Throughout the Covid-19 pandemic, face masks emerged as a critical tool to control the virus transmission. While previous studies have investigated the positive and negative attitudes towards the use of face masks when mandatory, our study looks at a different phase: the era of discretionary mask use. Our investigation reached Italian participants (1151), aged 18-64, who underwent an online survey. The study explored the associations between demographic, attitudinal, psychological, and emotional factors that may be involved in the behaviour of wearing a face mask. Then, by using generalized mixed effects models, we explored the predictive role of those factors selected via backward elimination starting from a full model and selecting the model with the best goodness of fit balanced with complexity, and higher explained variance. Specifically, our exploratory study expected that emotional experience aroused by wearing a face mask, negative affectivity, Covid-19-related fear, and anxiety might be significant predictors of face mask wearing. However, only the emotional experience of feeling a sense of care and protected while wearing a face mask, and Covid-19-related fear were significant predictors of face mask-use. We discussed the importance of considering attitudes involved in compliance with healthy behaviours to guide future health interventions.

Emerging adulthood is characterized by transitions toward independence, where separation anxiety may intensify. Despite its robust psychometric properties, previously investigated on adult samples, the Adult Separation Anxiety Questionnaire (ASA-27) lacks formal validation for emerging adults. This study aimed to investigate the psychometric properties of the ASA-27 on a sample of Italian emerging adults. 863 participants completed the ASA-27 and measures of anxiety and depression. With the aim of prospecting a shorter, optimized version of the tool, psychometric properties were assessed using the Classical Test Theory and Item Response Theory (IRT) approach. Convergent validity and measurement invariance across sex were also tested. The reduced 19-items version retained a unidimensional structure, strong internal consistency and convergent validity. Measurement invariance supported consistent use across sexes. The ASA-19 is a reliable and more user-friendly tool for assessing separation anxiety in emerging adults, contributing to improved psychological assessment and intervention strategies in this life stage.

BackgroundAdolescence is marked by significant changes. The presence of type 1 and type 2 diabetes mellitus (T1D and T2D) amplifies these challenges, with diabetes being the second most common chronic disease among adolescents worldwide. Adolescents with diabetes are at heightened risk for mental health issues, which escalate the risk of complications. eHealth interventions using Information and Communication Technologies show promise in improving diabetes management and psychological well-being. However, research has predominantly focused on adults, leaving gaps in understanding the efficacy of these interventions for adolescents. Medical management often prioritizes physical health, neglecting psychosocial aspects.ObjectiveThis meta-analysis aims to provide evidence on eHealth interventions’ efficacy in supporting the psychosocial well-being of adolescents with T1D and T2D, and to investigate their impact on Hemoglobin A1c (HbA1c), quality of life, diabetes distress, anxiety, and depression symptoms.MethodA PRISMA-guided systematic search was conducted. Randomized Controlled Trials (RCTs) regarding eHealth interventions for adolescents with diabetes were included. Data were pooled using Standard Mean Difference (SMD). Outcomes were quality of life and HbA1c. Intervention acceptability was assessed using the Odds Ratio (OR) of dropout rates.ResultsA total of ten RCTs involving only adolescents with T1D (aged 10-22) were included in the analysis. The interventions resulted in significant improvements in quality of life (SMD = 0.73; 95% CI [0.08, 1.38]; k = 6), indicating a moderate positive effect, as well as in satisfaction with life, a subscale of the overall quality of life (SMD = 0.51, 95% CI [0.08, 0.95]; k = 3). For HbA1c levels, however, the effect was small and not statistically significant (SMD = -0.21; 95% CI [-0.69, 0.27]; k = 8). Additionally, the interventions were well accepted, as suggested by the OR of 0.47 (95% CI [-0.07, 1.01]; k = 7), indicating no significant difference in dropout rates between intervention and control groups.ConclusionThese results underscore the potential of eHealth interventions to enhance the quality of life and satisfaction with life in adolescents with T1D. Future research should continue to explore and refine eHealth interventions, ensuring an integrated approach that addresses both the medical and psychosocial needs of adolescents with diabetes.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021218623.

