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Adolescence is a period of rapid physical, psychological, and neural maturation that makes youth vulnerable to emerging psychopathology, highlighting the need for improved identification of psychopathology risk indicators. Recently, a higher-order latent psychopathology factor (p-factor) was identified that explains latent liability for psychopathology beyond internalizing and externalizing difficulties. However, recent proposals suggest reconceptualizing the p-factor model in terms of impairments in personality encompassing difficulties in both self-regulation (borderline features) and self-esteem (narcissistic features), but this remains untested. To address this, this study examined the p-factor structure and the contribution of borderline and narcissistic features using two cross-sectional data collections. In Study 1, 974 cisgender adolescents (63% assigned females at birth; age range: 13–19; Mage = 16.68, SD = 1.40) reported on internalizing and externalizing problems (YSR) to test via structural equation models (SEM) different theoretical models for adolescent psychopathology. In Study 2, 725 cisgender adolescents (64.5% assigned females at birth; age range: 13–19; Mage = 16.22, SD = 1.32) reported internalizing and externalizing problems (YSR), borderline personality features (BPFSC-11), and narcissistic personality traits (PNI), to explore, via SEM, the contribution of borderline and narcissistic traits to the p-factor and accounting for gender differences. Results confirmed the utility of a bi-factor model in adolescence. Furthermore, findings highlighted the contribution of borderline features and narcissistic vulnerability to general psychopathology. The study provides the first evidence supporting a p-factor model reconceptualized in terms of personality impairments encompassing difficulties in self-regulation and self-esteem in adolescents.

While the objective level of intelligence is not associated with narcissism, relations to self-assessed intelligence (SAI) have been repeatedly reported. Existing research suggests that different facets of narcissism may have different associations with SAI. In the current daily diary study (N = 176; N = 3975 total observations), we employed dynamic structural equation modeling to examine the relationships between facets of trait and state narcissism (i.e., agentic, antagonistic, and neurotic) and the level, variability, and instability of SAI assessed over 28 consecutive days. Both trait and state narcissism were consistently related to SAI: agentic narcissism showed a positive relationship, whereas antagonistic and neurotic narcissism showed negative relationships with SAI. Trait agentic and state antagonistic narcissism predicted greater variability of SAI scores throughout the study, while neither trait nor state narcissism predicted the instability of SAI. Finally, we found that experiencing increased agentic narcissism on one day, predicted perceiving oneself as more intelligent on the next day, but feeling smarter did not predict feeling narcissistic over time. Moreover, we demonstrated that differentiating between narcissism facets yielded more theoretically accurate results compared to distinguishing between grandiose and vulnerable narcissism.

Background: Clinical and subclinical forms of narcissism may increase suicide risk. However, little is known and there are controversies on this topic. This systematic review aims at providing an overview of studies investigating this association. Methods: We used PubMed, Scopus, and PsycInfo databases and followed PRISMA. We focused on cohort, case-control, cross-sectional and case series studies. We referred to both clinical (i.e., narcissistic personality disorder (NPD) and/or NPD criteria) and subclinical forms (i.e., grandiose and vulnerable narcissistic traits) of narcissism. Moreover, we considered: Suicidal Ideation (SI), Non-Suicidal Self-Injury(s) (NSSI), Deliberate Self-Harm (DSH), Suicide Attempt(s) (SA), Suicide Risk (SR), and Capability for Suicide. Results: We included 47 studies. Lack of association between NPD diagnosis/criteria and suicide-related outcomes (SI) or mixed results (SA) were found. Higher homogeneity emerged when considering narcissistic traits. Vulnerable narcissism was associated with SI, less impulsive NSSI, and DSH. Grandiose narcissism was associated with severe NSSI and multiple SA with high intent to die, but it was protective against SI and SR. Vulnerable narcissism seemed to be associated with suicide-related outcomes characterized by low intent to die, while grandiose narcissism seemed to be a risk factor for outcomes with high planning and severity. Limitations: Between-study heterogeneity and lack of longitudinal studies. Conclusions: Assessing suicide risk in subjects with clinical or subclinical forms of narcissism may be useful. Moreover, considering the most vulnerable form of narcissism, and not just the grandiose one, may contribute to a more nuanced risk stratification and to the identification of distinct therapeutic approaches.

