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The prevalence of comorbidity among different disorders, known as Dual Diagnosis (DD), is common in clinical practice. Particularly, preliminary studies indicate high co-occurrence rates of personality disorders (PDs) and substance use disorders (SUDs). Previous research has shown the relevance of investigating different pathological organizations in personality profiles among individuals with DD compared to those with single psychiatric diagnoses. Despite its clinical relevance, very little research has been conducted on the topic. To this end, we evaluated the personality structure of 147 individuals (Mean age = 35.8 ± 10.9), categorized into three distinct samples: 60 participants from the community, 45 outpatients with SUDs, and 42 inpatients with DD of SUDs and co-occurring PD. Participants were interviewed through the Structured Interview of Personality Organization-Revised (STIPO-R), assessing Kernberg's dimensional model of personality. Analysis of variance revealed that SUD and DD patients shared poorly integrated identity and object relations, rigid and primitive defenses, poorly integrated moral values, and higher self-directed aggression levels compared to individuals from the community sample. Moreover, DD patients were characterized by an impaired sense of self, overall maladaptive defenses, higher levels of other-directed aggression, and narcissism. Findings suggest that the SUD and the DD patients exhibit similar patterns limited to some aspects of personality organization. However, results highlight the specific role of some dimensions in shaping DD pathological personality organization, with consequent implications for diagnosis and treatment.

Traits of pathological narcissism are linked with dysfunctional interpersonal processes and an array of negative emotions. Given their relevance in clinical settings, this study explores interpersonal and emotional processes linked to narcissism during psychotherapy sessions, using an experience sampling design. Patients enrolled in individual psychotherapy are assessed on a number of trait variables, including grandiose and vulnerable narcissistic traits, prior to entering a 17-week experience sampling (ES) procedure. The ES procedure collects patient’s emotions and patient-reported dominance and hostility (both relative to self and therapist’s behavior) as they occur during treatment, session by session, with a brief survey administered after each psychotherapy session using a smartphone app and following an event-contingent design. Preliminary data are available from 25 patients (19 female), rating an average of 3.72 sessions each and providing a total of 93 observations. Random-intercept multilevel models indicate that grandiose narcissism predicts describing one’s behavior during the sessions as both dominant and warm, while vulnerable narcissism predicts describing one’s behavior as hostile. Perceptions of therapist’s behavior are not predicted by narcissism. Grandiose narcissism also predicts experiencing more pride in the interaction with the clinician. Current data suggest that no additional in-session emotion is predicted by narcissistic traits. Though very preliminary in nature, these findings start shedding new light on the emotional and interpersonal dynamics associated with traits of pathological narcissism in clinical settings.

Pathological narcissism implies a fragile self-view. The psychological effects of ego-relevant events in people high in pathological narcissism, however, are still uncertain. The study examined the effects of pathological narcissism on psychological reactions to ego-relevant events occurring in private or public settings. Participants (N = 410) completed measures of pathological narcissistic traits, and then they took part in a scenario-based experimental session. They were randomly assigned to four conditions: ego-threatening vs. ego-fostering events in public vs. private settings. Self-esteem and affective states before and after the experimental manipulation were measured. Results showed that vulnerable and grandiose manifestations of pathological narcissism affect differently psychological reactions to ego-relevant events. Vulnerable narcissism made people particularly sensitive to ego-threatening and ego-fostering events, especially when occurring in public settings. Grandiose narcissism was linked to a reduction in emotional responses to ego-relevant events. Findings suggest that self- and affective reactions to ego-relevant events depend on narcissistic prevailing manifestations, and that public exposure has a key role in vulnerable narcissism.

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.

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.

Background: the onset of the COVID-19 pandemic brought disruptive changes in everyone's everyday life, among which pervasive anxiety about the risk of infection, the fear of worsening physical symptoms, and the experience of isolation and loneliness due to lockdowns and other strict governments' rules. These kinds of repercussions of pandemic situations impact individuals' psychological wellbeing resulting in heightened perceived stress, anxiety, and depression. "Italia Ti Ascolto" (ITA) has been developed as an internet-based intervention to offer an online solution for psychological support needs. Methods: ITA is an app available on iOS and Android systems. Users complete a baseline assessment on emotion regulation strategies (cognitive reappraisal and expressive suppression), psychological stress, anxiety, depression, and perceived social support. Participants select between several one-hour long clinical groups held by expert psychotherapists. After every session, people are asked to complete a quick users' satisfaction survey. Discussion: 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 and depressive, anxious symptoms, and level of stress. Moreover, the role of perceived psychological support is considered. Future developments and implications for clinical practice and treatment are discussed.

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.

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.

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.