The onset of chronic diseases in childhood represents a stressful event for both young patients and their caregivers. In this context, coping strategies play a fundamental role in dealing with illness-related challenges. Although numerous studies have explored coping strategies employed by parents of children with chronic diseases, there remains a gap in the understanding of children’s coping strategies and their correlation with their and their parents’ anxiety. This study aims to investigate coping strategies and their interaction with anxiety in groups of young patients with cancer, type 1 diabetes (T1D), and their respective caregivers, in comparison to healthy children and caregivers. We recruited a total of 61 control children, 33 with cancer, and 56 with T1D, 7 to 15 years old, along with their mothers. Each participant completed a customized survey and standardized questionnaires. No significant differences emerged in coping strategies used by children among the different groups. However, when examining the association between coping strategy and anxiety, we found specific patterns of interaction between children’s use of coping strategies and their and their mothers’ anxiety levels. This study underscores the importance of an illness-specific approach to gain deeper insights into this topic and develop targeted interventions aimed at enhancing the psychological well-being of these vulnerable populations.

Phenylketonuria (PKU) is an inborn error of metabolism resulting from a deficiency of phenylalanine hydroxylase enzyme activity. Diagnosis in the first days of life allows early initiation of dietary therapy. The maintenance of this treatment raises demanding management issues in everyday life, often resulting in a psychological burden for patients and families. In this brief report, we aimed to investigate parenting stress and parents’ perceptions of their child’s adjustment, focusing on correlations between the perspectives of mothers and fathers. We conducted an observational study, enrolling parents of pediatric patients (aged 2–18) diagnosed with PKU and treated from birth. A total of 20 parenting couples of 20 PKU-affected children were included. The mean Phe level was 301.60 µmol/L (SD = 128.39). Most PSI-SF and SDQ-P scores were below the clinically relevant threshold. Significant correlations emerged between paternal parenting stress and the child’s Phe level and, additionally, between mothers’ and fathers’ scores. Parents of PKU-affected children reported acceptable levels of parenting stress and their children’s psychological adjustment. However, fathers perceived greater stress in maintaining adequate Phe levels for their children. Our results suggest a similar perspective of both parents in relation to their child’s psychological adjustment. Therefore, the psychological well-being of PKU patients and their parents must be monitored to provide family-centered care and psychological support in the process of accepting a rare disease.

Background/Objectives: The literature reports that emotional disorders in asthmatic children and their parents may affect asthma control. This research explores the baseline psychological well-being of asthmatic children and their mothers’ and fathers’ psychological functioning, focusing on the influence of the parents’ anxiety and separation anxiety on children’s asthma. Methods: In this cross-sectional study, we enrolled children with non-severe asthma and their parents, and a group of healthy children and their parents. The asthmatic children underwent anamnestic investigation, including asthma control and spirometry. Then, both the asthmatic and control triads filled a survey assessing their psychological functioning. Results: Among the 40 asthmatic children enrolled (8–18 years old), most had good clinical control maintained with GINA (Global Initiative for Asthma) therapy step 1–2 (14 patients, 35%) or step 3–4 (26 patients, 65%); 12 patients (30%) had at least one steroid course in the year before enrollment. They exhibited normal psychological adjustment but elevated levels of general (U = 179,500; p < 0.001) and state anxiety (U = 170,000; p < 0.001) compared to healthy peers. Additionally, the asthmatic children’s mothers displayed higher levels of separation anxiety compared to the fathers (t = −2.865, p = 0.006). Increased separation anxiety in the mothers corresponded to a history of at least one exacerbation in the previous year. Conclusions: The asthmatic children exhibited normal psychological adjustment with higher general and state anxiety. Also, their mothers showed greater levels of separation anxiety compared to their fathers. Lastly, higher mothers’ separation anxiety corresponded to a history of at least one exacerbation in the previous year. The influence of the parents’ psychological well-being on the children’s asthma control was previously unexplored.

