Search Results (218)

Background: Comorbid personality disorders (PDs) in patients with anorexia nervosa (AN) are associated with increased psychopathology, higher suicide risk, and poorer treatment response and outcomes. This study aimed to examine associations between gray matter (GM) volume and PDs in female adolescents with AN before and after short-term psychotherapeutic and nutritional therapy. Methods: Eighteen female adolescents with acute AN, mean age 15.9 years, underwent 3T magnetic resonance imaging before and after weight restoration. The average interval between scans was 2.6 months. Structural brain changes were analyzed using voxel-based morphometry. PDs were assessed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID II) and the Assessment of Identity Development Questionnaire. Results: SCID-II total scores showed significant positive associations with GM volume in the mid-cingulate cortex at both time points and in the left superior parietal–occipital lobule at baseline. The histrionic subscale correlated with GM volume in the thalamus bilaterally and the left superior parietal–occipital lobule in both assessments, as well as with the mid-cingulate cortex at follow-up. Borderline and antisocial subscales were associated with GM volume in the thalamus bilaterally at baseline and in the right mid-cingulate cortex at follow-up. Conclusions: PDs in female adolescent patients with AN may be specifically related to GM alterations in the thalamus, cingulate, and parieto-occipital regions, which are present during acute illness and persist after weight restoration therapy. Full article

Prenatal cannabis exposure (PCE) has been associated with altered prefrontal cortex (PFC) activity and connectivity in adulthood, potentially increasing the risk of psychopathology later in life. This risk is thought to involve a complex interplay between the endocannabinoid and dopaminergic systems. We investigated the transcriptional regulation of genes associated with these systems in an animal model of PCE during adolescence, focusing on DNA methylation and specific microRNAs (miRNAs). Our study revealed increased mRNA levels of dopamine D1 and D2 receptors (Drd1 and Drd2) in the PFC, with a notable effect on Drd2 in male offspring. Notably, we observed a consistent reduction in Drd2 DNA methylation levels in PCE male rats. Both Drd1 and Drd2 expressions were regulated by selective miRNAs. Accordingly, we found changes in the excitability of PFC pyramidal neurons in male adolescent PCE offspring, along with alterations in the Netrin-1/DCC guidance cue system. Our findings highlight PCE-induced modifications of the PFC dopaminergic system while maintaining stable gene expression of the endocannabinoid system in male offspring. Changes in this complex interaction during sensitive developmental periods like adolescence might lead to sex-dependent divergent behavioral outcomes induced by PCE. Full article

Background: Exposure to early life stress significantly increases the risk of psychopathology later in life. However, the impact of early life stress on the gut microbiome and its potential role in mental health outcomes remains insufficiently understood. This narrative review examines the current knowledge on how early life stress and its associated consequences may affect the gut microbiome, with a particular focus on conditions such as anxiety, depression, and post-traumatic stress disorder. Method: A comprehensive literature search was conducted in the PubMed and Web of Science databases between January and February 2025, covering studies published between 2015 and 2025. Results: Early life stress can profoundly impact cognitive function and neurodevelopment, with maternal early-life nutrition playing a significant role in modulating the effects of prenatal and postnatal stress. Early life stress influences the gut microbiome, disrupting its composition and function by altering the synthesis of microbial metabolites, neurotransmitters, and the activation of key metabolic pathways. However, the precise role of the gut microbiome in modulating stress responses during childhood and adolescence has not yet been fully elucidated. Conclusions: Several studies have demonstrated an association between early life stress and the gut microbiome. However, causality has not yet been established due to the numerous intrinsic and extrinsic factors influencing the microbiome-gut–brain axis. In the coming years, research on key microbial regulators, such as short-chain fatty acids, amino acids, and psychobiotics, may represent a promising approach for addressing central nervous system alterations linked to early life stress. Thus, further studies will be necessary to evaluate their potential as therapeutic agents. Full article

