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Stress adjustment and resilience after multiple natural disaster exposure, specifically two successive earthquakes (i.e. 2009 and 2016 earthquakes) have been investigated in persons with mental disorder and compared to a clinical sample evaluated after the first seismic 2009 event. Seventy-one persons referred to the Mental Health Service of L'Aquila for psychotic, mood and anxiety disorders, were evaluated for 'bounce back resilience' (BRS) and subjective adjustment after the 2016 natural disaster, the earthquake that hit Central Italy. They had already been exposed to a previous natural disaster, the earthquake that hit L'Aquila in 2009 (i.e. '2009/2016 sample'). The 2016 evaluations have been compared to that previously obtained at the 2009 event in an independent clinical sample (i.e. '2009 sample'). A relevant lower number of persons refer a good adjustment after the second natural disaster when compared to the assessment performed on the independent clinical '2009 sample'. After the second natural disaster, the total sample showed no differences in BRS scores compared to the 2009 sample. However, when diagnoses were taken into account, the highest BRS scores were observed in the sample of persons with psychoses and mood disorders in the '2009/2016 sample'. In contrast, those with anxiety disorders showed the lowest one. Among mental health service clients hit twice by a natural disaster in seven years, those with anxiety disorders are 'sensitized' to the trauma, therefore susceptible of more problematic adjustment., Author(s): Paolo Stratta [sup.1] , Valentina Socci [sup.2] , Alessandro Rossi [sup.1] [sup.2] , Giulia Carnaghi [sup.2] , Dalila Talevi [sup.2] , Francesca Pacitti [sup.2] , Rodolfo Rossi [sup.3] Author [...]

Background/objective: Emotional dysregulation is bidirectionally associated with sleep disturbances, with potentially critical implications for emotional reactivity, in patients with borderline personality disorder (BPD). This study evaluated subjective and objective sleep quality, emotional regulation, and emotional reactivity in 20 patients with BPD compared to 20 non-clinical individuals. Methods: Subjective and objective sleep quality was assessed using the Pittsburgh Sleep Quality Index and a 3-day actigraphic measurement. Emotional regulation was evaluated using the Difficulties in Emotion Regulation Scale and the Berkeley Expressivity Questionnaire. Furthermore, each participant underwent an emotional reactivity task selected from the International Affective Picture System. Results: Compared to control subjects, individuals with BPD reported poor subjective sleep quality and objective sleep continuity disturbances, with more sleep fragmentation and decreased sleep efficiency. Moreover, BPD patients showed emotional dysregulation and altered subjective reactivity to emotional stimuli, particularly positively valenced stimuli. Conclusion: These results suggest the importance of further clarifying the specific direction of sleep-dependent emotional modulation in individuals with BPD, with significant clinical implications for patients with co-occurring sleep disturbances. [ABSTRACT FROM AUTHOR]

Background: This study examined psychiatric hospitalisation patterns in San Salvatore Hospital in L' Aquila (Italy), during two major crises: the 2009 earthquake and the COVID-19 pandemic lockdown. The investigation spans two four-year periods, from 2008 to 2011 and from 2019 to 2022, with a focus on the trimester around the earthquake and the first wave/lockdown of the pandemic. Methods: We analysed weekly psychiatric unit admissions of adults diagnosed with schizophrenia spectrum disorder, major depression, bipolar disorder, and alcohol/substance use disorder. Four-year periods around the Earthquake and COVID-19 Lockdown were divided into sixteen trimesters, and Generalised linear models were used to analyse the relationship between weekly hospitalisation frequency and trimesters by diagnosis using a Poisson distribution. Results: A total of 1195 and 1085 patients were admitted to the psychiatric ward in the 2008–2011 and 2019–2022 periods, respectively. Weekly hospitalisations in the earthquake trimester were lower than during the previous one for all diagnoses (schizophrenia spectrum: −41.9%, p = 0.040; major depression: −56.7%, p = 0.046; bipolar disorder: −69.1%, p = 0.011; alcohol/substance use disorder: −92.3%, p = 0.013). This reduction persisted for 21, 18, and 33 months after the earthquake for schizophrenia spectrum, bipolar, and alcohol/substance use disorders, respectively. Contrarily, patterns of weekly admissions around the COVID-19 lockdown remained substantially stable in the short term. However, a consistent long-term hospitalisation increase for all diagnoses characterised the first half of 2022 (the cessation of anti-COVID-19 measures; schizophrenia spectrum: +68.6%, p = 0.014; major depression: +133.3%, p = 0.033; bipolar disorder: +180.0%, p = 0.034; alcohol/substance use disorder: +475.0%, p = 0.001). Conclusions: The present study indicated that exposure to major health crises can have both short- and long-term effects on psychiatric ward admission, holding significant implications for current and future major health emergency management strategies. [ABSTRACT FROM AUTHOR]

