Conceptualizing gambling disorder with the process model of emotion regulation

Introduction Nowadays, gambling disorder (GD) is a worldwide health issue and there is a growing need to both improve our understanding of this disorder and to tailor specific interventions for its treatment. Moreover, theoretical models and preliminary empirical results suggest that difficulty in regulating emotional states might be involved in GD. However, literature describing clinical and theoretical aspects of emotional dysregulation among pathological gamblers (PGs) shows a lack of systematic description. Objectives We aimed to provide, within an exhaustive theoretical framework of emotion regulation (ER) processing, empirical evidence supporting a conceptual model of GD as an ER affliction. Methods We commented on empirical evidence on the relationship between ER and GD in the light of two main conceptual models of emotion (dys)regulation. Results The results suggest there are actual deficits of ER processing among PGs, manifesting themselves through different ways and in different steps of the ER timeline. In addition, dysregulation of positive emotions may play a central role in GD. From a clinical point of view, we pointed out that deficits in ER might be multiple in nature and an assessment for GD should be accurate to identify the specific components accounting for the development and maintenance of the disorder. It should also orientate the clinician in selecting therapeutic objectives. Conclusions The nature of emotional states that are difficult to regulate might account for the GD severity and indicate the subtype of PGs the patient belongs to. Treatment programs should be tailored on the specificity of PGs

Narcissistic Implications in Gambling Disorder: The Mediating Role of Emotion Dysregulation

Gambling Disorder (GD) is a complex psychopathology involving a numbers of cognitive, behavioral, emotional and neurobiological determinants. Previous research suggests that GD may frequently co-occur with Narcissistic Personality Disorder. However, there is still a lack of study investigating Pathological Narcissism (PN) in both its vulnerable and grandiose facets among clinical population. Moreover, emotional dysregulation is commonly thought to underlie GD albeit research on this topic remains poor. The present study aims to investigate the role of both vulnerable and grandiose narcissism in relation to GD as well as the mediator role played by emotion dysregulation in such link. We administered to a sample of addicted gamblers (n = 74) and a sample of heathy controls (n = 105), the South Oaks Gambling Screen (SOGS), the Pathological Narcissism Inventory (PNI) and the Difficulties in Emotion Regulation Scale (DERS). Differences across groups emerged on the scores obtained on the PNI and DERS. Moreover, we found positive associations between SOGS scores and both PNI and DERS. Also, strategic addicted gamblers showed higher levels of vulnerable narcissism compared to others. Finally, emotion dysregulation difficulties appeared to fully mediate the relationship between grandiose narcissism and GD severity. Grandiose and vulnerable narcissism appear important variables involved in GD. Also, emotion regulation deficits seem to account for GD and to explain the pathways by which grandiose narcissism leads to GD. Clinical implications and future directions are discussed

ALEXITHYMIA IN FACEBOOK ADDICTION: ABOVE AND BEYOND THE ROLE OF PATHOLOGICAL NARCISSISM

Background: Personality dysfunctions and deficits in the capacity to cope with negative emotional states have been related to internet addictions. However, in relation to Facebook addiction, this issue remains poorly investigated. Specifically, few studies explored the role played by grandiose and vulnerable narcissism in Facebook addiction. Furthermore, the relationship between alexithymia and pathological narcissism has not yet been explored in relation to problematic Facebook use. The main objective of this study was to examine the association among Facebook addiction, pathological narcissism and alexithymia. Method: A cross sectional study was designed to this aim. A sample of adult participants (N=270; Mage= 41.05; SD = 14.05) was administered the Bergen Facebook Addiction Scale (BFAS), The Pathological Narcissism Inventory (PNI) and the Toronto Alexithymia Scale (TAS-20). Results: Results showed that pathological narcissism, and especially grandiose narcissism, appears to be an important factor associated to problematic Facebook usage among adults. Moreover, difficulties in the capacity to identify their own emotional states may be a risk factor for such condition. Conclusions: In conclusion, these results are in line with other data found in the field of behavioral addictions and add further reflection for planning more specific clinical intervention programs for individuals addicted to Facebook with narcissistic traits. These may benefit from a greater focus on the impairments in self-monitoring capacities such as emotional awareness. Personality psychopathologies should be targeted by clinical interventions, but also broader functional impairments (as such as alexithymia) should be addressed as more strategic therapeutic objectives in the field of Facebook Addiction

