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Interpersonal coordination processes facilitate interpersonal synchrony through a continuous mutual adaption and corepresentation of self and others' actions. Such a process has been found to enhance prosocial behaviors, affiliation, and trust. While research has investigated the general underlying cognitive and social mechanisms that facilitate interpersonal synchrony, much less is known about how interpersonal impairments influence it in various psychopathological conditions-such as borderline personality disorder (BPD). In this study, we investigated the role of the social cognitive processes of individuals with high BPD traits during a synchronized interaction task. Participants ( N = 206) were recruited from the general population. BPD traits were assessed, and interpersonal synchrony was measured with a finger-tapping task. Participants were instructed to interact with a virtual partner (VP) that varied its adaptivity level in response to their taps across different conditions of adaptivity (α), ranging from nonadaptive to overly adaptive. After each interaction, the perception of synchrony and affect were assessed. Results showed an overall main significant effect of the adaptivity of the VP on interpersonal synchrony and the interaction experience, such that when VP adaptivity increased, asynchrony and perceived synchrony decreased. High levels of BPD traits were associated with higher asynchrony and variability, depending on the level of VP adaptivity, and an overall more negative perception of synchrony and affect. These findings show that high BPD traits are associated with reduced interpersonal synchrony during interaction. Consistent with these findings, interventions might consider the potential role of interpersonal synchrony in building the therapeutic relationship. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Aims: Borderline personality disorder (BPD) patients show negative emotional reactions to both excluding and including social scenarios, with levels normalizing only during extreme inclusion. Prior research among healthy individuals highlights the right ventrolateral prefrontal cortex (rVLPFC) role in regulating emotional responses to social exclusion, since transcranial direct current stimulation (tDCS) of rVLPFC decreases rejection-related emotions following social exclusion. This pilot study investigated whether, in BPD patients, tDCS over the rVLPFC reduces rejection-related emotions not only after social exclusion but also after fair social inclusion., Methods: Forty BPD patients randomly received either real or sham tDCS on rVLPFC before participating in the Cyberball paradigm, which involved phases of inclusion, exclusion, and over-inclusion. Participants self-reported their level of rejection-related emotions following each phase., Results: Transcranial direct current stimulation reduced rejection-related emotions during both social exclusion and fair inclusion, but not during over-inclusion. Specifically, those in the Real tDCS group exhibited comparable emotional responses to fair and over-including scenarios, unlike those in the Sham group who experienced heightened rejection-related emotions during fair inclusion compared to over-inclusion., Conclusions: Transcranial direct current stimulation over the rVLPFC reduces BPD patients' tendency to feel rejected both in fairly including and excluding scenarios. These findings confirm the rVLPFC involvement in emotional regulation and highlight a therapeutic potential for tDCS in moderating BPD's typical heightened rejection-related emotional responses to fairly including scenarios. This study supports the application of tDCS in BPD treatment, providing new insights into neuromodulatory interventions that can aid BPD patients to better regulate their emotions during varying social scenarios., (© 2025 The Author(s). Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.)

Both the new ICD-11 and the latest Alternative DSM-5 Model for Personality Disorders focus on self and interpersonal functioning as the central feature of personality pathology, also acknowledging that personality disorders are organized along a dimensional continuum of severity. This revised understanding is in line with long-standing psychodynamic conceptualisations of personality pathology, in particular Kernberg's object relations model of personality organization. Despite existing evidence for the clinical utility of the derived Structured Interview of Personality Organization (STIPO-R), empirical support for the identification of clear cut-points between the different levels of personality functioning is missing. For this purpose, a total of 764 adult participants were recruited across two clinical (outpatient and inpatient) settings ( n =  250) and two non-clinical (university students and general community) samples ( n =  514). Results from the mixture modeling suggested the existence of five groups across the clinical and non-clinical samples that covered: healthy personality functioning, maladaptive personality rigidity, and mild, moderate, and severe levels of personality pathology. All five indicators of personality organization were found to be reliable predictors of personality pathology. Of the five STIPO-R indicators, Aggression and Moral Values had the most discriminative power for differentiating between the Mild, Moderate, and Severe personality disorder groups. Implications of these findings are discussed.

With the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, a set of dimensional criteria was added as an emerging alternative model to the diagnosis of personality disorder (PD; American Psychiatric Association, 2013). Parallel to this, within the object relations conceptualization of personality pathology, a structured interview, the Structured Interview of Personality Organization (STIPO), was developed to assess pathological personality and then revised (STIPO-R). In this study, the reliability and validity of the Chinese version of the STIPO-R were tested on a sample of 236 Chinese participants, including both psychiatric patients and healthy individuals. Overall, the STIPO-R showed good internal consistency, interrater and test-retest reliability, and generally satisfactory results in structure and convergent validity. The STIPO-R also demonstrated discriminant validity (healthy individuals vs. psychiatric patients with PD vs. psychiatric patients without PD). Results are also discussed in light of cultural differences between Chinese and Western cultures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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.

The "Healthcare workers' wellbeing [Benessere Operatori]" project is an exploratory longitudinal study assessing healthcare workers' mental health at three different time points over a 14-month period during the COVID-19 pandemic. We collected socio-demographic and work-related information and assessed the perceived social support, coping strategies, and levels of depression, anxiety, insomnia, anger, burnout, and PTSD symptoms. In total, 325 Italian healthcare workers (i.e. physicians, nurses, other healthcare workers, and clerks) participated in the first initial survey and either the second or third subsequent survey. Participants reported subclinical levels of psychiatric symptoms that remained mostly unchanged across time, except for an increase in stress, depression, state anger, and emotional exhaustion symptoms. Despite subclinical levels, healthcare workers' distress can adversely affect the quality of care, patient satisfaction, and medical error rates. Therefore, implementing interventions to improve healthcare workers' wellbeing is required., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose of Review: Unstable relationships are a core feature of borderline personality disorder (BPD). Impairments in trust processes (i.e., appraisal and learning regarding others' trustworthiness) can subserve interpersonal problems associated with BPD, but the determinants, mechanisms, consequences, and variations in trust impairments among individuals with BPD remain poorly characterized. Thus, a better understanding of such impairments could help target interventions that address the interpersonal problems of individuals with BPD beyond emotion dysregulation, impulsivity, and aggression., Recent Findings: We conducted a pre-registered systematic review of empirical studies on trust processes and BPD features (k = 29). Results are organized around a heuristic model of trust processes in BPD comprising the following stages: developmental factors, prior beliefs and dispositions, situation perception, emotional states, trust appraisal, behavioral manifestations, and trust learning. Based on the synthesis of the findings, we recommended directions for future research and clinical assessment and intervention, such as managing trust during the early stages of therapy and considering improvements in trust processes as a central mechanism of change in treating individuals with BPD., (© 2023. The Author(s).)