Shame may be a transdiagnostic marker of psychopathology and might potentially have a negative impact on treatment outcome. This scoping review maps the empirical literature on shame and psychotherapy, with a focus on individual therapy. Searching the terms shame and psychotherapy in PubMed and PsycInfo, we identified 2,520 unique records. After screening and selection, 46 empirical studies were included in the review and three themes were extracted from them: the impact of psychotherapy on shame, the impact of shame on psychotherapy, and additional shame-related themes. Narrative synthesis suggested that shame decreases after psychotherapy. In a subset of quantitative treatment evaluation studies, a preliminary meta-analysis indicated a medium size decrease in shame. The impact of shame on individual psychotherapy was more nuanced. Additional themes included but were not limited to shame-appropriate versus nonappropriate therapeutic interventions or investigations of therapists’ reactions to patients’ shame. Research gaps and recommendations for future investigations are outlined.

Traits of pathological narcissism are linked with dysfunctional interpersonal processes. This intensive longitudinal study will investigate how pathological narcissism and interpersonal perceptions shape patients’ emotions during psychotherapy, specifically shame. There is no current data available: patients enrolled in individual psychotherapy will be assessed for narcissistic traits prior to entering a 17-week experience sampling assessment, collecting in-treatment emotions and perceptions of dominance (of self and therapist) after each psychotherapy session. We anticipate analyzing preliminary data from at least 50 participants using multilevel modeling. Patients who perceive themselves as less dominant than usual compared to their therapist (i.e., patients experiencing a higher-than-usual dominance dierential) are expected to report higher shame; traits of vulnerable narcissism are expected to amplify this association (cross-level interaction). The study will shed new light on the emotional and interpersonal dynamics associated with traits of pathological narcissism in clinical settings.

The concept of personality organization, proposed by Kernberg and colleagues, has extensively contributed to the understanding and treatment of personality disorders, facilitating a paradigm shift in clinical practice. The Structured Interview for Personality Organization (STIPO-R) is a semi-structured interview designed for the dimensional assessment of personality organization as elaborated by Kernberg. In the present contribution, we tested the applicability and psychometric properties of the revised version of the Structured Interview for Personality Organization (STIPO-R) in the Italian population. In the first study, the STIPO-R was administered to 350 Italian participants, divided into 170 nonclinical participants and 180 clinical individuals. The theoretical dimensionality of the STIPO-R and the internal consistency of each scale were tested through Confirmatory Factor Analysis. Convergent validity was established using both criterion measures of maladaptive personality (Inventory of Personality Organization, IPO; Personality Inventory for DSM-5, PID-5) and general psychopathology (Symptom Checklist 90-R, SCL-90-R; Pathological Narcissism Inventory, PNI). Subsequently, a network analysis was conducted on the STIPO-R domains and subdomains to elucidate the interrelationships among personality organization components and investigate differences in their underlying structure in the community versus clinical sample. In a second study, we tested how STIPO-R performed in evaluating the personality structure in three different samples: 60 participants from the community, 45 outpatients with SUDs, and 42 inpatients with DD of SUDs and co-occurring PD. Analysis of variance (ANOVA) 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 a

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.

Although interindividual differences in narcissism are well studied, little is known about assessing narcissism at the within-person level. To fill this research gap, we investigated whether the narcissism construct is represented in the same way at the between- and within-person levels. We analyzed four established narcissism measures across multiple studies. In each of the studies, participants completed narcissism measures in ecological momentary assessment or daily diary studies. Equivalent construct representation across between- and within-person narcissism (i.e., cross-level measurement invariance) was found. State narcissism measures showed convergent validities for the trait narcissism scales. Moreover, we also found that antagonistic narcissism was most strongly related to within-person variability in narcissism. Our investigation sheds new light on the structure and assessment of narcissism on the within-person level by providing a comprehensive examination of its measurement.

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.

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.

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.

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.

Ghosting is a type of interpersonal rejection involving a unilateral communication interruption without explanation, using technological channels. Vulnerable narcissism and borderline traits can increase sensitivity to interpersonal rejection and reduce tolerance to ambiguity, whereas grandiose narcissism is related to low rejection sensitivity. Yet, the influence of narcissism and borderline on responses to ghosting is unexplored. We examined the influence of pathological personality traits on psychological reactions to direct breakup and ghosting (i.e., ambiguous breakup) in a sample of 604 young adults (mean age = 22.4 ± 2.74). After measuring borderline and narcissistic traits (grandiose and vulnerable), participants were randomly assigned to one of two scenario-based conditions: direct breakup or ghosting events. Negative emotions and state paranoia were assessed after the experimental manipulation. Participants experienced greater negative emotions and state paranoia in the ghosting condition compared to direct breakup. Individuals high in vulnerable narcissism and borderline traits anticipated higher negative emotions and state paranoia. Grandiose narcissism was unrelated to such reactions. Unexpectedly, pathological personality traits did not moderate the effect of breakup ambiguity on individuals' psychological reactions. Findings suggest that the impact of pathological personality traits is reduced in front of such a socially painful stimulus as an ambiguous rejection.