Aggression Among Offenders: The Complex Interplay by Grandiose Narcissism, Spitefulness, and Impulsivity

Impulsivity seems closely related to both narcissism and spitefulness as a potential common pathway by which these patho- logical personality traits lead to violence. We administered the Aggression Questionnaire (AQ), the Pathological Narcissism Inventory, the Spitefulness Scale, and the Impulsive Behavior Scale Short Form to a sample of individuals convicted of violent offenses (n = 182) and a sample of community participants (n = 203). Hierarchical regression analysis of the convicted sample showed that spitefulness predicted AQ scores positively and significantly beyond the roles of both pathological narcis- sism and impulsivity. Finally, mediation analyses showed that impulsivity partially mediated the relationships between aggres- sion and both grandiose narcissism and spitefulness. Our results support the hypothesis that spitefulness plays an important role in the prediction of aggressiveness. Finally, impulsivity seems to be a central common variable that explains the relation- ship between pathological personality traits and aggressive behavior among individuals convicted of violent offenses

Bell lysaker emotion recognition test: a contribution for the italian validation

INTRODUCTION: Emotion recognition deficits in psychopathology have been extensively studied with a variety of measures. The Bell Lysaker Emotion Recognition Test (BLERT; Bell et al., 1997) is an effective method to assess emotion recognition by presenting affect stimuli which may have greater verisimilitude with real life events. Indeed, BLERT combines facial expressions with affective information transmitted in prosody or body posture. This method has allowed the study of emotion recognition deficit in psychotic patients, as well as its relationships with other aspects of psychopathology (Vohs et al., 2014). OBJECTIVES: We aimed at testing the validity and reliability of an Italian version of the BLERT. AIMS: First, a group-comparison was carried out between clinical and nonclinical participants. Then, correlations among BLERT scores and other indices of psychological functioning were explored. METHODS: We recruited 12 inpatients with psychotic disorders (mean age= 54.75; 58.3% female) and 45 nonclinical participants (mean age= 24.04; 75.6% female). We administered the BLERT (Bell et al., 1997), along with the following measures: Empathy Quotient (Lawrence et al., 2004), Interpersonal Reactivity Index (Davis, 1980), Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), and the Inventory of Interpersonal Problems-47 (Pilkonis et al., 1996). RESULTS: Clinical participants resulted impaired in all indices of the BLERT. Further, the construct validity of the BLERT was confirmed by associations with measures of empathy, emotion dysregulation, and interpersonal problems. CONCLUSIONS: The use of the Italian version of the BLERT seemed promising for the study of emotion recognition in both clinical and nonclinical samples

Nocebo Effect in patients with Adverse Drug Reactions: The Role of Emotion Regulation

open4Patients who have experienced adverse drug reactions (ADRs) can show some psychological problems both pre-existing than consequently the reactions. Anxiety, depression, somatization, as well as a minor capability of expressing emotions, have been demonstrated in some of these subjects. Nevertheless, a negative expectation toward a new drug administration related to some nocebo reactions can complicate the evaluation of these patients. This study aims to investigate the link between the nocebo effect and emotional functioning in ADRs patients to better understanding the psychological mechanisms involved in this phenomenon. Therefore, patients who have manifested or not (non responders) a nocebo reaction following the administration of an inert substance (placebo) have been compared. One hundred twenty patients (N = 30 with nocebo reactions; N = 90 non responders) completed the Difficulties in Emotion Regulation Scale, Emotion Regulation Questionnaire, and Toronto Alexithymia Scale-20. ADRs patients with nocebo reactions showed: 1) higher level of Cognitive Reappraisal than non responders; 2) associations between higher level of emotion dysregulation and not immediate drug reactions; 3) associations between higher level of alexithymia, Expressive Suppression and more frequent access to healthcare services; 4) alexithymia and Expressive Suppression as predictors of more frequent access to healthcare services, evident in 35% of the sample. The clarification of some psychological mechanisms involved in the nocebo effect is a basic prerequisite to better understand and manage these patients.openMara Donatella Fiaschi; Susanna Voltolini; Patrizia Velotti; Fabiola BizziDonatella Fiaschi, Mara; Voltolini, Susanna; Velotti, Patrizia; Bizzi, Fabiol

