Orthorexia nervosa (ON) is a clinical condition characterized by rigid and inflexible rules about consuming healthy food, potentially leading to harmful consequences for physical and mental health and significant impairment in major life domains. Overlap or independence between ON and other clinical entities, like other eating disorders (EDs) or obsessive compulsive disorder (OCD), still needs clarification. Objectives: This study aims to examine the overlap versus independence of core symptoms of ON from these two classes of disorders using a network approach. Methods: A group of 422 university students (71.8% females), with a mean age of 20.70 years (SD = 3.44), completed questionnaires assessing those symptoms. Results: Results revealed that no ON symptoms were nested within the OCD and ED clusters, and vice versa, thereby supporting their empirical distinctiveness. Although the symptoms were organised into distinct communities, ON symptoms were more strongly linked to EDs than to OCD. Bridge symptom analyses revealed that the nodes "Emotional consequences due to healthy eating", "Worry about healthy food", and "Obsessing" exhibited the highest bridge strength connecting clusters of ON, EDs, and OCD symptoms. Conversely, the nodes "Food safety" and "Ordering" showed the lowest bridge strength, suggesting that these nodes played only a marginal role in linking ON, EDs, and OCD. Conclusions: From a nosological perspective, the findings provide empirical support for conceptualizing ON as a distinct yet symptomatically related condition within the broader spectrum of eating-related psychopathology, while acknowledging that definitive nosological classification requires further longitudinal and clinical research.

Objective This study aimed to address the need for a brief and practical screening inventory for the detection of eating disorders by adapting the Disordered Eating Questionnaire (DEQ) and examining its psychometric properties, including reliability and validity, in a Turkish adult sample. Method The adapted DEQ was administered to 637 adults (Mage = 22.22, SD = 4.75), along with the Eating Disorders Examination Questionnaire (EDE-Q) and the Eating Attitudes Test (EAT), to assess its validity. After removing 46 multivariate outliers, analyses were conducted with 591 participants. Construct validity was examined through EFA, CFA, and ESEM, while convergent and known-groups validity were tested using the EDE-Q, EAT, and BMI categories. Results EFA supported a 15-item, four-factor structure after the elimination of five items (A2, A10, A11, B3, and B4). Factor solution reflected Restrictive Behaviors, Bingeing Behaviors, Self-esteem, and Body Concealment. CFA and ESEM further confirmed the four-factor structure and supported the presence of a higher-order general disordered eating factor showed an acceptable fit (χ2 = 265.139; CFI = 0.934; TLI = 0.918; 90% C.I. RMSEA = 0.074–0.097; SRMR = 0.056). Significant associations with the EDE-Q and EAT provided evidence of convergent validity. Known-groups analyses showed significant differences across BMI categories, with higher DEQ scores among participants in the overweight and obesity groups. Conclusion Turkish DEQ is valid and reliable for assessing disordered eating behaviors in adults. Findings support a 15-item, four-factor structure with an overarching general disordered eating factor. Further studies should examine measurement invariance across more balanced sex and age groups.

Specific Learning Disorders (SLD) have been widely associated with lower levels of self-efficacy, particularly in academic and social domains, although to date, no recent systematic evidence has addressed this association comprehensively. This systematic review summarizes cross-sectional, longitudinal and experimental studies exploring the relationship between SLD status and self-efficacy. Five online databases (PsycArticles; PsycInfo; CINAHL Plus with Full Text; MEDLINE; ERIC Keywords) were searched for articles published until 2023. Twenty-four studies included had a cross-sectional design, seven examined the effects of interventions on self-efficacy in subjects with SLD, two studies explored longitudinal associations between SLDs and changes in self-efficacy, and one study examined levels of self-efficacy in one SLD sample across multiple experimental conditions. Most cross-sectional studies included (N = 28) agreed that individuals with SLD have lower self-efficacy than those without SLD. Longitudinal studies suggested the role of SLD status as a predisposing factor for reduced self-efficacy across time, whereas evidence for the efficacy of interventions indicated mixed results concerning self-efficacy beliefs. These findings suggest important clinical implications, highlighting the need to implement interventions aimed at strengthening self-efficacy beliefs in individuals with SLD.

