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Objective Maladaptive daydreaming (MD) is a recently defined clinical condition characterized by an excessively immersive use of fantasy and imagination, which can significantly impact both professional and social life. The primary aim of this study is to examine potential associations between MD levels, narcissistic personality traits, and defense mechanisms. Additionally, the study aims to test mediation models to explore the direct and indirect roles of narcissism on MD levels through defense mechanisms. Methods A total of 562 participants (mean age = 27.16 years; SD = 10.21; 68% female) completed an online survey comprising a socio‐demographic questionnaire, the Maladaptive Daydreaming Scale (MDS), the Pathological Narcissism Inventory (PNI), and the Defense Mechanisms Rating Scales‐Self Report‐30 item (DMRS‐SR‐30). Results The MDS score was positively related to the PNI total and subscales. Moreover, there were negative associations with mature defenses, and a positive association with neurotic and immature defenses. Age showed a weak negative association with MDS. A direct effect of narcissism on MD levels and an indirect impact through immature and neurotic defense and direct trough mature defenses, emerged. Conclusions The significant associations found in this study support a link between narcissistic personality traits and MD, where defenses seem to play a relevant role. Relevance to Clinical Practice These findings underscore the potential benefits of treatments and clinical interventions aimed at fostering mature defense mechanisms. Such approaches can be particularly valuable for young adults in managing psychological distress linked to narcissistic vulnerability, which directly contributes to maladaptive fantasies and social withdrawal. Highlights Maladaptive daydreaming (MD) is a relatively recent condition, and research examining its connection to narcissism and defense mechanisms are needed. A positive association emerged between MD scores and both narcissism and neurotic and immature defenses, while a negative association was found with mature defenses. Defensive mechanisms emerged as mediators in the relationship between narcissism and MD.

Background. Chronic headache (CH) is a condition that includes different subtypes of headaches and that can impair different life domains. Personality traits can play a relevant role both in the development and in coping with this medical condition. The first aim of the present study is to realize a systematic review of the personality traits associated with CH compared to healthy controls; the second objective is to carry out a quantitative meta-analysis with the studies using the same instrument to assess personality traits. Method. The literature search encompassed articles published from 1988 until December 2022 on the major databases in the field of health and social sciences: PubMed, Scopus, PsychInfo, and Web of Science. Results. Thirteen studies were included in the systematic review, but only three studies were deeply explored in a meta-analysis since the only ones used a common instrument for personality assessment (Minnesota Multiphasic Personality Inventory). According to the meta-analysis, different subtypes of CH patients scored higher than healthy controls on Hypochondriasis and Hysteria Scales. The systematic review showed higher levels of depressive and anxious personality dimensions and pain catastrophizing in CH compared to healthy controls. Moreover, frequent-chronic forms and medication-overuse headache were the most symptomatic and frail categories showing higher levels of dysfunctional personality traits and psychopathological symptoms. Conclusions. These results seem to confirm a “neurotic profile” in patients suffering from CH. The identification of the main personality traits involved in the onset and maintenance of headache disorders represents an important objective for developing psychological interventions.

Infertility is a deeply distressing experience, which can threaten important personal and martial goals, frequently affecting the psychophysical health. A supportive relationship and a secure romantic attachment appear to reduce infertility stress, as well as play a relevant role in the success of assisted reproductive technology treatments. The principal aim of the study is to investigate the predictive effect of romantic attachment, couple characteristics, quality of life and age on assisted reproductive technology outcome. A total of 88 infertile women, enrolled in an assisted reproductive technology Centre of Rome, completed the Experience in Close Relationship-Revised, the Couple Relationship Inventory, the Fertility Quality of Life and a socio-demographic questionnaire. The participants completed the questionnaires at the beginning of the medical treatment. Data analyses showed significant associations among Experience in Close Relationship-Revised dimensions, Couple Relationship Inventory and Fertility Quality of Life Scales. Assisted reproductive technology outcome was negatively correlated to Experience in Close Relationship-Revised Avoidance and positively related to Couple Relationship Inventory Dependence. A multi-variable logistic regression revealed that Experience in Close Relationship-Revised Avoidance decreased the probability of pregnancy. The present findings partially confirmed the study hypotheses since several associations among couple characteristics, attachment anxiety and avoidance dimensions, infertility-related quality of life in infertile women were found. Furthermore, according to a definition of Avoidance, assisted reproductive technology positive outcome appears to be associated to lower levels of fear of dependence and interpersonal intimacy, and to a low need both for self-reliance and for reluctance to self-disclose within the romantic relationship. Further investigations are needed both to confirm this preliminary finding and for promoting focused therapeutic interventions for couples facing assisted reproductive technology.