Background: Earthquake exposure has been linked with high rates of posttraumatic stress symptoms (PTSS) and comorbid conditions. Familial factors play critical roles in modulating these outcomes. This study examined youth trauma and parental influence following the twin earthquakes in Kefalonia, Greece, in 2014; Methods: A cross-sectional study was conducted with 502 adolescents (aged 11–18 years) and 474 parents from three regions categorized by proximity to the earthquake epicenter. Standardized self-report measures were administered. Data were analyzed using descriptive statistics, correlation analyses, and multiple hierarchical regression analyses to identify key predictors of adverse outcomes; Results: Among children, 5.2% exhibited probable PTSD, with girls reporting significantly higher symptom levels than boys. Higher earthquake exposure was associated with elevated PTSS and anxiety. In parents, 44.3% met criteria for probable PTSD, and those in the epicenter group reported significantly higher levels of stress, anxiety, and sleep disturbances. Earthquake exposure was identified as the strongest predictor of adverse outcomes, with parental psychopathology and diminished social support further contributing to increased symptom severity in children; Conclusions: The study demonstrates that both direct earthquake exposure and familial factors—particularly parental mental health and social support—play critical roles in shaping posttraumatic outcomes in youth, underscoring the need for integrated, family-centered mental health interventions in post-disaster settings. Full article

Background: Emotional and behavioral difficulties are prevalent among children and adolescents referred for psychiatric care. This study examined how these challenges vary across age and gender, including regulatory functioning. It also explored whether emotion regulation mediates the relationship between depressive symptoms and internalizing problems and whether this mediating effect is moderated by gender and age. Methods: A cross-sectional study was conducted among 661 children and adolescents (aged 9–17 years) referred to a psychiatric outpatient clinic. Participants completed self-report questionnaires assessing depressive symptoms (MFQ-C), anxiety (SCARED-C), emotion regulation (DERS), and emotional/behavioral problems (SDQ). Statistical analyses included group comparisons and moderated mediation modeling using SPSS 27. Results: Adolescents aged 15–17 years reported significantly higher levels of depressive symptoms, emotion regulation difficulties, and anxiety-related symptoms compared to younger participants. Girls exhibited higher levels of internalizing symptoms and greater emotion regulation difficulties than boys, whereas boys showed more conduct problems. A significant gender × age interaction was found for depressive symptoms. Depressive symptoms indirectly affected internalizing problems through emotion regulation, with the strongest effect among adolescent girls. Conclusions: The findings emphasize the need for developmentally tailored assessment and intervention strategies in youth psychiatric care. Emotion regulation emerged as a central mechanism linking depressive symptoms to internalizing difficulties, particularly in older adolescent girls, supporting the design of targeted interventions to reduce emotional distress. Full article

Objectives: Feeding and eating disorders (FED) represent a major public health issue and are the second leading cause of death among psychiatric conditions in children and adolescents. Psychopathological comorbidities play a significant role in the onset and persistence of FED, yet research on their underlying structure remains limited. This study explores the psychiatric comorbidities associated with FED, focusing on common etiopathogenetic factors and their clinical implications. Methods: Data were retrospectively collected from the Italian Regional Center for FED in the Emilia-Romagna Region between June 2023 and April 2024. Diagnoses were assigned following DSM-5 criteria using the Italian version of the semi-structured K-SADS-PL diagnostic interview. Principal component analysis (PCA) was performed to identify latent psychological dimensions underlying FED psychopathology, retaining five components based on the scree plot. Additionally, an analysis of covariance (ANCOVA) was conducted to examine differences in factor scores across FED subtypes, while adjusting for potential confounders. Results: Seventy-two participants were included (mean age: 14.6 years; mean BMI: 18.3 kg/m²; male-to-female ratio: 1:8). Diagnoses were distributed as follows: 63.9% anorexia nervosa (AN), 13.9% other specified feeding and eating disorder (OSFED), 6.9% avoidant restrictive food intake disorder (ARFID), 4.2% binge eating disorder (BED), 4.2% unspecified feeding and eating disorder (UFED), and 2.7% bulimia nervosa (BN). All participants met the criteria for at least one psychiatric comorbidity. Identified psychopathological clusters include the following: (1) mood disorders (66.5%); (2) anxiety disorders (87.5%); (3) obsessive–compulsive and related disorders (47.2%); (4) neurodevelopmental disorders, i.e., attention-deficit/hyperactivity disorder (ADHD) (30.5%); (5) disruptive and impulse-control disorders (13.9%); and (6) psychotic symptoms (40.3%). No instances of tic or elimination disorders were detected. Conduct disorder was more prevalent among UFED, BED, and BN patients compared to other FED (p = 0.005), and moderate/severe ADHD was associated with higher body mass index (BMI) (p = 0.035). PCA revealed distinct psychological dimensions underlying FED, while ANCOVA indicated significant differences in factor scores across FED subtypes, supporting the presence of shared transdiagnostic mechanisms. Conclusions: This study highlights the complex interplay between FED and psychiatric comorbidities, emphasizing the need for early intervention and personalized treatment approaches. The dimensional structure identified through PCA suggests that common psychopathological factors may drive FED development, and ANCOVA findings support their differential expression across FED types. Future research should further investigate these transdiagnostic mechanisms to optimize clinical care. Full article

