Search Results (987)

Background/Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, often persisting into adolescence and adulthood, with significant impacts on social, academic, and occupational functioning. Emerging research highlights the role of personality traits in ADHD, suggesting their influence on symptom presentation, functional impairments, and treatment adherence. This study aims to investigate maladaptive personality domains and traits in adolescents with ADHD using the Alternative Model of Personality Disorders (AMPD) framework and the Personality Inventory for DSM-5 Short Form (PID-5-SF), with a particular focus on the differences among same-sex peers and differences from typically developing peers. Methods: This study included 30 ADHD and 25 TD adolescents aged 11–17 (12.6 ± 2.1 vs. 14.9 ± 1.7; p < 0.001), recruited at IRCCS Centro Neurolesi “Bonino Pulejo”. Participants underwent clinical assessments, cognitive evaluation, and standardized rating scales, with maladaptive personality traits measured using the PID-5-SF. Chi-squared and Mann–Whitney U tests were used to compare the two groups, as appropriate. Results: ADHD adolescents showed significantly higher scores than TD peers in restricted affectivity (p = 0.007), distractibility (p = 0.001), impulsivity (p = 0.049), irresponsibility (p = 0.036), hostility (p = 0.046), perseveration (p = 0.010), submissiveness (p = 0.023), and risk-taking (p = 0.032). Among personality domains, disinhibition was significantly higher in the ADHD group (p = 0.002), while detachment approached significance. Female ADHD participants scored higher than TD females in restricted affectivity, distractibility, and risk-taking. Conclusions: These findings suggest that maladaptive personality traits play a key role in ADHD during adolescence, highlighting the need for tailored interventions. Integrating personality assessment into clinical practice may enhance diagnostic accuracy and support more effective, individualized treatment strategies. Full article

Young Black males (YBM), ages 15–17, experience disproportionately high rates of firearm violence and related structural disadvantages, shaping both their psychological and practical responses to violence-related stressors. These intersecting exposures influence their coping strategies, mental health, help-seeking behaviors, and broader social functioning. Generational shifts in how young males conceptualize identity, mental health, help-seeking, and masculinity, combined with increasing exposure to firearm violence, underscore the need for a closer examination of contemporary coping strategies. This qualitative study applies Thorne’s Interpretive Description (ID) to explore coping patterns among YBM navigating violence exposure in physical and online environments. Drawing from two focus groups of 33 YBM (M = 15.8, SD = 1.19) from a Midwest high school, we conducted a thematic analysis grounded in the interpretive description tradition. Integrating the Phenomenological Variant of Ecological Systems Theory (PVEST) and the Transactional Model of Stress and Coping (TMSC), we examined how structural and interpersonal factors shape YBM agency and coping responses. Four coping patterns emerged: (1) Problem-Focused Adaptive, (2) Problem-Focused Maladaptive, (3) Emotion-Focused Adaptive, and (4) Emotion-Focused Maladaptive. The findings underscore the dynamic interaction between environmental stressors, available resources, and cognitive appraisals, indicating that for Black adolescent males, coping strategies are neither static nor inherently adaptive or maladaptive. Full article

A general and still open question in clinical psychology is the crucial one: “What is a psychological/mental disorder?”. In the second half of the 20th century and now, the question has been addressed along two different parallel paths/approaches: one path aimed to classify those disorders, also thanks to the development of the international classification manuals (DSM and ICD); another path aimed to describe in what ways those “disorders” manifest themselves in the life of each individual. While the first path used explicitly the word “disorder”, the second one mainly preferred to use the words “pattern of adaptation/maladaptation”. In this brief perspective paper, we will discuss both paths and approaches, according to the perspective of clinical psychology and as a result of a narrative review. We discuss some differences between the two paths, some points of contact between them, and some critical issues. Moreover, we will briefly discuss a third integrative path that may integrate the first two. We then discussed if the third integrative path may increase the strength of both previous ones and overcome their limits, with the aim to support individual patterns of adjustment, prevent “mental/psychological disorder” and empower individuals in coping with adverse life events during all the phases of lifespan. Full article

