RIASSUNTO. Recentemente la ricerca ha focalizzato l'attenzione sul narcisismo come tratto di pers... more RIASSUNTO. Recentemente la ricerca ha focalizzato l'attenzione sul narcisismo come tratto di personalità non necessariamente patologico, che può essere presente fin dall'età scolare e può condurre, in taluni casi, a conseguenze negative nello sviluppo del bambino, come problematiche affettive e comportamentali. Dopo aver illustrato le principali ipotesi sulle origini di questi tratti in età evolutiva, questo articolo cerca di delineare il legame fra i tratti narcisistici, il livello di autostima e le problematiche affettive e comportamentali in età evolutiva. Infine, vengono presentati gli strumenti attualmente disponibili per la valutazione di questi tratti in bambini e adolescenti. PAROLE CHIAVE: narcisismo, autostima, disturbo oppositivo provocatorio, aggressività, Childhood Narcissism Scale. SUMMARY. Recently, studies have focused on narcissism as a personality trait, which can be detected during childhood, and can lead to negative outcomes, such as emotional and behavioral problems. After illustrating the main hypotheses on the development of narcissistic traits in children, this paper aims to outline the relation between narcissism, self-esteem and emotional, and behavioral problems in children. Finally, are presented measures for the assessment of narcissistic traits in children and adolescents.
Recently, studies have focused on narcissism as a personality trait, which can be detected during... more Recently, studies have focused on narcissism as a personality trait, which can be detected during childhood, and can lead to negative outcomes, such as emotional and behavioral problems. After illustrating the main hypotheses on the development of narcissistic traits in children, this paper aims to outline the relation between narcissism, self-esteem and emotional, and behavioral problems in children. Finally, are presented measures for the assessment of narcissistic traits in children and adolescents.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights RIPoSt-40 comprises four subscales and a negative emotion dysregulation score It measures affective instability, impulsivity, positive and negative emotionality All scores, but positive emotionality, are higher in cyclothymic and ADHD patients Internal consistency and test-retest reliability are generally good Significant correlations with affective temperaments are shown
This study demonstrates the feasibility and efficacy of using flow cytometric analysis with intra... more This study demonstrates the feasibility and efficacy of using flow cytometric analysis with intracellular cytokine staining for characterization of T-cell phenotype and functional status in extensive alopecia areata (EAA) scalp skin. Cell suspensions were made from scalp punch biopsies taken from 12 patients with long-standing EAA (average disease duration 14 years, 95% hair loss) and six control subjects. EAA samples had a lower percentage of CD-3-expressing cells, but CD-4/CD-8 ratios remained similar to controls. Expression of CD-69 was found only in EAA scalp biopsies, suggesting that T-cells from EAA scalp have undergone activation. No difference was found in tumor necrosis factor a expression. Surprisingly, EAA scalp T-cells produced less IL-2 and CD-8 T-cells produced less IFN-g. Immunohistochemical staining of formalin-fixed paraffin-embedded specimens demonstrated that IFN-g-producing cells in EAA scalp were not greater in number than in normal specimens. The few identified IFN-g-producing cells demonstrated no tendency to localize to the perifollicular region, and were similarly distributed as in control specimens. The abnormalities in cytokine production may explain the relative paucity of inflammatory change observed in the clinical setting and suggest that T-cell responses in EAA scalp are tightly, albeit aberrantly, regulated via mechanisms of peripheral T-cell tolerance.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Research on the association between callous–unemotional (CU) traits and intelligence yielded cont... more Research on the association between callous–unemotional (CU) traits and intelligence yielded contradictory results. Moreover, several previous studies focused on global intelligence scores or verbal vs. nonverbal/performance abilities usually evaluated with short/abbreviated instruments. The current study builds on these previous works and explores the link between CU traits and intelligence using the full version of the Wechsler Intelligence Scale for Children—4th Edition (WISC-IV), which provides four different verbal and nonverbal abilities scores. This guarantees a more detailed evaluation of children’s intelligence and its relation to CU traits. The sample included children (N = 149; age 6–14 years old) with severe behavioral problems. Clinicians administered the WISC-IV, and parents completed questionnaires evaluating the child’s externalizing problems and CU traits. Findings showed that CU traits were associated with lower verbal comprehension scores after also controlling fo...