Background: Although Intolerance of uncertainty (IU), separation anxiety, and negative affectivity seem theoretically interrelated, no empirical study has considered them jointly so far. However, deepening this topic is clinically relevant, especially during the delicate phase of emerging adulthood. This study aimed to pinpoint psychological profiles based on IU, separation anxiety symptoms, and negative affectivity in a group of Italian non-clinical emerging adults. Such profiles were then compared in terms of key psychological and psychosocial characteristics.Methods: 868 young adults (73 % women) aged 18-26 years entered the study. They completed a sociodemographic survey and self-report tools assessing IU, separation anxiety symptomatology, and personality traits. Subgroups exhibiting distinctive patterns of IU, separation anxiety symptoms, and negative affectivity were identified using latent profile analysis. To deepen disparities in psychological and psychosocial features by profile, analyses of variance and chi-square tests were performed.Results: Three profiles were detected, respectively with high, low, and moderate levels of the variables considered. In each profile, IU, separation anxiety symptoms, and negative affectivity had a consistent trend. The "High-level" profile had the greatest proportion of women and people who had not spent infancy with both parents. Limitations: The sample included mainly women and university students, and data were collected using self report questionnaires only.Conclusions: IU, separation anxiety symptoms, and negative affectivity can co-occur, highlighting the importance of transdiagnostic interventions. Preventive efforts should be directed to emerging adult women and those who did not spend infancy with both parents, as they may be particularly vulnerable to internalizing distress.

Le autrici presentano un lavoro di ricerca esplorativa e riflessione clinica confrontando due gruppi omogenei a tempo limitato con giovani adulti: uno in presenza presso studio privato e l'altro all'interno del Centro Ateneo dei Servizi Clinici Universitari Psicologici dell'Università di Padova (SCUP) in modalità online. A partire dai dati raccolti con il Group Questionnaire (Krogel et al., 2013) vengono presentate alcune riflessioni sullo sviluppo del processo terapeutico in presenza e online confrontando il Positive Bonding e la Negative relationship. Il materiale clinico presentato cerca di esplorare le differenze e comprendere le dinamiche del gruppo nei due diversi set.

Face mask wearing is a low-cost preventative measure for the Covid-19 pandemic. In Italy, face masks are no longer mandatory indoors from the 1st of May 2022. Some research focused on factors that influence the choice of using masks, but less is known about mask-wearing when non-mandatory. The present study aims to compare those who were still wearing masks indoors when non-mandatory and those who were not, in personality traits, anxiety, depression, and trust in healthcare professions, in Italy, in 2022. Furthermore, we analyze if resilience, reactance, political orientation, and Covid-19 vaccinations moderate between negative affectivity and the choice of wearing masks. 1151 adults, aged 18-64, were recruited. Using the Qualtrics platform, participants filled in a socio-demographic interview, and self-report questionnaires. Results showed that people who were still wearing a mask indoors had higher levels of psychoticism and negative affectivity, worse mental health, greater trust in healthcare professions, and worries about the pandemic. Moreover, resilience partially moderates the relationship between negative affectivity and the choice of wearing a mask. These findings provide a better understanding of individuals' responses to post-pandemic changes, identifying the personal and contextual aspects that can make people struggle with the process of returning to normality.

