Silvia Cerea

Assessment of Anxiety and Coping Features in Bruxers: A Portable Electromyographic and Electrocardiographic Study

AIMS To determine whether there is a correlation between any psychological features and sleep bruxism (SB). METHODS A total of 36 healthy volunteers underwent an in-home evaluation with a portable device combining electromyographic (EMG) and electrocardiographic (ECG) recordings for the diagnosis of SB. They were administered questionnaires that assessed state and trait anxiety levels and coping strategies. The study hypothesis was that the SB index was significantly correlated with an individuals anxiety and coping. Correlation between SB index and psychological features was assessed and a comparison between SB prevalences in subjects with different psychological scores was carried out. RESULTS Correlation analysis showed that the SB index was not correlated with any of the psychological scales; however, there were some significant correlations (r values range from 0.393 to 0.458) between the SB index and specific items from the trait anxiety and coping scales. Crosstabulations of subjects with SB and with high (overmedian) or low (undermedian) scores for the various psychological measures revealed significant correlations between the prevalence of SB in higher-scoring subjects for state anxiety scores (Phi coefficient = .456; P = .006), trait anxiety scores (Phi = 0.369; P = .027), and social support coping strategy (Phi = 0.387; P = .020). CONCLUSION These findings support the study hypothesis only in part and confirm the absence of a clear-cut relationship between SB and psychological features.

Socioemotional Features and Resilience in Italian University Students with and without Dyslexia.

Dyslexia is a permanent condition characterized by reading difficulties that include inaccurate or slow and effortful word reading, poor decoding, and poor spelling abilities. People with dyslexia may have psychological and psychopathological issues such as low self-esteem, poor resilience, and symptoms of depression and anxiety. They may also develop social problems and emotional issues, as well as low academic and social self-efficacy. The present study aimed to assess the psychological features of a sample of 28 Italian university students with dyslexia, comparing them with a control group of typically developing students matched for gender, education, and academic discipline, to enhance our knowledge of dyslexia outcomes in an Italian setting. The results show that university students with dyslexia experience higher levels of somatic complaints, social and attentional problems, lower self-esteem, and higher depression scores than controls, while no difference emerged between the two groups’ resilience scores. In conclusion, the present findings suggest that university students with dyslexia report more psychological issues than students without dyslexia and could benefit from intervention to improve their psychological and physical well-being.

Investigation of the Phenomenological and Psychopathological Features of Trichotillomania in an Italian Sample

Trichotillomania (TTM) is still a scarcely known and often inadequately treated disorder in Italian clinical settings, despite growing evidence about its severe and disabling consequences. The current study investigated the phenomenology of TTM in Italian individuals; in addition, we sought to examine patterns of self-esteem, anxiety, depression, and OCD-related symptoms in individuals with TTM compared to healthy participants. The current study represents the first attempt to investigate the phenomenological and psychopathological features of TTM in Italian hair pullers. One hundred and twenty-two individuals with TTM were enrolled: 24 were assessed face-to-face (face-to-face group) and 98 were recruited online (online group). An additional group of 22 face-to-face assessed healthy controls (HC group) was included in the study. The overall female to male ratio was 14:1, which is slightly higher favoring female than findings reported in literature. Main results revealed that a higher percentage of individuals in the online group reported pulling from the pubic region than did face-to-face participants; furthermore, the former engaged in examining the bulb and running the hair across the lips and reported pulling while lying in bed at higher frequencies than the latter. Interestingly, the online TTM group showed greater functional and psychological impairment, as well as more severe psychopathological characteristics (self-esteem, physiological and social anxiety, perfectionism, overestimation of threat, and control of thoughts), than the face-to-face one. Differences between the two TTM groups may be explained by the anonymity nature of the online group, which may have led to successful recruitment of more serious TTM cases, or fostered more open answers to questions. Overall, results revealed that many of the phenomenological features of Italian TTM participants matched those found in U.S. clinical settings, even though some notable differences were observed; therefore, cross-cultural invariance might represent a characteristic of OCD-related disorders.

