misuse, but unlikely to exhibit other externalizing problems. DiscussionInternalizing psychopathology is particularly common among youth who die by suicide, with comorbid externalizing psychopathology, substance misuse, and medical problems contributing to youth suicide risk. Because less than a third of youth who die by suicide have a prior history of recognized suicidal thinking or behavior, universal screening for youth suicide risk should be considered, particularly in younger children, and efforts to integrate suicide prevention in traditional health care settings should be prioritized.

Neurodevelopmental profile in children born to mothers affected by systemic sclerosis

BackgroundSystemic sclerosis (SSc) is a chronic immune-mediated connective tissue disease that can affect women of childbearing age. The long-term outcomes of their offspring remain poorly explored. Aim of this study was to detail the neurodevelopmental profile of children born to SSc mothers. MethodsTwenty children (mean age: 96 ± 4.32 months; 10 males) born to SSc mothers were enrolled. We collected data on clinical history, neurological examination, cognitive profile and adaptive behavior in all subjects. According to the chronological age, we also investigated quality of life, behavioral characteristics, psychological functioning and self-image. ResultsAll the children had normal neurological examination, cognitive profile and adaptive functioning, except for one (5 %) who suffered from Autism Spectrum Disorder. An important discrepancy was observed between parental and child opinion regarding the perception of quality of life, more compromised in the latter. We documented a risk for internalizing behavioral problems in 2 cases (10 %), for externalizing problems in 3 (15 %), for both in 1 (5 %) and for social and out-of-school activities in 5 (25 %). As regards psychological functioning, evaluated in 11 children, three (28 %) were at risk for anxiety, 1 (9 %) for depressive disorders and other 4 (36 %) for somatic disturbances. Emotional fragility and poor competence in metabolizing one's emotional experiences were observed in 9 out of the 13 subjects assessed (70 %). ConclusionsChildren born to SSc women exhibit normal cognitive and adaptive abilities but an increased vulnerability to psychopathological problems and fragility in social functioning. These observations might reflect that children need to feel mature to accept maternal chronic disease that, in turn, may hinder support for offspring's social and emotional development.

Cognitive flexibility, mental health status, and sleep quality in adults with psychosocial vulnerability: The moderating role of risk factors for COVID-19

PurposeThis study is aimed to investigate the direct and indirect effects of cognitive flexibility on mental health status and sleep quality with regard to the mediating role of risk factors for COVID-19 based on Structural Equation Modeling (SEM) in adults with psychosocial vulnerability. MethodsThe participants of this study were 500 individuals that were selected by an availability sampling method within a cross-sectional study. A demographic questionnaire, the Cognitive Flexibility Inventory (CFI), the Risk Factor Checklist for COVID-19 (RFCCOVID), the Pittsburgh Sleep Quality Index (PSQI), and the Symptom Checklist (SCL-25) were used for data collection. ResultsThe SEM showed that cognitive flexibility plus risk factors for COVID-19 explain 11.8% of mental health status and 25.6% of sleep quality variations in adults. ConclusionThis conceptual model for the direct and indirect role of cognitive flexibility with the moderating influence of risk factors for COVID-19 on psychopathological and sleep problems is valuable for psychotherapeutic interventions and prevention programs in adults.

IPVAW male perpetrators convicted in Spain: a typology and characterization based on latent class analysis.

Men who assault their partners present deficits in the social skills necessary for adequate interpersonal interaction. Not all of them have the same difficulties, thus they do not constitute a homogeneous group. Various studies have proposed different typologies of abusers based on their sociodemographic characteristics, criminal history, intensity and extent of violent or psychopathological traits. The majority of these investigations have been conducted in community samples, prompting the question of their validity in samples of men convicted of gender violence. The aim of this study was to establish a typology of men convicted in Spain for a gender violences crimes. A total of 365 men participated and were subdivided into three classes of abusers based on their childhood, family experiences with violence, criminal history, sexist attitudes and attitudes toward violence, intensity and type of violence, psychopathological state and attachment style. Coinciding with the results found in other research, 30% of the participants were classified as generally violent. They engaged in severe forms of physical, psychological and sexual violence and were more likely to do so than the rest. Additionally, they are more likely to present psychopathological problems and an antisocial character. Twenty-one percent were classified as dysphoric/borderline. They are characterized by minor forms of psychological violence, borderline or depressive symptomatology and an anxious attachment style. The remaining 49% were classified as familial or normalized abusers. This group exhibits moderate attitudes toward violence and sexism, resulting in less psychological and physical aggression. They do not present psychopathological problems and are likely to present a secure attachment style. It is argued that determining the psychological characteristics of each type of abuser would contribute to improving and adapting intervention protocols in Spain, leading to a significant improvement in the current issue of abuse.

