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The COVID-19 pandemic has brought about new stressors on university students, with a negative impact on their mental health and well-being. The purpose of this study was to examine the usefulness of a brief psychodynamically oriented intervention on general functioning by investigating changes in symptoms of depression, anxiety, hopelessness, and burnout. The sample was comprised of 67 university students (22.4% males), with a mean age of 23.27 (standard deviation (SD) = 3.27), who asked for psychological help at a psychological university service. Pre- and posttreatment data showed a significant improvement in general functioning and symptom reduction due to the psychological intervention. The mean change was very high for depression (

This is a preprint of a commentary on the newly published article “One month version of Hikikomori Questionnaire-25 (HQ-25M): Development and initial validation”. This commentary was first submitted in December 2022. The manuscript has been accepted for publication in the Asian Journal of Psychiatry on April 26, 2023 (https://authors.elsevier.com/a/1g-M66gcL7Bzn9). This preprint corresponds to the accepted manuscript because no change was required during the review process. © 2023. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/

A serious form of social withdrawal, initially described within Japan as hikikomori, has received increasing attention from the international scientific community during the last decade. The 25-item Hikikomori Questionnaire (HQ-25) was initially developed and validated in Japan. To date, data on its psychometric properties in other populations where cases of hikikomori have been described are still scarce. Thus, the aims of this study were to (1) translate, adapt, and validate the Italian version of the HQ-25 analyzing its psychometric properties; and (2) verify the association between hikikomori and personality functioning, social support, and problematic Internet use. A sample of 372 Italian adults aged 18 to 50 years completed the HQ-25 and measures of psychoticism, personality dysfunction, social support, and problematic Internet use were employed to test the convergent validity of the HQ-25. The data showed a satisfactory fit for a three-factor model, significantly better than a one-factor model. The three factors (socialization, isolation, and emotional support, as in the original study on the HQ-25) correlated positively with psychoticism, personality dysfunction, and problematic Internet use, and correlated negatively with social support. A lifetime history of hikikomori was present in 1.1% of the sample (n = 4). This is the first study to use the Italian validated version of the HQ-25 with an adult population. The findings from this study provide evidence of the satisfactory psychometric properties of the Italian version of the HQ-25 and support further investigation of the HQ-25 as an instrument to help screen for and investigate the presence of hikikomori.

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Despite findings from previous studies, there is still little consistent knowledge regarding the co-occurrence patterns of somatic, depressive and anxiety symptoms in childhood and adolescence. Moreover, functional disability due to somatic symptoms at different concomitant levels of depression and anxiety is understudied. The present study examined the co-occurrence patterns of somatic symptoms and symptoms of depression and anxiety, in children and adolescents using two-step cluster analysis. Differences in functional disability due to somatic symptoms were tested with ANCOVA controlling for gender and age. The sample comprised 1127 Italian children and adolescents (48.7% males, n = 549) aged 8–16 years (Mage = 11.7, SD = 2.37). Data were collected using the Children Somatization Inventory-24, the Children Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, and the Functional Disability Inventory. A four-cluster solution based on the co-occurrence of internalizing symptoms best fit the data. The four clusters were labelled as follows: cluster 1: “High somatic symptoms and average depression/anxiety”; cluster 2: “High somatic symptoms and high depression/anxiety”; cluster 3: “Average somatic symptoms and above average depression/anxiety”; and cluster 4: “Low somatic symptoms and low depression/anxiety”. Significant differences between the four groups according to gender and age were shown. Participants with high levels of somatic, depressive, and anxiety symptoms reported greater functional disability due to somatic symptoms than the other three groups. Our findings indicate that children and adolescents who demonstrate high symptoms of depression and anxiety also reported higher levels of disability in daily life due to somatic symptoms.