Personality traits are potentially associated with the presence of chronic temporomandibular joint pain in patients without effusion as determined by T-2 weighted magnetic resonance

Abstract Objective: The study aimed at investigating personality traits in chronic temporomandibular joints (TMJ) pain patients with and without joint effusion. Methods: Two groups of chronic TMJ pain patients were recruited. The TMJ pain control group was composed of patients showing magnetic resonance imaging (MRI) signs of TMJ effusion, while the TMJ pain test group included patients with chronic TMJ pain seemingly not justified, due to the absence of MRI-detected disorders. A third set of pain free individuals was selected as a comparison group. All patients completed a personality assessment with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) instrument, and the between-group differences were assessed for significance by performing an analysis of variance test. Results: Patients of the TMJ pain test group had higher scores than subjects belonging to the TMJ pain and pain-free control groups in almost all of the MMPI-2 clinical scales. A significant difference was shown for the scales related to concerns about physical health (Scale 1-Hs; F = 7.74; p = .001) and physical symptoms (Scale 3-Hy; F = 8.43; p = .001). Conclusions: Chronic TMJ pain patients without MRI-detected TMJ effusion have a different personality profile than patients with TMJ effusion and pain-free individuals, regarding high levels of concerns about physical health and physical symptoms. Clinical implications: This study has important clinical implications for temporomandibular disorders practitioners, providing suggestions that symptoms in the TMJ area are not only related to a physical disorder. The possible existence of a psychologically modulated condition in patients who refer pain in the TMJ area without signs of effusion should be carefully taken into consideration.

Body dysmorphic disorder and its associated psychological and psychopathological features in an Italian community sample

Abstract Objective: Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by preoccupation with perceived defects in physical appearance that are not observable or appear slight to others, along with low self-esteem, high perfectionism, and high comorbidity. Little is known about BDD prevalence and phenomenology in the Italian context, and no data are currently available on BDD prevalence using DSM-5 criteria in the Italian context. The aims of the current study were to explore the prevalence and the phenomenology of BDD and its associated psychological and psychopathological features such as self-esteem, perfectionistic traits, social anxiety, depressive, and obsessive–compulsive symptoms in a community sample. Methods: Six hundred and fifteen community individuals completed a battery of self-report questionnaires. Results: 10 (1.63%) individuals met DSM-5 diagnostic criteria for BDD; hair, nose and teeth were the most common areas of concern. Individuals with BDD reported also lower levels of self-esteem, more severe social anxiety symptomatology, general distress, depression and obsessive–compulsive features than people without BDD. Conclusions: BDD is not a rare condition in the Italian context and it emerged to be associated with significant morbidity.

Are difficulties in emotion regulation and intolerance of uncertainty related to negative affect in borderline personality disorder?: Emotion regulation and IU in BPD

Objective: Investigating whether intolerance of uncertainty interacts with difficulties in emotion regulation and negative affect in Italian individuals with borderline personality disorder compared to healthy controls. Method: A group of patients with borderline personality disorder (N = 48; clinical group) and a group of healthy participants (N = 48) matched on gender filled-in self-report measures assessing difficulties in emotion regulation, intolerance of uncertainty, and negative affect. Results: Individuals in the clinical group showed higher levels of difficulties in emotion regulation (except for lack of emotional awareness), intolerance of uncertainty, and negative affect than healthy participants. Interestingly, while difficulties in emotion regulation were correlated with negative affect in both groups, significant medium-large correlations between difficulties in emotion regulation and intolerance of uncertainty were observed only in the clinical group. Lastly, findings from a stepwise hierarchical multiple regression analysis conducted on the clinical group revealed that difficulties in emotion regulation were the most significant predictors of negative affect above and beyond IU. Conclusions: Current findings highlight that difficulties in emotion regulation can be intended as a core, high-level process underlying borderline personality disorder and that IU might be involved—although more marginally—in predicting negative affect in this population. Future research further exploring whether and how intolerance of uncertainty and difficulties in emotion regulation interact in borderline personality disorder may inform psychological assessment and treatment.