Background: Individuals with inflammatory bowel diseases (IBDs) have an increased risk of developing psychiatric co-morbidities, including restrictive eating disorders (REDs), with which they share common pathogenic mechanisms, including gut–brain axis dysregulation. We conducted a case–control study systematically exploring the psychopathological profiles and alexithymia in adolescents with IBDs compared with a clinical group of adolescents diagnosed with REDs in order to test the hypothesis of common psychological characteristics between the two patient populations. Methods: We recruited 76 patients with IBDs and 76 age-matched controls with REDs (64 adolescents with anorexia nervosa and 12 adolescents with avoidant/restrictive food intake disorder). All participants completed a validated psychometric battery assessing psychological symptoms (SCL-90-R), ED features (EDI-3), and alexithymia (TAS-20). Comprehensive socio-demographic and clinical data were extracted from the medical records. Results: A total of 12 patients with IBDs (15.8%) scored higher than the cut-off (>70th percentile) on the EDI-3 scale for Eating Disorder Risk (EDI-EDRC), with a psychological profile comparable to RED patients. Female gender (OR = 0.133, p = 0.020) and longer disease duration (OR = 1.055, p = 0.036) were identified as significant risk factors for the development of EDs. Conclusions: Our findings suggest common psychological traits between patients with REDs and patients with IBDs at risk of developing EDs during adolescence, highlighting the need for early screening for EDs in patients with IBDs who present with specific socio-demographic and disease characteristics. Full article

Adolescent externalizing problems are commonly linked to maternal psychological distress and family functioning, but these associations remain underexplored in the Greek sociocultural context. This study examined how maternal symptoms of depression, anxiety, and stress, along with adolescent-perceived family functioning, predict externalizing behaviors in Greek adolescents. A total of 563 adolescent–mother dyads (63.4% girls; M_age = 15.03 and SD = 0.83) participated. Mothers completed the Child Behavior Checklist (CBCL), the Depression Anxiety Stress Scales (DASS-21), and the Family Assessment Device (FAD–GF), while adolescents completed the Youth Self-Report (YSR) and FAD–GF. Hierarchical regression analysis showed that adolescent-perceived family functioning was the strongest predictor of externalizing behavior (β = 0.24 and p < 0.001), even after accounting for demographic and maternal mental health variables. The final model explained 18% of the variance in adolescent externalizing problems. Mediation analysis confirmed that family functioning partially mediated the relationship between maternal depression and adolescent externalizing problems, with a significant indirect effect (a × b = 0.088, Sobel z = 2.90, and p = 0.004). Gender differences were found for self-reported aggressive behavior (t = −2.40, p = 0.017, and d = 0.20), with girls scoring higher than boys. These findings highlight the indirect impact of maternal depression through family dynamics and underscore the importance of culturally sensitive, family-centered interventions to reduce adolescent externalizing problems. Full article

Background: Anorexia nervosa (AN) remains a severe psychiatric disorder with multifactorial pathogenesis and an uncertain prognosis. It is essential to identify any factors that may contribute to its onset in order to improve the targeting of preventive and therapeutic interventions. The present study explores the characteristics of parents of daughters with AN, comparing those with different ages of onset and ages at intake, in order to identify potential contributing factors from the parental side. Methods: The study recruited 69 adolescents and 56 adults diagnosed with AN, along with 73 healthy controls (HC). The 80 mothers and 69 fathers of the participants were compared to controls in terms of the age of onset and age at intake of their daughters. Self-administered instruments were used to assess personality (TCI), eating behaviors (EDI-2), general psychopathology (BDI), and family functioning (FAD). Results: The analysis revealed that several personality and psychopathological traits distinguished the parents of AN participants from the HC group in both conditions. Both mothers of adolescent- and adult-onset AN participants with any age at intake displayed greater harm avoidance and lower self-directedness facets, as well as greater inadequacy and social insecurity than controls. Fathers were less disordered and more self-indulgent and compassionate, but lower in role definition. Specifically, mothers of daughters with adolescent-onset AN and younger age at intake were more prone to depression. In contrast, mothers of daughters with an adult age at intake showed lower resourcefulness and higher levels of perceived inadequacy. Conclusions: Higher resourcefulness and a lower sense of ineffectiveness may help mothers facilitate earlier therapeutic intervention for their daughters. On the other hand, maternal depressive symptoms may play a significant role in the earlier onset of and intake for AN in their daughters. Supporting assertive qualities in mothers through preventive interventions is recommended, while maternal depression should be appropriately treated to prevent an early psychopathological onset in daughters. Full article