This study analyzed the predictive relationship between reading fluency and school outcomes acros... more This study analyzed the predictive relationship between reading fluency and school outcomes across school levels (primary, secondary, and high school), after controlling on the effect of reading comprehension. The sample included 489 children attending Italian primary (grades 4 and 5), secondary (grades 6 and 8), and high schools (grade 9). Students' reading fluency and comprehension were examined with a standardized reading achievement test. At the end of the school year, we requested the school reports of each participant. According to our data, reading fluency predicted all school marks in all literacy-based subjects, with reading rapidity being the most important predictor. School level did not moderate the relationship between reading fluency and school outcomes, confirming the importance of effortless and automatized reading even in higher school levels. Overall this study emphasizes the importance of identifying evidence-based tasks that can be administered in a short time and to many different individuals, which are easy to create, and are linked to school outcomes.
Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum D... more Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum Disorders (ASD) and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. The characterization of the sensory processing in ASD has thus become crucial to identify the sensory and motor features influencing the development of personal autonomy. Objectives: The present study has two aims: (1) to compare the sensory processing between school-aged children with ASD and typically developing peers (TD); (2) to evaluate whether, within the ASD sample, the cognitive level and reported sensory symptoms explain the scores exhibited at the Sensory Processing Measure (SPM-2). Methods: The SPM-2 test was administered to the parents of 105 children with ASD and 70 TD. The ASD group was further subdivided into two groups, namely high and low functioning based on their cognitive level (High Functioning (HF), IQ > 80; Low Functioning (LF...
Aggressive behaviors and disruptive/conduct disorders are some of the commonest reasons for refer... more Aggressive behaviors and disruptive/conduct disorders are some of the commonest reasons for referral to youth mental health services; nevertheless, the efficacy of therapeutic interventions in real-world clinical practice remains unclear. In order to define more appropriate targets for innovative pharmacological therapies for disruptive/conduct disorders, the European Commission within the Seventh Framework Programme (FP7) funded the MATRICS project (Multidisciplinary Approaches to Translational Research in Conduct Syndromes) to identify neural, genetic, and molecular factors underpinning the pathogenesis of aggression/antisocial behavior in preclinical models and clinical samples. Within the program, a multicentre case-control study, followed by a single-blind, placebo-controlled, cross-over, randomized acute single-dose medication challenge, was conducted at two Italian sites. Aggressive children and adolescents with conduct disorder (CD) or oppositional defiant disorder (ODD) wer...
Emotional dysregulation (ED) is currently the most frequently used term to describe children with... more Emotional dysregulation (ED) is currently the most frequently used term to describe children with an impaired regulation of emotional states. Recent research studies speculate whether ED may be a neurodevelopmental disorder itself, a shared risk factor, or a common key feature of several psychiatric disorders, including, among others, attention deficit hyperactivity disorder (ADHD), and bipolar spectrum disorders (BSD). The association between ADHD and ED is one of the main reasons of misconceptions in the definition of boundaries between ADHD and BSD, leading to the frequent misdiagnosis of ADHD as BSD. Since ED is a multidimensional concept, a novel instrument—the Reactivity, Intensity, Polarity and Stability (RIPoSt) scale—was recently developed to assess the different dimensions of ED, which could help in detecting specific ED profiles in clinical youths. Our study included 154 patients, aged 13.8 ± 2.3 years, diagnosed with either ADHD, BSD, or comorbid condition, and a school-...
Executive functions have been previously shown to correlate with empathic attitudes and prosocial... more Executive functions have been previously shown to correlate with empathic attitudes and prosocial behaviors. People with higher levels of executive functions, as a whole, may better regulate their emotions and reduce perceived distress during the empathetic processes. Our goal was to explore the relationship between empathy and executive functioning in a sample of children and adolescents diagnosed with Attention Deficit and Hyperactivity Disorder alone or associated with comorbid Disruptive Behavior Disorders and/or Autism Spectrum Disorder. We also aimed to examine the role of empathic dimensions and executive skills in regulating externalizing behaviors. The 151 participants with ADHD were assigned to four groups according to their psychiatric comorbidity (either “pure” or with ASD and/or ODD/CD) and assessed by means of either parent- or self-reported questionnaires, namely the BRIEF−2, the BES, and the IRI. No questionnaire was found to discriminate between the four groups. Aff...