Single and multiple clinical syndromes in incarcerated offenders: Associations with dissociative experiences and emotionality

The present study examined the prevalence and correlates of clinical syndromes in a large group (N = 438) of incarcerated violent offenders, looking at differences between inmates with one and those with more than one clinical syndromes. More than a half of the sample (57%) reported clinically relevant symptoms for at least one clinical syndrome (n = 252), and the majority of them (38%) reported more syndromes in comorbidity (n = 169). Increased severity of clinical conditions (none, one, more than one syndrome) corresponded with significantly greater levels of personality disorder traits, psychological symptoms, dissociation, and negative emotionality, with large effect sizes. After controlling for co-occurrence of personality disorder traits and other symptoms, the presence of more than one comorbid syndrome significantly predicted unique variance in dissociation (positively) and positive emotionality (negatively). The presence of one clinical syndrome significantly and positively predicted negative emotionality. Findings support the possibility that the complexity, and not just the presence, of psychopathology could identify different groups of inmates

Emotion regulation, mindfulness, and alexithymia: Specific or general impairments in sexual, violent, and homicide offenders?

Purpose: Problems in emotional functioning have been identified as a risk factor for both sexual and violent offending, yet the precise pattern of impairment in emotional functioning that is experienced by sexual and violent offenders remains unclear. Methods: In this study, we examined self-reported difficulties in emotion regulation, the use of different strategies for regulating emotions, levels of trait alexithymia, and dispositional mindfulness in men with a history of sexual offending, non-sexual violent offending, homicide, and community controls. Results: A comparison between these groups showed that while sexual offenders had some circumscribed difficulties in emotional nonacceptance, violent offenders showed more generalized problems in emotional nonacceptance, alexithymia, and mindfulness. In contrast, homicide offenders reported few difficulties compared with other offender groups. Conclusions: Our results have implications for the allocation of individuals to treatment modules aimed at improving emotion regulation to reduce negative affect and offending behavior

Emotion regulation mediates relationships between mindfulness facets and aggression dimensions

Recent years have witnessed an increase of research on socio-affective factors that can explain individual differences in aggressive tendencies across community and offender populations. Specifically, mindfulness and emotion regulation have emerged as important factors, which could also constitute important prevention and treatment targets. Yet, recent studies have advanced the possibility that mindfulness may also have a "dark" side, being associated with increased levels of aggression-related variables, especially when accounting for the variance associated with emotion regulation. The present study sought to elucidate relationships among mindfulness, emotion regulation, and aggression dimensions (i.e., verbal and physical aggression, anger, and hostility) across violent offender (N = 397) and community (N = 324) samples. Results revealed expected associations between both mindfulness and emotion regulation and aggression dimensions, such that greater impairments in mindfulness and emotion regulation were related to increased levels of aggression across samples. Further, analyses of indirect effects revealed that a latent emotion dysregulation factor accounted for (i.e., mediated) relationships between mindfulness facets and aggression dimensions in both samples. Previously reported positive associations between the residual variance in mindfulness scales (i.e., controlling for emotion regulation) and aggression-related variables were not replicated in the current samples. Taken together, findings suggest that mindfulness and emotion regulation have unequivocal relations with lower levels of aggression, and should therefore be considered as relevant targets for prevention and treatment programs aimed at reducing aggressive tendencies

Metacognitive interpersonal mindfulness-based training for worry about interpersonal events:A pilot feasibility and acceptability study

Individuals with personality disorders experience worry and repetitive thoughts regarding interpersonal scenarios. Mainstream mindfulness-based approaches may be insufficient to soothe these individual's distress due to difficulties in letting thoughts go and refocusing attention to the present moment. For this reason, we devised an adapted form of mindfulness-based program called Metacognitive Interpersonal Mindfulness-Based Training (MIMBT) for personality disorders. In this pilot study, 28 individuals attended nine weekly sessions to evaluate the feasibility and acceptability, and to establish preliminary outcomes. All individuals completed the program. Attendance was very high (96%). Significant changes were observed on the primary outcome of reduction in repetitive thinking, measured using the Metacognition Questionnaire-30. We also observed a decrease in depression severity. Despite important limitations, this pilot study suggests that MIMBT has the potential to be a viable and well-accepted option for increasing positive outcomes in the treatment of personality disorders. Clinical considerations and directions for future research are discussed