Individuals suffering from borderline personality disorder (BPD) show a pervasive sense that others cannot be trusted, are vulnerable to negative therapeutic reactions, and can oscillate between idealized and persecutory interactions with others. These trust processing impairments impact both the immediate and wider social milieu of individuals with BPD, including therapist-patient interactions. Recently, research started unraveling the social-cognitive mechanisms of these impairments in BPD. In this Special Issue, we attempt to close the gap between research findings and clinical theories on trust processing impairment in BPD. The first section includes five original studies on trust processing in BPD. The second section includes five articulations of trust processing impairment as a treatment target in evidence-based treatments for BPD and as an indispensable "common factor" in the treatment of BPD. These cutting-edge research and clinical contributions advance a potential integrative, clinical science framework for conceptualizing and intervening effectively with those who struggle with BPD.

The perception of social exclusion among patients with opioid use disorder (OUD) could be affected by long-term opioid use. This study explores the emotional and cardiac autonomic responses to an experience of ostracism in a sample of participants with OUD on opioid agonist treatment (OAT). Twenty patients with OUD and twenty healthy controls (HC) performed a ball-tossing game (Cyberball) with two conditions: Inclusion and Ostracism. We measured self-reported ratings of perceived threat towards one's fundamental needs and respiratory sinus arrhythmia (RSA) immediately after the game and 10 min after Ostracism (Reflective stage). Following ostracism, participants with OUD self-reported blunted feelings of threat to the fundamental need to belong. RSA levels were significantly suppressed immediately after ostracism and during the Reflective stage in comparison with HC, indicating an autonomic alteration in response to threatening social situations. Finally, only among HC higher perceived threats towards fundamental needs predicted increases in RSA levels, suggesting an adaptive vagal regulation in response to a perceived threat. Conversely, among patients with OUD the subjective response to ostracism was not associated with the autonomic reaction. OAT may have a protective effect against negative feelings of ostracism. However patients with OUD on OAT present poor autonomic regulation in response to social threats, which could reflect their trait hypersensitivity to social rejection., (Copyright © 2023. Published by Elsevier Inc.)

Individuals with borderline personality disorder (BPD) struggle to identify whom they can safely trust, and this struggle contributes to profound emotional turmoil in their close relationships. Transference-focused psychotherapy (TFP) is an application of object relations theory (ORT) that posits that polarized mental representations of self and other define the personality organization of BPD. TFP aims to utilize a clear treatment frame coupled with an analysis of the therapeutic relationship (i.e., the transference) to help individuals with BPD integrate their polarized mental representations. Improvement in the capacity to trust others is inherent in the mechanisms of change in TFP. In this article, a social cognitive model of trust processing provides a new lens through which we formulate how TFP may enhance trust processing in BPD. Recent evidence from randomized clinical trials supports the argument that TFP may intervene with BPD in a way that is concordant with uniquely improved trust processing.

There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce. The aim of the study was to examine the experiences of psychodynamic psychotherapists, mainly delivering Transference-Focused Psychotherapy (TFP), with the transition and delivery of VCP during the first wave of the COVID-19 pandemic. Four hundred seventy-nine licensed psychotherapists completed an online survey during the peak of the pandemic. Survey data were analyzed using qualitative analysis. Results are presented and discussed concerning advantages and disadvantages regarding the access to psychotherapy, the specificity of the online video setting, bodily aspects, the quality of the therapeutic relationship, the therapeutic process including technical aspects and therapist's experience. Furthermore, we analyzed and discussed the statements concerning transference and countertransference reactions differentiating between high-level borderline and neurotic patients and low-level borderline patients. Our results support the importance to identify patients who potentially benefit from VCP. Further research including more prospective randomized controlled trials are needed to investigate the therapeutic implications of the findings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Laczkovics, Blüml, Kapusta, Hoffmann-Lamplmair, Casini, Bazan, Torres, Lendvay, Normandin, Nowacki, Snigur, Doering, Yeomans, Clarkin and Preti.)

Objective: Personality involves both trait and state components, personal goals serving a crucial regulatory function for the expression of personality states. The present study investigates the dynamic interplay between conscientiousness-related goals, conscientious personality states, and trait conscientiousness., Method: A sample of 244 community participants responded to a baseline survey (T1), a 5-times-a-day Ecological Momentary Assessment (EMA) for 15 days, and a post-EMA survey (T2)., Results: Pre-registered multilevel analyses indicated significant contemporaneous positive and negative associations between momentary conscientious and unconscientious goals and state conscientiousness, respectively. Cross-lagged associations also emerged, with goals predicting future states of conscientiousness. A latent growth model was fitted on a subsample of participants (N = 159). Results indicated that change in trait conscientiousness from T1 to T2 was explained by growth in conscientiousness-related goals during the EMA phase, with a mediating effect of growth in state conscientiousness., Conclusions: Overall, the results corroborate the importance of goals for modeling contemporaneous and cross-lagged personality dynamics, both in short and longer timeframes., (© 2022 The Authors. Journal of Personality published by Wiley Periodicals LLC.)

The Pathological Narcissism Inventory (PNI) is extensively used in recent empirical literature on pathological narcissism. However, most studies using the PNI are community-based, and no studies have used the PNI to investigate narcissistic presentations in personality disordered patients. This study investigates measurement invariance of the PNI in community participants and patients with personality disorders, and examines differences of narcissistic presentations in these samples through a multimethod approach. Results show that the PNI can be used reliably to measure and compare traits of pathological narcissism in community participants and patients with personality disorders. Personality disordered patients show higher traits reflecting vulnerable narcissism and overt manifestations of grandiose narcissism, compared with controls. Finally, network analysis indicates that traits of grandiose fantasies and entitlement rage have a central role in defining manifestations of PNI pathological narcissism, regardless of the presence of an underlying personality disorder. Research and clinical implications are discussed.

