The present research has two goals: first, to validate the Italian version of the Attribution Questionnaire-9. Second, to investigate the validity of the Attribution Questionnaire-9, using a network analysis approach, with four mental disorders-that is, schizophrenia, anorexia, major depressive disorder, and bipolar disorder. In Study 1 (N = 951), a confirmatory factor analysis was conducted. In Study 2 (N = 3,966), a network analysis, was performed to assess relationships among the main facets of stigma toward the aforementioned four different mental health disorders. Also, network comparisons were investigated. Findings of Study 1 confirmed that the Italian adaptation of the Attribution Questionnaire-9 has a unidimensional factor structure solution with good fit indexes. Study 2 highlighted differences in the network structure related to different facets of stigma toward mental health illness, revealing fear as a central factor in stigma toward mental illness.

The present research aimed to develop and validate the Uncertainty in Illness Questionnaire (UIQ), a self-report tool designed to assess uncertainty in illness (UI) among Italian-speaking patients and caregivers. Across three studies, the psychometric properties of the UIQ were rigorously evaluated in large, diverse samples. In Study 1, the novel exploratory graph analysis (EGA) revealed a robust four-factor structure – uncertainty about symptoms, treatments, future change, and relationships (optimal stability > .90, negligible cross-loadings). Such structure was then confirmed in Study 2, in an independent sample, through confirmatory factor analysis (CFA) with a hierarchical model with four first-order factors showing good fit (robust RMSEA = 0.065[90

BackgroundBreast cancer diagnosis and surgical treatment can be experienced as traumatic events, triggering psychological distress including anxiety, depression, and post-traumatic symptoms. The Recent Traumatic Episode Protocol (R-TEP), an early EMDR intervention, has shown efficacy in reducing psychological symptomatology following recent traumatic events.ObjectivesThis protocol describes a randomized controlled trial designed to assess the efficacy of the EMDR R-TEP protocol in primarily reducing psychological distress and post-traumatic symptoms in breast cancer patients undergoing surgery, with secondary focus on emotion regulation, hopelessness, body image and global psychological symptomatology.MethodsA prospective, longitudinal, single-blind randomized controlled trial will be conducted at the Breast Unit of ASST Rhodense (Milan, Italy). A minimum of 122 female patients, accounting for 20% attrition, with first breast cancer diagnosis scheduled for surgery will be randomized into three groups: treatment as usual (TAU), TAU plus psychoeducational intervention, and TAU plus EMDR R-TEP. Assessments will be conducted at baseline (pre-surgery), post-surgery/pre-psychological intervention, post-psychological intervention, and at 3-month follow-up. Primary outcomes include the Psychological Distress Inventory-Revised and Post-Traumatic Symptom Questionnaire.DiscussionThis protocol provides the methodological framework for generating evidence on EMDR R-TEP as an early psychological intervention for breast cancer patients.

Childhood emotional neglect has been associated with maladaptive online behaviours, including problematic social media use (PSMU). However, less is known about the conditions under which this early relational vulnerability is more strongly related to PSMU in young adulthood. The present study examined whether loneliness moderated the association between childhood emotional neglect and PSMU in young adults, and whether this effect was conditioned by positive solitude. A total of 784 young adults (M = 23.87; SD = 3.33; 69.6% women) completed self-report measures. We performed a moderated moderation model examining the interactions among childhood emotional neglect, loneliness, and positive solitude in predicting PSMU, controlling for gender. Results showed that childhood emotional neglect and loneliness were positively associated with PSMU. Additionally, a three-way interaction emerged, indicating that the moderating role of loneliness in the association between childhood emotional neglect and PSMU was significant only at very low levels of positive solitude. Our findings suggest that PSMU may serve as a dysfunctional compensatory strategy among individuals exposed to childhood emotional neglect, particularly in the presence of negative solitary experiences and diminished capacity to benefit from solitude. Accordingly, solitary experience may be better understood from a multidimensional perspective when investigating vulnerability pathways to PSMU.

