Search Results (121)

Background: Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, cognitive difficulties, and psychological symptoms. Patients often present distinct personality traits and psychopathological patterns associated with symptom severity. Objective: To examine psychopathological profiles in FM patients based on functional, physical–somatic, and emotional impairment domains, as well as on cumulative disease severity. Materials and Methods: A cross-sectional study was conducted with 70 women clinically diagnosed with FM at a specialized Fibromyalgia Unit. Psychological functioning was assessed using the Personality Assessment Inventory, and disease impact was measured with the Fibromyalgia Impact Questionnaire. Hierarchical cluster analyses were used to classify participants into mild and severe clusters across FIQ domains, and psychological profiles were compared. Results: Patients with severe functional impairment had more affective dysregulation (76.43 vs. 70.20, p < 0.01) and somatic complaints (85.57 vs. 79.76, p < 0.05) than those with mild impairment. The severe–physical cluster showed greater mood instability, somatization, and suicidal ideation (60.94 vs. 53.61, p < 0.05). The severe–emotional cluster had higher rates of major depression (85.71% vs. 64.28%) and persistent depressive disorder (76.19% vs. 70.61%, p < 0.05). Severe showed more emotional instability and somatization, distinguishing it from mild. Greater cumulative severity intensified depressive and somatic disorders. Discussion: Findings support FM’s biopsychosocial profile, where emotional distress may relate to psychological and physical symptoms, reinforcing the need for personalized, multidisciplinary care and comprehensive assessment. Full article

Background/Objectives: Despite medical advances, stigma remains a major challenge for people living with HIV (PLWH). This study examined clinical, sociodemographic, and psychological predictors of HIV-related stigma, and explored whether affective temperament moderates the impact of depression on stigma. Methods: This cross-sectional observational study included 97 PLWH attending a tertiary infectious disease unit in Rome, Italy. Participants completed a battery of validated psychometric instruments assessing depressive symptoms, anxiety, manic symptoms, mixed affective states, general psychopathology, impulsivity, and affective temperament. HIV-related stigma was evaluated using the Berger HIV Stigma Scale, which measures personalized stigma, disclosure concerns, negative self-image, and concerns with public attitudes. Descriptive statistics were used to characterize the sample. Univariate linear regressions were conducted to explore associations between clinical, psychometric, and sociodemographic variables and each stigma subdimension, as well as the total stigma score. Variables significant at p < 0.05 were included in five multivariate linear regression models. Moderation analyses were subsequently performed to assess whether affective temperaments moderated the relationship between significant psychopathological predictors and stigma. Bonferroni correction was applied where appropriate. Results: Higher depressive symptom scores are significantly associated with greater internalized stigma (B = 0.902, p = 0.006) and total stigma (B = 2.603, p = 0.008). Furthermore, moderation analyses showed that anxious temperament significantly intensified the relationship between depressive symptoms and both negative self-image (interaction term B = 0.125, p = 0.001) and total stigma (B = 0.336, p = 0.002). Conclusions: Depressive symptoms and anxious temperament are associated with HIV-related stigma. Integrating psychological screening and targeted interventions for mood and temperament vulnerabilities may help reduce stigma burden in PLWH and improve psychosocial outcomes. Full article