Psychological distress represents a longstanding issue that has been observed in university student populations. The present study aimed to explore the psychological distress in a group of university students seeking for psychological help available in an Italian University Counselling Service. Participants were 597 students (70.5% female, Mage = 24.79, SDage = 5.08) who consulted the Psychological Service at the University and completed the Adult Self-Report (ASR) questionnaire prior to a brief psychodynamic intervention (T1) and 372 of them (70.4% females, Mage = 24.85, SDage = 5.44) were re-evaluated on the same scales three months after the end of the intervention within a follow-up session. Findings demonstrated that students who dropped out at follow-up had slightly higher baseline scores in Thought Problems and Rule-Breaking Behavior. Adopting a Latent Change Score Difference (LDS) approach to model the differences between T1 and T2 scores in ASR scales, results showed an average significant and reliable decrease in all psychopathological syndromes, although the rate of this change was not uniform for all individuals (in the case of somatic complaints, this was partially accounted for by gender). Students reporting higher symptoms in three syndromes at T1 (i.e., somatic complaints, depressive symptoms, withdrawal) showed a steeper decrease of such scores at the follow-up. Findings suggest that a short-term psychological counselling intervention may represent an efficacious way to deal with emerging psychopathological distress within university contexts.

The association among alexithymia, somatic symptoms and clinical correlates has been scantly investigated in children. The present study examined alexithymic features and somatic symptomatology in schoolchildren with high and low levels of depression, testing the role of depressive symptoms in mediating the associations between alexithymia and somatic symptoms. Seven-hundred schoolchildren were involved in this study and divided into two subgroups (8-10 years and 11-14 years) in order to test differences according to the age. Participants completed the Children's Somatization Inventory-24 for the assessment of somatic symptoms, the Alexithymia Questionnaire for Children to evaluate alexithymic features and the Children's Depression Inventory-2 to investigate depressive symptoms. Results showed that children with high levels of depression reported both higher alexithymia and somatic symptoms levels. Despite a direct effect of alexithymia on somatic symptoms, the mediation analyses also highlighted an indirect effect of alexythimia on somatic symptoms through depressive symptoms. Findings suggested that a depressive symptomatology may clarify why schoolchildren with high alexithymia scores tend to report higher levels of health problems. Results also support the possibility that depressive symptoms may contribute to the development of somatic symptomatology among schoolchildren in the presence of high levels of alexithymia.

The present study investigated the concurrent relations between language ability, executive difficulties, and behavior problems in a sample of 142 preschoolers ranging in age between 3 and 6 years of age. Language skills were assessed with a direct task, whereas ratings of executive difficulties and behavior problems were obtained from teachers. Regression analyses indicated that difficulties in flexibility and inhibitory self-control were positively associated with internalizing problems, and difficulties in inhibitory self-control were positively associated with externalizing problems. The associations between emergent metacognition and internalizing problems and between inhibitory self-control and externalizing problems were both moderated by sex, being stronger in boys than in girls. Lastly, language had indirect effects on internalizing problems by decreasing children's difficulties in flexibility, as well as on externalizing problems by decreasing children' difficulties in inhibitory self-control. Overall, these findings support the idea that low language skills may interfere with preschoolers' ability to exploit the executive functions of inner language to self-regulate their own behaviors, especially in boys.

Introduction: A wide proportion of children and adolescents with headache tends not to respond to various pharmacological treatments in use. The failure to respond to symptomatic treatment and prop...

Migraine is one of the most frequent complaints in children and adolescents and it can have a significant impact on quality of life. There are several factors underlying the onset and the maintenance of this disorder and there is still no a clear etiopathogenesis common to all subjects suffering from migraine. Psychological factors such as individual characteristics, psychiatric comorbidities, and temperament are strictly related to psychosomatic disorders and to migraine. Also, the environmental influence is very relevant and studied: socio-economic status, family dysfunctions, attachment style, or psychiatric disease in parents can influence the onset of migraine in children. Finally, many studies are trying to find out any alteration in genetics or in cerebral areas or networks that can explain migraine vulnerability. In this review, we analyze the most recent findings on neurological, psychological, and environmental factors that may potentially cause migraine.