Background: Caregiver sensitivity is associated with positive child outcomes, and improving sensitivity is often the aim of parenting-directed interventions. However, sensitivity was conceptualized in Western cultures, and its application in populations with different backgrounds is still limited., Objective: This study aimed to foster a contextualized cultural understanding of the meaning and nature of sensitivity by assessing the possibility of evaluating sensitivity in a low-income population living in Ethiopia and describing the nature of (in)sensitive parenting. Moreover, the associations between sensitivity and discipline, the quality of the environment, and individual characteristics were explored., Methods: Parental sensitivity was coded on naturalistic video-recorded observations of free interactions between 25 female primary caregivers and their children. Caregivers completed questionnaires on discipline strategies and the level of satisfaction with the environment (access to basic needs, quality of house condition, community and family support, quality of learning opportunities, and working conditions)., Results: The assessment of sensitivity in this population was possible, with caregivers showing the full range of sensitivity levels. A description of manifestations of sensitivity in this population is provided. A K-means cluster analysis evidenced that high sensitivity was associated with high satisfaction regarding housing conditions and family environment. No association between sensitivity and discipline emerged., Conclusion: The findings show the feasibility of assessing sensitivity in this sample. The descriptions of observed behaviors contribute to understanding culturally specific aspects of sensitivity to consider when assessing sensitivity in similar populations. The study provides considerations and guidelines to inform the structure of culturally-based interventions to promote sensitive parenting in similar cultural and socioeconomic situations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Spinelli, Preti, Kassa, Asale, Goshu, Tsega, Gezie, Fasolo and Mesman.)

Introduction: Identifying longitudinal trajectories of emerging personality (EP) is crucial to highlight developmental patterns that might foster personality pathology in adolescence and early adulthood. Research on the exacerbation of personality pathology in adolescence identifies the significant contribution of internalizing and externalizing problems and suggests the importance of considering aspects such as mentalization, while accounting for gender differences., Methods: In our study, we adopted a mixed-model approach to (1) explore longitudinally EP (Adolescent Personality Structure Questionnaire; APS-Q) over 12 months in a sample of adolescents (N = 178, 62% females, mAGE = 15.04, SD = 1.27), accounting for gender effects. Moreover, (2) we assessed the longitudinal effect of internalizing and externalizing problems (Youth Self-Report; YSR-112) on EP. Finally, (3) we addressed the moderating role of mentalization (Movie Assessment for Social Cognition; MASC) in this developmental pathway., Results: Results highlighted a two-way pattern of EP. No changes were found in the level of difficulties in Self-acceptance, Investments and Goals, and Relationships with family dimensions. However, significant changes were found in personality functioning in the dimensions of Sense of Self, Aggression, and Relationships with friends. More, changes in difficulties in Sexuality emerged only in females. Also, gender differences emerged in the level of severity of EP. In addition, Internalizing and Externalizing problems differentially predicted difficulties in personality dimensions. Finally, mentalizing features moderated the relationship between Internalizing problems and Sense of Self and Internalizing problems and Self-acceptance, respectively., Conclusions: Our contribution aligns with recent developmental models of personality pathology, suggesting that different personality dimensions develop at different paces. More, it highlights the predictive power of externalizing and internalizing problems on difficulties in personality dimensions. Finally, it advances the discussion on the contribution of mentalizing abilities to EP., (© 2022 The Foundation for Professionals in Services for Adolescents.)

Contemporary models of the diagnosis and classification of personality disorders have diverged from the categorical diagnostic framework of the DSM system. One response to this movement can be found in the Alternative DSM-5 Model for Personality Disorders (AMPD), which uses dimensions of personality functioning, coupled with identification of dominant pathological traits, to define and classify personality disorders. By applying psychodynamic object relations theory to the AMPD, therapists can enrich the understanding and assessment of personality functioning and pathology as described in the AMPD.

Introduction: Elaborated intrusion theory suggests that imagery is central to craving; however, the possibility that cue-elicited multisensory imagery produces such urges has not been studied enough in the literature. Thus, we investigated the role of cue-elicited multisensory imagery on alcohol craving in individuals who are hazardous and social drinkers compared to mental and neutral imagery conditions., Methods: In an online experiment, hazardous and social drinkers (N = 348) between 18 and 45 years old were randomised to multisensory, mental, and neutral imagery exposure. The level of craving intensity was measured before and after imagery exposure. Also, participants rated vividness and sensory features scales after the exposure., Results: The level of craving was significantly higher in multisensory imagery condition compared to neutral condition (b = 1.94, p < 0.001, SE = 0.30, t(344) = 6.52, standardised mean difference [SMD] = 0.89) and in mental imagery condition compared to neutral condition (b = 1.82, SE = 0.30, t(344) = 6.52, p < 0.001, SMD = 0.83). The difference between the level of craving intensity between the multisensory and mental was not significant (b = 0.12, SE = 0.22, t(344) = 0.53, p = 0.594, SMD = 0.06). Moreover, craving intensity in response to multisensory versus neutral imagery was significantly stronger among hazardous drinkers (b = -2.90, SE = 0.83, t(341) = -3.50, p < 0.001). The level of vividness was not significantly different between any conditions. The difference between levels of sensory features was higher in multisensory imagery condition compared to neutral (b = 0.95, SE = 0.30, t(345) = 3.17, p = 0.002, SMD = 0.49) and mental imagery condition (b = 0.67, SE = 0.23, t(345) = 2.36, p = 0.004, SMD = 0.35)., Conclusion: Results suggest that cue-elicited multisensory imagery may be a useful tool for eliciting alcohol craving responses and provide an additional means for better understanding the multi-layered mechanism of craving., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Although previous studies have shown that rejection sensitivity (RS) is related to aggressive, prosocial, and withdrawal behaviors, little is known on the underlying mechanisms. This contribution aims to fill this gap by showing the usefulness of differentiating between the cognitive (expectation) and emotional (anxiety, anger) components of RS and testing the potential mediating role of cognitive emotion regulation (ER) strategies for predicting aggressive, prosocial, and withdrawal tendencies. Results from data collected in a sample of young adults (N = 445) showed that rejection expectation was only negatively linked to prosociality and that 2 functional ER strategies (i.e., positive reappraisal and putting into perspective) negatively mediate this relation. Conversely, dysfunctional ER strategies positively mediated the positive links between anger about rejection and aggression (i.e., catastrophizing and other blaming) as well as withdrawal (i.e., catastrophizing) and between anxiety about rejection and withdrawal (i.e., self-blame and rumination). We discussed the implications of the results for the comprehension of the role of ER strategies in behaviors linked to RS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Introduction: Italy is one of the high-income countries hit hardest by Covid-19. During the first months of the pandemic, Italian healthcare workers were praised by media and the public for their efforts to face the emergency, although with limited knowledge and resources. However, healthcare workers soon had to face new challenges at a time when the national health system was working hard to recover. This study focuses on this difficult period to assess the impact of the COVID-19 pandemic on the mental health of Italian healthcare workers., Materials and Methods: Healthcare workers from all Italian regions [ n = 5,502] completed an online questionnaire during the reopening phase after the first wave lockdown. We assessed a set of individual-level factors (e.g., stigma and violence against HCWs) and a set of workplace-level factors (e.g., trust in the workplace capacity to handle COVID-19) that were especially relevant in this context. The primary outcomes assessed were score ≥15 on the Patient Health Questionnaire-9 and score ≥4 on the General Health Questionnaire-12, indicators of clinically significant depressive symptoms and psychological distress, respectively. Logistic regression analyses were performed on depressive symptoms and psychological distress for each individual- and workplace-level factor adjusting for gender, age, and profession., Results: Clinically significant depressive symptoms were observed in 7.5% and psychological distress in 37.9% of HCWs. 30.5% of healthcare workers reported having felt stigmatized or discriminated, while 5.7% reported having experienced violence. Feeling stigmatized or discriminated and experiencing violence due to being a healthcare worker were strongly associated with clinically significant depressive symptoms [OR 2.98, 95%CI 2.36-3.77 and OR 4.72 95%CI 3.41-6.54] and psychological distress [OR 2.30, 95%CI 2.01-2.64 and OR 2.85 95%CI 2.16-3.75]. Numerous workplace-level factors, e.g., trust in the workplace capacity to handle COVID-19 [OR 2.43, 95%CI 1.92-3.07] and close contact with a co-worker who died of COVID-19 [OR 2.05, 95%CI 1.56-2.70] were also associated with clinically significant depressive symptoms. Similar results were found for psychological distress., Conclusions: Our study emphasizes the need to address discrimination and violence against healthcare professionals and improve healthcare work environments to strengthen the national health system's capacity to manage future emergencies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Moro, Calamandrei, Poli, Di Mattei, Perra, Kurotschka, Restrepo, Romano, La Torre, Preti, Mascayano, Picardi, Chiarotti, Rapisarda, Urban, Alvarado, Susser and Carta.)