Background/Objectives: Muscle dysmorphia (MD), a subtype of body dysmorphic disorder, is prevalent among males who engage in the non-medical use of anabolic–androgenic steroids (AASs) and performance-enhancing drugs (PEDs). These individuals often experience severe psychopathology, including mood instability, compulsivity, and a distorted body image. Despite its clinical severity, no randomized controlled trials (RCTs) have evaluated structured psychological treatments in this subgroup. This study aimed to assess the efficacy of a manualized cognitive behavioral therapy (CBT) protocol in reducing MD symptoms and associated psychological distress among male steroid users. Results: Participants in the CBT group showed significant reductions in MD symptoms from the baseline to post-treatment (MDDI: p < 0.001, d = 1.12), with gains sustained at follow-up. Large effect sizes were also observed in secondary outcomes including depressive symptoms (PHQ-9: d = 0.98), psychological distress (K10: d = 0.93), disordered eating (EDE-Q: d = 0.74), and exercise addiction (EAI: d = 1.07). No significant changes were observed in the control group. Significant group × time interactions were found for all outcomes (all p < 0.01), indicating CBT’s specific efficacy. Discussion: This study provides the first RCT evidence that CBT significantly reduces both core MD symptoms and steroid-related psychopathology in men engaged in AAS/PED misuse. Improvements extended to mood, body image perception, and compulsive exercise behaviors. These findings support CBT’s transdiagnostic applicability in addressing both the cognitive–behavioral and affective dimensions of MD. Materials and Methods: In this parallel-group, open-label RCT, 59 male gym-goers with DSM-5-TR diagnoses of MD and a history of AAS/PED use were randomized to either a 12-week CBT intervention (n = 30) or a waitlist control group (n = 29). CBT sessions were delivered weekly online and targeted distorted muscularity beliefs, compulsive behaviors, and emotional dysregulation. Primary and secondary outcomes—Muscle Dysmorphic Disorder Inventory (MDDI), PHQ-9, K10, EDE-Q, EAI, and BIG—were assessed at the baseline, post-treatment, and 3-month follow-up. A repeated-measures ANOVA and paired t-tests were used to analyze time × group interactions. Conclusions: CBT offers an effective, scalable intervention for individuals with muscle dysmorphia complicated by anabolic steroid use. It promotes broad psychological improvement and may serve as a first-line treatment option in high-risk male fitness populations. Future studies should examine long-term outcomes and investigate implementation in diverse clinical and cultural contexts. Full article

Background/Objectives: With the rapid progression of technology, applications have been proposed as a promising alternative to conventional psychotherapeutic treatment. Nonetheless, research on unguided self-help applications for binge eating remains scarce, with most existing studies utilizing cognitive behavioral therapy (CBT) principles. Therefore, this paper presents the protocol for a randomized controlled trial designed to evaluate the efficacy and acceptability of eMOTE, a standalone application designed specifically for women in Portugal who binge eat. eMOTE, adapted from dialectical behavior therapy (DBT), is unique in that it focuses on teaching emotion regulation skills while also integrating core CBT strategies. Methods: At least 68 females who self-report binge eating episodes will be randomized into an intervention group with access to eMOTE for eight weeks or a delayed waitlist, which will have access to eMOTE after the T1 assessment. Assessments will be conducted at baseline (T0), post-intervention (T1), and at 2-month follow-up (T2). The primary outcomes will include objective and subjective binge eating frequency and binge eating symptomatology, while secondary outcomes will assess global levels of ED psychopathology, shape concern, weight concern, eating concern, dietary restraint, compensatory behaviors, mindfulness, emotion regulation difficulties, intuitive eating, psychological distress, and body mass index. Conclusions: This study will contribute to the limited literature on the use of smartphone technology as an alternative to traditional psychotherapy. Furthermore, this standalone application will offer insights into the use of emotion regulation and food monitoring components designed for adult females experiencing binge eating episodes. Full article

Psychological distress and gut dysbiosis play key roles in IBD. This study investigated whether specific psychopathological and gut microbiota features predict adverse outcomes in UC patients. This retrospective cohort study included 35 UC patients recruited in 2019. Baseline assessments involved clinical interviews, psychiatric evaluations, and stool sampling. In 2024, follow-up interviews and medical record reviews assessed disease progression, including biologic therapy failure, hospitalization, surgery, and diagnosis changes. Disease activity was measured via the Mayo score. Psychological testing included MMPI-2, STAI-Y2, GSES, CD-RISC, and TAS-20. Patients with biological therapy failure showed increased levels of Proteobacteria, Fusobacteria, Enterobacteriaceae, and Trabulsiella, while Firmicutes were less abundant. UC-related hospitalized patients had lower levels of Rikenellaceae, Ruminococcaceae, Faecalibacterium, Lachnospira, Methanobrevibacter, and Phascolarctobacterium compared to non-hospitalized patients. Hospitalized patients scored higher on the Sc clinical scale and the OBS and HEA content scales. Acidaminococcus and Bilophila were more abundant in patients who underwent surgery. PCA revealed differences between patients with and without biological failure. Logistic regression found that Fusobacteria were negatively correlated with the failure of three or more biologics, while Hy and Pd were positively correlated. Pa and Pt were negatively correlated with multifailure. Obsessiveness, health concerns, somatization, and reduced SCFA-producing bacteria may predict UC-related adverse outcomes. 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

