Silvia Tempia Valenta

Background/Objectives: Sociocultural factors, including migration and acculturation, may influence the clinical profile and course of eating disorders (EDs). This study examined differences between immigrant and native-born Spanish patients with EDs in (1) clinical presentation and (2) treatment response. Methods: Consecutive outpatients from the Eating Disorders Unit at Bellvitge University Hospital (Barcelona, Spain) were assessed using the Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90-R (SCL-90-R), and Temperament and Character Inventory-Revised (TCI-R). Statistical analyses included chi-square tests, ANOVA, Cox regression for dropout, and logistic regression for predictors of poor outcome, adjusted for ED subtype. Results: The sample included 1104 patients (947 native-born; 157 immigrants). Immigrant patients showed a distinct clinical profile, with lower drive for thinness and body dissatisfaction but higher interpersonal distrust, maturity fears, perfectionism, anxiety-related symptoms, and self-transcendence. They also presented a worse treatment response, including higher dropout rates, poorer outcomes, and lower remission rates. Predictive models identified different risk factors for poor treatment response in each group: among native-born patients, younger age of ED onset, higher novelty seeking, and lower self-directedness were associated with worse outcomes, whereas among immigrant patients, greater ED severity, lower harm avoidance, and lower self-transcendence predicted poorer results. Conclusions: Immigrant patients with EDs exhibit a differentiated clinical presentation and less favorable treatment response compared to native-born patients. The differential predictors of poor outcome highlight the need for culturally informed and individually tailored interventions that consider both sociocultural context and personality-related vulnerabilities.

Introduction: Body dissatisfaction (BD) and body appreciation (BA) are relevant psychological concerns that affect individuals across various age groups. However, limited research has focused on these issues among older men. The aim of this study is to investigate the prevalence of BD and BA and their relationships with body mass index (BMI) and mental health symptoms in a sample of community‐dwelling Italian men aged 65 and above. Methods: Participants in this cross‐sectional study (N = 122) completed self‐report measures including the figure rating scale (FRS), the body appreciation scale (BAS‐2), the Geriatric anxiety scale‐short form (GAS‐10), and the Geriatric depression scale‐short form (GDS‐SF). The Kruskal‐Wallis test was used to examine differences between groups, and the Mann‐Whitney U test was applied for pairwise comparisons. Results: 45.1% of participants experienced some level of BD, with 13.9% demonstrating severe BD, while only 39.3% reported BA. BD was significantly higher in individuals with overweight or obesity. Anxiety and depression symptoms were significantly more common among participants with BD compared to those without. A significant association was also observed between lower BA and increased anxiety, whereas BMI cutoffs did not show significant correlations with BA. Conclusion: This study highlights the importance of considering BD in older adults. These findings indicate differences in BD across BMI categories, suggesting potential benefits of using age‐specific BMI thresholds (27.27 kg/m ² or 28 kg/m ² ) when assessing body image in aging populations. Further research should explore age‐specific differences in body image and their implications for mental health in older adults.

Introduction: Climate change poses a serious threat to fundamental human needs, including access to water, air, food, and housing. It also contributes to a range of mental health risks. Among its psychological impacts, eco-anxiety, defined by the American Psychological Association as a chronic fear of environmental doom, is receiving increasing attention. Although awareness of eco-anxiety is growing, research on this phenomenon remains limited, especially in countries like Italy, which the Intergovernmental Panel on Climate Change identifies as especially vulnerable to the consequences of global warming. Methods: This study investigated the prevalence of eco-anxiety in a sample of healthy Italian adults recruited among voluntary blood donors, focusing on its distribution across generational cohorts. In May 2024, an online questionnaire was administered via QR code to members of AVIS (Associazione Volontari Italiani Sangue) in Bologna. A total of 1,795 participants (1,060 males, 727 females, 8 non-binary) took part, ranging in age from 18 to 70 years (M = 46.6). Eco-anxiety was assessed using the Hogg Eco-Anxiety Scale (HEAS). Results: The sample showed a median HEAS score of 4.0 (IQR = 8.0). Kruskal–Wallis tests revealed significant differences across generational cohorts ( p < .001; ε² = 0.0603), with Generation Z (18–28 years) reporting the highest levels of eco-anxiety. Nearly half of Generation Z participants (48.4%) exhibited high levels of eco-anxiety (χ² = 81.3; p < .001; V = 0.213). Spearman’s correlation and linear regression analyses confirmed a strong association between younger age and elevated eco-anxiety scores. After adjusting for general anxiety and depressive symptoms, Generation Z participants were more than four times as likely as Baby Boomers to report high eco-anxiety (OR = 4.21; 95% CI [2.755, 6.421]). Conclusions: These findings highlight a marked generational gap in climate-related distress, underscoring the need for targeted psychological interventions for younger populations and further research into the mechanisms underlying eco-anxiety.