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
BACKGROUND The failure to regulate emotions, namely emotional dysregulation (ED), is a relevant c... more BACKGROUND The failure to regulate emotions, namely emotional dysregulation (ED), is a relevant construct in adolescent psychiatry, in terms of prognostic and developmental implications. We developed and validated a novel self-report questionnaire for the assessment of ED, the RIPoSt-Y, both in clinical and non-clinical samples. METHODS Items selection and subscales construction were conducted on healthy controls (n=374), while test-retest reliability was evaluated in a subsample (n=72); internal consistency was examined both in the control group and in two clinical samples, respectively including patients with Bipolar Spectrum Disorders (BSD; n=44) and ADHD (n=34). Construct, concurrent and convergent validity were also assessed. RESULTS Thirty-one items were finally retained, and three subscales were identified (Affective Instability, Emotional Reactivity, Interpersonal Sensitivity). Test-retest was significant for each subscale with moderate-to-good correlations, and internal consistency showed good-to-excellent coefficients. Construct validity was supported by significant differences between patients and controls and gender-related differences. Concurrent validity was confirmed through significant associations with two subscales of the CHT-Q, while convergent validity proved to be significant with the CBCL/YSR dysregulation-profile. Cut-offs were also computed to discriminate clinically significant scores of ED. LIMITATIONS The use of a school-based survey to recruit controls could have biased our results; gender distributions between clinical and non-clinical samples were significantly different. CONCLUSIONS Our novel questionnaire proved to be a valid and reliable tool able to assess the presence of ED in youths and to characterize this fundamental construct in its multidimensional facets.
LEGO®-based therapy is a social skills development program aimed at children with autism spectrum... more LEGO®-based therapy is a social skills development program aimed at children with autism spectrum disorder (ASD). A systematic review of the literature was conducted using PRISMA guidelines. PubMed, Scopus and Web of Science bibliographic databases were searched from their date of inception to August 2020. The review included 19 studies. Studies were classified according to experimental designs (e.g., Randomized Control Trial, Non-Randomized Studies of Interventions and case report and series) and a narrative synthesis of each was provided, along with a critical discussion of the strengths and weaknesses of the available literature on the topic. Although LEGO®-based therapy appears a promising treatment for social interaction in ASD, the findings of LEGO®-based therapy studies should be interpreted and generalized with caution, due to the low quality of the studies and the small sample sizes.
Although childhood-onset psychiatric disorders are often considered as distinct and separate from... more Although childhood-onset psychiatric disorders are often considered as distinct and separate from each other, they frequently co-occur, with partial overlapping symptomatology. Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) commonly co-occur with each other and with other mental disorders, particularly disruptive behavior disorders, oppositional defiant disorder/conduct disorder (ODD/CD). Whether these associated comorbidities represent a spectrum of distinct clinical phenotypes is matter of research. The aim of our study was to describe the clinical phenotypes of youths with ADHD with and without ASD and/or ODD/CD, based on neuropsychological and psychopathological variables. One-hundred fifty-one participants with ADHD were prospectively recruited and assigned to four clinical groups, and assessed by means of parent-reported questionnaires, the child behavior checklist and the behavior rating inventory of executive functions. The ADHD alone grou...
Several studies have investigated relationships between narcissism, self-esteem and behavioral pr... more Several studies have investigated relationships between narcissism, self-esteem and behavioral problems in children. Most of these studies have been conducted in community samples, rather than in clinical referred samples. This field of research is clinically important, because data on community samples suggest that narcissism is a significant risk factor for children's behavioral problems. The study aimed to test the psychometric properties of the Child Narcissism Scale (CNS) in a community sample of Italian children and to explore the clinical utility of CNS in a sample of referred children with Oppositional Defiant Disorder (ODD). In the community sample, the Italian version of the CNS was shown to be a normally distributed, single-factor measure of childhood narcissism with very good internal consistency. Furthermore, high levels of narcissism were associated with less self-esteem in family relationships, more parent-reported conduct problems, and less teacher-reported pro-s...