In many Western cultures, trying to make others feel better is considered critical for psychological health and social relationships. However, given that people think about emotions and relationships differently across cultures, the desirability, means, and benefits of making others feel better may also vary by culture. In two multicountry survey studies (Study 1: N = 3,154, 13 countries; Study 2: N = 3,503, 17 countries) and in a daily dairy study (Study 3: N = 243, 2 countries), we assessed motivation and strategies used for influencing others' and one's own emotions. To test whether potential cross-cultural differences in motivation and strategies in emotion regulation are unique to social interactions, we compared cultural differences in making others feel better to making oneself feel better. Across studies, cultural differences in influencing others' emotions were greater than those in influencing one's own emotions. Members of more individualist (vs. collectivist) cultures were more motivated to make others (but not themselves) feel better, were more likely to express care and less likely to encourage others to suppress their emotions or to ruminate. These patterns, in turn, were linked to an index of relationship closeness in an individualist (but not a collectivist) culture. These findings suggest that helping others feel better may not be equally desirable across cultures.

Alexithymia concerns a difficulty identifying, describing, and valuing feelings, and is regarded as a transdiagnostic dimensional construct, expressed at different levels in both non-clinical and clinical populations. Despite evidence supporting the relationship between traumatic experiences, adult attachment insecurity, uncertain reflective functioning, and alexithymia, there is a need to model their relationships to inform research, preventative actions, and clinical practice. Accordingly, this study aimed to investigate the mediating effect of adult attachment insecurity (M1) and uncertain reflective functioning (M2), on the relationship between traumatic experiences (X) and alexithymia (Y) in a community sample of young adults. N = 1,510 community members (78

INTRODUCTION:Childhood traumatic experiences (CTEs) represent a significant vulnerability factor for addiction-like eating behaviors, yet the underlying developmental pathways remain poorly understood. According to infancy research and attachment theory, this study tested a comprehensive mediation model examining how CTEs contribute to addiction-like eating patterns (i.e., appetite drive and low diet control) through attachment insecurity, impaired reflective functioning, and emotional eating. METHOD:A cross-sectional study was conducted on a conventional non-clinical sample 1,014 Italian adults. Participants completed a set of validated and standardized scales. Structural equation modeling with latent variables and bootstrap resampling (10,000 iterations) was employed to test the hypothesized model. RESULTS:The model demonstrated adequate fit and supported all hypotheses. CTEs significantly predicted both attachment anxiety, attachment avoidance, and impaired reflective functioning. Attachment anxiety, but not avoidance, mediated the relationship between CTEs and impaired reflective functioning. Also, impaired reflective functioning significantly predicted emotional eating, which in turn predicted both appetite drive and low dietary control. The complete mediation pathway was statistically significant, explaining 53.5% of variance in appetite drive and 20.6% in dietary control. DISCUSSION:These findings provide the first empirical support for a trauma-based developmental model of addiction-like eating behaviors. The results highlight the central role of attachment anxiety and impaired reflective functioning in linking early relational trauma to emotional eating and food addiction-like patterns. Clinical implications suggest that mentalization-based interventions targeting attachment insecurity and emotion regulation may be particularly beneficial for individuals with trauma histories and problematic eating behaviors.

ObjectiveOrthorexia Nervosa (ON) is characterized by the pursuit of perfect eating, leading to severe physical, psychological, and social problems. Although not yet formally recognized as an official diagnosis, ON shares etiological factors with traditional eating disorders, such as adverse childhood experiences (CT). This study explores the association between different CT types and ON, a relationship scarcely investigated in the literature.MethodsA sample of 175 participants (age 18–74 years, M = 44.10; SD = 12.85) completed the Italian Düsseldorf Orthorexia Scale (I-DOS) and the Childhood Trauma Questionnaire (CTQ-SF), assessing Physical Abuse (PA), Emotional Abuse (EA), Sexual Abuse (SA), Physical Neglect (PN), and Emotional Neglect (EN). A backward linear regression analysis investigated the CT-ON association.ResultsThe regression model explained 7.8% of variance in ON. EA emerged as the strongest predictor. SA showed limited relevance. The negative association with PA likely reflects statistical suppression effects and should be interpreted with caution. PN and EN showed positive but non-significant associations with ON.ConclusionThese findings support the role of CT, particularly EA, in ON development. EA represents the most clinically relevant trauma type, suggesting therapeutic interventions should prioritize addressing emotional abuse. However, the modest variance explained indicates that future studies should investigate additional psychological factors (e.g., perfectionism, cognitive restraint, attachment) to gain comprehensive understanding of ON etiology. This exploratory study provides foundational knowledge for future research on CT’s role in ON.