Bondage/discipline, Dominance/submission, Sadism/Masochism (BDSM) is a multifaceted spectrum of consensual sexual practices, that has long intrigued the psychological community for its implications on mental health and personality. While previous research has shed light on its psychopathological aspects, less is known about the distinct psychosexual dimensions that characterize individuals who assume dominant or submissive roles within these dynamics. Our research aims to identify differences in personality traits between dominant and submissive individuals and explore the relationship between BDSM roles and mental health outcomes. While previous studies have explored personality traits in BDSM practitioners, research specifically examining the associations between BDSM roles and multiple psychological constructs remains limited. To address this, we employed Bayesian methods with non-informative priors, including ANOVA and linear regression, to evaluate the associations between self-identified BDSM roles and psychological constructs with the specific intent to build informative priors for future research. A sample of 99 BDSM practitioners from online forums participated, providing responses across several psychometric instruments. The study utilized comprehensive psychometric evaluations, including the Big Five Inventory for personality assessment, the Hypersexual Behavior Inventory for hypersexuality, the Brief Sensation Seeking Scale for sensation seeking, the Patient Health Questionnaire for depression, and the General Anxiety Disorder scale for anxiety. Bayesian regression analysis revealed that dominant practitioners exhibit lower hypersexuality and agreeableness, while submissive practitioners show higher levels of agreeableness, depression, hypersexuality, and sensation seeking. These findings highlight distinct psychosexual profiles associated with BDSM roles and provide several implications for mental health professionals working with BDSM practitioners, emphasizing the need to assess and address underlying psychological factors. Future research should further explore these psychosexual dynamics to develop targeted interventions for enhancing psychological well-being and relationship satisfaction within the BDSM community. Full article

Background/Objectives: Recently, interest in studying food addiction (FA) in the context of behavioral addictions (BAs) has increased. However, research remains limited to determine the FA prevalence among various BAs. The current study aimed to investigate FA in a clinical sample of patients seeking treatment for gaming disorder, compulsive buying-shopping disorder (CBSD), compulsive sexual behavior disorder, and the comorbid presence of multiple BAs, as well as to determine the sociodemographic characteristics, personality traits, and general psychopathology of this clinical population. In addition, we analyzed whether FA is linked to a higher mean body mass index (BMI). Methods: The sample included 209 patients (135 men and 74 women) attending a specialized behavioral addiction unit. The assessment included a semi-structured clinical interview for the diagnosis of the abovementioned BAs, in addition to self-reported psychometric assessments for FA (using the Yale Food Addiction Scale 2. 0, YFAS-2), CBSD (using the Pathological Buying Screener, PBS), general psychopathology (using the Symptom Checklist-Revised, SCL-90-R), personality traits (using the Temperament and Character Inventory-Revised, TCI-R), emotional regulation (using Difficulties in Emotion Regulation Strategies, DERS), and impulsivity (using Impulsive Behavior Scale, UPPS-P). The comparison between the groups for the clinical profile was performed using logistic regression (categorical variables) and analysis of covariance (ANCOVA), adjusted based on the patients’ gender. The sociodemographic profile was based on chi-square tests for categorical variables and analysis of variance (ANOVA) for quantitative measures. Results: The prevalence of FA in the total sample was 22.49%. The highest prevalence of FA was observed in CBSD (31.3%), followed by gaming disorder (24.7%), and the comorbid presence of multiple BAs (14.3%). No group differences (FA+/−) were found in relation to sociodemographic variables, but the comorbidity between FA and any BA was associated more with females as well as having greater general psychopathology, greater emotional dysregulation, higher levels of impulsivity, and a higher mean BMI. Conclusions: The comorbidity between FA and BA is high compared to previous studies (22.49%), and it is also associated with greater severity and dysfunctionality. Emotional distress levels were high, which suggests that the group with this comorbidity may be employing FA behaviors to cope with psychological distress. However, a better understanding of the latent mechanisms that contribute to the progression of this multifaceted comorbid clinical disorder is needed. One aspect that future studies could consider is to explore the existence of FA symptoms early and routinely in patients with BAs. 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: Co-occurring conditions and psychiatric comorbidities are more frequently observed in autistic individuals than in typically developing populations. Objective: The present study aimed to investigate the agreement of parent- and self-reported psychopathological assessment using the Child Behavior Checklist (CBCL/6-18) and the Youth Self Report (YSR/11-18), respectively, in autistic adolescents without intellectual impairment. Methods: 54 autistic adolescents without intellectual impairment (11–18 years; M = 14.73; SD = 2.28) were assessed with a psychiatric and psychological evaluation conducted by expert clinicians also using self- and parent-reported scales and semi-structured interviews (K-SADS PL, CDI, MASC) including CBCL/6-18 and YSR/11-18. Results: According to clinical judgment, over 90% of participants had at least a comorbidity: anxiety (68.5%) and mood disorder (57.4%) were the most frequent. The results indicate significant discrepancies between parent- and self-reports across the three summary scales, which assess emotional and behavioral problems, as well as their combined presentation, often observed in youth with ASD. Specifically, differences were found in Internalizing (p < 0.001), Externalizing (p = 0.013), and Total Problems (p < 0.001) scales. Conclusions: The findings show the lack of agreement in parent- and self-reported scales in our sample. These results suggest the need for a cross- and multi-informant approach to support clinical judgment and understand psychopathological comorbidities of autistic adolescents without intellectual impairment. Full article