Adolescence is a crucial period for the development of personality and its dysfunctions. In this regard, it is essential to evaluate the nature and degree of maladaptive personality functioning. However, measures currently available present some limitations, mainly being adaptations from adult's tailored instruments and length. Moreover, no instrument considers the crucial dimensions related to body development and sexuality. This contribution presents data on the Adolescent Personality Structure Questionnaire (APS-Q) development, a self-report measure to capture core aspects of personality functioning in adolescence while being agile and reliable. On two large samples of adolescents (total N = 1,664), we investigated the psychometric properties of the APS-Q. We explored its factor structure and construct and incremental validity in the first sample, testing specific associations with existing measures of severity of personality pathology, maladaptive personality traits, and psychological distress. In the second sample, we confirmed its factor structure, assessing gender and age invariance. Overall, our findings support the APS-Q's validity as a reliable and useful measure to assess personality functioning. Moreover, the APS-Q highlighted developmentally vital dimensions such as self-functioning (encompassing mental and bodily changes and considering the dimension of sexuality), interpersonal functioning (discriminating the dimensions of family and peers), and emotion regulation.

Introduction: Prevalence of suicidal thoughts and behaviours is higher among patients with borderline personality disorder than the general population. However, evidence concerning the role of specific borderline symptoms for predicting suicide-related outcomes is lacking and no systematic review/meta-analysis (SR/MA) investigated this topic. Our aim will be to investigate the relationship between any borderline symptom (except criterion 5) and suicide-related outcomes both through an SR/MA and an individual patient data meta-analysis (IPD-MA)., Methods: We will search PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, CINAHL and Cochrane Library databases from 1974 until September 2021. Both published and unpublished studies showing the association between any borderline symptom (except criterion 5) and suicide-related outcomes (death wish, suicidal ideation, suicidal plan, non-suicidal self-injury, deliberate self-harm, suicide attempt, suicidal behaviour disorder, suicide) will be included. Two team members will independently perform the selection of the studies and data extraction, with the supervision of two other members in case of discrepancies; and assess each study with study quality assessment tools by National Institutes of Health and Grading of Recommendations Assessment, Development and Evaluation. Each author will be contacted. If possible, we will perform both random-effect meta-analyses on the collected data (odds, risk, rate ratios or correlations) and an IPD-MA on collected databases., Ethics and Dissemination: This study does not require an ethical approval. Results will be publicly disseminated, included in research presentations and published in peer-review journals., Prospero Registration Number: CRD42018078696., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: COVID-19 forced healthcare workers to work in unprecedented and critical circumstances, exacerbating already-problematic and stressful working conditions. The "Healthcare workers' wellbeing (Benessere Operatori)" project aimed at identifying psychological and personal factors, influencing individuals' responses to the COVID-19 pandemic., Methods: 291 healthcare workers took part in the project by answering an online questionnaire twice (after the first wave of COVID-19 and during the second wave) and completing questions on socio-demographic and work-related information, the Depression Anxiety Stress Scale-21, the Insomnia Severity Index, the Impact of Event Scale-Revised, the State-Trait Anger Expression Inventory-2, the Maslach Burnout Inventory, the Multidimensional Scale of Perceived Social Support, and the Brief Cope., Results: Higher levels of worry, worse working conditions, a previous history of psychiatric illness, being a nurse, older age, and avoidant and emotion-focused coping strategies seem to be risk factors for healthcare workers' mental health. High levels of perceived social support, the attendance of emergency training, and problem-focused coping strategies play a protective role., Conclusions: An innovative, and more flexible, data mining statistical approach (i.e., a regression trees approach for repeated measures data) allowed us to identify risk factors and derive classification rules that could be helpful to implement targeted interventions for healthcare workers.

Many suicidal people do not receive professional assistance due to economic problems, the desire to autonomously solve the problem, or the stigma. Internet and Mobile-based Interventions (IMIs) can overcome many of these obstacles, offering flexible and accessible interventions. We conducted a narrative literature review about the characteristics of IMIs focused on suicide risks. We studied their efficacy and some examples of applications and websites used to prevent and treat suicide risk., Method: Literature research was conducted on Pub Med and PsycINFO databases., Results: IMIs are a viable alternative to traditional treatments and several studies supported their effectiveness in reducing suicidal ideation and behaviors. Most IMIs are based on cognitive-behavioral therapy, which is very structured and easily transferable to digital format. Empowerment, reinforcement mechanisms and human support are the main features that promote the change of the individual and her or his adherence to the treatment. Some IMIs developed for suicide prevention are Stay Alive (UK), Virtual Hope Box (USA), This way up (Australia), and Jaspr Health (USA)., Conclusions: IMIs can be considered a valid aid in suicide prevention. It is necessary to continue the research supporting their effectiveness and implement their interventions in Italy.