Hypertension-induced cardiac remodeling is a complex process driven by interconnected molecular and cellular mechanisms that culminate in hypertensive myocardium, characterized by ventricular hypertrophy, fibrosis, impaired angiogenesis, and myocardial dysfunction. This review discusses the histomorphometric changes in capillary density, fibrosis, and mast cells in the hypertensive myocardium and delves into the roles of key regulatory systems, including the apelinergic system, vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) pathways, and nitric oxide (NO)/nitric oxide synthase (NOS) signaling in the pathogenesis of hypertensive heart disease (HHD). Capillary rarefaction, a hallmark of HHD, contributes to myocardial ischemia and fibrosis, underscoring the importance of maintaining vascular integrity. Targeting capillary density (CD) through antihypertensive therapy or angiogenic interventions could significantly improve cardiac outcomes. Myocardial fibrosis, mediated by excessive collagen deposition and influenced by fibroblast growth factor-2 (FGF-2) and transforming growth factor-beta (TGF-β), plays a pivotal role in the structural remodeling of hypertensive myocardium. While renin–angiotensin–aldosterone system (RAAS) inhibitors show anti-fibrotic effects, more targeted therapies are needed to address fibrosis directly. Mast cells, though less studied in humans, emerge as critical regulators of cardiac remodeling through their release of pro-fibrotic mediators such as histamine, tryptase, and FGF-2. The apelinergic system emerges as a promising therapeutic target due to its vasodilatory, anti-fibrotic, and cardioprotective properties. The system counteracts the deleterious effects of the RAAS and has demonstrated efficacy in preclinical models of hypertension-induced cardiac damage. Despite its potential, human studies on apelin analogs remain limited, warranting further exploration to evaluate their clinical utility. VEGF signaling plays a dual role, facilitating angiogenesis and compensatory remodeling during the early stages of arterial hypertension (AH) but contributing to maladaptive changes when dysregulated. Modulating VEGF signaling through exercise or pharmacological interventions has shown promise in improving CD and mitigating hypertensive cardiac damage. However, VEGF inhibitors, commonly used in oncology, can exacerbate AH and endothelial dysfunction, highlighting the need for therapeutic caution. The NO/NOS pathway is essential for vascular homeostasis and the prevention of oxidative stress. Dysregulation of this pathway, particularly endothelial NOS (eNOS) uncoupling and inducible NOS (iNOS) overexpression, leads to endothelial dysfunction and nitrosative stress in hypertensive myocardium. Strategies to restore NO bioavailability, such as tetrahydrobiopterin (BH₄) supplementation and antioxidants, hold potential for therapeutic application but require further validation. Future studies should adopt a multidisciplinary approach to integrate molecular insights with clinical applications, paving the way for more personalized and effective treatments for HHD. Addressing these challenges will not only enhance the understanding of hypertensive myocardium but also improve patient outcomes and quality of life. Full article

This review examines the relationship between tennis participation and mental health, highlighting both the psychological benefits and challenges associated with the sport. Using a retrospective, citation-based methodology, peer-reviewed studies published in English, French, and Greek between 2000 and March 2025 were included. The findings indicate that tennis participation is associated with reductions in depressive and anxiety symptoms, improved self-confidence, and enhanced resilience. However, competitive tennis also presents significant psychological demands, including elevated stress levels and susceptibility to maladaptive coping behaviors. To address these complexities, this review introduces the Resilience Racket Model, a conceptual framework representing the integration of physical readiness, psychological resilience, and systemic support. The model uses the metaphor of a tennis racket: the handle reflects foundational physical skills; the strings represent resilience components; the frame denotes environmental and organizational support; and the sweet spot signifies the optimal balance between physical and mental readiness. The review also highlights the effectiveness of psychological interventions, such as cognitive-behavioral therapy and mindfulness, in supporting athlete well-being. These findings advocate for a holistic approach to athlete development, emphasizing parity between mental health and physical training, and call for further research into tailored, sport-specific mental health interventions in tennis. Full article