Objectives: Children with chronic illnesses and their parents are more at risk to develop sleep problems, which are linked to worse psychological and physical well-being. This study aimed to assess sleep patterns and their connections with psychological outcomes in children with type 1 diabetes (T1D) and cancer and their caregivers, compared to a control sample. In addition, we explored the associations between caregiver and child's sleep quality across the three groups. Methods: We enrolled 56 children with T1D, 33 children with cancer, and 61 healthy children between 7 and 15, and their respective caregivers. Caregivers filled out an ad-hoc survey assessing their sleep disturbances, parenting stress, general well-being, anxiety, and their children's sleep patterns and psy-chological adjustments. Results: Children with cancer showed lower sleep quality than the other groups. Moreover, worse psy-chological adjustment was associated with greater sleep disturbances in both clinical groups. As for caregivers, the cancer group reported the worst sleep quality and greater anxiety compared to the other samples. Greater anxiety was also linked to worse sleep quality. Furthermore, greater sleep problems in children were associated with poorer caregivers' sleep quality in the whole sample and the T1D group. Conclusions: A better understanding of sleep patterns and problems for chronically ill children and their parents is fundamental to provide adequate care for these vulnerable populations. Furthermore, an illness-specific approach may better inform and guide the practitioners in clinical practice.& COPY; 2023 Elsevier B.V. All rights reserved.

The prevalence of obesity in children and adolescents in the United States and Europe has increased over the past decade. Extensive research supports the importance of family variables in the etiology, maintenance, and treatment of pediatric overweight. Family adversity, maternal depression, and insecure attachment of the primary caregiver influence the treatment response. This chapter addresses obesity in adolescence and demonstrates the core role of attachment in a family-based approach for working with overweight and obese teens. The case describes a 15-year-old girl referred to the Healthy Lifestyle Institute (CURIAMo) of the University of Perugia in Italy. She was referred for treatment for being overweight and helping with her eating practices. The chapter discusses the role of the Adult Attachment Projective Picture System (AAP) in assessment and treatment recommendations for the girl, who was judged Dismissing Failed Mourning and her Unresolved parents. It demonstrates how the AAP, in combination with other assessment tools, helps develop a treatment plan. It emphasizes the importance of considering the interrelationships of family attachment patterns in examining parental feeding practices and their effects on children’s physical health and emotional well-being.

Having cancer in childhood is a risk factor for separation anxiety symptoms, with negative effects on the disease and psychological wellbeing. The Covid-19-pandemic-related concerns could have a negative effect. The present study explores the interplay between separation anxiety symptoms and COVID-19-related worries in pediatric cancer patients and their mothers, compared to a group of healthy children and their mothers, during the pandemic. Thirty-three subjects with cancer, aged 7–15 years, and their mothers were compared to a control sample of 36 healthy children and caregivers. They were administered a pandemic-related psychological experience survey and standardized questionnaires assessing psychological wellbeing, anxiety, and separation anxiety symptoms. Children with cancer reported significantly higher prosocial behaviors, fear of being alone, and fear of abandonment. Their mothers had worse psychological wellbeing, higher COVID-19 concerns, anxiety, and separation anxiety symptoms. The multiple linear regression model showed that an increase in children’s separation anxiety symptoms was associated with younger age, more recent diagnosis, more mother-child time, lower mothers’ worry for children’s contagion, and higher mothers’ and children’s anxiety. COVID-19-related worries of clinical children’s mothers seem to be protective for children’s psychological wellbeing. Early psychosocial support interventions for mothers are essential in health services for cancer.

We used an epidemiological study to explore the perception of change in several psychosocial dimensions during the COVID-19 quarantine. We focused on emotions, use of social network sites (SNSs), family life, important relationships, body functions, and school life. Using snowball recruitment, N = 1047 Italian children, pre-adolescents, and adolescents (M = 13.74 ± 3.59) were selected to complete ad hoc online questionnaires. A differential semantic inventory plot was prepared to analyze the emotional experience of children, pre-adolescents, and adolescents during quarantine compared to the pre-quarantine period. The Kruskal–Wallis test was run to assess gender and age differences in emotions experienced, habitual SNS use, and the experience of attending classes remotely. A post hoc Wilcoxon test was performed to compare such differences. Results showed that most of the sample (93.1%) attended classes using technological devices and reported missing their classmates very much (59.3%). Adolescents experienced more negative emotions (M = 3.69 ± 1.33) than pre-adolescents (M = 4.64 ± 1.32), who experienced negative emotions more than children (M = 5.11 ± 1.24). Females were more prone to experience negative emotions compared to males. Adolescents were also the most prolific SNS users (78.1%), particularly female adolescents. Overall, these finding highlight the necessity of preserving the emotional state and relational well-being of youth in these developmental phases by considering their school and social lives.