Muscle Dysmorphia and its Associated Psychological Features in Three Groups of Recreational Athletes

Muscle Dysmorphia (MD) is a psychological disorder characterized by the preoccupation with the idea that one’s body is not lean and muscular. The current study aimed to explore MD behaviours and symptoms in three groups of recreational athletes: bodybuilders (BB; n = 42), strength athletes (SA; n = 61), and fitness practitioners (FP; n = 22). Furthermore, we assessed MD-related psychological features as well as possible psychological predictors of MD among groups. Results highlighted that the BB group reported more beliefs about being smaller and weaker than desired compared to the other groups, whereas individuals in the SA group reported setting higher standards for themselves than the FP group. Lastly, orthorexia nervosa and social anxiety symptoms emerged as predictors of MD symptoms in the BB group. Taken together, our findings suggest that individuals in the BB group are characterized by more MD general symptomatology than those in the other groups; furthermore, only orthorexia nervosa and social anxiety may play a specific role in predicting MD general symptoms in bodybuilders.

Non-weight-related body image concerns and Body Dysmorphic Disorder prevalence in patients with Anorexia Nervosa

Patients with Anorexia Nervosa (AN) and patients with Body Dysmorphic Disorder (BDD) are both characterized by body image disturbance and dissatisfaction; furthermore, these disorders share clinical features and frequently co-occur. However, few studies have explored the relation between AN and BDD. Therefore, the first aim of the study was assessing the prevalence of BDD and presence of non-weight-related body image concerns in patients with AN. Second, we were interested in comparing patients with AN and non-weight-related body image concerns, patients with weight-related body image concerns only, and a healthy control group with respect to several psychological and psychopathological features. Sixty-one female patients with AN were divided in two subgroups: 39 with non-weight-related body image concerns and 22 with weight-related body image concerns only. Sixteen (26.23%) patients with AN had probable comorbid BDD. Moreover, patients with AN and non-weight-related body image concerns reported, overall, greater psychopathology than patients with AN and weight-related body image concerns only, with the exception of AN core features and general distress. In conclusion, patients with AN and non-weight-related body image concerns showed a more severe body image disturbance unrelated to a more severe eating disorder pathology.

The role of distress tolerance, anxiety sensitivity, and intolerance of uncertainty in predicting hoarding symptoms in a clinical sample

Hoarding disorder (HD) is characterized primarily by difficulty discarding possessions, leading to severe clutter and significant distress and impairment. Although promising psychological treatments have emerged, treating HD remains a clinical challenge. A greater understanding of the role of psychological vulnerability factors in predicting hoarding symptoms in a clinical HD sample could further enhance treatments. To investigate the role of proposed individual difference factors (i.e., distress tolerance, anxiety sensitivity, intolerance of uncertainty), we administered a diagnostic and self-report battery to 73 individuals diagnosed with HD who were seeking treatment for hoarding at a community clinic. Results indicated that when controlling for depression and anxiety symptoms, only distress tolerance predicted the severity of hoarding symptoms. Furthermore, meditation analyses revealed that the impact of distress tolerance on hoarding severity was partially mediated by hoarding beliefs. These results have important theoretical and clinical implications for HD.

Affective correlates of trichotillomania across the pulling cycle: Findings from an Italian sample of self-identified hair pullers

Etiological models of trichotillomania (TTM) conceptualize hair pulling as a dysfunctional emotion regulation strategy; accordingly, some research has found that affective states change differentially across the hair pulling cycle. We explored emotional changes in a sample of Italian individuals reporting TTM. Eighty-nine participants reporting TTM completed a 12-item section of the Italian Hair Pulling Questionnaire online and rated the extent to which they had experienced 12 affective states before, during, and after hair pulling. Overall, participants reported increased levels of shame, sadness, and frustration from pre- to post-pulling, and decreased levels of calmness after hair pulling episodes. Moreover, participants reported increased pleasure and relief across the pulling cycle, and variations in the direction of change for anger and anxiety depending on the hair pulling phase. Lastly, reported boredom decreased across the hair pulling cycle. These findings highlight the importance of considering emotional changes experienced across the pulling cycle in Italian hair pullers.