Chronic psychological stress is known to influence immune function and contribute to development of autoimmune disorders through dysregulated inflammatory responses. This study investigates relationships between acute stress, life trauma, and autoimmune salivary biomarkers in firefighter recruits during psychophysical stress training. Salivary samples were collected from firefighter recruits during two stress tests to evaluate responses to acute stress. Samples were obtained at three time points—pre-stress, post-stress, and recovery—across both tests. Cortisol was measured to characterize acute stress response (ASR) profiles, while immune function was assessed through the analyzing C-reactive Protein (CRP), Complement C4 (C4), Pigment Epithelium Derived Factor (PEDF), and Serum Amyloid P (SAP). Results showed significant changes in CRP, C4, and PEDF after stress inoculation. Higher previous life trauma was associated with lower baseline cortisol (r = −0.489) and delay in cortisol recovery (r = 0.514), suggesting a learned biological response, potentially protective against stress-induced dysregulation. Cluster analysis revealed four distinct cortisol ASR profiles which were found to have significantly different past life trauma (p = 0.031). These findings suggest that trauma history influences stress biomarker dynamics, potentially reflecting individualized adaptive or maladaptive responses. The insights gained may inform strategies to enhance stress resilience and mitigate autoimmune risk among high-stress populations. Full article

Background/Objectives: Lower-limb amputation (LLA) leads to disability, impaired mobility, and reduced quality of life, affecting 1.6 million people in the USA. Post-amputation, motor cortex reorganization occurs, contributing to phantom limb pain (PLP). Transcranial magnetic stimulation (TMS) assesses changes in cortical excitability, helping to identify compensatory mechanisms. This study investigated the association between TMS metrics and clinical and neurophysiological outcomes in LLA patients. Methods: A cross-sectional analysis of the DEFINE cohort, with 59 participants, was carried out. TMS metrics included resting motor threshold (rMT), motor-evoked potential (MEP) amplitude, short intracortical inhibition (SICI), and intracortical facilitation (ICF). Results: Multivariate analysis revealed increased ICF and rMT in the affected hemisphere of PLP patients, while SICI was reduced with the presence of PLP. A positive correlation between SICI and EEG theta oscillations in the frontal, central, and parietal regions suggested compensatory mechanisms in the unaffected hemisphere. Increased MEP was associated with reduced functional independence. Conclusions: SICI appears to be a key factor linked to the presence of PLP, but not its intensity. Reduced SICI may indicate impaired cortical compensation, contributing to PLP. Other neural mechanisms, including central sensitization and altered thalamocortical connectivity, may influence PLP’s severity. Our findings align with those of prior studies, reinforcing low SICI as a marker of maladaptive neuroplasticity in amputation-related pain. Additionally, longer amputation duration was associated with disrupted SICI, suggesting an impact of long-term plasticity changes. Full article

Obesity is a chronic disease with prevalence rates that have risen dramatically over the past four decades. This increase is not due to changes in the human genome but rather to environmental factors that promote maladaptive physiological responses. Emerging evidence suggests that external influences, such as high-fat diets, modify the epigenome—the interface between genes and the environment—leading to persistent alterations in energy homeostasis. This review explores the role of epigenetic mechanisms in obesity, emphasizing insights from transgenic animal models and clinical studies. Additionally, we discuss the evolution of obesity research from homeostatic to allostatic frameworks, highlighting key neuroendocrine regulators of energy balance. Full article