Research showed that psychological vulnerabilities may underlie the problematic use of social networking sites, including TikTok. This study aimed to investigate the interrelationships between attachment attitudes, self-esteem, motives and behaviors related to TikTok use, and symptoms of problematic TikTok use among adolescents and young adults from China, Italy, and Spain. The sample comprised 3,313 TikTok users, who completed self-report measures. A network analysis was conducted to examine the interrelationships among the variables for the entire sample. Differences between the network structures of the Chinese, Italian, and Spanish groups were assessed using a network comparison test. Active TikTok usage behaviors were associated with symptoms of addictive engagement, whereas low self-esteem, high levels of attachment anxiety, and escapism motives were linked to TikTok use as compensatory strategy. Few differences were observed between the network structures. These findings may help professionals create culturally sensitive interventions to promote healthier TikTok usage behaviors.

Introduction: Childhood emotional maltreatment, which includes emotional abuse and neglect, has been identified as a significant risk factor for the development of disordered eating behaviors related to overeating and reduced dietary control. At the same time, the literature suggests that childhood emotional maltreatment appears to be linked to deficits in reflective functioning which, in turn, may increase vulnerability to dysregulated, impulsive, and addictive behaviors. However, to date, the role of a key factor, such as food addiction (FA), within this model has not yet been investigated. Therefore, the aim of this study was to test a mediation model in which emotional abuse and neglect predict overeating and reduced dietary control through deficits in reflective functioning and FA symptoms. Method: Using a cross-sectional design, a conventional non-clinical sample of 543 participants was recruited and completed a set of standardized questionnaires. A multiple mediation model with observed variables was specified (10,000 bootstrap resampling). Results: The multiple mediation model showed good results, confirming the initial hypotheses. Specifically, emotional abuse and neglect were associated with FA symptoms through deficits in reflective functioning. In turn, FA symptoms predicted overeating behaviors and poor dietary control. Discussion: These findings highlight the central role of FA in linking reflective functioning deficits to disordered eating patterns associated with excessive food consumption. This study advances our understanding of the psychological mechanisms underlying disordered eating behaviors and underscores the need for targeted interventions addressing reflective functioning deficits and food addiction in individuals with a history of childhood emotional maltreatment.

Background/Objectives: General Self-Efficacy (GSE) refers to an individual’s belief in their overall ability to perform effectively across various situations. Research shows that GSE is a key predictor of multiple outcomes, including psychological resilience, better health, and improved overall well-being across different populations and environments. Numerous tools have been developed to measure GSE, enhancing our understanding of self-efficacy and its broader implications. This study aimed to evaluate the psychometric properties of the Italian version of the New General Self-Efficacy Scale (NGSES) in a community sample of adults recruited through social media platforms. Methods: The NGSES was adapted into Italian following the back-translation procedure. A total of 811 participants (mean = 43.18; 68.8% females) completed the scale. A confirmatory factor analysis (CFA) was used to examine the factorial structure of the questionnaire. Adjusted item-total correlations and internal consistency were assessed using McDonald’s omega. Additionally, multi-group CFA was used to test factorial invariance across gender. Results: The trimmed model exhibited a strong fit to the data: RMSEA = 0.068, CFI = 0.994, SRMR = 0.043. An omega coefficient of 0.872 confirmed the scale’s strong reliability. Convergent validity was established by a moderate and significant correlation with the NGSES. Configural, metric, scalar, and latent means invariance across genders were all confirmed. Conclusions: The NGSES was found to be a valid and reliable tool, suitable for both clinical and research applications in the Italian context. It can also inform the development of educational and therapeutic interventions aimed at enhancing GSE in the general population.