Background/Objectives: Alexithymia, emotion regulation, and impulsivity are key factors in youths with mood disorders. However, gender differences within these dimensions remain insufficiently studied in this population. This study seeks to explore these dimensions in a sample of adolescents and young adults with mood disorders, aiming to identify gender-specific characteristics with important clinical implications. Methods: We assessed 115 outpatients aged 13 to 25 years with a DSM-5 diagnosis of mood disorder. The evaluation included the Toronto Alexithymia Scale (TAS-20), the Difficulties in Emotion Regulation Scale (DERS), and the UPPS-P Impulsive Behavior Scale. The associations with suicidal ideation were tested using two different multivariate models. Results were controlled for age and intelligence measures. Results: The first model (Wilks’ Lambda = 0.720, p < 0.001) revealed significantly higher scores in women than men for TAS-20 (p < 0.001), DERS (p < 0.001), and the UPPS-P subscales “Lack of Premeditation” (p = 0.004) and “Lack of Perseverance” (p = 0.001). Regression analyses confirmed gender as a significant predictor of these variables, also controlling for age and intelligence. Furthermore, intelligence measure influenced Lack of Premeditation and age influenced Lack of Perseverance. Conclusions: Women with mood disorders exhibit greater alexithymia, emotional dysregulation, and impulsivity, particularly in difficulties with planning and task persistence. These findings highlight the need for gender-sensitive interventions that address emotional awareness and impulse control to improve clinical outcomes. Full article

Background: This study explores parental dysregulation when associated with adolescents’ involvement in street fights with peers. Parental dysregulation, characterized by emotional volatility, impulsivity, and inconsistent discipline, significantly affects adolescent development, influencing their social, emotional, and behavioral functioning. Street fights, which involve physical violence among adolescents in public settings, pose risks to both individuals and the community. This research aims to identify risk factors and underlying mechanisms associated with adolescent street fights, providing insights for targeted interventions and prevention strategies. Aim: The study employs social learning theory to explain how adolescents may model aggressive behaviors observed in dysregulated parents and family systems theory to highlight the role of dysfunctional family dynamics in being associated with aggression. A sample of 292 male adolescents and their parents was assessed using self-report measures. Results: Statistical analyses revealed higher levels of emotional dysregulation, depression, and hostility among parents of adolescents frequently involved in street fights. Conclusions: These findings underscore the need for interventions focusing on improving parental emotional regulation, reducing hostile behaviors, and enhancing family communication to mitigate adolescent aggression. Further research should explore diverse populations and longitudinal data to strengthen these conclusions. Full article

Background/Objectives: Interparental conflict, with its multiple dimensions, represents a risk factor for youth mental health, triggering a series of cascading processes. Despite recent evidence highlighting that psychological inflexibility is a risk factor for adolescents’ psychopathology after stressful events, a limited number of studies have investigated its role in family conflicts. This study aims to investigate whether psychological inflexibility mediates the impact of conflict characteristics (intensity, frequency, and resolution) and threat appraisal of interparental conflict on the psychological difficulties of adolescent offspring. Methods: A sample of 195 adolescents aged between 15 and 19 years old completed the Children’s Perception of Interparental Conflict Scale, the Strengths and Difficulties Questionnaire, and the Avoidance and Fusion Questionnaire for Youth on Google Forms. Results: The findings revealed that adolescents living in a family environment characterized by high levels of perceived interparental conflicts exhibit a wide spectrum of psychological difficulties, either emotional or behavioral, partially mediated by their psychological inflexibility. However, when conflict between parents is interpreted as threatening, adolescents’ inflexibility appears to mediate the relationship between conflict and psychological difficulties. Conclusions: While future studies are needed to better understand this association, psychological flexibility might represent a relevant treatment target in adolescents exposed to interparental conflict. Full article