Many stressors have been identified for shelter dogs, and while stress is a natural physical response, exposure to shelter stressors has been implicated in poor dog welfare including the formation of maladaptive behaviors that manifest as unappealing responses toward humans. Inappropriate behavioral reactions to humans lead to longer lengths of stay in the shelter, so identifying ways to reduce these responses to human presence would not only benefit the immediate welfare of the dog but could also decrease the amount of time the dog spends in the shelter. Previous studies have shown that response-independent food paired with an auditory stimulus reduced behaviors that likely prolong time to adoption; however, these interventions used an explicit discriminative stimulus where a more easily deployed design would be effective without requiring an additional stimulus to precede the food. The purpose of the present study was to extend that work to evaluate the effect of noncontingent reinforcement on reducing behavioral reactions to humans in the presence both of the experimenter and other people. Overall, the intervention was effective at decreasing human-directed behavioral responses but did not decrease the dogs’ length of stay. Changes in reactive behaviors appear to be limited to the presence of the experimenter during the first and last trials, with improvements generalizing to non-experimenters only for two behaviors: staying in the front half of the kennel and facing the kennel front. Our recommendation for shelters is that this intervention would be most effective at improving behaviors directed at a person delivering treats to the dog. Full article

Myocardial infarction (MI) is associated with emotional distress, depression, and anxiety. Defense mechanisms and mentalized affectivity play key roles in affective regulation; however, their roles in individuals with MI remain underexplored. This study examined the relationship between depressive and anxiety symptoms, defensive functioning, and mentalized affectivity in MI patients. Sixty-seven patients with MI and 80 healthy controls completed the DSM-5 Self-Rated Level 2 Cross-Cutting Symptom Measures—Depression and Anxiety—Adult, the Defense Mechanisms Rating Scales-Self-Report-30, and the Brief-Mentalized Affectivity Scale. Multivariate analyses were used to compare the MI and healthy groups, while correlations and mediation models were used to evaluate associations between variables within the MI group. Compared to controls, patients with MI exhibited more severe depressive and anxiety symptoms, maladaptive defenses, and lower levels of mentalized affectivity. Within the MI group, the severity of depressive and anxiety symptoms was associated with immature defensive functioning and poorer abilities to regulate affects. Notably, the relationship between worse defensive functioning and severe depressive and anxiety symptoms was mediated by the capacity to process emotions. The mediating role of this specific dimension of mentalized affectivity emphasizes the potential of affect regulation as a target for tailored psychosocial interventions aimed at improving clinical outcomes. Full article

Adolescent dating violence is a critical issue with far-reaching consequences. This study explores the role of maladaptive emotional regulation strategies in the relationship between impulsivity and the perpetuation of violence, differentiating between violence received and exerted. A cross-sectional correlational design was used. For sample selection, a probabilistic sampling method was used, specifically a one-stage stratified random sampling with proportional allocation. The sample consisted of 700 female adolescents aged between 14 and 18 years (mean = 15.64, SD = 1.20) from Ecuador. Participants were selected if they had been in at least one romantic relationship lasting more than a month. The data analysis included descriptive statistics, Chi-square tests for categorical variables, t-tests and ANOVA for group comparisons, and Pearson’s correlation for continuous variables and mediation analysis. The results show that both physical violence exerted and received have significant positive correlations with impulsivity and maladaptive strategies, except for DERS Awareness, DERS Goals, and DERS Clarity. Impulsivity also maintains significant positive correlations with all emotional dysregulation strategies except for DERS Awareness. DERS Impulsivity and DERS Non-acceptance act as partial mediators in the relationship between impulsivity and violence (both exerted and received). Impulsivity itself is established as a clear predictor of physical violence in adolescent intimate relationships, highlighting the need for interventions and the development of educational programs aimed at improving emotional regulation strategies, such as controlling impulsivity and accepting emotions. Full article