Non suicidal self-injuries (NSSIs) are deliberate self-harm behaviors without suicidal intent, us... more Non suicidal self-injuries (NSSIs) are deliberate self-harm behaviors without suicidal intent, usually starting in adolescence, with increasing rates of occurrence both in epidemiological and clinical samples. Several studies associated cyclothymic-hypersensitive temperament (CHT) with self-harm behaviors and suicidal risk. Aim of this study is to explore the association between NSSIs and CHT in a clinical sample of adolescents. We hypothesized that CHT may differentiate NSSI from non-NSSI adolescents with mood disorders, when other psychopathological features are controlled for. A consecutive sample of 89 adolescents with mood disorders were assessed for presence and phenomenology of NSSIs, CHT, demographics, comorbid categorical psychiatric diagnoses, dimensional psychopathology, impairment and previous suicide attempts. NSSIs were reported in 52% of the sample, with higher rates in females and in bipolar disorder. Regression analyses showed that CHT, but not age, gender, bipolar ...
BACKGROUND Children's self-views encompass two independent dimensions: self-esteem and narcis... more BACKGROUND Children's self-views encompass two independent dimensions: self-esteem and narcissism, which recently have received growing attention from researchers and clinicians. The current study sought to test whether these dimensions might predict the developmental course of children with Oppositional Defiant Disorder diagnosis. METHOD The sample (N = 64, M age = 10.1 years, 57 boys) included children with Oppositional Defiant Disorder diagnosis. We examined longitudinal relationships between self-views (both self-esteem and narcissism) and parent-reported internalizing and externalizing behavioral problems. RESULTS The study spanned two time-points, spaced 12 months apart. None of the predictors were longitudinally associated with the levels of externalizing behavioral problems in children. However, narcissism predicted the levels of children's internalizing problems at the follow-up, whereas self-esteem did not. LIMITATIONS The relatively small sample and the lack of assessing causality limit the generalizability of the findings. Results need to be replicated in larger samples. CONCLUSIONS These findings illustrate the value of taking into account children's narcissistic traits in clinical assessment. By broadening knowledge of narcissistic traits in clinical samples of children, we hope to inform assessment procedures in standard clinical practice, as well as the development of tailored interventions to curb the emergence of later negative outcomes related to childhood narcissism, such as internalizing problems.
RIASSUNTO. Recentemente la ricerca ha focalizzato l'attenzione sul narcisismo come tratto di pers... more RIASSUNTO. Recentemente la ricerca ha focalizzato l'attenzione sul narcisismo come tratto di personalità non necessariamente patologico, che può essere presente fin dall'età scolare e può condurre, in taluni casi, a conseguenze negative nello sviluppo del bambino, come problematiche affettive e comportamentali. Dopo aver illustrato le principali ipotesi sulle origini di questi tratti in età evolutiva, questo articolo cerca di delineare il legame fra i tratti narcisistici, il livello di autostima e le problematiche affettive e comportamentali in età evolutiva. Infine, vengono presentati gli strumenti attualmente disponibili per la valutazione di questi tratti in bambini e adolescenti. PAROLE CHIAVE: narcisismo, autostima, disturbo oppositivo provocatorio, aggressività, Childhood Narcissism Scale. SUMMARY. Recently, studies have focused on narcissism as a personality trait, which can be detected during childhood, and can lead to negative outcomes, such as emotional and behavioral problems. After illustrating the main hypotheses on the development of narcissistic traits in children, this paper aims to outline the relation between narcissism, self-esteem and emotional, and behavioral problems in children. Finally, are presented measures for the assessment of narcissistic traits in children and adolescents.