Summary: In the context of sleep disturbances, increasing evidence suggests a critical role of sleep‐related dysfunctional metacognitive activity, including metacognitive control of intrusive thoughts in the pre‐sleep period. Although the relationship between sleep‐related thought‐control strategies and poor sleep quality is well recognized, the possible contribution of general metacognitive functioning within this relation is still unclear. In this study, we performed a mediation analysis to examine the role of thought‐control strategies on the relationship between metacognitive abilities and sleep quality in individuals with different self‐reported sleep characteristics. Two‐hundred and forty‐five individuals participated in the study. Participants completed the Pittsburgh Sleep Quality Index, the Thought Control Questionnaire Insomnia‐Revised, and the Metacognition Self‐Assessment Scale to evaluate sleep quality, thought‐control strategies and metacognitive functions, respectively. The results showed that worry strategy in the pre‐sleep period mediates the relationship between metacognitive functions and sleep quality. Particularly, the ability to understand one's mental states and mastery functions could be the two metacognitive domains primarily involved in the dysfunctional metacognitive thought‐control activity responsible for reduced sleep quality. The observed effect suggests that inadequate metacognitive functioning is associated with poor sleep quality in healthy subjects via the mediation of dysfunctional worry strategy. These findings suggest the potential relevance of clinical interventions to enhance specific metacognitive abilities, with the aim to promote more functional strategies for managing cognitive and emotional processes during the pre‐sleep period. [ABSTRACT FROM AUTHOR]

Abstract Background Autism spectrum disorders (ASDs) and schizophrenia spectrum disorders (SSDs), although conceptualized as separate entities, may share some clinical and neurobiological features. ASD symptoms may have a relevant role in determining a more severe clinical presentation of schizophrenic disorder but their relationships with cognitive aspects and functional outcomes of the disease remain to be addressed in large samples of individuals. Aims To investigate the clinical, cognitive, and functional correlates of ASD symptoms in a large sample of people diagnosed with schizophrenia. Methods The severity of ASD symptoms was measured with the PANSS Autism Severity Scale (PAUSS) in 921 individuals recruited for the Italian Network for Research on Psychoses multicenter study. Based on the PAUSS scores, three groups of subjects were compared on a wide array of cognitive and functional measures. Results Subjects with more severe ASD symptoms showed a poorer performance in the processing speed (p = 0.010), attention (p = 0.011), verbal memory (p = 0.035), and social cognition (p = 0.001) domains, and an overall lower global cognitive composite score (p = 0.010). Subjects with more severe ASD symptoms also showed poorer functional capacity (p = 0.004), real-world interpersonal relationships (p

Background: The emotional regulation process plays a pivotal role in daily-life functioning, modulating goal-directed and adaptive behavior. Conversely, altering this cognitive function can disrupt self-regulation and bring emotional dysregulation. Emotional instability could represent a core characteristic of BPD, also modulating the BPD symptom's onset. This systematic review aims to summarize the existing literature reporting the role of emotional instability in BPD to better define the role of the impairment of the emotional processes in the onset of the cognitive and behavioral symptoms of this complex mental disorder. Methods: MEDLINE, Scopus and Web of Science were independently searched for relevant studies. Eligible studies had to be identifiable through database searching, published and accessible. This systematic review was conducted according to PRISMA guidelines. The search period was from 2012 to 14 September 2022. Results: A pool of 120 studies was identified, out of which 11 met the selection criteria and were included. Overall, the studies confirm a relationship between emotional instability and borderline personality disorder. Conclusions: The evidences retrieved seem to point out the role of the emotional impairment not only in worsening of the disorder, but could also be one of the risk factors for its onset. [ABSTRACT FROM AUTHOR]

Introduction: Adjustment disorder (AjD) is a is a maladaptive emotional or behavioural reaction to a stressful event or change in a person's life. Compared to other previously validated tools, the International Adjustment Disorder Questionnaire (IADQ) stands out as one of the most reliable and handy one for AjD. Since no homologous instrument exists now, in this study, we aimed to validate an Italian version of the IADQ. Methods: Twenty‐one thousand two hundred and six subjects (80.4% females) during the initial stages of the SARS‐CoV‐2 pandemic were recruited. We conducted a confirmatory factor analysis (CFA), testing two latent models, a monofactorial and a bifactorial one. Concurrent validity by correlating the total and the two factors' scores with measures of depression, anxiety and post‐traumatic stress was then estimated. We finally estimated the rates of AjD among the population, and a binary logistic regression was conducted to analyse the predictors of such disorder. Results: CFA showed a bifactorial validity, with both excellent incremental and comparative fit indices. The IADQ scores correlated strongly with symptoms of depression, anxiety and stress. In the Italian sample, the prevalence of probable AjD was 8.23%. Female gender, being engaged, widowed and having COVID‐19‐related stressors resulted as significant independent risk factors for AjD. Conclusions: IADQ is an easy‐to‐use, brief and psychometrically sound self‐report measure for AjD. Thus, it may be considered a reliable tool for both research and clinical settings. To the best of our knowledge, our study reported for the first time the prevalence of AjD during COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]