Recent diagnostic developments suggest that paranoia is a transdiagnostic characteristic common to several personality disorders rather than a personality disorder per se. Nonetheless, empirical literature fails to provide comprehensive and univocal findings on whether and how paranoid presentations relate to different personality disorders. In the present scoping review, we map the empirical literature on paranoid presentations in personality disorders, considering the entire spectrum of paranoid manifestations (i.e., the paranoia hierarchy). In selecting original quantitative studies on paranoid presentations in personality-disordered patients, we screened 4,433 records in PsycArticles, PsycInfo and PUBMED. We eventually included 47 eligible studies in the review. Our synthesis indicates consistent empirical evidence of a wide range of paranoid presentations in Paranoid, Schizotypal and Borderline personality disorders. Conversely, little empirical literature exists on paranoid presentations in other personality disorders. Preliminary findings suggest broad-severity paranoid presentations, ranging from milder to severe forms, in Paranoid, Schizotypal and Borderline personality disorders. There is also some evidence of milder forms of paranoia in Avoidant, Antisocial and Narcissistic personality disorders. Conversely, there is poor evidence of paranoid presentations in Schizoid, Histrionic, Dependent or Obsessive-compulsive personality disorders. Research gaps and recommendations for improving empirical research on paranoid presentations in personality disorders are discussed.

Introduction. Adolescence is a sensitive period for developing internalizing and externalizing problems, and extensive research has shown that borderline personality traits may significantly impact both. Conversely, the relationship between narcissistic personality traits and internalizing and externalizing problems in adolescence has been understudied. The present study examines the current contribution of borderline and narcissistic personality traits to the presence and maintenance of internalizing and externalizing problems in adolescence. Methods. We conducted a two-wave study on a sample of adolescents (N baseline = 705; 65% F; Mage = 15.84, SD = 1.31; N follow-up = 186). They were asked to complete self-reported measures of borderline and narcissistic traits at the baseline and internalizing and externalizing problems at the baseline and the follow-up. Regression analyses were performed to examine the associations of borderline and narcissistic personality traits with the presence and maintenance of internalizing and externalizing problems. To account for gender-related patterns of associations and predictions, regression models were conducted separately on males and females. Results. Borderline personality traits were significantly related to both the presence and maintenance of internalizing and externalizing problems in both males and females. Moreover, grandiose narcissistic traits showed to be predictive of externalizing problems after 12 months in males only. Discussion. The study provides evidence of a significant but differential contribution of borderline and narcissistic personality traits to the presence of co-occurring internalizing and externalizing problems in adolescents and their maintenance over time.

Introduction: Both variable- and person-centered approaches identify grandiose and vulnerable themes in pathological narcissism (PN). However, person-centered results rely on cross-sectional data, preventing identification of subtypes of individuals through transitory self-states. Methods: We perform a cluster analysis on the joint trajectory of daily ratings of grandiose narcissism (GN) and vulnerable narcissism (VN), collected during a 28-day experience sampling (N = 196 participants). Results: The best partition—identified by multiple criteria—includes three clusters: a “low PN” cluster displays below-average levels of both daily GN and VN; a “high VN” cluster displays average daily GN and above-average levels of daily VN; a “high GN” cluster shows above-average levels of daily GN and below-average levels of daily VN. Significant inter-cluster differences emerge on both daily and trait measures of narcissism, and on trait measures of self-esteem and shame, but less sharply on impairment in personality structure. There is no inter-cluster difference on the variability and instability of daily narcissism. Discussion: We conclude that the constructs of daily GN and VN define corresponding groups of individuals with either high GN or VN, the latter group being more distressed. Yet, this group is also less “pure” in its narcissistic characterization, showing at least some levels of trait and state GN.

Introduction: Pathological narcissism (PN) entails both grandiose (GN) and vulnerable narcissism (VN). These can be studied both at the variable-level – focusing on the constructs, such as on their covariation – and at the person-level, focusing on subjects and grouping individuals on the basis of their similarities and differences in grandiose and vulnerable manifestations. While there is emerging agreement on the defining features of GN and VN at the variable-level, controversies still exist when looking at the person level. For instance, there is no definitive understanding of the nature of grandiose and vulnerable narcissism as subtypes or rather as fluctuating/coexisting dimensions. Methods: In this work, we perform a cluster analysis on the joint trajectory of daily ratings of grandiose (GN) and vulnerable narcissism (GN), collected during a 28-day experience sampling study (N = 196 participants). Results: We use multiple criteria to find the best partition, which identifies three discrete clusters of individuals: a “low PN” cluster with below-average levels of both grandiose and vulnerable daily manifestations; a “high VN” cluster, displaying average daily GN and above-average levels of daily VN; a “high GN” cluster, with above-average levels of daily GN but below-average levels of daily VN. The three clusters differ on several trait measures of maladaptive narcissism, as well as on measures of trait self-esteem and shame. Non-significant or less sharp inter-group differences emerge regarding impairment in personality organization and stability/variability of daily narcissism. Discussion: We conclude that the constructs of daily GN and VN define corresponding groups of individuals with either high GN or VN, the latter group being more emotionally distressed. Yet, this group also shows at least some levels of trait and state GN. To the best of our knowledge, this is the first study that applies person-centered analyses to longitudinally assessed manifestations