Hostile attributional biases in severe alcohol use disorder: replication, gender specificity, and mechanistic insights.

Despite their importance in the emergence and persistence of severe alcohol use disorder (SAUD), social cognition impairments remain understudied in this population. Hostile attributional biases (HAB), a key component of social cognition, may be involved in interpersonal problems and SAUD maintenance. However, current evidence for HAB in SAUD is highly preliminary, as it relies on a single study based on a small sample and on a task that cannot dissociate increased hostile from reduced benign attributions. We therefore used an improved methodology to further characterize this bias and disentangle underlying mechanisms. In addition, we explored potential gender differences. A total of 56 patients (28 women) diagnosed with SAUD and 66 (27 women) demographically matched controls completed the Word-Sentence Association Paradigm-Hostility, which provides a valid, spontaneous, and relatively implicit assessment of both hostile and benign social attributions related to ambiguous situations. They also completed self-report measures of psychopathology and interpersonal problems. At the group-level, patients with SAUD presented higher HAB than controls, without group differences for benign attributions. Gender analyses revealed that this effect selectively emerged in men with SAUD. Further, patients' benign attributions did not differ from their hostile attributions. Finally, HAB (not benign attributions) were associated with interpersonal problems and state anxiety in patients. The association between SAUD and HAB at the group level is genuine and replicable across samples and tasks. This association may further selectively emerge in men. Our results also confirm the functional significance of HAB in SAUD, and point to potential mechanisms and clinical recommendations.

Attachment styles, mental health, and trauma during the first wave of COVID-19 pandemic in an Italian adult population.

The COVID-19 pandemic has negatively impacted adults' mental health around the world. Various studies highlighted the role of sociodemographic risk factors, including age, gender, and level of education, in increasing this impact. Although insecure attachment styles are considered a vulnerability factor for psychopathology and difficulties in coping with stressful situations, few studies have examined the role of attachment styles in relation to psychological responses to the COVID-19 pandemic. This study aims to investigate the role of attachment styles in affecting psychopathological problems and post-traumatic symptoms during the COVID-19 pandemic in a sample of Italian adults (N=1548). During the first lockdown in Italy, the Attachment Style Questionnaire, the Impact of Event Scale-Revised, and Symptom Checklist 90-Revised were administered to the participants to assess attachment styles, trauma-related symptoms, and psychopathological problems. The results showed that 41% of the participants had symptoms of clinical and subclinical relevance during the pandemic. Anxious and avoidant insecure attachment styles predicted psychopathological problems and post-traumatic symptoms, whereas secure attachment style was a protective factor. Our results highlighted the significant role played by the quality of attachment styles on adult mental health during the pandemic, providing valuable elements for targeted psychological support interventions.

Academic Major and Mental Health among Chinese College Students

Background: A college student's academic major is not always the total free choice of the student in Chinese universities. If a student is not enrolled in the program, he/she has chosen, the student is usually placed in an academic program at the university's discretion. Further, a Chinese college student is usually required to finish and graduate from the program he/she has started in the freshman year. If a student does not like the academic major yet has to complete it, the student may feel frustrated during the years of college education and may experience certain psychopathological problems. Methods: A structured questionnaire including demographics, familial and social circumstances, and personal characteristics was administered to a sample of college students in China. The randomly selected sample consisted of 2,400 undergraduates (males=884, 36.8%; females=1,516, 63.2%) from a university campus in terms of mental health condition as well as social and cultural life. Major outcome variables were satisfaction with academic major, self-esteem (SE), depression (CES-D) and psychological strains (PSS). Results: Those students satisfied with the academic major scored higher on self-esteem (t = 3.997, p&lt;0.001), and lower on depression (t =-4.144, p&lt;0.001) and psychological strains (t =-4.729, p&lt;0.001) than those who were not satisfied with their academic majors. Conclusions: The college students who do not like their study area but must stick to it feel less happy and experience, to some extent, psychological strains. This can be a problem in the Chinese higher education system. Education reform should be recommended based on the findings from this research.