The Japanese term hikikomori is used to describe young people who lives a condition characterized by social withdrawal and isolation for an extended period of time. It is a particularly widespread phenomenon in Japan, in particular among adolescents and adults, and it represented the focus of an increasing attention from mental health professionals in many other countries, including Italy. The aim of this paper review is to explore the concept of hikikomori within Japanese sociocultural context, epidemiological aspects, risk factors clinical characteristics. Moreover, some theoretical models are discussed which allow possible interpretations of this condition which characterizes young people who convey their suffering more and more silently. A detailed review of the phenomenon is given considering the lack of a clear definition of the hikikomori that doesn't allow to plan preventive interventions.

Objectives: On 31 January 2020, a new type of coronavirus was first confirmed in Italy and spread rapidly across the country leading to a national lockdown. The aim of this pilot study was to explore the impact of the public health emergency due to COVID‐19 on individual’s mental health among 299 Italian adults after a month of home isolation due to COVID‐19. Design: Cross‐sectional study design. Adults of the general population were invited to a voluntary online health survey. Methods: Hierarchical multiple regressions were used to examine diverse psycho‐social and stressful contextual factors associated with symptoms of psychopathology. Results: Results indicated that females reported higher symptoms of depression, anxiety and circadian rhythm dysregulation, than males. Age and the capacity to adapt to a new environment and to cope with illness were negatively associated with all symptoms of psychopathology. Conversely, engaging in verbally aggressive behaviours and having experienced stressful events related to COVID‐19 were positively related to psychopathological symptoms. Finally, social support was negatively associated with depressive symptoms, and substance use during the past months was related to circadian rhythm dysregulation. Conclusions: The findings of this study raise particular concern about psychological well‐being considering the negative associations between stressful events during the COVID‐19 pandemic, symptoms of psychological distress, and perceived social support. These results have possible significant clinical implications.

Since the diffusion of recent models of mobile phones, anyone with an internet connection can communicate continuously and search for information. This raises some questions about the possible consequences of problematic mobile phone use (PMPU) in a complex life phase such as adolescence. Therefore, we performed a psychometric analysis of the brief version of the Test of Mobile Phone Dependence (TMD) in Italy. The sample comprised 575 Italian adolescents aged 11 to 18 years. Data were collected using the TMD-brief, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Short Form. Regarding test dimensionality, the best-fit measurement model included four factors: “Abstinence”, “Abuse and interference with other activities”, “Tolerance”, and “Lack of control” (Satorra–Bentler χ2 (48) = 185.96, p &lt, 0.01, robust root mean square error of approximation (RMSEA) = 0.079 (90% confidence interval (CI): 0.067, 0.091), robust TLI = 0.904, robust comparative fit index (CFI) = 0.930). The Italian version of the TMD-brief was found to have good reliability and psychometric properties, and a four-factorial structure. PMPU predicted significant sleep disturbances and this relationship was moderated by clinical personality traits. Findings from this study support the use of the Italian version of the TMD-brief as a screening tool to investigate PMPU in Italian adolescents.

In the last two decades, scientific research has explored the problematic use of internet, videogames and mobile phones. However, there is still little consistent knowledge regarding the co-occurrence of problematic technology use and the role of maladaptive personality characteristics in adolescence. The present study aimed to investigate adolescents' styles of technology use with a cluster analysis approach focusing on personality functioning. The sample comprised 408 Italian adolescents (46.3% males) aged 11 to 18 years (M age = 13.80; SD = 2.08). Data were collected using the Internet Addiction Test, the Videogame Dependency Scale, the Test of Mobile-Phone Dependence Brief Form and the Personality Inventory for DSM5 Brief Form. Results provided a four-cluster solution based on the co-occurrence of problematic technology use. The four clusters were labeled as follows: cluster 1: "Above average internet and mobile-phone use"; cluster 2: "Below average technology use"; cluster 3: "Above average videogame use"; and cluster 4: "Problematic technology use." Analyses on demographic variables (e.g., gender and age) demonstrated significant differences between the four groups. Adolescents with high levels of problematic technology use reported greater overall personality dysfunction than the other three groups. This finding supported our hypothesis on maladaptive personality functioning in adolescents at risk for addiction. Finally, the Antagonism domain played a specific role in differentiating the severity of adolescents' involvement in technology use. Further studies are needed to confirm our findings and to plan preventive interventions as well as therapeutic treatments.

