"As soon as you trust yourself, you will know how to live" (Goethe). Protective and mediator factors for internalizing disorders in early and mid-adolescence

Adolescence is often considered as a period of changes and challenges, during which youth are at particular risk for developing psychological disorders (Lee & Bukowski, 2012; Verona, Javdani, & Sprague, 2011). Anxiety and depression are two very common disorders in adolescence (Angold & Costello, 2008; Vierhaus, Lohaus, & Shah, 2010). Several authors have focused on the study of the possible risk factors that might interfere or enlarge the chance to develop such maladaptive behaviors. Some empirical studies have reported good quality of attachment relationships and positive evaluation of self as two of the most crucial protective factors for the psychological well-being in adolescence (Lee & Hankin, 2009; Tambelli, Laghi, Odorisio, & Notari, 2012; Wilkinson, 2004). Other studies, have focused on how different trends of psychological disorders and attachment relationships are detachable within the whole adolescence. Thus the central purpose of this study is to examine the relationships of attachment, in particular to mother, father, and peer, and self-esteem to depressive and anxiety symptoms, in early and mid-adolescence respectively. A community based sample of Italian early (n=1078) and mid-adolescents (n=1138) completed self-report measures of attachment (Inventory of Parent and Peer Attachment, IPPA, Armsden & Greenberg, 1987, 1989; Greenberg, Siegel, & Leitch, 1983) self-esteem (Rosenberg Self-Esteem Scale, RSES, Rosenberg, 1965) as well as anxiety (Spence Childrenâs Anxiety Scale, SCAS, Spence 1997) and depressive symptoms (Childrenâs Depression Inventory, CDI, Kovacs, 1992). After the evaluation of the psychometric properties (internal consistency and structural validity) of each selected measure, age and gender-related differences are evaluated. Correlations between the total scores of the measure are reported. Through structural equation modeling it is assessed the direct influence of both maternal and paternal attachment on psychological health, self-esteem and peer attachment. Moreover, the influence of peer attachment on psychological health is totally mediated by self-esteem. Anxiety and depressive symptoms are considered and evaluated separately. The multi-group approach is used to evaluate gender differences in the model. To avoid the artifacts of sampling and to strengthen the obtained results, the cross-validation procedure is adopted. Results indicate good psychometric characteristics for each measure. Additionally, the comparison between the two age-groups show early adolescence report higher levels of attachment (to mother, father and peer), and self-esteem, whereas mid-adolescents report higher levels of depressive symptoms. Furthermore, in general girls score higher on levels of attachment relationships to peer and on anxiety symptoms, while boys report higher levels of self-esteem and paternal attachment. The major finding from the model concerns the crucial role of self-esteem. Maternal, paternal and peer attachment have only a weak effect on anxiety and depressive symptoms respectively, whereas the self-esteem shows a greater effect on both. The only one exception regards the strong direct role of peer attachment on depressive symptoms showed by the mid-adolescents sample. However, the primary effect of the considered attachment relationships is on self-esteem. Symptom and age-related differences are discussed. To conclude, this study suggests that it is the evaluation of the self rather than the quality of attachment relationships that may influence the levels of psychological symptoms reported by early and mid-adolescents. Limits of the study and implications for research are presente

From research to clinical settings: validation of the Affect in Play Scale \u2013 Preschool Brief Version in a sample of preschool and school-aged Italian children