The first Italian lockdown during COVID-19 pandemic constituted an example of strong situation. Under this context, we investigated associations of HEXACO personality with COVID-19 mitigation behaviors (self-reported hygiene, distancing, going out). We tested unique associations through regularized regressions and out-of-sample prediction after establishing the best level of analysis (HEXACO traits, facets, items). Personality always explained out-of-sample variance over and above demographics, COVID-related knowledge, concern, impacts, and goals. Hygiene and distancing were best predicted by HEXACO traits, whereas facets constituted the best level for the prediction of going out. In general, honesty-humility (trait or facets) was the clearest predictor of safer behaviors. Results corroborate the relevance of personality even in strong situations, as well as its importance for COVID-19 mitigation., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Despite the widespread prevalence of mental health problems, most psychological distress remains untreated. Internet-based psychological interventions can be an essential tool for increasing treatment availability and accessibility. The main objective of the MindBlooming project is to design and implement an innovative Internet-based multi-approach treatment for university students suffering from psychological or physical problems. The intervention will focus on symptoms of depression, anxiety, sleep problems, self-destructive thoughts, job- and study-related stress and burnout, and chronic pain. It will be based on different approaches, primarily psychoeducation, Cognitive-Behavioral Treatment (CBT), and third-wave CBT. At the end of the treatment, user satisfaction and usability will be assessed. In addition, two further aims will be evaluating the treatment efficacy through a randomized controlled trial and tuning a predictive model through Machine Learning techniques. The intervention consists of a 7-week treatment on two problematic areas according to each students' personal needs, identified through an initial assessment. Besides the treatment assigned following the initial screening, participants will also be assigned to a different module to improve their relational skills. The treatment, which can be accessed through a mobile app, consists of psychoeducational videos followed by related exercises. We expect MindBlooming to be a remarkable tool for promoting the mental health of university students.

Background: Individuals with Borderline Personality Disorder (BPD) feel rejected even when socially included. The pathophysiological mechanisms of this rejection bias are still unknown. Using the Cyberball paradigm, we investigated whether patients with BPD, display altered physiological responses to social inclusion and ostracism, as assessed by changes in Respiratory Sinus Arrhythmia (RSA)., Methods: The sample comprised 30 patients with BPD, 30 with remitted Major Depressive Disorder (rMDD) and 30 Healthy Controls (HC). Self-report ratings of threats toward one's fundamental need to belong and RSA reactivity were measured immediately after each Cyberball condition., Results: Participants with BPD showed lower RSA at rest than HC. Only patients with BPD, reported higher threats to fundamental needs and exhibited a further decline in RSA after the Inclusion condition., Conclusions: Individuals with BPD experience a biased appraisal of social inclusion both at the subjective and physiological level, showing higher feelings of ostracism and a breakdown of autonomic regulation to including social scenarios., (© 2021. The Author(s).)

COVID-19 pandemic involved several psychosocial consequences. We aimed at monitoring the mental health of Italian adults during the lockdown imposed by the government. We present here results from the baseline assessment of the "EmotionalThermometer [TermometroEmotivo] project on a sample of 1548 Italian adults. We assessed the socio-demographic conditions of participants, individuals' perception of the COVID-19-situation, psychological distress, emotion regulation strategies, and perceived social support. Having a worse representation of COVID-19 and consulting news more frequently, with higher anxiety and less credibility of different sources of information, were positively associated with psychological distress and post-traumatic responses. Being female, younger age, living in high-risk regions, having symptoms of COVID-19, and having relatives/friends with such symptoms represented risk factors for a worse perception of COVID-19 and distress. Social support and cognitive reappraisal represented protective factors for mental health., (Copyright © 2021. Published by Elsevier B.V.)

This work investigates the relationship between goals and mitigation behaviors during the COVID-19 pandemic in Italy. Study 1 (pilot) identified goals ascribed to following and violating mitigation-related indications. Study 2 investigated the structure of and link between COVID-related goals and behaviors in a large community sample ( N = 995, 301 men). Our results showed substantial relationships between goals and behaviors. Goals were best described by a bi-dimensional structure (being safe vs. being free), whereas behaviors clustered into a three-component structure (hygiene, distancing, going out). Hierarchical multiple regressions demonstrated the incremental validity of goals in the prediction of behaviors. Network analysis suggested that goals imbued with social content were more directly related to both risky and preventive behaviors. Motivational aspects emerged as important contributors to the organization of behaviors in the context of the COVID-19 pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Costantini, Di Sarno, Preti, Richetin and Perugini.)

Emerging adulthood is a turning point in the life cycle with regard mental health. To assess psychological distress and attachment styles 688 university students of which 370 requested a counselling support responded to Symptom Checklist 90 Revised and Attachment Style Questionnaire. Counselling attending students (vs counselling non-attending students) have a higher psychological risk profile, with more psychological distress and insecure attachment. A marked percentage of students not attending counselling presents psychological distress. In both groups associations emerged between psychopathological problems and insecure attachment. The importance of communication strategies aimed to those students who, albeit non requesting psychological help, display psychological distress is discussed., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

During the last year, the COVID-19 outbreak put all the healthcare workers around the world at risk of physical and psychological sequelae. The general purpose of the present study was to assess the mental health of Italian healthcare workers during the COVID-19 outbreak and to identify high-risk groups. Here, we present results from the baseline assessment of the "Healthcare workers' wellbeing (Benessere Operatori)" project on a sample of 1055 healthcare workers. Participants completed the Depression Anxiety Stress Scale-21, the Insomnia Severity Index, the Impact of Event Scale-Revised, the State-Trait Anger Expression Inventory-2, and the Maslach Burnout Inventory. Healthcare workers who worked in COVID wards reported higher levels of anxiety, insomnia, post-traumatic stress, anger, and burnout, compared to those reported by the healthcare workers who worked in non-COVID wards. Moreover, nurses, both in COVID and non-COVID wards, were at higher risk of experiencing psychological distress compared to other groups of healthcare workers. These findings highlight the importance of implementing targeted psychological interventions for healthcare workers operating in COVID wards and nurses, who seem to be the most vulnerable categories.