IntroductionGrazing represents a clinically significant eating behavior characterized by repetitive consumption of small amounts of food, often associated with poor outcomes in bariatric surgery populations. Despite growing evidence linking childhood traumatic experiences to disordered eating, the specific psychological mechanisms underlying grazing behaviors remain poorly understood. Developmental theories suggest early relational trauma may disrupt attachment patterns and impair emotional self-regulation through mentalization deficits, which could lead to disordered eating behaviors. However, this pathway does not appear to have been tested. This study examined whether attachment insecurity and impaired reflective functioning mediate the relationship between childhood trauma and grazing behaviors.MethodA cross-sectional study was conducted with 681 Italian adults. Participants completed self-report measures. Structural equation modeling with latent variables and bootstrap resampling (5,000 iterations) was used.ResultsThe model demonstrated satisfactory fit and supported the hypothesized pathways. Childhood traumatic experiences were associated with both attachment anxiety and attachment avoidance. However, only attachment anxiety significantly mediated the relationship between childhood trauma and impaired reflective functioning. Impaired reflective functioning emerged as the strongest predictor of grazing behaviors. The complete mediation pathway through attachment anxiety and impaired reflective functioning was statistically significant, with the model explaining 36.4% of variance in grazing behaviors.DiscussionThese findings provide empirical support for a trauma-informed developmental model of grazing behaviors. The results highlight attachment anxiety and impaired reflective functioning as crucial mediators linking early relational trauma to problematic eating patterns. Clinical implications suggest mentalization-based interventions targeting attachment insecurity may be particularly beneficial for individuals with trauma histories presenting with grazing behavior.

Background. The literature suggests that deficits in mentalization, operationalized as reflective functioning, are associated with emotional and behavioral dysregulation, including emotional eating and uncontrolled eating. These eating behaviors may be intensified by food addiction, yet its moderating role within this framework has not been thoroughly investigated. This study examined whether the relationship between deficits in reflective functioning and uncontrolled eating is mediated by emotional eating, and whether food addiction diagnosis moderates this pathway. Methods. A cross-sectional survey was administered to 559 adults from the general population. Participants completed self-report measures assessing reflective functioning (RFQ-8), emotional and uncontrolled eating (TFEQ-R-18), and food addiction (YFAS 2.0). A moderated mediation model was tested using conditional process analysis with 10,000 bootstrap resamples. Results. Deficits in reflective functioning were positively associated with emotional eating (β = 0.155, p < 0.001), which in turn were associated with uncontrolled eating (β = 1.314, p < 0.001). Food addiction diagnosis significantly moderated the relationship between emotional eating and uncontrolled eating (β = 0.744, p < 0.001). Specifically, individuals with food addiction exhibited a stronger association between emotional eating and uncontrolled eating compared to those without food addiction. The indirect effect from reflective functioning to uncontrolled eating via emotional eating was significantly stronger among individuals with food addiction than those without. The overall model explained 57.3% of the variance in uncontrolled eating. Conclusions. Food addiction diagnosis amplifies the pathway from emotional eating to uncontrolled eating, originating from deficits in reflective functioning. These findings highlight the clinical importance of targeting mentalization processes and emotional eating in interventions for disordered eating behaviors, particularly among individuals with food addiction.

The Women's EmotionS, Trauma and EmpowErMent (W-ESTEEM) blends empowerment strategies with Dialectical Behavior Therapy (DBT) techniques to support women who have experienced Intimate Partner Violence (IPV). This innovative online psychoeducational program aims to enhance women's well-being and empowerment. The current study is as an internal pilot study aimed at evaluating the feasibility and efficacy of the W-ES.T.EEM intervention by comparing a Control Group (CG) – Treatment As Usual (TAU) – with a Treatment Group (TG) – TAU together with the W-ES.T.EEM intervention. The study was pre-registered (Trial registration number and date: ISRCTN12880309; December 20, 2021) and the protocol was published before conducting the study. A total of 44 women with an IPV experience were recruited: 22 women (Mage = 46.64) were randomly assigned to the TG (TAU + W-ESTEEM) and 22 to the CG (TAU) (Mage = 47.50). This pilot study considers two time points: the baseline (pre-treatment) assessment and the initial follow-up evaluation. Preliminary results of the W-ES.T.EEM Intervention showed promising improvements in psychological well-being, post-traumatic symptoms, emotional regulation, and self-esteem in the TG. However, between groups comparisons did not yield statistically significant differences. Further insights await completion of the study. The initial findings indicated positive impacts of the W-ES.T.EEM Intervention on psychological well-being, post-traumatic symptoms, emotional regulation, and self-esteem are promising. They suggested that the intervention has the potential to address key areas of concern for individuals with experiences of IPV.

