The personal and interpersonal components of perfectionism: the Italian validation of “Multidimensional Inventory of Perfectionism in Sport”

The present research focused on the general theme of perfectionism in the sport domain, and it provided the first empirical validation of the original 72-item “Multidimensional Inventory of Perfectionism in Sport” (MIPS) among Italian athletes. The study, specifically, also focused on the relations linking personal and interpersonal components of perfectionism to athletes’ competitive anxiety. The research overall relied on data from 644 Italian sport science students and professional athletes and included both cross-sectional and longitudinal designs. Data analyses primarily focused on structural equation modeling, and the findings overall supported the psychometric and construct validity of the Italian version of the MIPS, also highlighting the key role of the personal components of perfectionism

A consensus document on definition and diagnostic criteria for orthorexia nervosa

Purpose: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with “correct” eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. Methods: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A–Definition, Clinical Aspects, Duration; B–Consequences; C–Onset; D–Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. Results: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. Conclusions: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. Level of evidence_ Level V: opinions of expert committee

Perfectionism and eating disorder symptoms in adolescents and young adults: the mediating role of cognitive emotion regulation strategies

Eating disturbances, either clinical or subclinical, are highly prevalent in western countries (Makino, Tsuboi, & Dennerstein, 2004) and their prevalence have been increasing in the last 50 years, especially among adolescents. Full blown eating disorders are severe conditions that are very difficult to treat (Treasure, Cardi, Leppanen, & Turton, 2015). The scientific and clinical understanding of these disorders has been progressing slowly, but we know several risk factors. Individuals with disturbed eating attitudes and behaviours typically report problematic perfectionistic standards and intense evaluative concerns, as well as maladaptive emotional processes. The present dissertation aims to examine the associations between perfectionistic aspects, emotion regulation strategies and disturbed eating in two samples representative of two distinct developmental ages. In the first chapter, the construct of perfectionism and its clinical relevance were described and discussed by summarizing studies in scientific literature focused on the conceptualization, measurement and psychological implications of the construct. In the second chapter, theoretical models assessing the relationship between perfectionistic dimensions and eating symptoms were discussed. In the third chapter, principal theories on emotion regulation strategies were explained and results of a cross-sectional investigation examining the specific relationships among perfectionistic facets, emotion regulation strategies and eating symptoms reported by two samples of adolescents and young adults were observed. In particular, the mediation role of adaptive and maladaptive emotion regulation in explaining the associations between perfectionistic dimensions and eating pathology was examined. Finally, in the fourth chapter, results obtained from the study conducted were discussed

A short version of the cognitive emotion regulation questionnaire: psychometric properties in an Italian student sample.

Cognitive Emotion Regulation Questionnaire (CERQ) is a largely used tool to assess cognitive emotion regulation strategies. The objective of this study is to validate the Italian 18-item short version of the CERQ (CERQ-S) and to test its psychometric properties. Participants (n=442; Mage=21.12; SD=3.69; 69.1% females) completed a battery of self-report questionnaires including the CERQ-S, the emotional regulation questionnaire (ERQ) and the multidimensional perfectionism scale (MPS). In order to confirm the original CERQ-S nine factor structure, a confirmatory factor analysis (CFA) was computed. Cronbach’s alphas were computed to examine the internal consistency of each subscale. Criterion validity was gathered via the analysis of the correlations with the ERQ and the MPS. Factorial invariances tests across age were computed including an additional adolescent sample (n=256; Mage=14.81; SD=0.59; 55,5% males). CFA confirmed the nine-factor structure. All fit indices suggested a great fit to the data:χ2(99)=136.73; CFI=0.982; TLI=0.975; SRMR=0.030; RMSEA=0.029. Except for rumination (.65), all subscales had an acceptable (.70) or greater reliability. ERQ reappraisal score was associated with the CERQ-S positive reappraisal (r=.409; p<.001). The discriminant validity of the scale was confirmed by several non-significant correlations with the MPS facets. Configural, metric and scalar invariance were reached. Compared to adolescents, young adults reported higher latent means on acceptance, rumination, refocus on planning and positive reappraisal dimensions, while scored lower on positive refocusing dimension. The brevity of this tool and its good psychometric properties suggest that it could be a useful screening tool in both clinical and research practice. Additionally, the factor structure emerged as invariant across age, suggesting that the CERQ-S underlying constructs are structurally similar across the developmental spectrum from adolescence to young adulthood