Objectives Consistent with the debate surrounding the association between nonsuicidal self-injury (NSSI), suicidal intent, and suicidal behavior, and between NSSI and dysregulation processes, we attempted to analyze suicide intent and emotion dysregulation in NSSI adolescents, in the framework of the attachment representations and exploring these clues of emotion dysregulation characteristics of insecure attachment. Furthermore, we intended to focus on these attachment-related segregated systems regarding death and suicidal ideations, to explore how differently they would characterize self-injuring adolescents with and without suicide attempts. Methods Thirty-four NSSI inpatient adolescents, 17 with suicide attempts, 17 without suicide attempts, and 17 healthy controls (age 11-17) were assessed using Adult Attachment Projective, which allows for the classification of attachment status and related emotion dysregulation and segregated systems. Results The majority of the NSSI group with and without suicide attempts showed unresolved (disorganized) attachment-related representations and clues of damaged reflective functions, whereas only the NSSI with suicide attempts showed clues of impaired interpersonal relationships. The two clinical groups used words expressing suicidal intent, whereas the healthy group did not. Conclusions Therapists are encouraged not to underestimate suicidal ideation in NSSI regardless of whether or not they have already attempted suicide.

The literature shows that homesickness can have a negative impact on different areas of psychological functioning such as cognitive, emotional, behavioral, physical and social ones. The study, conducted on a sample of first-year university students, aimed to test a model hypothesizing that two distinct dimensions of homesickness, attachment to home and disliking university, could have both direct and indirect effects on their psychological distress and sleep difficulties. Two hundred and seventy-seven first-year students (70.4% Female) living away from home (mean age= 21.3, SD= 2.7) were included in the study and filled out questionnaires assessing homesickness, psychological distress and sleep difficulties. Structural Equation Model (SEM) analysis confirmed that the two homesickness dimensions worked differently since only the one relating to new place adjustment difficulties (i.e. disliking the university) resulted having both direct and indirect effects on students’ sleep difficulties. Although female students reported higher levels of psychological distress compared to males, the multi-group SEM analysis showed that the pattern of multivariate relationships linking the two dimensions of homesickness, psychological distress and sleep difficulties, was invariant across gender. The results of the present study suggest that university counselling and guidance services should quickly screen students experiencing homesickness and offer effective counselling programs focusing on enhancing their capacities to deal with the new academic environment.

Research Findings: The present cross-sectional study investigated the question of whether 6 different temperament dimensions (inhibition to novelty, social orientation, motor activity, positive emotionality, negative emotionality, and attention) influenced cognitive and affective theory of mind (ToM) in 168 children (86 three/four-year-olds and 82 four/five-year-olds). Temperament was measured via a parent-report questionnaire, cognitive ToM via a classical false-belief task, and affective ToM via a comprehensive test tapping 3 levels of emotion comprehension (external, mental, and reflexive). In addition, language competence was assessed with a direct test evaluating both receptive and expressive language. The results showed that after we controlled for language ability, inhibition to novelty predicted higher levels of cognitive ToM in 4/5-year-old children. In addition, higher levels of social orientation predicted better comprehension of the external aspects of emotion in both younger and older...