Recently, studies have focused on narcissism as a personality trait, which can be detected during... more Recently, studies have focused on narcissism as a personality trait, which can be detected during childhood, and can lead to negative outcomes, such as emotional and behavioral problems. After illustrating the main hypotheses on the development of narcissistic traits in children, this paper aims to outline the relation between narcissism, self-esteem and emotional, and behavioral problems in children. Finally, are presented measures for the assessment of narcissistic traits in children and adolescents.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights RIPoSt-40 comprises four subscales and a negative emotion dysregulation score It measures affective instability, impulsivity, positive and negative emotionality All scores, but positive emotionality, are higher in cyclothymic and ADHD patients Internal consistency and test-retest reliability are generally good Significant correlations with affective temperaments are shown
This study demonstrates the feasibility and efficacy of using flow cytometric analysis with intra... more This study demonstrates the feasibility and efficacy of using flow cytometric analysis with intracellular cytokine staining for characterization of T-cell phenotype and functional status in extensive alopecia areata (EAA) scalp skin. Cell suspensions were made from scalp punch biopsies taken from 12 patients with long-standing EAA (average disease duration 14 years, 95% hair loss) and six control subjects. EAA samples had a lower percentage of CD-3-expressing cells, but CD-4/CD-8 ratios remained similar to controls. Expression of CD-69 was found only in EAA scalp biopsies, suggesting that T-cells from EAA scalp have undergone activation. No difference was found in tumor necrosis factor a expression. Surprisingly, EAA scalp T-cells produced less IL-2 and CD-8 T-cells produced less IFN-g. Immunohistochemical staining of formalin-fixed paraffin-embedded specimens demonstrated that IFN-g-producing cells in EAA scalp were not greater in number than in normal specimens. The few identified IFN-g-producing cells demonstrated no tendency to localize to the perifollicular region, and were similarly distributed as in control specimens. The abnormalities in cytokine production may explain the relative paucity of inflammatory change observed in the clinical setting and suggest that T-cell responses in EAA scalp are tightly, albeit aberrantly, regulated via mechanisms of peripheral T-cell tolerance.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Research on the association between callous–unemotional (CU) traits and intelligence yielded cont... more Research on the association between callous–unemotional (CU) traits and intelligence yielded contradictory results. Moreover, several previous studies focused on global intelligence scores or verbal vs. nonverbal/performance abilities usually evaluated with short/abbreviated instruments. The current study builds on these previous works and explores the link between CU traits and intelligence using the full version of the Wechsler Intelligence Scale for Children—4th Edition (WISC-IV), which provides four different verbal and nonverbal abilities scores. This guarantees a more detailed evaluation of children’s intelligence and its relation to CU traits. The sample included children (N = 149; age 6–14 years old) with severe behavioral problems. Clinicians administered the WISC-IV, and parents completed questionnaires evaluating the child’s externalizing problems and CU traits. Findings showed that CU traits were associated with lower verbal comprehension scores after also controlling fo...
This study analyzed the predictive relationship between reading fluency and school outcomes acros... more This study analyzed the predictive relationship between reading fluency and school outcomes across school levels (primary, secondary, and high school), after controlling on the effect of reading comprehension. The sample included 489 children attending Italian primary (grades 4 and 5), secondary (grades 6 and 8), and high schools (grade 9). Students' reading fluency and comprehension were examined with a standardized reading achievement test. At the end of the school year, we requested the school reports of each participant. According to our data, reading fluency predicted all school marks in all literacy-based subjects, with reading rapidity being the most important predictor. School level did not moderate the relationship between reading fluency and school outcomes, confirming the importance of effortless and automatized reading even in higher school levels. Overall this study emphasizes the importance of identifying evidence-based tasks that can be administered in a short time and to many different individuals, which are easy to create, and are linked to school outcomes.
Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum D... more Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum Disorders (ASD) and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. The characterization of the sensory processing in ASD has thus become crucial to identify the sensory and motor features influencing the development of personal autonomy. Objectives: The present study has two aims: (1) to compare the sensory processing between school-aged children with ASD and typically developing peers (TD); (2) to evaluate whether, within the ASD sample, the cognitive level and reported sensory symptoms explain the scores exhibited at the Sensory Processing Measure (SPM-2). Methods: The SPM-2 test was administered to the parents of 105 children with ASD and 70 TD. The ASD group was further subdivided into two groups, namely high and low functioning based on their cognitive level (High Functioning (HF), IQ > 80; Low Functioning (LF...
Aggressive behaviors and disruptive/conduct disorders are some of the commonest reasons for refer... more Aggressive behaviors and disruptive/conduct disorders are some of the commonest reasons for referral to youth mental health services; nevertheless, the efficacy of therapeutic interventions in real-world clinical practice remains unclear. In order to define more appropriate targets for innovative pharmacological therapies for disruptive/conduct disorders, the European Commission within the Seventh Framework Programme (FP7) funded the MATRICS project (Multidisciplinary Approaches to Translational Research in Conduct Syndromes) to identify neural, genetic, and molecular factors underpinning the pathogenesis of aggression/antisocial behavior in preclinical models and clinical samples. Within the program, a multicentre case-control study, followed by a single-blind, placebo-controlled, cross-over, randomized acute single-dose medication challenge, was conducted at two Italian sites. Aggressive children and adolescents with conduct disorder (CD) or oppositional defiant disorder (ODD) wer...