Background/Objectives: Weight-based stigma represents a pervasive psychosocial challenge affecting youth worldwide, with significant implications for mental and physical health. Although school-based interventions have been suggested as effective strategies to reduce weight bias, evidence regarding their content and efficacy in real-world educational contexts remains limited. The present study aimed to evaluate the effectiveness of a school-based intervention designed to reduce internalized weight stigma among Italian adolescents. Methods: A total of 539 secondary school students (Mage = 15.91 years; SD = 1.38; 51.5% males) from 10 schools in Italy were randomly assigned to either an intervention group (61.2%, n = 330) receiving the program or a minimal intervention control group (38.8%, n = 209). The intervention integrated psychoeducational modules and activities based on cognitive dissonance theory to address maladaptive weight-related attitudes and associated psychopathological outcomes. Pre- and post-intervention assessments evaluated internalized weight bias and body dissatisfaction in both groups. Results: A significant reduction in internalized weight bias was observed among students perceiving themselves as overweight following the intervention. Additionally, a marginally significant decrease in body dissatisfaction was reported in the intervention group from pre- to post-intervention. No comparable changes were found in the control group. Conclusions: These findings suggest that incorporating cognitive dissonance-based psychoeducational content within school-based programs may be a promising approach for reducing internalized weight stigma in adolescents. Further research is warranted to refine intervention strategies, explore the mechanisms underlying the observed effects, and assess the scalability and long-term impact of such initiatives in school settings.

OBJECTIVES:Adverse childhood experiences (ACEs) are established risk factors for developing depression in adulthood, although the mechanisms of this association are yet to be fully elucidated. In this study, we tested whether insomnia (i.e., difficulties in sleep onset and maintenance) can mediate the association between ACEs and adult depressive symptoms, and whether loneliness and hair cortisol, reflecting hypothalamic-pituitary-adrenal axis activity, can act as moderators. METHODS:We analyzed data of 1593 participants (64.7% female) aged 65.25 ± 8.15 from the English Longitudinal Study of Ageing (ELSA) across three waves of data collection. ACEs were retrospectively assessed in 2008-2009 (wave 4), insomnia symptoms, loneliness, and hair cortisol in 2012-2013 (wave 6), while depressive symptoms were assessed in 2014-2015 (wave 7). RESULTS:After accounting for health-related confounders and baseline values, conditional process analysis showed that insomnia symptoms exerted a mediating role between ACEs (ACEs total, parental bonding, and household dysfunction) and depressive symptoms, with a stronger effect in lonely older adults. Hair cortisol did not moderate the association between ACEs and insomnia symptoms. CONCLUSION:Results are consistent with the view of insomnia as a mechanism linking ACEs to depressive symptoms later in life. Elderly experience of loneliness may further increase the mediatory role of insomnia between ACEs and depression.

OBJECTIVES:This study aims to evaluate the association between ecological assessment experience of loneliness and nocturnal sleep in a sample of healthy adolescents and to investigate the potential mediating role of pre-sleep worry in this relationship. METHODS:Each evening, participants completed an electronic diary including items assessing loneliness and worry. The time of diary administration was set on an individual basis to capture the actual pre-bed experience. Sleep parameters were assessed using actigraphy. RESULTS:Analyses were conducted on 72 participants (53.9% boys; Mage = 15.65; SD = 1.32) and 535 nights. Multilevel structural equation modeling indicated that within person loneliness fluctuations over the assessment period predicted shorter sleep duration through the mediation of high pre-sleep worry (B = -1.634, p = .027); More specifically, at the within level, loneliness was significantly and positively related to worry (B = .131, p = .001), which in turn was negatively related to sleep duration (B = -12.502, p = .028).One step increase in loneliness-associated pre-sleep worry predicted a decrease of 12 minutes in sleep duration. The mediation path was not influenced by anxiety and gender differences in the adjusted analysis. Results on other sleep parameters were not significant. CONCLUSIONS:Findings suggest that adolescents' loneliness experienced at bedtime may influence sleep duration through worry. Sleep-promoting interventions in adolescents may benefit from targeting loneliness and pre-sleep cognitions.