Il presente contributo propone un modello euristico per lo studio della fiducia interpersonale. Sulla base di precedenti concettualizzazioni sul tema della fiducia consideriamo la fiducia interpersonale un processo interattivo, circolare e che prevede più fasi. Di conseguenza, sottolineiamo l'importanza di considerare le espressioni comportamentali di fiducia come l'esito di un processo dinamico in continua evoluzione piuttosto che come una disposizione personale statica. Nella presente tesi, miriamo ad approfondire i processi che sottostanno una minore predisposizione a fidarsi del prossimo da parte dei soggetti con tratti di personalità borderline (il così detto, untrustworthiness bias). Lungo l'intero elaborato di tesi esemplifichiamo un utilizzo del modello proposto per esplorare l'untrustworthiness bias in soggetti con tratti di personalità borderline. Nel primo Capitolo, forniamo una presentazione dettagliata del modello già menzionato in precedenza e una revisione sistematica della letteratura precedente in merito a difficoltà a fidarsi del prossimo in soggetti con Disturbo Borderline di Personalità. Nei capitolo successivi presentiamo cinque studi empirici che approfondiscono alcune fasi specifiche suggerite nel modello. Nei capitoli 2, 3 e 4 esploriamo l'influenza di alcune differenze individuali sull'untrustworthiness bias di soggetti con tratti di personalità borderline. Più di preciso, un questi capitoli ci occupiamo di esplorare rispettivamente la sensibilità all'esclusione sociale, all'ingiustizia e la sospettosità. In questi capitoli dimostriamo empiricamente come diverse disposizioni individuali possono influenzare diversamente la disposizione individuale a fidarsi del prossimo in soggetti con tratti borderline di personalità. Nel Capitolo 5, invece, esploriamo l'effetto che diversi indizi di fiducia (indizi diretti e indiretti) possono avere sull'untrustworthiness bias di soggetti con tratti borderline di personalità. I nostri risultati, The present work proposes a novel heuristic model for studying Interpersonal Trust. Building upon previous conceptualizations of trust, we recommend considering trust as an iterative, circular, and multi-step process. Hence, we stress the importance of considering trust expressions as a dynamic process in continuous evolution rather than a static personality disposition. In the present work, our main aim is to shed light on the processes underlying the lower propensity of individuals with Borderline Personality Disorder features to trust others (i.e., untrustworthiness bias). Throughout the thesis, we exemplify the use of the proposed model for exploring the well-established untrustworthiness bias of individuals with Borderline Personality Disorder (BPD) features. Chapter 1 provides a detailed illustration of the model mentioned above and a systematic review of the previous literature on trust impairments among individuals with BPD. In the following chapters, we present five empirical studies that elucidate the peculiar functioning of individuals with BPD features in some of the stages suggested by the model. In Chapters 2, 3, and 4, we investigate the influence of some individual differences on BPD’s untrustworthiness bias. We respectively focus on the exploration of Rejection Sensitivity, Justice Sensitivity, and Suspiciousness. In these chapters, we empirically prove that different trust-related personal dispositions have a typical influence on the interpersonal trust dispositions of individuals with BPD features. In Chapter 5, we explore the effects of diverse (i.e., direct or indirect) cues on the untrustworthiness bias of individuals with BPD features. Our findings remarkably suggest that the association between BPD features and untrustworthiness bias is not stable rather variable. Finally, in Chapter 6, we focus on the influence of Covid-19 circumstances on the interpersonal trust dispositions of individuals with BPD features. Surprisingly, we found similar i

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.

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.

Il presente lavoro di tesi propone un nuovo approccio allo studio della Rejection Sensitivity (RS) e dei suoi effetti sul funzionamento psicologico sia di adolescenti che di giovani adulti. Sottolinea quindi l’importanza di considerare la RS non solo come una disposizione statica di personalità, ma anche come un processo dinamico che prende forma all’interno dell’individuo, nel tempo e nell’interazione costante con le situazioni che l’individuo incontra nel corso della sua vita quotidiana. Per questo viene introdotta la necessità di studiare la RS integrando due approcci: quello nomotetico e quello idiografico. I primi tre capitoli descrivono ricerche effettuate seguendo un approccio nomotetico. Nel primo capitolo, abbiamo introdotto un metodo alternativo per calcolare i punteggi del Children Rejection Sensitivity Questionnaire. Secondo questo metodo, la componente cognitiva e le due componenti emotive della RS vengono considerate come fattori separati (rispettivamente, Aspettativa del rifiuto, Ansia e Rabbia per il rifiuto). Poi sono state prese in considerazione due caratteristiche individuali che possono giocare un ruolo importante nel modificare gli effetti della RS sul funzionamento psicologico degli individui. Nello specifico, nel Capitolo 2, abbiamo osservato il ruolo dell’Organizzazione di Personalità nel moderare l’associazione tra RS e le conseguenze negative sul funzionamento psicologico di adolescenti. Nel Capitolo 3, abbiamo esaminato se le strategie cognitive di regolazione emotiva potessero mediare gli effetti della RS sui comportamenti prosociali, aggressivi o di isolamento, in un campione di giovani adulti. Gli ultimi tre capitoli, invece, danno importanza e mettono in luce i vantaggi teorici e pratici di studiare la RS utilizzando un approccio idiografico. Nel Capitolo 4, utilizzando un approccio dinamico è stato studiato come un campione di giovani adulti percepisse le situazioni incontrate nel corso della propria vita quotidiana e come vi rea, The present work proposes a new approach for studying Rejection Sensitivity (RS) and its maladaptive effects on the individual's functioning, among adolescents and young adults. We stress the importance of considering RS not only as a static personality disposition but also as a dynamic process that unfolds within-person over time in interaction with the situations encountered. We thus propose to study it integrating both a nomothetic and an idiographic perspective. The first three chapters are situated within a nomothetic approach. In Chapter 1, we introduced an alternative scoring method for the Children Rejection Sensitivity Questionnaire, which considers the cognitive and the emotional components of RS as separate factors (i.e., rejection Expectation, Anxiety and Anger about rejection, respectively). Then the attention shifts toward two individual’s characteristics that may play an important role in strengthening the effects of RS on individuals’ psychological functioning. In Chapter 2, we assessed the role of Personality Organization in moderating the association between RS and negative psychological outcomes in early adolescence. In Chapter 3, we examined whether cognitive emotion regulation strategies mediate the effect of RS on prosociality, aggression, and isolation in a young adult sample. The last three chapters are organized around the theoretical importance and practical benefit of studying RS from a dynamic perspective (i.e., idiographic approach). In Chapter 4, we studied the dynamics of the situational characteristics perceptions and the emotional reactions and of their relationships over time in a young adult sample and how these dynamics could be influenced by RS. In Chapter 5, we focused more specifically on the dynamics of rumination, situational Adversity, and two maladaptive behaviors (i.e., aggression and isolation) over time in a sample of adolescents, again investigating the role of RS in these dynamics. Finally, in Chapter 6, we went a step