The onset of the coronavirus disease 2019 (COVID-19) pandemic impacted individuals' psychological wellbeing resulting in heightened perceived stress, anxiety, and depression. However, a significant issue in accessing psychological care during a lockdown is the lack of access to in-person interventions. In this regard, research has shown the efficacy and utility of psychological app-based interventions. 'Italia Ti Ascolto' (ITA) has been developed as a population tailored internet-based intervention to offer an online professional solution for psychological support needs. The ITA app is available on iOS and Android systems. Users completed a baseline assessment on emotion regulation strategies (cognitive reappraisal and expressive suppression), psychological stress, anxiety, depression, and perceived social support. Participants could select among several one-hour long clinical groups held by expert psychotherapists. After every session, people were asked to complete a quick users' satisfaction survey. Our contribution presents ITA's intervention protocol and discusses preliminary data on psychological variables collected at baseline. Data showed significant associations between emotion regulation strategies, symptoms of depression and anxiety, and level of stress. Moreover, the role of perceived social support is considered. Future developments and implications for clinical practice and treatment are discussed., (©Copyright: the Author(s).)

Purpose of Review: We report evidence on the negative psychological effects of pandemics in people with personality disorders (PDs) and on the role of personality pathology in compliance with mitigation-related behaviors. Considering the paucity of studies, after a description of the main features of PDs, on the basis of the current literature on pandemic and quarantine mental health impact, we trace some clinical hypotheses., Recent Findings: Paranoid traits and detachment (cluster A) might lead to worse psychological outcomes. Cluster B patients may show more intense stress-related reactions and react strongly to social distancing, especially considering borderline personality disorder. Cluster C patients might be particularly prone to anxiety and stress due to fear of contagion and may be less flexible in adaptation to new routines. Evidence on compliance with mitigation measures is mixed, with lower compliance in cluster B patients and higher in cluster C ones. We suggest that PD patients might be particularly affected by pandemics. Furthermore, they might react differently, according to their main diagnosis. Similarly, compliance with mitigation measures may differ according to specific PDs. Our results should be considered as a starting point to reflect on therapeutic strategies to be adopted in the post-COVID-19 situation.

The study examined the effectiveness of a brief psychodynamic counseling intervention on psychological distress and general life satisfaction in a sample of 124 students by comparing pre- and posttreatment data. The authors also tested the moderating role of pretreatment attachment styles. Results showed that most participants (57%) can be classified as a nonclinical population, whereas only a minority of participants belong to a clinical population (17%) and a subclinical population (26%) according to the Symptom Checklist 90 Revised (SCL-90-R). Psychodynamic counseling intervention was shown to be associated with a decrease in the Global Severity Index and the anxiety and depression subscales of the SCL-90-R. Clinical effectiveness was greater for participants belonging to the clinical group. General life satisfaction increased significantly for all students. The authors found no moderation effect of attachment styles. Brief psychodynamic counseling intervention was associated with a reduction of psychological distress and an increase in life satisfaction.

Smartphones are changing lives in a number of ways. However, the psychological literature has primarily focused on smartphone overuse, neglecting the impacts that are not strictly related to problematic use. The present research was aimed to develop a comprehensive self-report scale that accounts for the cognitive, affective, social, and behavioral impacts of smartphones in everyday life-the Smartphone Impact Scale (SIS). Study 1 ( N = 407) yielded a preliminary version of the scale, which was refined in Study 2 ( N = 601). The SIS is a 26-item scale that measures seven dimensions of smartphone impact. Results revealed meaningful associations between its subscales, psychosocial constructs, and daily usage of smartphones and apps. The SIS broadens the view of human-smartphone interaction by extending the concept of problematic smartphone use to further dimensions (e.g., emotion regulation) and introducing a proper measurement of underinvestigated smartphone impacts (e.g., tasks support). The implications of each SIS subscale are discussed.

In this article, we focus on rejection sensitivity (RS) in adolescents. Although the RS model distinguishes clearly between the emotional (i.e., anger and anxiety) and the cognitive (i.e., expectation of rejection) components, research has rarely examined their unique connection with psychological problems. We argue that considering the three components separately would provide additional insights regarding the relationship between RS and psychological problems. We aimed to test the goodness of fit of a three-factor solution and to investigate the validity of the three components separately in predicting self- and interpersonal functioning in adolescents. Indeed, 720 adolescents completed the Children's Rejection Sensitivity Questionnaire, self-reports of self- and interpersonal functioning (self-esteem and interpersonal reactivity), and peer ratings of preference and bothersomeness. The three-factor solution showed fit indexes comparable to the two alternative one-factor solutions underlying the traditional approach of the composite scores. More importantly, we found specific contributions of each of the three RS components in predicting different features of self- and interpersonal functioning. Thus, depending on the psychological problems under consideration, the role of the three RS components varies. We discuss the implications of these findings.

Objective: Assuming personality to be a system of intra-individual processes emerging over time in interaction with the environment, we propose an idiographic approach to investigate potential changes of intra-individual dynamics in the perception of situations and emotions of individuals varying in personality traits. We compared the semiparametric time-varying autoregressive model (TV-AR) that takes into account the non-stationarity of psychological processes at the individual level, with the standard AR model., Method: We conducted analyses of individual time series to assess intra-individual changes in mean levels and inertia on data from two adolescents who completed measures of personality and indicated their situation perceptions and emotions five times a day for 19 days., Results: For the less honest, emotional, extraverted, and more agreeable adolescent, the TV-AR model detected reliable changes in the intra-individual dynamics of situation perceptions and emotions whereas, for the other individual, the standard AR model was more preferred, given the lack of changes in the intra-individual dynamics., Conclusions: Psychological processes dynamics in situation perception and emotions may vary from person to person depending on their personality. This work constitutes a first step in demonstrating that an idiographic approach has advantages in identifying changes in individuals' perceptions and reactions to situations., (© 2020 Wiley Periodicals, Inc.)