Background: The transition to adult care for patients with epilepsy is a complicated clinical issue associated with adverse outcomes, including non-adherence to treatment, dropout of medical care, and worse prognosis. Moreover, youngsters with epilepsy are notably prone to emotional, psychological, and social difficulties during the transition to adulthood. Transition needs depend on the type of epilepsy and the epileptic syndrome, as well as on the presence of co-morbidities. Having a structured transition program in place is essential to reduce poor health consequences. A key strategy to optimize outcomes involves the use of transition readiness and associated factors assessment to implement the recognition of vulnerability and protective aspects, knowledge, and skills of these patients and their parents. Therefore, this study aims to provide a comprehensive framework of clinical and psychosocial aspects associated with the transition from pediatric to adult medical care of patients with epilepsy. Methods: Measures examining different aspects of transition readiness and associated clinical, socio-demographic, psychological, and emotional factors were administered to 13 patients with epilepsy (Mage = 22.92, SD = 6.56) with (n = 6) or without (n = 7) rare diseases, and a respective parent (Mage = 56.63, SD = 7.36). Results: patients showed fewer problems in tracking health issues, appointment keeping, and pharmacological adherence as well as low mood symptoms and moderate resiliency. Moreover, they referred to a low quality of sleep. Notably, parents of patients with rare diseases reported a lower quality of sleep as compared to the other group of parents. Conclusions: Increasing awareness around transition readiness is essential to promote self-management skills of patients with epilepsy and their parents. Anticipating the period of transition could be beneficial, especially to prevent problematic sleep patterns and promote independence in health care management. Parents of patients with epilepsy and rare diseases should be monitored for their mental status which can affect patients’ well-being.

Exposure to adverse childhood experiences (ACEs) confers a higher risk of developing depression in adulthood, yet the mediation of inflammation remains under debate. To test this model, we conducted a systematic review and two-stage structural equation modelling meta-analysis of studies reporting correlations between ACEs before age 18, inflammatory markers and depression severity in adulthood. Scopus, Pubmed, Medline, PsycInfo, and CINAHL were searched up to 2 October 2023. Twenty-two studies reporting data on C-reactive protein (CRP, n = 12,935), interleukin-6 (IL-6, n = 4108), tumour necrosis factor-α (TNF-α, n = 2256) and composite measures of inflammation (n = 1674) were included. Unadjusted models revealed that CRP (β = 0.003, 95 % LBCI 0.0002 to 0.0068), IL-6 (β = 0.003, 95 % LBCI 0.001 to 0.006), and composite inflammation (β = 0.009, 95 % LBCI 0.004 to 0.018) significantly mediated the association between ACEs and adult depression. The mediation effects no longer survived after adjusting for BMI; however, a serial mediation model revealed that BMI and IL-6 sequentially mediated the association between ACEs and depression (β = 0.002, 95 % LBCI 0.0005 to 0.0046), accounting for 14.59 % and 9.94 % of the variance of IL-6 and depressive symptoms, respectively. Due to the cross-sectional nature of assessment of inflammation and depression findings should be approached with caution; however, results suggest that complex interactions of psychoneuroimmunological and metabolic factors underlie the association between ACEs and adulthood depression.