Due to its strategic position and direct relationship with multiple stakeholders, the HoReCa sector can be a crucial node for the promotion of sustainability in the agri-food chain. However, the sector is currently responsible for a high environmental, social, and economic load. A recent response to these impacts is the diffusion of initiatives that assess and promote sustainable practices at the catering business level. The study aims to verify, using a scientific methodology, how current sustainability programs enable the HoReCa sector to achieve the Sustainable Development Goals (SDGs) and the level of implementation of sustainable practices in the Italian context. To this end, seven currently available national and international sustainability programs were selected, analyzed, and compared. A matrix approach was adopted to understand the balance of the programs with respect to the three pillars of sustainability. A more in-depth analysis was conducted on the Italian Ristorazione Sostenibile 360 (RS 360) case study, which was analyzed both in terms of compliance with the SDGs and in terms of the sustainability performance of the 29 restaurants that participated in the pilot phase of the project. Although the programs differ from each other, they comply with the 2030 Agenda goals, with a particular focus on achieving Goal 12. Furthermore, the analysis highlighted how a balance between the social, environmental, and economic spheres is essential to ensure the sustainable growth of the sector and to bring benefits to the community. As for the case study, 76 % of the analyzed restaurants achieve at least 70 % of the maximum level of fulfillment of the SDGs achievable by the HoReCa sector. This is a symptom of the sector's potential to contribute to supply chain sustainability. However, continuous improvement is essential to ensure the resilience of the HoReCa sector in the future.

Objective: Evidence suggests that pathological narcissism impacts psychotherapy process and outcome. This study investigates whether traits of pathological narcissism account for distinctiveness (construal) of patients' interpersonal perceptions in treatment settings. Methods: Patients enrolled in psychological/psychotherapeutic treatment (N = 150) described a segment of a session in a written format and subsequently assessed both self- and clinician's behavior on the dimensions of dominance and hostility (patient-reported ratings), along with their pathological narcissistic traits. Three independent raters also assessed interpersonal behaviors (observer-reported ratings) based on the written session descriptions. Indices of construal were defined by the residuals of self-reported (net of observer-reported) ratings and were regressed onto pathological narcissistic traits. Results: No association emerged between pathological narcissism and construal in patients' perceptions of their clinicians. However, grandiose traits of pathological narcissism were related to distinctively perceiving oneself as more dominant, while vulnerable traits were related to distinctively perceiving oneself as more hostile. The former association (but not the latter) also held after incorporating additional observer ratings to investigate the robustness of the results. Conclusion: Findings are discussed in light of treatment-related self-enhancement and self-concealment processes.

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.

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.

Background: Due to the high pressure they sustain, family members of substance users are thought to experience negative consequences in mental and physical health. This scoping review provided a comprehensive overview on the mental and physical health of adult Affected Family Members (AFMs). Method: We searched in-journal English articles in PubMed, with no date limit, guided by the concepts of stress, strain, and burden, and including several terms related to substance use. Eligibility criteria included focus on adult AFMs, mental and physical health, and clinical forms of substance use. Results: PubMed search identified 3549 articles, with 46 additional papers from other sources. Fifty-six articles were included, quantitative (N = 39), qualitative (N = 15) and both (N = 2). Quantitative findings show that AFMs are subject to increased stress and burden, and impaired mental health. Variable rates of physical problems emerge, with some medical conditions being more common among AFMs of substance users versus controls. Finally, evidence shows increased risk for aggression and reduced quality of life and social adjustment. AFMs report higher stress and strain if they are women, in low socio-economic families, and co-habiting with more severe substance users. Qualitative studies additionally suggest that stigma, self-blame, and social isolation are common. Conclusions: AFMs of substance users represent a population at higher risk for negative health-related outcomes and should be systematically regarded as targets for treatment.

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.