Background: Clinical High Risk for Psychosis (CHR-P) is a psychopathological condition requiring early prevention, particularly in adolescence. Methods: We enrolled 151 patients to assess the potential of the Rorschach Performance Assessment System (R-PAS) in predicting the course of CHR-P and transitions to psychosis. Adolescents with DSM-5 Attenuated Psychotic Symptoms (APS) at baseline were compared with those diagnosed with Early-Onset Psychosis (EOP) and those with other conditions (non-APS). We also examined whether antipsychotics influenced patients’ performance in the R-PAS. Finally, we analyzed correlations between DSM-5 diagnoses at one-year follow-up and baseline R-PAS indexes. Results: APS and EOP patients exhibited similar R-PAS profiles, with APS showing greater impairments in specific Perception and Thinking Problem indexes. Antipsychotic use did not confound results. A distinct R-PAS profile emerged for individuals at risk of psychosis after one year, with the most significant alterations in the Self and Other Representation and the Stress and Distress domains. Conclusions: This study highlights the R-PAS as a valuable tool for early psychosis risk detection and prevention strategies. Targeted, person-centered interventions (i.e., psychotherapy, mindfulness, and relaxation techniques) are recommended to address vulnerabilities. Integrating psychological assessment into early intervention frameworks may enhance outcomes and improve patients and families’ quality of life. Full article

Background/Objectives: The psychological health of deaf children and adolescents with cochlear implants (CIs) appears to be related to the degree of auditory and linguistic recovery achieved, as well as contextual factors. Few studies have investigated the influence that maternal psychological characteristics and resources may have in supporting the mental health of these children and adolescents. The aim of this pilot study was to investigate the psychological well-being of pre-teens/teenagers with CIs and the mental health of their mothers. The secondary aim was to analyze which maternal characteristics (anxiety, depression, resilience, and time spent sharing emotions) were most related to the psychological health of the pre-teen/teenager. Methods: A group of 15 pre-teens/teenagers with CIs and 27 hearing peers and their mothers participated in the study. The Strengths and Difficulties Questionnaire, the Generalized Anxiety Disorder Scale, the Beck Depression Inventory II, the Connor–Davidson Resilience Scale, and an additional ad hoc question quantifying the time that the mothers dedicate to conversing with their sons/daughters about the emotions were administered to the included subjects. Results: No significant differences between the two groups of pre-teens/teenagers emerged; however, a great percentage of pre-teens/teenagers with CIs appeared at higher risk for developing psychopathology. The resilience scores for both groups of mothers were lower than anticipated and related to the psychological health of pre-teens/teenagers. Conclusions: These results underscore the need for targeted psychological support alongside auditory rehabilitation and suggest avenues for enhancing family-centered care in this clinical population. Full article

Objective: This study sought to evaluate the effectiveness of a serious game, that embeds cognitive bias modification for interpretation (CBM-I), in altering the negative interpretive bias of early aged adolescents diagnosed with Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Specific Learning Disorders. The difficulties that adolescents with neurodevelopmental disorders (NDDs) experience navigating the social nuances of everyday environments make them prone to the cognitive biases that lead to the development of negative thought patterns. Directly tackling the biased interpretive processes that give rise to negative thinking may be effective in reducing negative bias and mental health problems. Method: Minds Online, a 10-episode 3-D animated serious game that embeds CBM-I was introduced using a three-phase multiple baseline design in a school setting. Eight adolescents diagnosed with an NDD completed the 10 episodes. Results: Real-time data revealed that seven of the eight adolescents altered their negative interpretive bias to a benign bias. However, pre- and post-test standardized measures revealed non-significant changes in the desired direction for mental health. Visual analyses of 308 daily self-reported ratings about worry about schoolwork, worry about peer relationships, and feelings of loneliness did not demonstrate a replicated intervention effect. However, when these interrupted time series data were analyzed statistically, significant individual improvements were evident. Engagement with Minds Online was excellent, as was adherence to daily data collection. Conclusions: Minds Online seems to be highly effective in altering the negative interpretive biases of adolescents with NDDs, which is promising because such cognitive biases are involved in the onset and maintenance of psychopathology. Full article