Psychological interventions are viable, cost-effective strategies for improving clinical and psychological impact of inflammation-related conditions. However, their efficacy on immune system function remains controversial. We performed a systematic review and frequentist random-effects network meta-analysis of randomised controlled trials (RCTs) assessing the effects of psychological interventions, against a control condition, on biomarkers of innate and adaptive immunity in adults. PubMed, Scopus, PsycInfo, and Web of Science were searched from inception up to Oct 17, 2022. Cohen's d at 95% confidence interval (CI) was calculated to assess the effect sizes of each class of intervention against active control conditions at post-treatment. The study was registered in PROSPERO (CRD42022325508). Of the 5024 articles retrieved, we included 104 RCTs reporting on 7820 participants. Analyses were based on 13 types of clinical interventions. Compared with the control conditions, cognitive therapy (d = - 0.95, 95% CI: -1.64 to - 0.27), lifestyle (d = - 0.51, 95% CI: -0.99 to 0.02), and mindfulness-based (d = - 0.38, 95% CI: -0.66 to - 0.09) interventions were associated with posttreatment reduction of proinflammatory cytokines and markers. Mindfulness-based interventions were also significantly associated with post-treatment increase in anti-inflammatory cytokines (d = 0.69, 95% CI: 0.09 to 1.30), while cognitive therapy was associated also with post-treatment increase in white blood cell count (d = 1.89, 95% CI: 0.05 to 3.74). Results on natural killer cells activity were non-significant. Grade of evidence was moderate for mindfulness and low-to-moderate for cognitive therapy and lifestyle interventions; however, substantial overall heterogeneity was detected in most of the analyses.

Insomnia has been suggested as a potential modulator of systemic inflammation. However, few studies have examined the longitudinal association between insomnia and inflammation as well as the role of sex differences, despite accumulating evidence of the vulnerability of women to immune consequences of disturbed sleep. In this study, we tested the association between self-reported insomnia symptoms and serum C-reactive protein, a marker of systemic inflammation, at 1-year follow-up, in 54 outpatients with inflammatory bowel disease (52.81 +/- 16.09, 40.7% women). Insomnia symptoms were measured using the Insomnia Severity Index. After controlling for baseline inflammation and health variables, longitudinal moderated regression analysis showed that baseline insomnia symptoms predicted C-reactive protein levels at follow-up in women (beta = 0.416, p = 0.014), but not in men (beta = -0.179, p = 0.212). Results were not influenced by sex differences in insomnia severity or C-reactive protein levels. This study suggests insomnia symptoms may partially influence systemic inflammation in women with inflammatory bowel disease. Sex-specific psychological, immune and neuroendocrine pathways linking sleep to inflammation should be further elucidated.

IntroductionBody shaming (BS) is a growing phenomenon within the school context, especially among adolescents. Recently, it has been described as an unrepeated act in which a person expresses unsolicited, mostly negative comments about an individual’s body. The targeted person perceives these comments as negative, offensive or body shame-inducing. Empirical evidence also suggests that body weight is the most common reason that youths are teased and bullied. Indeed, weight stigma, described as bias or discriminatory behaviors, attitudes, feelings, and thinking about individuals, because of their weight, can lead to weight-based discrimination and victimization. Preliminary evidence suggests that BS and weight stigma have negative effects on psychological health both in the short and long term. In the delicate stage of adolescence development and pubertal maturation, BS experiences can be highly prevalent and it can lead to adverse outcomes such as eating disorders (ED). However, prevalence data in the Italian context are still lacking.MethodsThe study aims to estimate weight-related BS perceived by different sources (i.e., peers and family members) and their associations with public and internalized weight bias, body mass index (BMI), body dissatisfaction, and ED symptoms. A sample of 919 high school students (Mage = 15.97, SD = 1.58; 57.1% boys) completed a battery of self-report questionnaires assessing these variables.ResultsOne in four students reported experiences of weight-related BS by peers or family members. A total of 37% reported having at least one BS experience in a lifetime. Higher scores of ED symptoms, body dissatisfaction, and weight bias were reported by adolescents who experienced BS, especially females. Among overweight participants, results showed that internalized weight bias partially mediated the relationship between BS by family members and ED symptoms and fully mediated the relationship between BS by peers and ED symptoms, after controlling for age, sex and BMI.DiscussionThese findings, despite their cross-sectional nature, add an important contribution to the creation of quantitative empirical evidence on the phenomenon of BS. Its role in explaining eating disorders, both alone and with the mediation of internalized weight stigma has been first proved and needs to be confirmed by longitudinal results.