Numerous studies have established the importance of body image self-consciousness in predicting sexual distress and dissatisfaction in women. However, there is a dearth of information analyzing whether the same relation applies to men. Sexual perfectionism is a sexual correlate that has shown diverse links with sexual-related outcomes. The aim of the present study was to determine the degree to which certain sexuality-related factors, such as body image self consciousness and sexual perfectionism, and certain personality traits, namely grandiose and vulnerable narcissistic traits, may be associated with sexual discomfort in men. An online survey including self-report measures of sexual correlates variables and narcissistic personality traits was administered to a sample of 212 men, who provided the data used to investigate these associations. We performed a stepwise regression analysis, including the sexual-specific variables in the first step and vulnerable and grandiose narcissism in the second step. Sexual distress was linked to vulnerable narcissistic features and body image self-consciousness, according to our research. The clinical implications of our findings emphasize the need of evaluating body image concerns and taking personality characteristics into account when addressing sexual difficulties in men.

The authors investigate whether and how borderline and pathological narcissistic traits differ in their associations with trait and state rejection sensitivity, and with affective reactions to experiences of social rejection occurring in daily life. Community adults (N = 189) completed baseline measures of rejection sensitivity, borderline personality, and pathological narcissism, and daily measures of perceived social rejection and affective states for 7 days. Vulnerable narcissism was the main driver of negative anticipated emotions for social rejection. Borderline personality made people prone to experiencing social rejection in daily life. Moreover, borderline personality traits predicted greater self-directed aggressive impulses when experiencing social rejection. Grandiose narcissism showed only a negative association with anticipatory anxiety for rejection. These findings highlight that sensitivity to social rejection is crucial in both borderline personality and pathological narcissism.

Dysfunctional eating attitudes and behaviors are very common among women. Recent findings suggest that these attitudes are linked to traits of pathological narcissism. However, mechanisms underlying this association need to be elucidated. We investigated the relationship between traits of pathological narcissism and dysfunctional eating attitudes and behaviors in women, testing whether perfectionistic tendencies mediate this association. The study involved a community-based sample of women (N = 306) who completed measures of grandiose and vulnerable narcissistic traits, attitudes of perfectionistic discrepancy and perfectionistic self-presentation, and dysfunctional eating attitudes and behaviors. Results show that vulnerable narcissistic traits are linked to dysfunctional eating attitudes and behaviors. Moreover, discrepancy between the actual self and the ideal self partially explains why women high in vulnerable narcissism engage in dysfunctional eating attitudes and behaviors. Grandiose narcissism was not uniquely associated with dysfunctional eating. The study suggests that the narcissistic need for being perfect, but not the narcissistic need for presenting oneself as perfect to others, promotes dysfunctional eating attitudes and behaviors in women.

The PFQ-2 is a brief and widely used questionnaire assessing shame- and maladaptive guilt-proneness. As empirical literature suggests cultural differences in self-conscious emotions, the present study aimed at validating the PFQ-2 in an Italian community sample (N = 367; 258 females; M age = 33.67). In particular, we investigated the factor structure of the PFQ-2, its invariance across genders, and associations of the two scales with clinically relevant constructs. Confirmatory Factor Analysis showed that a modified two-factor model fitted our data and could be replicated fairly well across genders. Both guilt- and shame-proneness scales showed acceptable internal consistency, adequate test-retest reliability, and significant associations with criterion measures (e.g., personality pathology, narcissism, psychopathological symptoms). Specific concerns regarding potentially weak items and implications of our findings were discussed. Overall, results mirror previous studies on shame- and guilt-proneness, and provide a validated Italian version of the PFQ-2 for the assessment of their clinical correlates in community samples.

Borderline Personality Disorder is a severe condition that affects self and interpersonal dimensions and emotional and behavioral regulation. Since the last decades of the 20th century, an impressive amount of research and clinical contributions on BPD came from specific fields such as psychiatry, clinical psychology, psychopharmacology, and, more recently, cognitive neuroscience. All contributions tackled the challenges of finding reliable diagnostic categories, highlighting detailed developmental trajectories, and fostering effective treatment protocols. However, as results come from different areas, it is often challenging to depict a coherent and yet multifaceted framework on this topic. In this study, we conducted a scientometric analysis of the available literature on BPD to provide a systematic and comprehensive overview of research on BPD and emphasize historical changes, intertwining between fields and new areas of investigation. Results clearly show the evolution of research on BPD starting from the initial development of the construct, passing through the studies on treatment efficacy, the results of longitudinal studies, the advances in cognitive neurosciences, and the recent dimensional conceptualization in DSM-5. Moreover, it emphasizes promising areas of investigation, such as the relations of BPD with NSSI, ADHD, and vulnerable features of narcissism.

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. Summary: 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.