Identify adolescents' help-seeking intention on suicide through self- and caregiver's assessments of psychobehavioral problems: deep clustering of the Tokyo TEEN Cohort study

Psychopathological and behavioral problems in adolescence are highly comorbid, making their developmental trajectories complex and unclear partly due to technical limitations. We aimed to classify these trajectories using deep learning and identify predictors of cluster membership. We conducted a population-based cohort study on 3171 adolescents from three Tokyo municipalities, with 2344 pairs of adolescents and caregivers participating at all four timepoints (ages 10, 12, 14, and 16) from 2012 to 2021. Adolescent psychopathological and behavioral problems were assessed by using self-report questionnaires. Both adolescents and caregivers assessed depression/anxiety and psychotic-like experiences. Caregivers assessed obsession/compulsion, dissociation, sociality problem, hyperactivity/inattention, conduct problem, somatic symptom, and withdrawal. Adolescents assessed desire for slimness, self-harm, and suicidal ideation. These trajectories were clustered with variational deep embedding with recurrence, and predictors were explored using multinomial logistic regression. Five clusters were identified: unaffected (60.5%), minimal problems; internalizing (16.2%), persistent or worsening internalizing problems; discrepant (9.9%), subjective problems overlooked by caregivers; externalizing (9.6%), persistent externalizing problems; and severe (3.9%), chronic severe problems across symptoms. Stronger autistic traits and experience of bullying victimization commonly predicted the four "affected" clusters. The discrepant cluster, showing the highest risks for self-harm and suicidal ideation, was predicted by avoiding help-seeking for depression. The severe cluster predictors included maternal smoking during pregnancy, not bullying others, caregiver's psychological distress, and adolescent's dissatisfaction with family. Approximately 40% of adolescents were classified as "affected" clusters. Proactive societal attention is warranted toward adolescents in the discrepant cluster whose suicidality is overlooked and who have difficulty seeking help. Japan Ministry of Health, Labor and Welfare, Japan Agency for Medical Research and Development, and Japan Science and Technology Agency.

Internalising and Externalising Symptoms and Their Association with the Family Environment in Young Children with Williams Syndrome: A Longitudinal Study.

Williams Syndrome (WS) involves high rates of psychopathology across the lifespan. However, little is known about the early, longitudinal trajectory of internalising/externalising symptoms or the association between these and the family environment in WS. WS (n = 16; aged 2 years, 2 months to 9 years, 5 months) and typically developing or TD (n = 46; aged 2 years, 2 months to 11 years, 1 month) children were assessed on two occasions over 2.5 years utilising parent report questionnaires-the Child Behaviour Checklist and the Family Environment Scale. No statistically significant changes were found in CBCL/psychopathology profiles across timepoints, on average, for either WS or TD children. However, reliable change scores showed WS children had considerable variability in CBCL scores over time. Cross-sectionally, the WS group showed higher scores (reflecting more psychopathology) compared to TD controls at both time points across most CBCL subscales, with elevated overall psychopathology problems identified in 56-68% of WS children (versus 8% in TD controls). Psychopathology was not associated with sex, chronological age, or cognitive ability in WS. Conflict in the family environment was positively associated with higher Attention Problems at Time 1 in the WS group, whilst the TD group showed associations between family conflict and total psychopathology problems at both time points and between family cohesion and total psychopathology problems at Time 2. Family environment did not differ between groups, except for lower engagement in intellectual and cultural activities in WS. Findings highlight variable Internalising and Externalising Problems in young WS children over time, with greater biological than environmental contributions to psychopathology in WS.

Effortful Control Protects Against Familial Liability for ADHD: Longitudinal Results from the ABCD Study in the United States.