Background/Objectives: Adolescence is a developmental stage characterized by profound physical and psychological transformations, often leading to vulnerabilities such as body dissatisfaction, identity challenges, and the use of maladaptive coping strategies. This often leads to body-related psychopathologies, including headaches, restrictive eating disorders, and non-suicidal self-injury (NSSI). The present study aimed to describe the typical functioning and features of these conditions and the differences between the three groups, and to identify the most effective assessment for predicting these conditions. Methods: Sixty adolescent patients (51 female; mean age = 15.34 ± 1.80) were divided into three groups: headaches, restrictive eating disorders, and NSSI, and assessed for differences in symptoms, cognitive performance, personality, functioning, and illness severity using semi-structured interviews, clinician-based scales, and performance-based tests like the Rorschach inkblot test, according to the Rorschach Performance Assessment System (R-PAS). Results: Individuals with headaches experienced more internalizing symptoms, had an average IQ, maintained some functioning areas, and had distorted patterns of self–other relationships with the tendency to project malevolent aspects onto others. Patients with restrictive eating disorders had high levels of depressive symptoms, above-average IQ scores, negative symptoms, moderate presence of obsessive–compulsive personality traits, disorganized thinking, and a tendency to interpret situations subjectively. Patients with NSSI showed the highest level of depressive symptoms and social anxiety symptoms, and a considerable presence of psychotic symptoms and perceptual distortions. Negative symptoms, borderline personality traits, and psychosis symptoms had the strongest predictivity. Conclusions: The study provides clinicians with relevant insights into the features of these conditions and highlights assessment strategies, tailored interventions, and enhanced outcomes for these vulnerable populations. Full article

Background/Objectives: Cognitive and psychological factors, such as eating disorder psychopathology, irrational food beliefs, and internalized weight stigma, have not been sufficiently explored in the context of obesity treatment. This study evaluated the role of these variables as predictors of weight loss in patients with severe obesity following a brief intensive cognitive–behavioral therapy for obesity (CBT-OB) program. Methods: A total of 400 patients (mean BMI: 41.9 kg/m²; mean age: 55.9 years) participated in a 21-day residential CBT-OB intervention, followed by a 12-month follow-up assessment. The Eating Disorder Examination Questionnaire, Weight Bias Internalization Scale, and Irrational Food Beliefs Scale were administered at admission and discharge. Body weight was also assessed at the 12-month follow-up. Results: Of the participants, 371 patients (92.2%) completed the intensive CBT-OB program, and 310 (81.1%) attended the follow-up. On average, completers achieved 9% weight loss at follow-up, accompanied by a significant reduction in binge-eating episodes. Cognitive factors, including lower baseline eating concern, higher baseline weight concern, and greater improvement in irrational beliefs (specifically self-deception about eating and weight control), significantly predicted weight loss at 12 months. However, internalized weight stigma did not predict weight loss in this cohort. Conclusions: This study underscores the importance of targeting specific cognitive factors in obesity treatment to enhance long-term outcomes. Addressing irrational food beliefs and promoting flexible dietary restraint may improve weight loss and maintenance in individuals with severe obesity. Further research is warranted to refine cognitive–behavioral interventions for personalized obesity management strategies. Full article