Objective The purpose of this cross-sectional study was to determine whether migraine or tension-type headaches are associated with abuse of the internet and/or mobile phones and to explore whether headache and the abuse of the two technologies are associated with sleep disturbances and other self-reported somatic symptoms. Background In the last several years, estimates indicate the increasing pervasiveness of the internet and other technologies in the lives of young people, highlighting the impact on well-being. Design A population-based cross-sectional study was conducted between February 2013 and June 2014. Method The initial sample was composed of 1004 Italian students (aged 10–16 years) recruited within public middle schools not randomly selected in central Italy. The final convenience sample consisted of 841 students (Males = 51.1%; Females = 48.9%) who were included in the analysis. Data were collected using self-reported measures. Results Headache was reported by 28.0% of the total sample. A significant relationship was determined with gender (χ2(1) = 7.78, P

Background: Some studies have demonstrated the high impact of headache and migraine in several areas of children and adolescents' life. In recent years, there has been an increase in scientific interest in the relationship between migraine and emotional regulation, investigating the possible consequences of emotional dysregulation on physical and mental health. While some studies have been carried out on the relationship between alexithymia and headache or migraine (especially in adults), no data exist on relationship between Theory of Mind (TOM), metacognition, and alexithymia in children and adolescents with migraine. Methods: Children with diagnosis of migraine without aura (MWoA) (36 males and 34 females) were compared to a healthy control group (31 males and 39 females). The age range was from 8 to 13 years in both groups. All children completed the Alexithymia Questionnaire for Children (AQC) for the assessment of alexithymia levels and the Domain of Social Perception included in the NEPSY-II to evaluate levels of TOM. Metacognitive development was evaluated with Io e La Mia Mente for children aged between 8 and 10 years and with Metacognitions Questionnaire for Children (MCQ-C) for children from 11 to 13. Results: There were no differences between children with MWoA and the control group in metacognitive abilities; only in the subscale “Negative Meta Worrying” of MCQ-C girls scored higher than boys, regardless of the group they were part of. Also, in the NEPSY-II subscale there were no statistically significant differences between the two groups. Children with MWoA scored higher in the AQC subscales “Difficulty Identifying Feelings” and “Difficulty Describing Feelings” than controls. Moreover, children between 8 and 10 years statistically differed from older children in “Difficulty Identifying Feelings” and in Total Score. Conclusion: Our data suggest that children with MWoA have no metacognitive and TOM problems compared to a healthy group. The experimental group showed higher traits of alexithymia, confirming what suggested by other studies in the literature. Future research will have to focus on migraine with aura and tension-type headache to evaluate any differences with children with MWoA.

The Internet is widely used among adolescents for different purposes, including social connections, entertainment and schoolwork. Nevertheless, research has demonstrated the negative impact of problematic internet use (PIU) on psychophysical well-being in adolescence. This study aims to investigate internet use and its association with somatic symptoms, exploring the specific role of sleep disturbances that affect overall sleep quality. A mediation model was used to demonstrate the link between PIU, somatic symptoms and sleep disturbances in a sample of 412 adolescents (52% of males) aged 10–17 (M = 14.12, SD = 1.46). We also investigated whether somatic symptoms were differently experienced and reported by participants at risk of developing internet addiction (n = 58) from those not-at risk (n = 354). Sleep disturbances partially mediated the relationship between PIU and somatic symptoms. Furthermore, PIU seems to lead to poorer sleep quality which may in turn result in physical problems with an increase in somatic symptoms. Findings of this study showed that adolescents at risk of developing internet addiction suffered from a specific somatic symptomatology respect to those not-at risk. Finally, PIU has a positive direct effect on somatic symptoms. These results highlight the role of sleep disturbances with implications for overall sleep quality in the association between PIU and somatic symptoms. When designing intervention programs, the associations between PIU, sleep quality and somatic symptoms in adolescence and the negative repercussions of PIU on psychophysical health should be kept in mind. Results are discussed within the context of recent scientific research.

Traditionally, non-suicidal self-injury (NSSI) has been investigated through the lens of borderline personality disorder. The present study tried to overcome such a limitation, considering new criteria suggested by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Specifically, the aim of the current study was to compare the performance of a clinical sample of adolescent inpatients who engage in self-injurious acts with healthy controls on an emotion recognition task. Results showed that adolescents with NSSI scored worse than healthy controls on the recognition of both positive and negative emotions, as well as on the entire task. Conversely, no differences between the two groups were found when they had to discriminate between neutral facial expressions. Theoretical and clinical implications were discussed.