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

Background: Hypermobility Ehlers–Danlos syndrome (hEDS) is a clinical condition characterized by hypermobility and tissue fragility and is associated with chronic pain. The present study aimed to investigate the associations between affect regulation, pain perception, and psychophysical dimensions as well as alexithymic characteristics in the pathological range. Methods: Twenty-five hEDS patients completed a socio-anamnestic questionnaire as well as the Brief Pain Inventory (BPI), the 36-Item Short Form Survey (psychophysical health), the Difficulties in Emotion Regulation Scale (DERS), and the 20-item Toronto Alexithymia Scale (affect regulation). Results: Correlational analysis showed several negative significant associations between the SF-36, DERS, and TAS-20. The BPI showed few significant associations with both affect regulation measures. Moreover, a relationship between psychological dimensions and the time since diagnosis emerged. A total of 28% of participants reported TAS-20 scores in the clinical range and 36% reported scores in the borderline area. Discussion: Patients with hEDS seem to show high alexithymia levels; pain seems to interfere with the practical aspects of daily life and may reduce an individual’s awareness of their emotional capabilities. The perception of heightened pain has a stronger impact on emotional resources when it interferes with affective life than when it interferes with practical life. Finally, delayed diagnoses of hEDS entail psychological consequences such as alexithymia. Conclusions: The present findings highlight the importance of promoting affect regulation capabilities through the implementation of psychological intervention programs for patients suffering from this medical condition.

Background To date, the comprehensive geriatric assessment (CGA) does not include an evaluation tool for handicap. Aim To develop a new instrument for assessing handicap in the elderly: the Geriatric Handicap Scale (GHS). Methods 656 community-dwelling elderly were enrolled in this study. We identified the thematic areas investigated by the CGA which showed a significant correlation with the handicap condition (handicap yes/not) to be included in our scale (Phase 1). Afterwards, we evaluated the possible correlations between: (1) the score obtained in each area of GHS and those obtained in CGA tests investigating similar dimensions, (2) GHS total score and the Multidimensional Prognostic Index (MPI) total score (Phase 2). Results In Phase 1, data analysis showed several significant correlations between the handicap condition and the scores obtained to the CGA tests exploring cognition, mood, functional impairment, comorbidity, social and environmental variables. Thus, we developed a tool considering five variables: (1) cognition and mood; (2) functional impairment; (3) hearing/visual impairment; (4) any additional comorbidity factors; (5) environmental/social risk factors. In Phase 2, data analysis showed significant correlations between the score obtained in each area of GHS and those obtained in the CGA tests investigating similar dimensions. A positive correlation between GHS total score and MPI total score ( r  = 68; p  = 0.001) was also reported. Cut-off score for the GHS was established. Psychometric properties of GHS were also investigated and adequate estimates of internal reliability were demonstrated. Conclusions Our tool could prove useful to correctly categorize the disadvantageous condition related to patient’s disability.

The COVID-19 pandemic has deeply affected the psychophysical wellbeing of children worldwide. Alexithymia, a personality trait involving difficulties in identifying and expressing feelings represents a vulnerability factor for stress-related disorders. Under pandemic stress exposure, we aimed to investigate the role of parents’ and children’s alexithymia in the psychophysical symptomatology shown by children and to evaluate possible differences according to age, gender and history of COVID-19 infections. The perception of parents and children about the impact of the pandemic on children’s emotional, social and physiological wellbeing was also explored. Sixty-five familial triads were surveyed in the period from March to May 2022: children (n = 33 males; mean age = 9.53, sd = 1.55), mothers (mean age = 44.12; sd = 6.10) and fathers (mean age = 47.10; sd = 7.8). Both parental and children’s alexithymia scores were significantly associated with somatic and externalizing symptomatology in children. Self-reported anger and externally oriented thinking scores were higher in younger children (age 8–9.9 years) than in older ones (10–12 years). Girls scored higher than boys in somatic complaints, as reported by parents. No difference emerged between children affected/not affected by COVID-19. Notably, children reported a greater negative impact of the pandemic on their emotional and psychosocial well-being than their parents. The findings emphasize the role of alexithymia in the occurrence of psychophysical symptoms in children during the COVID-19 pandemic. The reduced parental awareness of the emotional burden imposed by the pandemic on children indicates the need to better consider how epidemics affect children’s mental health and to develop adequate preventive strategies to support them in these exceptional times.