The relationship between perfectionism and eating-related symptoms in adolescents: A systematic review

The clinical significance of two major aspects of perfectionism, perfectionistic strivings (PS) and perfectionistic concerns (PC), in eating disorders (EDs) symptoms was well-established among adults. However, no systematic review has assessed evidence examining associations between both unidimensional and multidimensional perfectionism and EDs in early and middle adolescence. For this aim, three online databases (PsycINFO, Medline and PsycArticle) were searched for articles published until January 2019, and observational studies were considered. Study quality was systematically appraised, and results were summarized using a narrative synthesis approach. Fifty-one cross-sectional and 28 longitudinal studies were included. Most studies supported the relationship between perfectionism and EDs, with the majority adopting a unidimensional approach for assessing perfectionism. Among studies that employed multidimensional measures of perfectionism, the majority (n = 11) of evidence supported the relationship between eating symptoms and PC, while fewer (n = 5) studies provided significant unique associations with PS. These findings are consistent with the body of research suggesting the strength of the relationship between PC and EDs was greater than between PS and EDs. It was recommended that preventive interventions should be primarily focused on reducing self-critical perfectionism, since it resulted to be the most relevant perfectionistic dimension in the development of eating symptoms in adolescents

Perfectionism and eating behavior in the COVID-19 pandemic

The novel coronavirus disease 2019 (COVID-19) represents a massive global health crisis leading to different reactions in people. Those reactions may be adaptive or not depending on situational or psychological processes. Disordered eating attitudes and behaviors are likely to be exacerbated by the pandemic through multiple pathways as suggested by Rodgers et al. (2020). Among the psychological variables that may have increased dysfunctional eating attitudes and behaviors as a consequence of the social distancing and isolation, we looked at perfectionism. Perfectionism is a well-recognized risk and maintaining factor of eating-related symptoms and interact with stress increasing the probability of dysfunctional reactions (e.g., Wang and Li, 2017). The present study investigated the relationship between multidimensional perfectionism and eating behaviors by considering the mediating role of psychological distress. Data were collected from two countries (Italy and Spain) by means of an online survey. The samples included 465 (63.4% female) participants from Italy and 352 (68.5% female) from Spain. Participants completed the short form of the Hewitt and Flett Multidimensional Perfectionism Scale (Lombardo et al., 2021) to assess self-oriented, other-oriented and socially prescribed perfectionism, as well as the short form of Three Factors Eating Questionnaire (Karlsson et al., 2000) and the Italian version of Depression Anxiety and Stress Scale-21 (Bottesi et al., 2015), respectively used to assess restrictive, emotional and uncontrolled eating on one hand, and depression, anxiety and stress on the other. Multigroup analysis was performed to test the hypothesized model. Results showed that other-oriented and socially prescribed perfectionism were indirectly related to most of the dysfunctional eating aspects through the mediation of psychological distress, and the pattern obtained was consistent in both countries. These findings evidence that the psychological distress potentially related to the COVID-19 disease mediates the negative impact of interpersonal perfectionism and the tendency to eat in response to negative emotions

Insomnia symptoms moderate the relationship between perseverative cognition and backward inhibition in the task-switching paradigm

Perseverative cognition (PC), that is, the continuous cognitive representation of uncontrollable threats, is known to dampen executive control processes in experimental paradigms. Similarly, PC has been shown to impair sleep and to be implicated in the exacerbation of insomnia, which may in turn contribute to the disruption of executive functions. The interactions between PC and insomnia in influencing executive functions, however, have never been tested to date. In the present study, we explored whether insomnia symptoms may moderate the associations between PC and disrupted executive functions, with the hypothesis to find a stronger relationship between these variables at increasing levels of insomnia. Fifty participants completed measures of trait PC and insomnia severity in the previous month and also completed a computerized task-switching paradigm assessing backward inhibition, switch cost, and accuracy. Prior to the task switching, participants completed a measure of state rumination in order to control for the effects of state PC on cognitive performance. Results show that trait PC was significantly correlated with higher insomnia symptoms and state rumination and marginally correlated with lower backward inhibition and longer switch cost. Moreover, insomnia severity moderated the relationship between trait PC and backward inhibition after controlling for the effects of state rumination; that is, the relationship between PC and inhibitory deficits was stronger in those with higher versus lower levels of insomnia symptoms. Findings suggest the need to better elucidate the associations between PC, insomnia, and executive functioning in clinical samples and longitudinal designs