Factitious Disorder Imposed on Another (FDIA), also known as Munchausen Syndrome by Proxy (MSbP) is a very serious form of child abuse. The perpetrator, usually the mother, invents symptoms or causes real ones in order to make her child appear sick. Usually this is due to a maladaptive disorder or to an excessive of attention-seeking on her part. We report here two new cases of FDIA. The first one is a 9-year-old boy with a history of convulsive episodes, reduced verbal production, mild psychomotor disorder and urological problems who underwent several invasive procedures and hospitalizations before a diagnosis of FDIA was made. The second is a 12 year-old girl with headache, abdominal pain, lipothymic episodes, seizures and a gait impairment, who was hospitalized in several hospitals before an FDIA was diagnosed.

Background: Headache is one of the most common complaints in children and adolescents and comorbidity rates are very high and the major associated diseases are depression, anxiety, atopic disorders, sleep, and behavioral disorders. In recent years, it has been highlighted that difficulties regulating emotions such as alexithymia have also been associated with diagnosis of somatization. Methods: We carried out a mini review analyzing the relation between alexithymia and primary headache (e.g., migraine and tension type headache) in children and adolescents by synthesizing the relevant studies in the literature on PubMed, PsycINFO, and Google Scholar. Search terms were "alexithymia" combined with the "primary headache," "migraine," "tension type headache," "children," and "adolescents." Results: All analyzed studies found higher levels of alexithymia in children and adolescents with headache than control groups but there are different opinions about the relationship between headache and alexithymia. For example, some studies suggest that the association between headache and alexithymia in children may be due to an incomplete development of emotive competency or a general immature cognitive development, instead other studies found a correlation between headache symptoms, insecure attachment, and alexithymia. There seems to be also differences between children with migraine compared to those with tension type headache (TTH). Conclusion: There are some studies on adults suffering from headache or migraine and alexithymia, but there is only a moderate amount of research on pediatric age with different opinions and theories about this relationship. Further studies on children and adolescents are necessary to effectively understand this relationship and to help children to reduce headache and improve emotional consciousness.

Background It is widely recognised that there are associations between headache, psychiatric comorbidity and attachment insecurity in both adults and children. The aims of this study were: 1) to compare perceived attachment security and anxiety in children and adolescents with migraine without aura and a healthy control group; 2) to test whether the child’s perceived security of attachment to the mother and the father mediated the association between migraine and anxiety. Methods One hundred children and adolescents with Migraine without Aura were compared with a control group of 100 children without headache. The Security Scale (measures perceived security of attachments) and the Self-Administered Psychiatric Scales for Children and Adolescents, a measure of anxiety symptoms, were administered to all participants. Results The clinical group had lower attachment security than the control group and higher scores on all anxiety scales. Anxiety was negatively correlated with attachment. Children’s attachment to their mother mediated the increase in global anxiety in the clinical group. Insecure paternal attachment was associated with greater insecurity in maternal attachment, suggesting that there is a complex pathway from migraine to anxiety symptoms mediated by perceived insecurity of paternal attachment and hence also by perceived insecurity of maternal attachment. Conclusion These results suggest that insecure parental attachment may exacerbate anxiety in children and adolescents with migraine and point to the importance of multimodal interventions, perhaps taking account of family relationships, for children and adolescents with migraine.

Background: University students confront psychological difficulties that can negatively influence their academic performance. The present study aimed to assess several areas of adaptive and maladaptive psychological functioning among university students who request counseling services. Method: One hundred eighty-four young female students seeking professional psychological help (Counseling seekers) and 185 young female students who have never asked for psychological help (Non-counseling seekers) were asked to complete the Adult Self-Report (ASR) to evaluate both their internalizing and externalizing problems through DSM-oriented scales as well as their adaptive functioning. Results: ANOVA results indicated worse psychological functioning for the students who sought counseling. They reported lower score in ASR Adaptive Functioning Scales (i.e., friends, jobs, family, education), and higher scores in DSM-oriented scales (i.e., Depressive, Anxiety, Somatic, Avoidant Personality, Attention Deficit/Hyperactivity symptoms) than the students who never asked psychological help. Furthermore, discriminant analysis successfully discriminated between the two groups of students on the basis of the ASR’s adaptive and DSM-oriented scales. Conclusion: The study findings could be useful to guide university counseling services in their screening activities as well as useful for clinical practice.