Affect in Play Scale-Preschool (APS-P) is one of the few standardized tools to measure pretend play. APS-P is an effective measure of symbolic play, able to detect both cognitive and affective dimensions which classically designated play in children, but often are evaluated separately and are scarcely integrated. The scale uses 5 min standardized play task with a set of toys. Recently the scale was extended from 6 to 10 years old and validated in Italy preschool and school-aged children. Some of the main limitations of this measure are that it requires videotaping, verbatim transcripts, and an extensive scoring training, which could compromise its clinical utility. For these reasons, a Brief version of the measure was developed by the original authors. This paper will focus on an APS-P Brief Version and its Extended Version through ages (6\u201310 years), which consists \u201cin vivo\u201d coding. This study aimed to evaluate construct and external validity of this APS-P Brief Version and its Extended Version in a sample of 538 Italian children aged 4-to-10 years. Confirmatory factor analysis yielded a two correlated factor structure including an affective and a cognitive factor. APS-P-BR and its Extended Version factor scores strongly related to APS-P Extended Version factor scores. Significant relationships were found with a divergent thinking task. Results suggest that the APS-P-BR and its Extended Version is an encouraging brief measure assessing pretend play using toys. It would easily substitute the APS-P and its Extended Version in clinical and research settings, reducing time and difficulties in scoring procedures and maintaining the same strengths

Environmental Mastery and Self-Acceptance during Emerging Adulthood: A Study of the Determinant Factors in College Students

Emerging Adulthood is a transitional and critical period characterized by multiple challenges. How individuals face life transitions are related to their psychological wellbeing considered a process of self-fulfillment. The most fragile psychological wellbeing dimensions during Emerging Adulthood are environmental mastery and self-acceptance. Few studies have explored the determinants of these dimensions, some of these focused on demographic factors, less on the impact of intrapersonal factors. Interest of this study was investigated with a longitudinal study conducted in 243 Emerging Adults (56.4% females), the role of external (gender, relationship status, socioeconomic status) and internal factors (self-esteem and self-control) in environmental mastery and self-acceptance. Only internal factors predicted both dimensions studied explaining approximately 38% of the variance of environmental mastery and 33% of the variance of self-acceptance.  The study suggests that self-esteem and self-control could be important protective factors for EAs attending university to improve their sense of mastery and competence to manage the environment and possess a positive attitude toward the self. These findings add to a growing body of literature highlighting the determinant factors of specific dimensions of PWB of particular relevance during this lifestage and may have important implications in research and clinical fields, providing insights for the development of clinical actions targeting at university students

“Ripple effect”: Psychological responses and coping strategies of Italian children in different COVID-19 severity areas

COVID-19 has affected learning and the outdoor activities of more than 862 million children or adolescents worldwide. This study investigated the mental health of Italian children and explored their psychological response and coping strategies in different COVID-19 epidemic severity areas, with the aims of alleviating the impacts of COVID-19, promoting targeted intervention, and reducing the risk of future psychological problems. 1074 parents of children aged 6 to 12 years old participated in an ad-hoc online survey. Among them, 40.3% were from the high-risk areas in the North, and 59.7% were from the medium/low-risk areas in the center of Italy. The results showed that, compared to the children in medium- or low-risk areas, children in the North scored significantly higher for symptoms of anxiety, moods, and cognitive changes, showing a “ripple effect” trend. Moreover, children in the northern areas used fewer task-oriented strategies and more emotion- and avoidance-oriented strategies than those in the central areas. Specifically, children in the northern areas were more likely to show acceptance and seek affection from others, while those in the central areas used more humor when their parents talked about quarantine or coronavirus. These findings provide relevant evidence and a reference point for crisis management in children’s mental health.El COVID-19 ha afectado el aprendizaje y las actividades al aire libre de más de 862 millones de niños o adolescentes en todo el mundo. Este estudio investigó la salud mental de los niños italianos y exploró su respuesta psicológica y las estrategias de afrontamiento en diferentes áreas de gravedad de la epidemia de COVID-19, con el objetivo de aliviar los impactos de la misma, promover la intervención específica y reducir el riesgo de futuros problemas psicológicos. 1074 padres de niños entre 6 a 12 años de edad participaron en una encuesta ad-hoc online. De ellos, el 40,3% procedían de las zonas de alto riesgo del norte y el 59,7% de las zonas de riesgo medio/bajo del centro de Italia. Los resultados mostraron que, en comparación con los niños de las áreas de riesgo medio o bajo, los niños del norte obtuvieron una puntuación significativamente más alta en cuanto a los síntomas de ansiedad, cambios cognitivos y de estado de ánimo, mostrando una tendencia de “efecto dominó”. Además, los niños de las zonas del norte utilizaron menos estrategias orientadas a las tareas y más estrategias orientadas a las emociones - y la evitación - que los de las zonas centrales. Concretamente, los niños de las zonas del norte eran más propensos a mostrar aceptación y a buscar el afecto de los demás, mientras que los de las zonas centrales usaban más el humor cuando sus padres hablaban de la cuarentena o del coronavirus. Estos hallazgos proporcionan evidencia relevante y un punto de referencia para el manejo de crisis en la salud mental de los niños