The phenomenon of body shaming: preliminary results of a study on a group of Italian adolescents

Introduction: Body Shaming (BS) is defined as the act of bullying or insulting people by expressing negative opinions about their physical/body image. BS is reinforced by weight stigma—the discrimination based on a person’s weight —and is particularly prevalent in the school contexts , especially among students with overweight/obesity. Nonetheless, the study of factors associated to weight victimizations in youth is limited; mixed evidence is also available on efficacy of interventions aimed at its reduction. Aim: A pilot study was conducted with the aim of evaluating relationships between relevant factors associated to BS and assessing feasibility of an educational and experiential weight-related teasing prevention program conducted on a group of Italian high-schoolers. Methods: A group of questionnaires was administered at T0 and after four sessions (T1) of intervention to all the students recruited. The preliminary analysis presented here are focused on the Weight Bias Internalization Scale-Modified (WBIS), the Disordered Eating Questionnaire (DEQ), the Attitudes Toward Obese Persons (ATOP) and a questionnaire on Weight-Based Victimization. Results: A sample of 86 students completed the T0 assessment (Mage = 17.22 ± 1.82; 64% M) and 39 participants completed the T1 (Mage = 17.02 ± 1.73; 82% M). History of weight victimizations by peer and family at T0 significantly correlated with DEQ (r = 0.473 and r = 0.331, ps < 0.01, respectively), WBIS (r = 0.541 and r = 0.375, ps < 0.01, respectively) and partially with ATOP (r = 0.284, p < 0.01 and r = 0.020, p = 0.863, respectively). Also, WBI (r = 0.681, p = 0.001) and ATOP (r = 0.197, p = 0.080) were significantly and marginally associated with DEQ, respectively. The paired t-tests assessing mean differences between pre-to-post intervention on the experimental group revealed a decreasing trend in some aspects, although not statistically significant, probably due to low statistical power (see Table 1). Discussion and conclusions: Findings showed that the more adolescents experienced weight stigma and victimizations, the more they reported disordered eating symptoms. The preliminary results on the intervention are encouraging in supporting the reduction of BS-related factors after this pilot program, supporting feasibility and the implementation of the program on a larger sample size

Effects of pre-sleep cognitive intrusions on subjective sleep and next-day cognitive performance in insomnia

Pre-sleep cognitive intrusions about next-day activities, or proprioceptive and environmental stimuli are thought to trigger insomnia in neurocognitive models. Recent research showed that intrusive cognitions at bedtime may interact with sleep in influencing next-day emotional functioning; their effects on cognitive functioning, however, is largely unknown. We tested the effects of pre-sleep cognitive intrusions on subjective sleep and next-day cognitive performance in 80 participants, either with chronic insomnia or good sleepers. Pre-sleep intrusions were inspected using a validated questionnaire and sleep was assessed with a sleep diary. Cognitive functioning the following morning was measured using task switching paradigm assessing executive functions. Structural equation modelling with manifest variables (i.e., path analysis) shows that pre-sleep cognitive intrusions predicted increased sleep onset latency and wake after sleep onset, and lowered sleep efficiency. Moreover, task switching accuracy was independently predicted by pre-sleep cognitive intrusions in the previous night in those with insomnia but not in controls, beyond the effects of trait anxiety, task switching components, and previous night's sleep. Findings confirm detrimental effects of pre-sleep intrusions on sleep continuity and suggest the presence of links between pre-sleep conscious activity and next-day executive performance in patients with insomnia, with the need to better elucidate potential mediators