BackgroundIn recent years, researchers have begun to explore the implications of shyness for the psychosocial wellbeing of children and adolescents, exploring its association with internalizing problems. Research in an Italian context is hindered by the lack of a validated self-report measure of shyness. We report two studies aimed to assess the psychometric properties of an Italian translation of the Children's Shyness Questionnaire (CSQ-it) and investigate its correlations with convergent and divergent constructs. The first study aimed to examine associations between CSQ-it and self-report measures of anxiety and somatic symptoms and attachment with parents and peers. The second study aimed to investigate its relations to internet addiction.MethodsThe self-report measures were completed by 550 participants in the first study and 131 participants in the second study. Parents provided information on their child's problems. Psychometric properties were assessed by Cronbach's alpha in both studies and by exploratory and confirmatory factor analysis in Study 1. The relations between shyness and measures of internalizing problems and attachments were analyzed by correlational methods. In Study 2 a moderated mediation model tested the hypothesis that the relationship between shyness and internet addiction is mediated by somatic symptoms and that shyness moderates the relationship between somatic symptoms and internet addiction.ResultsThe reliability and validity of the Italian Version of the Children's Shyness Questionnaire were satisfactory. Results from confirmatory factor analyses confirmed the single-factor model of the questionnaire previously identified in North American and Chinese studies. There were significant correlations between shyness, anxious and somatic symptomatology, impaired psychosocial functioning and specific components of attachment relationships. In Study 2 the indirect effect of shyness on internet addiction through somatic symptoms was significant as well as significantly moderated for high shyness scores but not for low levels of shyness.ConclusionTo our knowledge this is the first study that explored the psychometric proprieties of the Children's Shyness Questionnaire in the Italian context. Findings demonstrated that this self-reported measure of shyness has sound psychometric properties and can be used as a sensitive and appropriate instrument for the assessment of shyness in children and adolescents.

Background Headache is a common disorder affecting a growing number of children and adolescents. In recent years, there has been an increase in scientific interest in exploring the relationship between migraine and emotional regulation, and in particular, the impact of emotional dysregulation on mental and physical health. The present study aims to explore the relationship between migraine and alexithymia among adolescents and their mothers as well as the impact of this association on mental health. An additional aim is to verify whether alexithymia may be a predictor of psychopathological symptoms in adolescents and mothers with migraines. Methods A total of 212 subjects were involved in this study. The sample was divided into (a) Experimental Group (EG) consisting of 106 subjects (53 adolescents and 53 mothers) with a diagnosis of migraine according to International Classification of Headache Disorders (ICHD-3) and (b) Control Group (CG) including 106 subjects (53 adolescents and 53 mothers) without a diagnosis of migraine. All participants completed the Toronto Alexithymia Scale to assess alexithymia and the Symptom Checklist-90-R to assess psychopathological symptoms. Results Higher rates of alexithymia were found in the adolescents and mothers of the EG in comparison to the adolescents and mothers of the CG. Furthermore, adolescents and mothers experiencing both migraine and alexithymia, demonstrated a higher risk of psychopathology. Conclusions Findings from this study provide evidence that the co-occurrence of migraine and alexithymia increases the risk of psychopathology for both adolescents and their mothers.