Networks have been recently proposed for modeling dynamics in several kinds of psychological phenomena, such as personality and psychopathology. In this work, we introduce techniques that allow disentangling between-subject networks, which encode dynamics that involve stable individual differences, from within-subject networks, which encode dynamics that involve momentary levels of certain individual characteristics. Furthermore, we show how networks can be simultaneously estimated in separate groups of individuals, using a technique called the Fused Graphical Lasso. This technique allows also performing meaningful comparisons among groups. The unique properties of each kind of network are discussed. A tutorial to implement these techniques in the "R" statistical software is presented, together with an example of application

Recent reasoning in psychopathology sees mental disorders as phenomena that emerge, at least in part, from complex patterns of symptom-symptom interactions. Borderline Personality Disorder (BPD) is characterized by instability of self-image, interpersonal relationships, and affects, as well as by marked impulsivity. In this study, we investigated the dynamical interplay of BPD symptoms over time. We employed an Ecological Momentary Assessment (EMA) protocol assessing BPD symptoms five times a day for 31 days in a sample of 156 participants. Participants also completed a comprehensive assessment of personality, including BPD, before the EMA, after the EMA, and one month later. We examined BPD symptoms at two timescales: The short scale of EMA and the long scale offered by the three questionnaires. At the short timescale, we employed a multilevel vector auto-regressive network model, which provided insights into the contemporaneous and cross-lagged relationships among symptoms. At the long timescale, we observed a decrease in all BPD symptoms immediately after EMA and after one month, suggesting beneficial effects of the self-reflection induced by EMA. We discuss how each analysis gave unique insights into the dynamics of BPD.

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.

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.

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.

This study aims at investigating factors associated with early dropout in dual diagnosis patients, considering socio-demographic, diagnostic and personality structure variables. We hypothesized that the personality structure of the patient will show stronger associations with dropout, as compared to descriptive variables. Forty-seven patients consecutively admitted in a dual diagnosis residential treatment unit were administered the Structured Interview of Personality Organization (STIPO), the Structured Clinical Interview for Axis II Disorders (SCID II), the Response Evaluation Measure 71 (REM71), the Symptom Check List 90–R (SCL90-R), and the Borderline Personality Disorder Check List (BPDCL). Significant differences emerged between the dropout and no-dropout group: Investments and self-coherence problems (STIPO) were higher among dropouts; moreover, in the dropout group a significantly higher number of patients showed a borderline personality organization (88.9 %). Results support the use of structural interviews in the assessment of dual diagnosis patients; implications regarding research and clinical practice are discussed.

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

Background: Although dual diagnosis has been a topic of great scientific interest for a long time, few studies have investigated the personality traits that characterize patients suffering from substance use disorders and co-occurring personality disorders through a dimensional approach. The present study aimed to evaluate structural personality profiles among dual-diagnosis inpatients to identify specific personality impairments associated with dual diagnosis. Methods: The present study involved 97 participants divided into three groups: 37 dual-diagnosis inpatients, 30 psychiatric outpatients and 30 nonclinical controls. Dimensions of personality functioning were assessed and differences between groups were tested using Kernberg's dimensional model of personality. Results: Results showed that dual diagnosis was associated with the presence of difficulties in three main dimensions of personality functioning. Dual-diagnosis inpatients reported a poorly integrated identity with difficulties in the capacity to invest, poorly integrated moral values, and high levels of self-direct and other-direct aggression. Conclusions: The present study highlighted that a dimensional approach to the study of dual diagnosis may clarify the personality functioning of patients suffering from this pathological condition. The use of the dimensional approach could help to advance research on dual diagnosis, and it could have important implications on clinical treatment programs for dual-diagnosis inpatients. © 2014 Elsevier Inc. All rights reserved.