Emotional dysregulation (ED) is currently the most frequently used term to describe children with... more Emotional dysregulation (ED) is currently the most frequently used term to describe children with an impaired regulation of emotional states. Recent research studies speculate whether ED may be a neurodevelopmental disorder itself, a shared risk factor, or a common key feature of several psychiatric disorders, including, among others, attention deficit hyperactivity disorder (ADHD), and bipolar spectrum disorders (BSD). The association between ADHD and ED is one of the main reasons of misconceptions in the definition of boundaries between ADHD and BSD, leading to the frequent misdiagnosis of ADHD as BSD. Since ED is a multidimensional concept, a novel instrument—the Reactivity, Intensity, Polarity and Stability (RIPoSt) scale—was recently developed to assess the different dimensions of ED, which could help in detecting specific ED profiles in clinical youths. Our study included 154 patients, aged 13.8 ± 2.3 years, diagnosed with either ADHD, BSD, or comorbid condition, and a school-...
Executive functions have been previously shown to correlate with empathic attitudes and prosocial... more Executive functions have been previously shown to correlate with empathic attitudes and prosocial behaviors. People with higher levels of executive functions, as a whole, may better regulate their emotions and reduce perceived distress during the empathetic processes. Our goal was to explore the relationship between empathy and executive functioning in a sample of children and adolescents diagnosed with Attention Deficit and Hyperactivity Disorder alone or associated with comorbid Disruptive Behavior Disorders and/or Autism Spectrum Disorder. We also aimed to examine the role of empathic dimensions and executive skills in regulating externalizing behaviors. The 151 participants with ADHD were assigned to four groups according to their psychiatric comorbidity (either “pure” or with ASD and/or ODD/CD) and assessed by means of either parent- or self-reported questionnaires, namely the BRIEF−2, the BES, and the IRI. No questionnaire was found to discriminate between the four groups. Aff...
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
BACKGROUND The failure to regulate emotions, namely emotional dysregulation (ED), is a relevant c... more BACKGROUND The failure to regulate emotions, namely emotional dysregulation (ED), is a relevant construct in adolescent psychiatry, in terms of prognostic and developmental implications. We developed and validated a novel self-report questionnaire for the assessment of ED, the RIPoSt-Y, both in clinical and non-clinical samples. METHODS Items selection and subscales construction were conducted on healthy controls (n=374), while test-retest reliability was evaluated in a subsample (n=72); internal consistency was examined both in the control group and in two clinical samples, respectively including patients with Bipolar Spectrum Disorders (BSD; n=44) and ADHD (n=34). Construct, concurrent and convergent validity were also assessed. RESULTS Thirty-one items were finally retained, and three subscales were identified (Affective Instability, Emotional Reactivity, Interpersonal Sensitivity). Test-retest was significant for each subscale with moderate-to-good correlations, and internal consistency showed good-to-excellent coefficients. Construct validity was supported by significant differences between patients and controls and gender-related differences. Concurrent validity was confirmed through significant associations with two subscales of the CHT-Q, while convergent validity proved to be significant with the CBCL/YSR dysregulation-profile. Cut-offs were also computed to discriminate clinically significant scores of ED. LIMITATIONS The use of a school-based survey to recruit controls could have biased our results; gender distributions between clinical and non-clinical samples were significantly different. CONCLUSIONS Our novel questionnaire proved to be a valid and reliable tool able to assess the presence of ED in youths and to characterize this fundamental construct in its multidimensional facets.
LEGO®-based therapy is a social skills development program aimed at children with autism spectrum... more LEGO®-based therapy is a social skills development program aimed at children with autism spectrum disorder (ASD). A systematic review of the literature was conducted using PRISMA guidelines. PubMed, Scopus and Web of Science bibliographic databases were searched from their date of inception to August 2020. The review included 19 studies. Studies were classified according to experimental designs (e.g., Randomized Control Trial, Non-Randomized Studies of Interventions and case report and series) and a narrative synthesis of each was provided, along with a critical discussion of the strengths and weaknesses of the available literature on the topic. Although LEGO®-based therapy appears a promising treatment for social interaction in ASD, the findings of LEGO®-based therapy studies should be interpreted and generalized with caution, due to the low quality of the studies and the small sample sizes.