Immediate Psychological Effects of the COVID-19 Quarantine in Youth From Italy and Spain

The COVID-19 quarantine has affected more than 860 million children and adolescents worldwide, but to date, no study has been developed within Western countries to examine the psychological impact on their lives. The present study aims to examine for the first time the emotional impact of the quarantine on children and adolescents from Italy and Spain, two of the countries most affected by COVID-19. Participants were 1,143 parents of Italian and Spanish children aged 3 to 18 years who completed a survey providing information about how the quarantine affects their children and themselves, compared to before the home confinement. Results show that 85.7% of the parents perceived changes in their children’s emotional state and behaviors during the quarantine. The most frequent symptoms were difficulty concentrating (76.6%), boredom (52%), irritability (39%), restlessness (38.8%), nervousness (38%), feelings of loneliness (31.3%), uneasiness (30.4%), and worries (30.1%). Spanish parents reported more symptoms than Italians. As expected, children of both countries used monitors more frequently, spent less time doing physical activity, and slept more hours during the quarantine. Furthermore, when family coexistence during quarantine became more difficult, the situation was more serious, and the level of stress was higher, parents tended to report more emotional problems in their children. The quarantine impacts considerably on Italian and Spanish youth, reinforcing the need to detect children with problems as early as possible to improve their psychological well-being

Anorexia and attachment: dysregulated defense and pathological mourning

The role of Defensive exclusion (Deactivation and Segregated Systems) in the development of early relationships and related to subsequent manifestations of symptoms of eating disorders was assessed using the Adult Attachment Projective Picture System (AAP). Fifty-one DSM-IV diagnosed women with anorexia participated in the study. Anorexic patients were primarily classified as dismissing or unresolved. Quantitative and qualitative analyses of defensive exclusion were carried out. Results showed potential benefits of using the AAP defense exclusion coding system, in addition to the main attachment classifications, in order to better understand the developmental issues involved in anorexia. Discussion concerned the processes, such as pathological mourning, that may underlie the associations between dismissing and unresolved attachment and anorexia. Implications for developmental research and clinical nosology are discussed

Psychological symptoms and behavioral changes in children and adolescents during the early phase of COVID-19 quarantine in three European countries

The coronavirus disease (COVID-19) pandemic forced the home confinement of the majority of population around the world, including a significant number of children and adolescents, for several weeks in 2020. Negative psychological effects have been identified in adults, but research about the impact of this type of social distancing measure on children and adolescents is scarce. The present study aimed to describe and compare the immediate psychological and behavioral symptoms associated with COVID-19 quarantine in children and adolescents from three southern European countries with different levels of restrictions (Italy, Spain, and Portugal). Parents of 1,480 children and adolescents (52.8% boys) between 3 and 18 years old (M = 9.15, SD = 4.27) participated in the study. An online survey using snowball sampling techniques was conducted during 15 days between March and April 2020, representing the early phase of the quarantine associated with COVID-19 outbreak. Parents answered questionnaires about sociodemographic data, housing conditions, immediate psychological responses during quarantine (e.g., anxiety, mood, sleep, and behavioral alterations), patterns of use of screens, daily physical activity, and sleep hours before and during the quarantine. The results revealed an increase in children's psychological and behavioral symptoms, increased screen-time, reduced physical activity, and more sleep hours/night. Italian children presented less psychological and behavioral symptoms compared with Portuguese and Spanish children. In general, hierarchical multiple regressions revealed that having an outdoor exit in the house (e.g., garden, terrace) contributed to lower levels of psychological and behavioral symptomatology. Future studies are needed to identify family and individual variables that can better predict children and adolescents' well-being during and after quarantine. Recommendations for families and implications for practice are discussed.info:eu-repo/semantics/publishedVersio

