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The COVID-19 pandemic has negatively impacted adults’ mental health around the world. Various studies highlighted the role of socio-demographic 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.

INTRODUCTION: Suicide is a major public health issue among adolescents, the fourth leading cause of death among 15-19-year-olds. Ambulatory Assessment (AA), or real-time monitoring, refers to a range of techniques (e.g., ecological momentary assessment (EMA), daily diaries) designed to assess individuals’ thoughts, feelings, and behaviors in their natural environment, intensively and repeatedly over time. It represents a suitable approach for capturing these fluctuations and dynamics. EVIDENCE ACQUISITION: The present narrative review aimed to describe all the published studies evaluating AA and suicide-related outcomes in adolescents and to critically evaluate the reported dynamic processes. A PubMed search was performed up to March 2022 to include studies focused on 1) adolescents; 2) any suicide-related outcome; and 3) AA and dynamic processes. EVIDENCE SYNTHESIS: We included 27 studies based on EMA (multiple assessments per day) (k=17), daily diary (one assessment per day) (k=9), or both (k=1). Among EMA studies, different types of sampling strategies were used: signal-contingent (self-report after a notification) (k=11), event-contingent (self-report after the event) (k=1), and mixed-based (k=4) sampling strategies. Nearly half of the studies measured positive and negative affects, while most studies measured suicidal ideation (SI), self-injurious thoughts and non-suicidal self-injury (NSSI). Nineteen studies yielded a dynamic aim, using a nomothetic (k=5) or an idiographic approach (k=22), respectively, a group-based and an individual-based approach. CONCLUSIONS: The shortness of NSSI episodes (from 1 to 30 minutes) and the high SI fluctuation over time suggest the importance of a real-time assessment of these phenomena. However, an idiographic approach to data analysis should accompany this type of monitoring. This approach captures the dynamics underlying these phenomena. It considers their intimate and individual nature, gaining a basic understanding of the

Objective: Research has shown the importance of delving into the variables associated with externalizing and internalizing behaviors in adolescence, highlighting gender-related differences in their presentations. This two-wave longitudinal study aims to address gaps in understanding the concurrent contribution of borderline and narcissistic personality traits to the presence and maintenance of internalizing and externalizing problems in adolescence. Method: We recruited 705 adolescents (65% females; age range 13-19 years old; Mage = 15.84, SD = 1.31) to self-report on behavioral problems (YSR-112), borderline (BPFSC-11) and narcissistic traits (PNI) at baseline and again on behavioral problems after 12 months. Results: Data highlighted significant differences between males and females for all variables except externalizing problems. Hierarchical regression models showed that borderline traits are a prominent risk factor for all behavioral problems in males and females at baseline and after 12 months. Moreover, regardless of gender, higher grandiose narcissism contributes to lower internalizing problems only when the direct contribution of vulnerable presentations of narcissism is considered. Grandiose narcissism is also a risk factor for externalizing problems after 12 months in females, whereas vulnerable narcissism significantly increases the likelihood of internalizing trajectories improving over 12 months. Conclusions: This study provides more evidence of the associations between maladaptive personality traits and adolescent internalizing and externalizing problems: (1) confirming that borderline traits are crucial beyond gender, (2) stressing the importance of considering both grandiose and vulnerable narcissistic traits, and (3) highlighting the adaptive value of narcissistic vulnerability in capturing the adolescent crisis. The implications for clinical practice and intervention are also discussed.

Suicide is a public health problem having important consequences also for people who survive to the suicide of a loved one – the suicide loss survivors. Since suicide bereavement can have a lasting and significant psychosocial impact on the bereaved individuals, psychosocial treatments are needed (postvention). Many countries have included postvention in their suicide prevention policies. This is a narrative review aiming to investigate the bereavement experience of suicide loss survivors, the associated symptoms, and to describe adequate treatments to properly reduce survivors’ grief and help them to adapt to the loss. Method. Literature review of peer reviewed literature (PubMed, PsycINFO), books about bereavement, suicide, postvention and postvention guidelines. Results. Suicide loss survivors may have an increased risk of developing psychiatric disorders such as post-traumatic stress disorder, depressive disorders, anxiety, and substance abuse; an increased risk of suicide; increased physical complaints; and an increased risk of developing Persistent Complex Bereavement. About postvention, two measures turn out to be very important. An immediate first on-the-spot intervention that includes: specific training for general practitioner and police; to direct survivors to support services; provide proactive and practical support; psychological autopsy. The second intervention is a long-term one and can be delivered in a variety of ways: the most effective therapy for survivors appears to be Complicated Grief Therapy, but in general the therapist must be adequately trained for individual psychotherapy with survivors. Other effective interventions include: writing projects; group psychotherapy; support groups. Conclusion. A public health approach to postvention can allow to tailor interventions to the needs of survivors, and to align postvention with suicide prevention programs.