Due to the COVID-19 pandemic, many families had to manage new difficulties, especially those of chronically ill children. More and more research has focused on the negative effects of the pandemic on psychological wellbeing, while less is known about the resources. The present study aimed to explore the role of time spent with mothers in chronically ill children’s populations during the COVID-19 pandemic. Moreover, it explored the differences in mothers’ and children’s psychosocial functioning in three clinical populations. Four groups were recruited and compared: 7–15 year old children with asthma (45), type 1 diabetes (52), and cancer (33), as well as their healthy counterparts (41), and their respective mothers. They were administered standardized questionnaires and ad hoc surveys assessing psychological wellbeing and worries. Children of the four groups scored significantly differently with respect to the concerns for contagion, internalizing symptoms, and prosocial behaviors; mothers had worries about the consequences of their children’s contagion related to the chronic illness, as well as time with the child. The multiple linear regression model showed an association of being affected by cancer, suffering from type 1 diabetes, and spending less time with the child with an increase in children’s internalizing problems. Time with mothers seemed to be a resource for psychological wellbeing during the pandemic. Clinical implications are discussed.

A headache is the most common neurological symptom in children. Its subtypes are migraine (MH) and tension-type headache (TTH). Internalizing rather than externalizing symptoms are more frequent in children with headaches, but little is known about the reasons why. We aim to: (a) examine the interplay between emotional experience, affective regulation, and internalizing symptoms in children suffering from primary headaches and their caregivers; (b) identify potential predictors of children with migraines' internalizing symptoms. Fifty children and adolescents with a diagnosis of primary headaches and their caregivers were compared to a sample of fifty-one healthy peers and caregivers. Self-reports and parent-reports were administered. Results indicate higher negative affect and internalizing symptoms and lower bodily awareness of emotions in the clinical sample (n = 50; Mage = 11.66, SD = 2.25) compared to controls (n = 51; Mage = 11.73, SD = 2.32); mothers of TTH children self-reported lower emotional awareness and higher difficulties in engaging in goal-directed behavior; a higher frequency of headaches was associated with greater emotional regulation difficulties. Internalizing symptoms were predicted by higher self-reported negative affect and parent-reported internalizing symptoms, and lower self-reported ability in the verbal sharing of emotions. These findings suggest the importance of assessing the psychological features linked to children with primary headaches' psychological well-being.

Emerging adulthood concerns the transition from adolescence to adulthood. It foresees the separation from the family and the creation of new significant relationships, whereby specific attachment styles might be triggered when facing these challenges. The present study investigates the influence of retrospective memories associated with childhood separation anxiety symptoms upon emerging adults' romantic avoidant vs. anxious attachment styles including adult separation anxiety symptoms as mediators. Age and gender were included as covariates. A community sample of N = 394 Italian emerging adults (Mage = 23.64, SD = 4.00, 70% females) completed self-report measures. The results showed that the participants presented a greater anxious attachment rather than an avoidant attachment style. Moreover, both adult separation anxiety and the memories of early separation anxiety were positively and significantly associated with anxious attachment and not with avoidant attachment. A mediation model conducted and focused on anxious attachment showed that, although not directly associated, child separation anxiety did show a significant positive indirect effect on anxious attachment as mediated by adult separation anxiety symptoms. Thus, the findings highlighted the influence of adult separation anxiety symptoms and retrospective childhood memories of separation anxiety upon anxious adult romantic attachment, yet not on avoidant attachment style. Clinical implications are discussed and suggestions for future research are provided.