Background: High body mass and adiposity during pregnancy can contribute to psychological distress, and body dissatisfaction may be a potential underlying mechanism of this association. Objective. This study aimed to evaluate the mediational role of body dissatisfaction in the relationship between body mass index (BMI) and depressive and anxious symptoms, respectively. Methods: Given the cross-sectional design of this study, two alternative models were investigated, positing that BMI was related to depressive (Model 1a) and anxious symptoms (Model 2a), which, in turn, predicted body dissatisfaction. Seventy-two pregnant women in the third trimester of pregnancy completed the Body Image Disturbance Questionnaire, the Beck Depression Inventory-II and the State-Trait Anxiety Inventory, as well as a demographic form assessing their BMI. Results: As hypothesized, body dissatisfaction mediated the relationship between BMI and psychopathological symptoms. Moreover, the alternative models of reverse mediation were also significant, suggesting that psychopathological symptoms mediated the relationship between BMI and body dissatisfaction. Findings from both the hypothesized and alternative models suggested that, on the one hand, higher distress symptoms associated with body dissatisfaction would result from high BMI and, on the other hand, that body dissatisfaction may result from the effect of BMI on distress symptoms. Conclusions: The present study suggests that body image theory and practice should be implemented by the inclusion of evidence-based clinical interventions for promoting psychological well-being during the antenatal period.

Orthorexia Nervosa (ON) is a proposed clinical condition characterised by an excessive fixation on consuming healthy and pure foods, leading to strict dietary restrictions and potentially negative consequences for both mental and physical health. Despite its increasing prevalence, ON has yet to be classified as a distinct disorder within diagnostic classification systems. To promote its recognition as a formal disorder, it is pivotal to establish a significant association between ON symptoms and psychosocial impairment. To this end, we adopted a multidimensional perspective and explored a broad range of psychosocial domains to address this knowledge gap. A total of 261 participants aged 18–73 years (Mage = 30.03 years, 85

INTRODUCTION:The relationship between maladaptive perfectionism and Internalizing (ID) and Externalizing Disorders (ED) in children needs to be better understood, along with the intergenerational transmission of these traits from parents to children. The present work aimed to share light on both these issues.METHOD:39 children with ID, 19 with ED, and their parents were recruited*. The Multidimensional Perfectionism Scale, the Big Five Inventory, the Child and Adolescent Perfectionism Scale, and the Hierarchical Personality Inventory for Children were used. The association between parent personality and perfectionism traits and children's perfectionism dimensions was evaluated through hierarchical regression analysis.RESULTS:ID and ED groups did not differ significantly concerning perfectionism. Fathers presented higher scores than mothers in Self-Oriented Perfectionism, Other-Oriented Perfectionism, and Socially-Prescribed Perfectionism. Parents of children with ID report higher levels of Obedience in their children, while parents of children with ED reported higher levels of Creativity and Perseverance. Significant associations were found between perfectionism in parents and their children, as well as between perfectionism and the personality of children.CONCLUSION:Results suggest a transdiagnostic nature of Perfectionism and support the transgenerational transmission of the personality traits investigated.

Background: Emotional impulsivity has been found to be relevant in explaining the association between sleep problems and depressive symptoms, suggesting the potential role of impulsivity as a key underlying mechanism of this link. The objective of this study was to take a preliminary step in understanding the mediating role of impulsivity in the relation between excessive daytime sleepiness (EDS) and depression in patients with obstructive sleep apnea syndrome (OSAS) and to compare psychological and demographic characteristics between different levels of daytime sleepiness. Methods: A total of 138 patients with OSAS underwent polygraphic cardiorespiratory monitoring and completed a series of questionnaires investigating perceived sleepiness, depression, impulsivity, and other psychological characteristics. A mediational model was tested in order to assess whether impulsivity mediated the relation between sleepiness and depressive symptoms while controlling for the effects of age, sex, BMI, and oxygen saturation parameters. Results: the mediation model showed that there was a significant indirect effect of impulsivity in the sleepiness–depression link (αβ = 0.084 [0.0243–0.1617]). Conclusions: The here-presented results showed that the sleepiness–depression link is not direct as previous studies asserted, but instead it may be better explained by impulsivity. Research and practical implications are discussed.