Purpose of Review: We aim to provide quantitative evidence on the psychological impact of epidemic/pandemic outbreaks (i.e., SARS, MERS, COVID-19, ebola, and influenza A) on healthcare workers (HCWs)., Recent Findings: Forty-four studies are included in this review. Between 11 and 73.4% of HCWs, mainly including physicians, nurses, and auxiliary staff, reported post-traumatic stress symptoms during outbreaks, with symptoms lasting after 1-3 years in 10-40%. Depressive symptoms are reported in 27.5-50.7%, insomnia symptoms in 34-36.1%, and severe anxiety symptoms in 45%. General psychiatric symptoms during outbreaks have a range comprised between 17.3 and 75.3%; high levels of stress related to working are reported in 18.1 to 80.1%. Several individual and work-related features can be considered risk or protective factors, such as personality characteristics, the level of exposure to affected patients, and organizational support. Empirical evidence underlines the need to address the detrimental effects of epidemic/pandemic outbreaks on HCWs' mental health. Recommendations should include the assessment and promotion of coping strategies and resilience, special attention to frontline HCWs, provision of adequate protective supplies, and organization of online support services.

The Alternative Model for Personality Disorders states that personality pathology involves significant impairment in personality functioning that can be assessed using the Level of Personality Functioning Scale (LPFS). However, the ability of the LPFS to capture impairments typical of personality pathology, rather than of general psychopathology, is still unclear. The authors applied a 12-item version of the LPFS to clinical interviews (i.e., the Structured Interview of Personality Organization [STIPO]) to test whether differences in levels of impairment in domains related to both self- and interpersonal functioning can be detected among patients with personality disorders ( n = 33), psychiatric outpatients ( n = 30), and nonclinical controls ( n = 30). Results show that the 12-item version of the LPFS scored using clinical material gathered through STIPO interviews captures impairments in identity, self-direction, and empathy uniquely linked to personality pathology. However, impairments in intimacy do not differentiate between patients with and without personality disorders.

Impulsivity is a multifaceted construct particularly relevant for understanding a wide variety of behaviors, especially risky behaviors. A recent conceptualization of impulsivity identifies three impulsivity factors-pervasive influence of feelings, feelings trigger action, and lack of follow-through-that have been shown to predict different behaviors. In this contribution, we examine the psychometric properties of an Italian version of such a three-factor model on a relatively large sample ( N  = 845). Moreover, on a subsample ( n  = 766) we determined whether specific dimensions of impulsivity are related to a series of risky behaviors, assessed 3 weeks later, by testing the predictive validity of the multidimensional inventory also in comparison with a standard measure of personality (HEXACO). An exploratory structural equation model confirmed the original 3-dimension structure and showed that the Italian adaptation has satisfactory psychometric properties. Convergent validity with the HEXACO dimensions was established. Furthermore, only the factors feelings trigger action and lack of follow-through, not pervasive influence of feelings, predicted risky behaviors. Findings provide a clear support to the 3-factor model of impulsivity and demonstrate its usefulness for a better comprehension of risky behaviors.

Purpose of Review: We review recent empirical investigations about two core processes subtending impairments in interpersonal functioning and, more precisely, cooperative behaviors in personality disorders: Trust toward others and rejection sensitivity. The main contributions are about borderline and narcissistic personality disorders but we report a little evidence about other personality disorders too (i.e., avoidant, antisocial, and paranoid personality disorders)., Recent Findings: Regarding borderline personality disorder, a misinterpretation of situations as threatening seems to be relevant for both trust and rejection sensitivity. With specific regard to narcissistic personality disorder, results suggest rejection sensitivity and distrust to be plausible risk factors for aggressive outbursts. Empirical findings display specific patterns of disturbances in rejection sensitivity and trust dynamics across different personality disorders. Nonetheless, further studies on personality disorders other than borderline or narcissistic personality disorder are needed. A deeper understanding may provide insight for better clinical management of such impairments among patients with personality disorders.

We argue that clinical information related to an object-relations model of personality pathology can be used by untrained and clinically inexperienced students to rate personality-disordered patients on the Level of Personality Functioning Scale (LPFS). To do so, 73 clinically inexperienced undergraduate students were asked to assess personality functioning of 10 female inpatients using the LPFS from audio recordings of the Structured Interview of Personality Organization (STIPO). LPFS ratings showed acceptable interrater reliability. Moreover, LPFS ratings were significantly associated with external measures of severity of personality pathology (number of DSM-IV-TR personality disorders) as assessed by experienced clinicians. Finally, the students' ratings were also associated with the level of personality organization as measured by experienced clinicians using the STIPO. Our findings confirm that untrained raters can reliably assess personality pathology by rating the LPFS based on material from the STIPO. Implications related to the use of the STIPO as a tool for the assessment of personality pathology according to the DSM-5 Alternative model are discussed.

Introduction: Emerging personality organization may play an important role in the psychological adjustment of early adolescents, but research in this area is still limited. The current study evaluated if personality organization moderates the association between rejection sensitivity and adverse psychological outcomes in early adolescence., Methods: Three-hundred eighty-six early adolescents (age range 13-15 years; 51% Female) attending junior high schools in Italy completed the semi-structured Interview of Personality Organization Processes in Adolescence (IPOP-A), the Children's Rejection Sensitivity Questionnaire (CRSQ), and the Youth Self Report/11-18 (YSR)., Results: Disruption in the emerging personality organization was associated with increasing symptom problems in early adolescence. Conversely, the successful development of personality organization buffered the relation between rejection sensitivity and negative psychological outcomes (i.e., conduct and affective problems)., Conclusion: These findings encourage to accurately evaluate personality organization in adolescence, in order to take into account difficulties but also strengths in personality organization when treating early adolescents., (Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

This article demonstrates the utility of a theory-guided psychodynamic approach to the assessment of personality and personality pathology based on the object relations model developed by Kernberg (1984). We describe a clinical interview, the Structural Interview (SI; Kernberg, 1984), and also a semistructured approach, the Structured Interview of Personality Organization (STIPO; Clarkin, Caligor, Stern, & Kernberg, 2004) based on this theoretical model. Both interviews focus on the assessment of consolidated identity versus identity disturbance, the use of adaptive versus lower level defensive operations, and intact versus loss of reality testing. In the context of a more clinically oriented assessment, the SI makes use of tactful confrontation of discrepancies and contradictions in the patient's narrative, and also takes into account transference and countertransference phenomena, whereas the more structured approach of the STIPO incorporates clinical judgment informed by clinical theory into a well-guided interaction with the patient. Both interviews have good interrater reliability and are coherent with the alternative model for personality disorder diagnosis proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Section III. Finally, they provide the clinician with specific implications for prognosis and treatment planning and can rationally guide clinical decision making.