In March 2020, the Italian Government imposed mandatory home confinement to limit the spread of COVID-19. Few studies assessed the psychophysical impact of COVID-19 on chronically ill children. This study examined these effects on children with Type 1 Diabetes Mellitus (T1D) and their caregivers. Seventy-one patients (7–13 years) with T1D and their caregivers were administered a survey created ad hoc and some standardized questionnaires, assessing psychological well-being and anxiety. Medical data (physical and biochemical characteristics) were recorded before (T0, January–February) and after (T1, May–June) the lockdown. Paired Student t-test, Spearman two-tailed correlations, and a linear regression model were used for statistical analysis. Children at T1 showed higher BMI (body mass index), daily total and basal insulin dose, and time spent in therapeutic range, and they showed lower HbA1c (glycated hemoglobin), time spent above the therapeutic range, and standard deviations of the mean glucose values than at T0. A total of 32.9% scored in the clinical range for separation anxiety. The increase in separation anxiety was predicted by younger age, female gender, more recent T1D diagnosis, less time spent in therapeutic range at T1, and higher perceived fear of COVID-19 infection. In a pandemic context, separation anxiety may be stronger in younger females, with more recent T1D diagnosis and poor metabolic control, thus affecting the parent’s ability to manage diabetes and to support children’s autonomy.

Abstract Background The lockdown imposed by the COVID‐19 pandemic resulted in a completely different style of life with possible effects on the attitude toward their disease in patients with chronic lung disease, such as asthma. The aim of our study was to investigate in asthmatic children the level of asthma control and the maintenance therapy used during the lockdown. Methods Among asthmatic children attending our clinic, we identified those who had been prescribed the same therapy in March‐April 2019 and March‐April 2020. The level of asthma control (GINA‐score) and the maintenance therapy used during the lockdown (March‐April 2020) were compared with those of March‐April 2019. We separately analyzed a small group of children with severe asthma treated with Omalizumab during the lockdown. Results We enrolled 92 asthmatic children (67 males). Compared to 2019, in 2020 a higher proportion of children modified their maintenance therapy (38% vs. 15.2%, p < .001), with a significant increase in both the proportion of children who increased (p = .033) and in that of children who decreased their therapy (p = .026). The level of control resulted as significantly higher in 2020 (March p = .023; April p = .007). Also, the 13 children treated with Omalizumab showed a good level of control in 2020. Conclusions In asthmatic children, the COVID‐19 pandemic lockdown had a significant impact on their asthma control and on their attitude toward maintenance therapy.

Background: Parents play a significant role in the management and monitoring of their children's Type 1 diabetes mellitus (T1DM), being considered a family disease. The current review intends to investigate parental stress, depression and anxiety symptoms associated with self-efficacy referred to paediatric diabetes management. Method: A literature review was carried out using PsycINFO, Web of Science and PubMed where the following terms were considered: diabetes mellitus, paediatric, parent-child relationship, self-efficacy, parenting stress, perceived stress, stress, depression, anxiety. Standing a defined list of inclusion and exclusion criteria, a total of 33 papers were finally included. Results: Findings have shown that parents experience relatively high levels of anxiety, depression and stress symptoms related to managing a child with T1DM and are associated with parental self-efficacy. Parental stress predicts a worsening in the control of HbA1c levels, while parental diabetes-specific distress predicts an increase in children depression symptoms. High parental self-efficacy associates with better monitoring, allowing better adherence and more balanced HbA1c levels in the children. Conclusions: Interventions aimed at fostering social support, improving diabetes management, and decreasing perceived stress, might alleviate parents' psychological symptoms by focusing on increasing their self-efficacy. Digital interventions might also represent valuable solutions to support parents in the management of paediatric diabetes not presented and substantiated in the main text and should not exaggerate the main conclusions.