Primary headache is a common somatic disorder in childhood that significantly affects quality of life. The condition is strongly associated with a variety of internalizing and externalizing disorders, and several dimensions are recognized to play a role in its development and expression, including attachment bonds. The present study aimed at exploring the associations between somatic symptoms, internalizing and externalizing problems, and attachment dimensions in a group of children and adolescents suffering from headache. The predictive effect of internalizing/externalizing problems and attachment dimensions on somatic symptoms was also explored. A sample of 50 children/adolescents with a headache diagnosis (i.e., 36 girls, 14 boys; mean age 13.18 years; SD = 2.85) participated in the study and completed the Children’s Somatization Inventory-24, the Experiences in Close Relationships Scale–Revised Child version, and a brief sociodemographic questionnaire. Mothers completed the Child Behavior Checklist 6–18. The correlational analysis revealed positive associations between child somatic symptoms and age, internalizing problems, and attachment anxiety and avoidance to the mother and the father, respectively; and a negative association between child somatic symptoms and secure attachment to the father. The regression analysis highlighted the significant effect of ECR-RC Avoidance-Father and CBCL Internalizing Problems in predicting greater somatic symptoms in young headache patients. The present findings highlight avoidant attachment to fathers and internalizing problems as risk factors for greater somatic symptoms in children/adolescents with headache. The results suggest that greater somatic symptoms in this clinical population may represent a learned maladaptive behavior to satisfy attachment needs. Clinical implications are discussed.

Infertility and related treatments can negatively affect a couple’s wellbeing. The aim of this study was to evaluate couples starting assisted reproductive treatment, differences in alexithymia and quality of life levels between partners, and the association of these psychological dimensions within the couple’s members. Data was collected in two fertility centres in Rome; 47 couples completed the Fertility Quality of Life (FertiQoL), the 20-item Toronto Alexithymia Scale (TAS-20), and a socio-demographic questionnaire. Data analysis showed a worsened quality of life in women compared with their partners, as well as higher externally oriented thinking in men compared with their spouses. Associations between alexithymia and quality of life levels between women and men emerged. According to the regression analysis, a better quality of life in women was predicted by a greater partner’s capabilities in identifying and describing emotion as well as by a better partner’s quality of life, whereas for men, a better quality of life was predicted by their spouse’s higher levels of quality of life. This study highlights the protective role that couples can play in the perception of the negative impact that infertility can have on their partner’s quality of life. Further investigations are needed for the development of specific therapeutic interventions for the promotion of the couples’ wellbeing.

(1) Background: The COronaVIrus Disease 2019 (COVID-19) pandemic poses a unique challenge as a severe global crisis affecting physical and psychological health. The main purpose of this work is to study the impact of a traumatic event while also observing the human ability to adapt. One of the first theories to study the adaptive importance of the evolutionary lineage of the affective systems is referred to as BrainMind (Panksepp, 2010). This study aims to explore whether primary emotional systems (PES) and emotion regulation (ER) strategies show differences between the pre- and post- lockdown period; and if positive systems and specific emotion regulation pre-pandemic act as a protective or risk factor for mental and physical wellbeing. (2) Methods: 98 participants who had participated in a previous study before the pandemic were re-contacted to refill the Affective Neuroscience Personality Scale (ANPS) and the Emotion Regulation Questionnaire (ERQ) after the outbreak of the pandemic with the addition of the Symptom Checklist-90-Revised (SCL-90R). (3) Results: The results showed that the COVID-19 lockdown rules had an impact on Emotional Regulation and on a re-balancing of PES. Moreover, pre-pandemic expressive–suppressive ERQ strategies and ANPS SADNESS scores appeared as relevant risk factors, which predicted higher Global Severity Index (GSI) scores during lockdown. (4) Conclusions: The lockdown appears to have activated PLAY and CARE as protective systems, but has detuned the ability to positively reinterpret the situation.