The current study investigates the longitudinal association between grandiose narcissism and multidimensional perfectionism over 2 years in adolescence. We adopted the Narcissistic Admiration and Rivalry Concept, which differentiates between two aspects of grandiose narcissism. We also considered multiple dimensions of perfectionism, including Socially Prescribed Perfectionism (SPP) and two forms of Self-Oriented Perfectionism (SOP), namely the tendencies to set high standards of performance (SOP-Striving) and to engage in overly critical self-evaluations (SOP-Critical). The study was conducted in a sample of Italian high school students ( n  = 331). Concurrent correlations indicated that Admiration was positively related to SOP-Striving and, to a lesser extent, to SOP-Critical and SPP. Rivalry was also positively related to the three perfectionistic dimensions, although correlations were smaller in size than those found for Admiration. Prospective associations between narcissism and perfectionism were analysed using a Random-Intercept Cross-Lagged Panel Model. Results showed that the predominant direction of effects was from narcissism to perfectionism, particularly from Admiration to SOP-Striving and SPP. Findings were discussed in terms of their implications for the understanding of the narcissism-perfectionism link.

Background: Existing research has revealed a robust association between bullying victimization and psychological distress, but less is known about the underlying mechanism of this link. cognitive emotion regulation (CER) strategies could be a potential mediator. The current study examined the role of functional and dysfunctional CER strategies as potential mediators of the association between bullying victimization and depression, anxiety, and stress symptoms among 638 high school students (53.9% boys; Mean age = 15.65, SD = 1.32). Method: Participants completed a series of questionnaires assessing bullying victimization (Olweus Bully/Victim Questionnaire), CER strategies (CERQ-18), and symptoms of depression, anxiety, and stress (DASS-21). The indirect relationships between bullying victimization and psychopathological symptoms via functional and dysfunctional CER strategies were tested through structural equation modeling. Results: Dysfunctional CER strategies mediated the impact of bullying victimization on depression, anxiety, and stress. In contrast, bullying victimization did not significantly influence functional CER strategies. Conclusions: The findings provide additional support for the detrimental role of bullying victimization on mental distress, also suggesting that this effect is not only direct, but indirect is well. These results are particularly relevant in light of the absence of mediation by protective factors such as the use of positive emotion regulation strategies.

While difficulties with emotion regulation (ER) are consistently linked to poor mental health in adulthood, findings in adolescence have been more mixed. Cognitive ER strategies, which involve the ability to manage emotions through mental processes, may be particularly important during different stages of development due to age-specific adjustments. We conducted two exploratory and cross-sectional studies to examine the relationships between cognitive ER strategies and mental health (i.e., depressive, anxiety, and insomnia symptoms) in two samples: 431 young adults (Mage = 20.66 ± 2.21; 70% women and 30% men) and 271 adolescents (Mage = 14.80 ± 0.0.59; 44.6% girls and 55.4% boys). The participants completed a group of questionnaires, including the Cognitive Emotion Regulation Questionnaire, the Insomnia Severity Index, the Beck Depression Inventory-II, the State–Trait Anxiety Inventory, and the Youth Self Report. We employed hierarchical multiple regressions to assess the unique contribution of cognitive ER strategies to mental health outcomes. Maladaptive strategies (such as rumination and catastrophizing) were consistently associated with impaired mental health in both samples, while adaptive strategies (such as positive refocusing and positive reappraisal) were only associated with better mental health in young adults. These findings support the importance of cognitive ER strategies as potential risk factors for psychopathology and suggest that interventions aimed at improving emotion regulation may be beneficial. The age-specific differences in the relationship between cognitive ER strategies and mental health may reflect the refinement of emotion regulation abilities across the lifespan.