COVID-19: psychological symptoms and coping strategies in preschoolers, schoolchildren, and adolescents

The present study aimed to compare psychological symptoms and coping strategies in 1480 preschoolers, schoolchildren, and adolescents during home confinement due to COVID-19. We enrolled parents from Italy, Portugal, and Spain who completed a survey between the second and fourth week of lockdown. The results showed that preschoolers displayed more sleeping difficulties, temper tantrums, and dependency while adolescents' reactions were more related to COVID-19 worries and uncertainty. Schoolchildren showed more difficulty in concentrating. Adolescent girls showed higher anxiety levels than schoolchildren boys. Schoolchildren relied more on emotion-oriented strategies, which were linked to increased internalizing and externalizing symptoms in all ages. Task-oriented strategies, regardless of the child's age, work best to cope with stress. Our findings provide information for professionals and parents about children's most common and adaptive coping strategies according to age. Furthermore, they contribute to the early detection of long-term psychological maladjustment in children.info:eu-repo/semantics/acceptedVersio

Psychological symptoms in Italian, Spanish and Portuguese youth during the COVID-19 health crisis: a longitudinal study

Aiming to slow down the spread of the COVID-19, a lockdown was declared in the first term of 2020 in many European countries, applying different restrictions measures. Although the psychological effects of home confinement in children have been described, there is a lack of longitudinal research examining the impact of the confinement over time. The present study analyzes the evolution of the psychological wellbeing of children and adolescents from three European countries with different restrictions. Parents of 624 Italian, Spanish, and Portuguese children and adolescents aged 3 to 18 years old completed the “Impact Scale of COVID-19 and Home Confinement on Children and Adolescents” two, five, and eight weeks after the lockdown. Results show a different pattern for each country. Children from Italy, the first European country that applied a lockdown, were better adapted than Spanish and Portuguese children the first two weeks after confinement but they were more psychologically impacted by home confinement at the eight-week assessment. Portuguese children, who followed a general duty of home confinement, were the best adapted to the situation, with no significant differences over time. A significant change was found in anxiety symptoms in Spanish children, with a decrease at the last assessment. Findings suggest that long confinements and hard restrictions affect children, so prevention measures should be applied during confinements to prevent psychological problems in children.info:eu-repo/semantics/publishedVersio

Anxiety and depressive symptoms in children and adolescents during COVID-19 pandemic: a transcultural approach

Background: Despite being necessary to delay the spread of COVID- 19, home confinement could have affected the emotional well-being of children and adolescents. Knowing which variables are involved in anxiety and depressive symptoms could help to prevent young people’s psychological problems related to lockdown as early as possible. This crosssectional study aims to examine anxiety and depressive symptomatology in Italian, Spanish, and Portuguese children and adolescents in order to determine which variables are related to poorer well-being during the pandemic. Method: The parents of 515 children, aged 3-18 years old, completed an online survey. Children’s anxiety symptoms were assessed using the Spence Children’s Anxiety Scale-Parent Version, and depressive symptoms were measured with the Short Mood and Feelings Questionnaire-Parent Version. Results: We found differences in anxiety and depression between countries, with higher anxiety scores in Spanish children, and higher depression scores in Spanish and Italian children compared to the Portuguese. Anxiety and depressive symptoms were more likely in children whose parents reported higher levels of stress. Conclusions: These findings are discussed in the light of detecting and supporting affected children as early as possible.info:eu-repo/semantics/publishedVersio