Previous evidence links psychosocial difficulties to social media (SM) use patterns in young adulthood. This study investigated differences between young adults' profiles based on loneliness and social isolation across different SM use patterns, including problematic SM use (PSMU), active and passive SM use, as well as online social anxiety, adult attachment orientations (anxiety and avoidance), and childhood trauma, through a person-centred approach. A total of 1487 young adults completed self-report measures. Latent profile analysis identified five profiles: Socially Connected (low social isolation, low loneliness), Lonely Alone (high social isolation, high loneliness), Mildly Solitary (moderate social isolation, moderate loneliness), Unlonely Alone (high social isolation, low loneliness), and Lonely Together (low social isolation, high loneliness). Profiles with moderate or high loneliness exhibited the highest levels of attachment anxiety, childhood trauma, and PSMU. Lonely Alone displayed higher levels of these variables than Lonely Together, greater attachment avoidance than Socially Connected, and the highest online social anxiety. These findings suggest that PSMU might act as a compensatory mechanism for both loneliness and social isolation, linked to childhood trauma and insecure adult attachment. Promoting secure attachment through responsive parenting could mitigate the effects of childhood trauma, reduce the risk of loneliness, social isolation, and PSMU in young adulthood.

Emotion regulation difficulties (ERD) serve as a transdiagnostic risk factor for psychopathology, and the Difficulties in Emotion Regulation Scale (DERS) is a widely-used self-report measure. Brief versions of such tools are essential for integration into longer assessment batteries and for longitudinal monitoring. However, DERS-8 has not yet been validated in the Italian context. This study aimed to provide the Italian validation of DERS-8 by examining its psychometric properties, factorial structure, and cut-off scores to distinguish between acceptable and at-risk levels of ERD, along with normative data. In Study 1 (N = 2016), confirmatory factor analysis (CFA) was used to test the DERS-8 structural validity. Also, its psychometric properties were tested. In Study 2 (N = 4221), measurement invariance across age and gender was conducted in an independent sample, together with a deep investigation of psychometric properties and clinical cut-off. Study 1 revealed that, initial model fit was poor but improved to good fit indexes after correlating specific residual pairs. Indeed, after correlating residuals between items #2-#4, #1-#7, and #3-#6, IT-DERS-8 provided good fit indexes (RMSEA = 0.042; 90

BACKGROUND:Schema Therapy is an integrative psychotherapy model with a growing evidence base in the successful treatment of eating disorders (ED). To specifically assess schema modes in ED, the Schema Mode Inventory for Eating Disorders - Short Form (SMI-ED-SF) was developed but its English adaptation is still lacking. OBJECTIVE:The aim of this study is to evaluate the psychometric properties of the English version of the SMI-ED-SF (EN-SMI-ED-SF) within a community sample and to explore its relationship with ED conditions and personality traits. METHOD:An observational design was used, recruiting participants from the general population and specialized clinics for ED treatment. A confirmatory factor analysis was performed to test its factorial structure. A multivariate analysis of variance was conducted to ascertain differences between ED conditions on the dimensions of the EN-SMI-ED-SF. Lastly, the relationship between schema modes and personality traits was explored. RESULTS:The EN-SMI-ED-SF demonstrated excellent fit indices, with robust validity and reliability for measurement of schema modes. Maladaptive schema modes were systematically higher in ED compared to non-ED individuals, and adaptive schema modes were lower in ED groups compared to non-ED individuals. Whereas maladaptive schema modes showed the strongest positive correlations with neuroticism, adaptive modes were strongly correlated with psychological flexibility. DISCUSSION:The EN-SMI-ED-SF demonstrated robust psychometric properties, indicating its validity and reliability for assessment of schema modes. The results provide strong evidence for the role of schema modes in ED pathology, and their association with key personality correlates and the protective function of psychological flexibility.

Problematic social media use (PSMU) has emerged as a growing concern due to its association with mental health challenges and social functioning difficulties. We investigated the role of attachment anxiety, loneliness (i.e., isolation, relational disconnectedness, and trait loneliness), and death anxiety in PSMU. A sample of 799 adult social media users (412 women, 387 men) aged 18-65 completed a battery of self-report questionnaires and socio-demographic data. A sequential mediation model tested whether loneliness and death anxiety mediated the relationship between attachment anxiety and PSMU, controlling for age and gender. Attachment anxiety was positively associated with PSMU, with this relationship mediated by isolation and relational disconnectedness. Additionally, death anxiety mediated the relationship between attachment anxiety, relational disconnectedness, and PSMU. These findings underscore the significance underlying psychological processes in PSMU, suggesting potential avenues for targeted interventions that address attachment-related insecurities, relational disconnectedness, and existential concerns.