Although childhood-onset psychiatric disorders are often considered as distinct and separate from... more Although childhood-onset psychiatric disorders are often considered as distinct and separate from each other, they frequently co-occur, with partial overlapping symptomatology. Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) commonly co-occur with each other and with other mental disorders, particularly disruptive behavior disorders, oppositional defiant disorder/conduct disorder (ODD/CD). Whether these associated comorbidities represent a spectrum of distinct clinical phenotypes is matter of research. The aim of our study was to describe the clinical phenotypes of youths with ADHD with and without ASD and/or ODD/CD, based on neuropsychological and psychopathological variables. One-hundred fifty-one participants with ADHD were prospectively recruited and assigned to four clinical groups, and assessed by means of parent-reported questionnaires, the child behavior checklist and the behavior rating inventory of executive functions. The ADHD alone grou...
Several studies have investigated relationships between narcissism, self-esteem and behavioral pr... more Several studies have investigated relationships between narcissism, self-esteem and behavioral problems in children. Most of these studies have been conducted in community samples, rather than in clinical referred samples. This field of research is clinically important, because data on community samples suggest that narcissism is a significant risk factor for children's behavioral problems. The study aimed to test the psychometric properties of the Child Narcissism Scale (CNS) in a community sample of Italian children and to explore the clinical utility of CNS in a sample of referred children with Oppositional Defiant Disorder (ODD). In the community sample, the Italian version of the CNS was shown to be a normally distributed, single-factor measure of childhood narcissism with very good internal consistency. Furthermore, high levels of narcissism were associated with less self-esteem in family relationships, more parent-reported conduct problems, and less teacher-reported pro-s...
Non suicidal self-injuries (NSSIs) are deliberate self-harm behaviors without suicidal intent, us... more Non suicidal self-injuries (NSSIs) are deliberate self-harm behaviors without suicidal intent, usually starting in adolescence, with increasing rates of occurrence both in epidemiological and clinical samples. Several studies associated cyclothymic-hypersensitive temperament (CHT) with self-harm behaviors and suicidal risk. Aim of this study is to explore the association between NSSIs and CHT in a clinical sample of adolescents. We hypothesized that CHT may differentiate NSSI from non-NSSI adolescents with mood disorders, when other psychopathological features are controlled for. A consecutive sample of 89 adolescents with mood disorders were assessed for presence and phenomenology of NSSIs, CHT, demographics, comorbid categorical psychiatric diagnoses, dimensional psychopathology, impairment and previous suicide attempts. NSSIs were reported in 52% of the sample, with higher rates in females and in bipolar disorder. Regression analyses showed that CHT, but not age, gender, bipolar ...
BACKGROUND Children's self-views encompass two independent dimensions: self-esteem and narcis... more BACKGROUND Children's self-views encompass two independent dimensions: self-esteem and narcissism, which recently have received growing attention from researchers and clinicians. The current study sought to test whether these dimensions might predict the developmental course of children with Oppositional Defiant Disorder diagnosis. METHOD The sample (N = 64, M age = 10.1 years, 57 boys) included children with Oppositional Defiant Disorder diagnosis. We examined longitudinal relationships between self-views (both self-esteem and narcissism) and parent-reported internalizing and externalizing behavioral problems. RESULTS The study spanned two time-points, spaced 12 months apart. None of the predictors were longitudinally associated with the levels of externalizing behavioral problems in children. However, narcissism predicted the levels of children's internalizing problems at the follow-up, whereas self-esteem did not. LIMITATIONS The relatively small sample and the lack of assessing causality limit the generalizability of the findings. Results need to be replicated in larger samples. CONCLUSIONS These findings illustrate the value of taking into account children's narcissistic traits in clinical assessment. By broadening knowledge of narcissistic traits in clinical samples of children, we hope to inform assessment procedures in standard clinical practice, as well as the development of tailored interventions to curb the emergence of later negative outcomes related to childhood narcissism, such as internalizing problems.
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