Previous research has demonstrated both direct and indirect relationships between parental attachment and gaming addiction in adolescents. This study aimed to investigate the role of parental attachment in adolescent gaming addiction, specifically examining how maladaptive daydreaming and perceived social support function as mediators in this relationship. A convenience sample of 898 Italian adolescents (550 female, M_age = 14.89 years, SD = 1.71) completed a questionnaire that included the Inventory of Parent and Peers Attachment, the Maladaptive Daydreaming Scale, the Game Addiction Scale, and a demographic survey. Correlation analyses confirmed a negative relationship between parental attachment and gaming addiction. Mediation analyses also showed that perceived social support and maladaptive daydreaming serve as significant serial mediators in this relationship. These results emphasize the importance of both factors in understanding how parental attachment influences gaming addiction. Adolescents exhibiting gaming addiction is caused by low perceived social support and maladaptive daydreaming may benefit from psychological interventions targeting adaptive regulation strategies. Strengthening the sense of security and self-confidence through such interventions may help to reduce excessive gaming behaviors. Full article

Chronic pain is a maladaptive neurological disease that remains a major global healthcare problem. Voltage-gated sodium channels (Na_vs) are major drivers of the excitability of sensory neurons, and the Na_v subtype 1.7 (Na_v1.7) has been shown to be critical for the transmission of pain-related signaling. This is highlighted by demonstrations that gain-of-function mutations in the Na_v1.7 gene SCN9A result in various pain pathologies, whereas loss-of-function mutations cause complete insensitivity to pain. A substantial body of evidence demonstrates that chronic neuropathy and inflammation result in an upregulation of Na_v1.7, suggesting that this channel contributes to pain transmission and sensation. As such, Na_v1.7 is an attractive human-validated target for the treatment of pain. Nonetheless, a lack of subtype selectivity, insufficient efficacy, and adverse reactions are some of the issues that have hindered Na_v1.7-targeted drug development. This review summarizes the pain behavior profiles mediated by Na_v1.7 reported in multiple preclinical models, outlining the current knowledge of the biophysical, physiological, and distribution properties required for a Na_v1.7 inhibitor to produce analgesia. Full article

Objectives: The present cross-sectional web-based survey study aimed to examine the impact of gender and frontline/non-frontline condition on psychological health (depression and peritraumatic distress) of a sample of Italian healthcare workers, and to explore the mediating effects of emotional processing in these relationships. Methods: Emotional processing styles and depressive and peritraumatic distress symptoms were assessed between March and December 2021, a period which in Italy corresponds to the third and the start of the fourth wave of COVID-19, along with gender, frontline versus non-frontline role in the pandemic emergency, and other sociodemographic and background variables. Results: Results showed that emotional processing mediated the relationship between gender and frontline/non-frontline role with depressive and peritraumatic distress symptomatology. Being a woman, working on the frontlines, and having a maladaptive emotional processing style increased the negative effects of stress during the pandemic. Conclusions: The obtained results strengthen the importance of providing useful psychological support for health professionals to facilitate the expression and management of emotions as well as the learning of healthy and functional styles of emotional processing. Full article

Extreme heat, a leading cause of weather-related morbidity and mortality, particularly affects vulnerable populations such as older people, increasing their risk of stroke. There is a gap between scientific knowledge and policy implementation, particularly regarding climatic risk factors for stroke. This study aims to identify knowledge barriers and enablers and formulate recommendations. We held eight focus groups of participants aged ≥ 60 years (N = 56), a workshop with 36 public health policy experts and stakeholders, and six in-depth interviews with experts. Three main themes emerged: (1) risk perception and responsibility attribution, revealing varying awareness of climate change risk for stroke and complex personal, cultural, and institutional responsibilities; (2) barriers to climate change adaptation, including knowledge gaps, environmental maladaptation, and insufficient governmental resources; and (3) enabling factors and adaptive solutions, highlighting individual coping strategies, education, and collaborative policy interventions. Focus group participants demonstrated diverse adaptive behaviors, while policymakers emphasized interagency collaboration and targeted knowledge dissemination. Older individuals demonstrated limited knowledge about climate change and its health risks. National policies lack effective communication. There is a critical need for knowledge dissemination, coping tools, and solutions for healthcare providers and at-risk groups, particularly regarding the health implications of climate change. Full article