Effortful control, the ability to regulate complex and goal-directed behavior, may protect individuals from developing mental health symptoms. This study tested the potential for child effortful control and executive functioning to buffer the effects of familial liability for attention deficit hyperactivity disorder (ADHD) problems across a one-year timeframe. Data from the prospectively-collected Adolescent Brain Cognitive Development (ABCD)® study were used to examine whether caregiver-rated child effortful control and executive functioning moderated the association between familial ADHD risk and later ADHD symptoms in a sample of children (N = 6,133; ages 9-10 years at baseline). Two independent variables were considered to compare the predictive powers of specific (family ADHD) and broad (family psychopathology) risk factors. Two additional moderating variables (surgency, negative affect) were tested to examine specificity of effortful control and executive functioning as moderators. All variables of interest were measured on a continuum and via caregiver report. At high levels of effortful control and executive functioning, there was no association between familial liability for ADHD or broad psychopathology and later child ADHD problems. The moderator effects were specific to effortful control and executive functioning domains. Etiological models of heritable psychiatric disorders, such as ADHD, should consider the risk and protective contributions of individual traits, such as effortful control and executive functioning. Clinical prevention and intervention efforts may target self-regulation skills in children to buffer against familial liability for ADHD problems.

Developmental Timing of Trauma Exposure Relative to Puberty and Violent Behavior in Adulthood

ABSTRACT Childhood trauma confers tremendous negative consequences for development, including the emergence of psychopathology and behavioral problems, yet the impact of different dimensions of trauma exposure remains unknown. Existing research suggests that, due to increased neuroplasticity, early childhood and puberty may serve as sensitive periods that elevate risk, but also provide windows of opportunity for prevention and intervention. We examined whether the developmental timing of exposure to potentially traumatic events is differentially associated with engagement in violence during early adulthood. College students (n = 356, 81% women) reported the nature and extent of their violent behavior as well as their exposure to potentially traumatic events using a developmentally sensitive measure of trauma exposure relative to individual differences in pubertal timing. Negative binomial regression models revealed that men and women who were exposed to at least one potentially traumatic event during puberty reported engagement in significantly more past year violent behavior. Additionally, men, but not women, exposed to trauma during early and middle childhood reported engagement in significantly more violent behavior. Findings suggest that puberty may serve as a unique sensitive period for trauma-related violent behavior among women, whereas exposure to potentially traumatic events at any time during or prior to puberty serves as a risk factor for men’s violent behavior in adulthood. This study informs future research on underlying mechanisms linking trauma exposure to violent behavior and suggests possible opportunities for increasing intervention efficiency and effectiveness when administered during puberty.

Mood and anxiety spectrum disorders detected by neuropsychiatric interviews in young adults born preterm: A prospective cohort study.

Psychopathology has not yet been studied beyond pediatric age for all degrees of prematurity, including late-preterm, particularly in those who grew up with no apparent neurodevelopmental sequelae. This study aimed to examine psychopathological outcome following preterm birth and admission to neonatal intensive care in young adults without major neurodevelopmental and psychopathological problems that emerged during childhood. An Italian single-center prospective cohort study. Eighty-nine young adults (40 admitted to neonatal intensive care unit with less than 37 weeks of gestation and no medical history of other neurological or psychiatric conditions in childhood and 49 healthy peers born at term, matched by age, sex, and education) underwent neuropsychiatric interviews at the age of 20±1 years; MINI International Neuropsychiatric Interview, Beck Depression Inventory and Barratt Impulsive Scale, results were correlated to individual neonatal data and cognitive measures. We found a significantly higher prevalence of psychopathology at MINI score (22.5% vs. 4.2%; χ2=6.7; p=0,010) and prevalence of previous stressful life events in the preterm compared to at-term group. B.D.I. (testing depression) and BIS-11(testing impulsivity) did not highlight a statistically significant difference between the groups. All patients had average I.Q., a statistically significant difference (p<0.001) was observed between groups with a better performance in controls than cases. Preterm infants attaining young adult age with otherwise typical development during childhood are at risk of psychopathology and lower resilience to stressful life events. The MINI interview could be a useful tool to highlight the psychopathology of preterm infants attaining adult age.

Psychotic experiences, suicidality and non-suicidal self-injury in adolescents: Independent findings from two cohorts.