Objective: Clinical theories suggest that narcissists have a compromised self-concept. However, empirical investigation on attributes of the self that would be impaired in pathological narcissism is limited and inconsistent. The present study aims at detecting distinctive profiles of narcissistic manifestations on facets of the self that have been indicated as relevant in clinical and empirical literature on narcissism. Method: We measured adaptive and pathological narcissistic traits in a community sample of adults (N = 539). Participants also completed measures of self-uniqueness, self-authenticity, self-consistency, and self-other comparisons on agentic and communal domains. Results: Results indicate distinctive profiles of adaptive and pathological narcissistic manifestations on these facets of the self. Among the set of distinctive facets for each narcissistic manifestation, however, some showed to have a more prominent role. Adaptive and pathological narcissism were captured mostly by a greater sense and need for uniqueness that was primarily expressed by public exposure. Sense of superiority over others in the agentic domain, however, showed to have an essential role only in adaptive narcissism. Moreover, self-concept in adaptive grandiose narcissism was qualified by high levels of self-authenticity and a consistent sense of self. Self-concept in vulnerable pathological narcissism revealed greatest impairment, especially in facets of high concern regarding others’ reactions and feeling of a tenuous existence. Conclusions: The study points out that adaptive and pathological manifestations of narcissism can be profiled based on specific facets of self. Theoretical and research implications are discussed.

During the last decades, empirical interest in narcissism has steeply increased, leading to controversial findings. Its investigation has been conducted predominantly with self-report measures, which could distort empirical findings on narcissism and its correlates due to narcissists’ need to maintain a positive and inflated self-view. In the present work, we summarize studies that use alternative research designs for the investigation of narcissism. First, we briefly describe studies examining psychophysiological correlates of narcissistic phenomena, such as hostility, empathic dysfunctions, and stress sensitivity. Then, we review current literature on the investigation of narcissism in a neuroscientific perspective, both in clinical and non clinical samples. Because studies in this field are very recent, we focus on those brain regions whose involvement in narcissistic functioning has received by now the strongest empirical support. In particular, we underline the role of the anterior insula and of the pre-frontal regions, discussing their implications in narcissistic dysfunctions, such as empathy deficits, emotion dysregulation, heightened sensitivity to rejection, and self-enhancing tendencies. Rather than considering brain activity as the cause of narcissism, our aim is to highlight the importance of personality neuroscience for the development of a more complete view over narcissism, due to the ability of brain research to dig into the emotional and cognitive mechanisms underlying personality functioning

Objective: Whilst the relationship between narcissism and emotion regulation is a topic of great interest, little is known about the nature of this association. The aim of the present study is to clarify the relationship of both grandiose and vulnerable narcissism with difficulties in emotion regulation, controlling for the effect of borderline personality traits. Method: Narcissistic traits, borderline personality traits and difficulties in emotion regulation were assessed in 293 non clinical participants (72.7% women, M= 26.99, SD= 9.13) Results: Narcissistic vulnerability was associated with difficulties in accessing emotion regulation strategies, and in understanding, accepting and being clear about emotional states. Borderline personality traits were associated with difficulties in inhibiting impulsive emotional responses and in accomplishing goal directed behaviours during negative emotional states. Narcissistic grandiosity was not associated with any difficulties in emotion regulation. Conclusions: These findings clarified the relationship between narcissism and emotion regulation, highlighting the importance of considering both grandiose and vulnerable manifestations of pathological narcissism. Research and clinical implications are discussed.

Le malattie del trofoblasto di origine gestazionale (GTD) rappresentano una complicanza rara della gravidanza. Esse si dividono in forme benigne (mola idatiforme parziale e completa) e maligne (tumori del trofoblasto, GTN). Nonostante la prognosi favorevole che attualmente accompagna tale diagnosi, la natura stessa di queste malattie costituisce una considerevole fonte di stress per le pazienti che ne sono affette. Metodi. Trentuno pazienti affette da GTD hanno completato una batteria di questionari autosomministrati volti a valutare il ruolo dei meccanismi di difesa nell’influenzare l’adattamento psicologico alla malattia, in particolare la presenza di sintomi ansiosi e depressivi e lo stress legato all’infertilità. Risultati. Le pazienti affette da tumori del trofoblasto riportano un maggiore utilizzo di meccanismi di difesa maturi rispetto alle pazienti con mola idatiforme. Le analisi di regressione evidenziano che, al netto di variabili demografiche e mediche correlate alla patologia, i meccanismi di difesa immaturi mantengono una relazione specifica con l’ansia di stato e con lo stress legato all’infertilità riportato dalle pazienti. Conclusioni. I risultati suggeriscono l’importanza di considerare, nella progettazione di interventi clinici, gli specifici meccanismi di difesa messi in atto dalle pazienti, in quanto significativamente coinvolti nel modulare l’adattamento psicologico alle GTD, Gestational Trophoblastic Disease (GTD) is a group of disorders that derive from the placenta and arise after a rare gestational event. They can be divided into pre-malignant forms (partial and complete hydatidiform mole) and malignant forms called Gestational Trophoblastic Neoplasia (GTN). Despite a favourable prognosis, the nature of this group of disorders can be a source of stress for patients who are affected by this disease. Methods. Thirty-one patients diagnosed with GTD completed a battery of self-administered questionnaires aimed at analysing the psychological adaptation of the patients to the disease. The variables analysed were the following: defense mechanisms, anxiety, depression and infertility-related stress. Results. Patients with GTN use mature defense mechanisms significantly more than patients with hydatidiform mole. Regression analyses highlight that, considering demographic and clinical variables, immature defense mechanisms are significantly related to state anxiety. Immature defence mechanisms also significantly predict infertility-related global stress. Conclusions. The results show the importance of taking into consideration defense mechanisms used by patients, as they are involved in the modulation of psychological adaptation to GTD.