This study aims to explore rates of deliberate self-harm (DSH) behaviors and their psychological and psychopathological correlates within a sample of nonclinical young adults (N = 365; 63% women; M age = 23 ± 4.06). Participants completed the Deliberate Self-Harm Inventory and other self-report questionnaires assessing clinical (borderline personality, dissociative, and depersonalization traits) and nonclinical (body perception, behavioral inhibition and activation, cognitive emotional regulation, and the Big Five traits) dimensions of their personality. The rate of DSH in the present sample was 39%, comparable to that found in previous studies of young adults in other countries. Further, consistent with past research, DSH was found to be associated with clinical dimensions of personality pathology, including borderline personality and dissociative symptoms. Finally, results revealed an association between DSH and nonclinical dimensions of personality, including the behavioral activation dimension of fun-seeking, more negative body perception and lower body protection, the use of more nonadaptive cognitive strategies for regulating emotions, higher levels of openness to experience, and lower levels of emotional stability. This pattern of results is consistent with those found for other impulsive behaviors and impulse control disorders. Language: en

The aim of the present study is to investigate different facets of the theory of mind (ToM), i.e. first vs. third-person, first vs. second-order ToM, egocentric vs. allocentric perspective, in a clinical sample of 20 non-suicidal self-injury (NSSI) adolescent inpatients and 20 healthy controls. Methods: We investigated whether performance in ToM tasks was related to both the type and frequency of self-injuring behavior and attitude toward life and death, using a semi-structured interview and different self-report questionnaires. Results: NSSI participants performed less well than the control group in all the ToM dimensions investigated. Furthermore, ToM performance was negatively related to Attraction to Death, in terms of both the type and frequency of self-injuring behavior, and it was positively related to Attraction to Life. Conclusions: These preliminary findings have interesting implications for future clinical investigations, in that they provide previously unavailable information regarding the association between ToM and NSSI behavior.

Chronic daily headache (CDH) in children and adolescents presents features not sufficiently recognized by the current classification system. The aim of our study was to analyze the applicability of adult CDH classification in child and adolescent clinical populations, outlining similarities and differences. In the developmental age, frequent and severe migraine attacks may overlap daily crises of tension-type headache. The clinical onset features are similar to the subsequent (chronic) trend, while in adults, it is more typical that migraine changes over time, taking tension features with almost daily crises. Headache with onset in children or adolescents presents age-related characteristics and the classification system should be better tailored to the peculiarities of this clinical phenomenology. Having a strong diagnostic system is the sine qua non of further investigations in epidemiology, etiopathogenesis, and therapy of CDH.

Overall, previous studies on the prevalence of non-suicidal self-injury (NSSI) behaviors in the general population have stressed the importance of differentiating between occasional and repetitive NSSI, examining different severity levels (e.g., frequency and variety of methods), as well as investigating the diverse psychopathological correlates of NSSI. However, existing NSSI measures have not been explicitly developed by to comply with the NSSI diagnostic criteria proposed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The purpose of this study is to develop a measure of repetitive NSSI by considering its essential features, as described in the proposed DSM-5 as well as in other clinically relevant aspects emerging from case reports. Two independent samples of participants (N1=383 young adults and 251 adolescents; N2=953 adolescents) belonging to the general population were involved in the present study. The questionnaire showed satisfactory fit statistics and reliably discriminated between occasional and repetitive self-injurers (Area Under Curve, AUC=0.755). The pattern of correlations with psychopathological measures confirmed a more clinically-compromised profile for repetitive rather than occasional self-injurers.

The aims of this study were to investigate the rates of deliberate self-harm (DSH) behavior among an Italian adolescent sample, as well as to explore its clinical correlates. On a sample of 234 adolescents in Italian secondary schools (Mean age = 16.47; SD = 1.7) were assessed the DSH as well as externalizing symptoms (including both conduct disorder [CD] and oppositional defiant disorder [ODD] symptoms), borderline personality disorder [BPD] symptoms, dissociative symptoms, and the incidence of life-stressors. Consistent with past research on DSH in youth, 42% of the adolescents in this sample engaged in DSH. Results indicate a positive association between DSH and all psychopathological correlates, including BPD, dissociative, and ODD and CD symptoms. Further, findings revealed an association between DSH and specific life-stressors (i.e., psychological and sexual abuse, natural disasters and serious accidents, the loss of someone important, and the witnessing of family violence or a serious accident).