We argue that the series of traits characterizing Borderline Personality Disorder samples do not weigh equally. In this regard, we believe that network approaches employed recently in Personality and Psychopathology research to provide information about the differential relationships among symptoms would be useful to test our claim. To our knowledge, this approach has never been applied to personality disorders. We applied network analysis to the nine Borderline Personality Disorder traits to explore their relationships in two samples drawn from university students and clinical populations (N = 1317 and N = 96, respectively). We used the Fused Graphical Lasso, a technique that allows estimating networks from different populations separately while considering their similarities and differences. Moreover, we examined centrality indices to determine the relative importance of each symptom in each network. The general structure of the two networks was very similar in the two samples, although some differences were detected. Results indicate the centrality of mainly affective instability, identity, and effort to avoid abandonment aspects in Borderline Personality Disorder. Results are consistent with the new DSM Alternative Model for Personality Disorders. We discuss them in terms of implications for therapy.

Dysfunctions in social cognition characterize personality disorders. However, mixed results emerged from literature on emotion processing. Borderline Personality Disorder (BPD) traits are either associated with enhanced emotion recognition, impairments, or equal functioning compared to controls. These apparent contradictions might result from the complexity of emotion recognition tasks used and from individual differences in impulsivity and effortful control. We conducted a study in a sample of undergraduate students (n=80), assessing BPD traits, using an emotion recognition task that requires the processing of only visual information or both visual and acoustic information. We also measured individual differences in impulsivity and effortful control. Results demonstrated the moderating role of some components of impulsivity and effortful control on the capability of BPD traits in predicting anger and happiness recognition. We organized the discussion around the interaction between different components of regulatory functioning and task complexity for a better understanding of emotion recognition in BPD samples., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

This contribution aims to establish a set of validated vocal Italian pseudowords that convey three emotional tones (angry, happy, and neutral) for prosodic emotional processing research. We elaborated the materials by following a series of specific steps. First, we tested the valence of a set of written pseudowords generated by specific software. Two Italian actors (male and female) then recorded the resulting subset of linguistically legal and neutral pseudowords in three emotional tones. Finally, on the basis of the results of independent ratings of emotional intensity, we selected a set of 30 audio stimuli expressed in each of the three different emotions. Acoustic analyses indicated that the prosodic indexes of fundamental frequency, vocal intensity, and speech rate anchored individual perceptions of the emotions expressed. Finally, the acoustic profile of the set of emotional stimuli confirmed previous findings. The happy tone stimuli showed high f0 values, high intensity, high pitch variability, and a faster speech rate. The angry tone stimuli were also characterized by high f0 and intensity, but by relatively smaller pitch variability and a lower speech rate. This last profile echoes the description of "cold anger." This new set of prosodic emotion stimuli will constitute a useful resource for future research that requires emotional prosody materials. It could be used both for Italian and for cross-language studies.

Increasing evidence suggests that individuals with borderline personality disorder (BPD) might feel rejected even when socially included by others. A psychological mechanism accounting for this response bias could be that objective social inclusion violates BPD patients' underlying implicit needs of "extreme" inclusion. Thus, this study investigated whether, during interpersonal exchanges, BPD patients report more rejection-related negative emotions and less feelings of social connection than controls unless they are faced with conditions of extreme social inclusion. Sixty-one BPD patients and 61 healthy controls completed a modified Cyberball paradigm. They were randomly assigned to a condition of ostracism, social inclusion, or overinclusion (a proxy for extreme social inclusion). They then rated their emotional states and feelings of social connection immediately and 20 min after the game. BPD patients reported greater levels of negative emotions than controls in the ostracism and the inclusion conditions, but not when overincluded. Furthermore, only for BPD participants was overinclusion associated with experiencing less negative emotions than the ostracism condition. However, BPD patients reported lower feelings of social connection than controls in any experimental situation. Thus, in BPD, a laboratory condition of "overinclusion" is associated with a reduction of negative emotions to levels comparable to those of control participants, but not with similar degrees of social connection. These results suggest that for BPD patients, even "including contexts" activate feelings of rejection. Their implicit expectations of idealized interpersonal inclusion may nullify the opportunity of experiencing "real" social connection and explain their distorted subjective experiences of rejection., ((c) 2015 APA, all rights reserved).)

This work aims to further validate the object-relations-based model of personality pathology assessment, evaluating the psychometric properties of the Italian version of the Inventory of Personality Organization (IPO), a self-report instrument for the assessment of personality organization according to O. Kernberg's model of personality pathology. Six hundred ninety-six nonclinical volunteers and 121 psychiatric patients completed a set of questionnaires including the IPO, the Severity Indices of Personality Problems, the Borderline Personality Disorder Checklist, the Response Evaluation Measure 71, and the Symptom Checklist 90-Revised. Confirmatory factor-analyses on the IPO items supported the 1-, 2-, 3-, and 4-factor solutions. The last (Instability of sense of self/others, Instability of goals, Instability of behaviors, Psychosis) resulted in relatively better fit indexes. Invariance across samples (nonclinical, clinical) and gender was confirmed. The 4 IPO subscales showed good levels of internal coherence and, in the nonclinical sample, good test-retest reliability. Associations with the convergent measures were in line with theoretical expectations and supported the benefit of adopting a 4-factor solution. The 4 factors showed the expected criterion relations: All the dimensions discriminated between clinical and nonclinical subjects, whereas only Instability of self/others and Instability of goals discriminated patients with borderline personality disorder from patients with other diagnoses. Our results suggest that the Italian version of the IPO is a reliable and valid tool for the assessment of personality organization according to Kernberg's model. Results are discussed in the context of the current directions in the evaluation of personality disorders proposed by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition., ((c) 2015 APA, all rights reserved).)

Objectives: The aim of the present study is to explore the association between defensive functioning (as assessed through the REM-71) and psychiatric symptoms in a large sample from the community, and the moderating role of age and gender on that association. Furthermore, we explored the concurrent validity of REM-71 as compared with "caseness" (SCL-90-R)., Methods: The REM-71 was administered together with SCL-90-R to a community sample of 1,060 Italian high-school and university students (mean age=19.01±3.85 years; 66.7% females)., Results: Factor 1 defenses were by far the primary contributors to the predictor synthetic variable (i.e. association between defenses and psychopathology). Gender proved to moderate the association between immature defenses and symptoms. Using ROC analysis, we derived a cut-off score for Factor 1 defenses., Conclusions: Our results support the adoption of the REM-71 as a useful instrument for the assessment of defensive array and psychopathological liability in adolescents and adults., (Copyright © 2014 Elsevier Inc. All rights reserved.)