Prior studies have shown that psychotic experiences are prospectively associated with an increased risk of suicidality. However, it is unclear whether this association is causal or arises from shared risk factors. Furthermore, little is known about the association between psychotic experiences and non-suicidal self-injury (NSSI). We used data from two independent samples of young adolescents, which we analyzed separately. In a population-based cohort, data on hallucinatory experiences and suicidality were collected at ages 10 and 14years (N=3435). In a cross-sectional study of a population oversampled for elevated psychopathology levels, psychotic experiences, suicidality, and NSSI were assessed at age 15years (N=910). Analyses were adjusted for sociodemographic covariates, maternal psychopathology, intelligence, childhood adversity, and mental health problems. Psychotic experiences were prospectively associated with an increased risk of suicidality, even when considering self-harm ideation at baseline. Furthermore, persistent and incident, but not remittent, patterns of psychotic experiences were related to an increased burden of suicidality. Self-harm ideation was also prospectively associated with the risk for psychotic experiences, although of smaller magnitude and only by self-report. Among at-risk adolescents, psychotic experiences were cross-sectionally associated with a greater burden of suicidality and a higher frequency of NSSI events, with more extensive tissue damage. Psychotic experiences are longitudinally associated with suicidality beyond the effects of shared risk factors. We also found modest support for reverse temporality, which warrants further investigation. Overall, our findings highlight the importance of assessing psychotic experiences as an index of risk for suicidality and NSSI.

Understanding psychoanalytic work online and back to the couch in the wake of the COVID-19 pandemic: an investigation among Italian psychoanalysts.

Worldwide, psychotherapists' clinical experience went through rapid developments with transition to teletherapy during the COVID-19 pandemic. Literature on the use of remote psychoanalysis was not conclusive, leaving the issue of the consequences of the necessary setting alternation open. This study aimed to investigate the psychoanalysts' experiences of shifting to remote work and then returning to in-person setting, considering the effect of the patients' attachment styles and personality configurations. Seventy-one analysts of the Italian Psychoanalytic Society were asked to fill out an online survey about patients who found the transition easier and patients who found it more difficult. General questions on therapeutic work, ISTS (Interpretive and Supportive Technique Scale) for interpretive and supportive aspects of technique, WAI-S-TR (Working Alliance Inventory-Short Revised-Therapist) for therapeutic alliance, RQ (Relationship Questionnaire) for attachment style, and PMAI (Prototype Matching of Anaclitic-Introjective Personality Configuration) for personality configurations were administered. All of the analysts chose to continue the treatment using audio-visual tools. Patients with difficult transitions had a significantly higher frequency of insecure attachment and a higher score on RQ Dismissing scale than patients with easy transitions. No significant differences were found between the two groups in personality configurations, psychotherapeutic alliance, and psychotherapeutic technique. Moreover, a higher level of therapeutic alliance was positively correlated to RQ Secure scale and was negatively correlated to RQ Dismissing scale. Patients with easy transition both to remote work and back to in-person setting had higher scores of therapeutic alliances than those with difficult transition both to remote work and back to in-person setting. Online psychoanalytic therapy was widely used during the COVID-19 pandemic. Patients with insecure attachment styles had greater difficulties in adapting to setting alternations, thus confirming that insecure attachment is a vulnerability factor not only for psychopathological problems but also for a well-functioning therapeutic collaboration. Patient's personality configuration did not influence their adaptation to the setting alternation. The supportive and interpretive styles did not undergo significant changes in the transition from in-person setting to remote setting and vice versa, thus suggesting a continuity in the analysts' "internal setting."

Relationship between family mental health problems and substance use disorders: a gender perspective analysis

ABSTRACT Background Little is known about family mental illness and substance use disorder (SUD). This case-control study explored the relationship between family (parents and/or siblings) mental health problems (FMHP) and lifetime substance use disorder (SUD), considering a gender perspective. Methods A sample of 387 patients (n = 306 men, 79.1%; n = 81 women, 20.9%) was recruited from the Proyecto Hombre Navarra (Spain) addiction treatment program. Patients with (80 men; 24 women) and without (226 men; 57 women) FMHP were compared, taking sex into account. Results The prevalence of FMHP was 26.9%, without significant differences between men (n = 80; 26.1%) and women (n = 24; 29.6%). Men with FMHP reported higher severity in family/social and psychiatric areas than those without FMHP. Women with FMHP reported a higher severity in the psychiatric area and a higher prevalence of anxiety problems, suicidal attempts, previous psychopharmacological treatments, and physical abuse than women without FMHP. Conclusions FMHP is highly prevalent in patients with SUD. They are associated with lifetime psychopathological problems, mainly in men. Further specific research is needed to evaluate this issue to develop specific treatments tailored to the needs of patients with FMHP.