Background/Objectives: Being a healthcare professional often involves exposure to complex situations that can contribute to the development of psychological problems. Evidence suggests that both mental and physical health are crucial for the well-being of these professionals, which in turn influences the quality of care they provide to patients. The main aim of this study was to examine the association between adaptive and maladaptive forms of humor and psychopathological disorders among healthcare workers. Methods: A cross-sectional and descriptive correlational design was employed. The participants consisted of 250 healthcare professionals at a general hospital. Humor styles and the presence of psychological and psychosomatic symptoms were assessed. Data were collected using the Humor Styles Questionnaire (HSQ), the Short Checklist of Symptoms (LSB-50), and sociodemographic information. Spearman correlation analysis and linear regression analysis were conducted. Results: Healthcare professionals were more inclined to use affiliative and self-enhancing humor styles compared to self-defeating and aggressive humor. Affiliative and self-enhancing humor styles were negatively correlated with psychological symptoms, whereas aggressive humor and, to a lesser extent, self-defeating humor styles showed a significantly positive correlation with most psychological symptoms. Regression analysis revealed that positive humor styles negatively predicted all severity indices of the LSB-50. In contrast, negative humor styles, particularly self-defeating humor, positively predicted the severity indices. Being female, working night shifts, and having temporary contracts were positive predictors of most global indices of the LSB-50. Conclusions: This study highlights the importance of considering different types of humor as a potential strategy for improving the mental health of healthcare professionals, as well as the influence of other independent variables related to their personal and work environment. Positive humor styles, specifically affiliative and self-enhancing humor, are associated with a lower prevalence of psychological symptoms among healthcare professionals. Negative humor styles are correlated with a higher prevalence of these symptoms. Full article

The Sense of Agency (SoA) refers to the subjective experience of controlling one’s actions and the external events resulting from those actions. This study aimed to critically evaluate the construct validity, robustness, and clinical utility of the Sense of Agency Scale (SoAS) in an Italian-speaking population, using a data-driven approach to explore potential factor structures. A sample of 992 adults completed the SoAS alongside other validated psychological measures, allowing for a comprehensive analysis of the scale’s psychometric properties. An iterative process of exploratory and confirmatory factor analyses (EFA and CFA) was implemented to assess both two-factor and bifactor models. A refined 10-item version of the SoAS was established, comprising two distinct factors: Sense of Positive Agency (SoPA, five items) and Sense of Negative Agency (SoNA, five items). The results favored a two-factor solution supported by satisfying fit indices, factor loadings, and stability. The revised scale demonstrated strong internal consistency, with McDonald’s omega values of 0.79 (SoNA) and 0.87 (SoPA). This study extends the literature by providing evidence of the scale’s convergent and divergent validity, with significant correlations in the expected directions with constructs such as sense of self, hopelessness, impulsiveness, psychosis-like experiences, and schizotypal traits. These findings support the revised SoAS as a reliable and valid measure for assessing the Sense of Agency and highlight its broader applicability in understanding psychological and psychopathological constructs. Full article

Background/Objectives: In the new conceptualization of personality disorders (PD) in ICD-11 and Diagnostic and Statistical Manual 5 Alternative Model of Personality Disorders (DSM-5 AMPD), identity development in terms of impaired personality functioning plays a central role in diagnostic guidelines and determining PD severity. On the one hand, there is a temporary identity crisis while keeping an integrated sense of identity and, on the other hand, there is pathological identity diffusion, which is associated with a high risk of a current or emerging PD. The latter is characteristic not only of borderline PD but of all personality disorders and should be detected as early as possible to prevent chronic illness and critical life courses. Maternal psychopathology is linked to several areas of child psychopathology (e.g., eating disorders, depression). In the current study, its potential to predict a child’s impaired identity development is investigated. Methods: A total of 101 mothers were asked about their health status 2 weeks after the birth of their child and when their child was 6 weeks, 4 months, 14 months and 5.5 years of age. Specifically, physical and psychological symptoms were assessed with SCL-90-R. In addition, their children were assessed in young adulthood regarding their identity development with the AIDA (Assessment of Identity Development in Adolescence) questionnaire. Linear regression models were used to investigate the amount of explanation of children’s identity diffusion by maternal symptom burden. Results: Maternal psychopathology significantly predicted identity diffusion at all time points with small effect sizes, while after 14 months, the explanation model showed a medium effect size. Conclusions: The present data suggest a relevant influence of maternal psychopathological symptoms on their children’s identity development in terms of functioning that has not yet been empirically shown in a longitudinal study. This finding highlights the importance of including further factors (particularly on the part of the child) in longitudinal studies and of investigating this clinically highly relevant relationship in greater depth. Full article