Multiple family group (MFG) therapy is a psychoeducational intervention designed for caregivers of individuals with borderline personality disorder (BPD). This study is the first to compare MFG therapy with treatment as usual (TAU). The objectives were to assess MFG therapy's impact on caregivers' social functioning, perceived support from mental health professionals, coping and communication skills development, and overall satisfaction with the program. A randomized controlled trial (RCT) was conducted at the West Community Mental Health Center in Bologna, Italy. This study enrolled 57 caregivers of 48 adult patients diagnosed with BPD. Participants were randomly assigned to the MFG or TAU intervention. Psychometric assessments were conducted at baseline (T0) and 6 months (T1). Between‐group differences in improvements were analyzed using independent sample t‐tests and linear mixed model (LMM) analyses to account for unequal group sizes and missing data. Compared to the TAU group, caregivers completing the MFG program reported significant improvements at T1 in social functioning, perceived support from mental health professionals, and family coping skills, including improved access to information and a marked reduction in avoidance behaviors. LMM analysis showed that MFG participants improved more over time in social support, communication, and service satisfaction than controls. This study highlights that MFG therapy has strong potential for improving social functioning and coping skills among caregivers of individuals with BPD. These findings support the feasibility and clinical relevance of integrating MFG programs into generalist mental health services.

Purpose Dysfunctional eating behaviors are associated with emotional dysregulation and obsessive-compulsive symptoms. Traditionally, obsessiveness has been linked to anorexia nervosa (AN), while dysregulation has been associated with bulimia nervosa (BN) and binge eating disorder (BED). However, this dichotomous view fails to account for the frequent diagnostic crossover observed among individuals with eating disorders (EDs). This study aimed to identify specific clusters in individuals with EDs based on emotional dysregulation, obsessive-compulsive symptoms, eating symptoms, and body uneasiness. Methods An observational cross-sectional study was conducted at the ED Unit of Clinical Psychiatry, Bologna, Italy. Participants (N = 360) completed the Difficulties in Emotion Regulation Scale (DERS), Obsessive Compulsive Inventory-Revised (OCI-R), Eating Disorders Examination Questionnaire (EDE-Q), and Body Uneasiness Test (BUT). Hierarchical and two-step cluster analyses were applied. Cluster differences were examined using Kruskal-Wallis tests and post-hoc comparisons. Results The analysis identified three clusters with increasing levels of emotional dysregulation, obsessive-compulsive symptoms, eating symptoms, and body uneasiness (Cluster size ratio = 2.04; Silhouette = 0.30). Symptom severity ranged from more functional (Cluster 1) to moderate (Cluster 2) to more dysfunctional (Cluster 3). Conclusion This study identified three clusters representing a progressive gradient in the symptoms assessed, challenging the traditional dichotomy linking obsessiveness solely to AN and dysregulation solely to BN/BED. Graphical abstract

Introduction. Obesity is a complex condition associated not only with physical health risks but also with social discrimination and a reduced quality of life (QoL). Psychological factors, including attachment styles, may play a role in emotional regulation and eating behaviors. According to attachment theory, insecure attachment is linked to difficulties in managing emotions and an increased likelihood of engaging in dysfunctional eating patterns. This study aimed to investigate the relationship between past and present attachment styles, binge-eating behaviors, and QoL scores in individuals with overweight or obesity (BMI ≥ 25 kg/m²) compared to those with a BMI in the normal weight range (18.5–24.9 kg/m²). Methods. A cross-sectional study evaluated 96 women with overweight/obesity and 96 women with normal weight. Psychological measures included the Parental Bonding Instrument (PBI), the Attachment Style Questionnaire (ASQ), the Binge Eating Scale (BES), and the Obesity-Related Well-being questionnaire (ORWELL 97). Data analysis included between-group comparisons of attachment dimensions and hierarchical regression to examine associations with the QoL score. Results. Participants with overweight/obesity showed less secure attachment (U = 5508, p = 0.019) and more avoidant attachment styles (U = 3825, p = 0.042) compared to participants with normal weight. Conversely, no significant differences were observed in PBI scores. Regression analysis revealed that attachment anxiety (B = 0.83, p = 0.009) and binge-eating behaviors (B = 0.57, p = 0.003) were significantly associated with a lower QoL. Conclusions. Obesity is associated with avoidant attachment in adulthood, but no differences were found in parental attachment when compared to individuals with normal body weight. Anxious attachment in individuals with obesity is strongly linked to reduced QoL, underlying the role played by attachment-related factors in the psychosocial challenges individuals often have to face.

Background: Eating disorders (EDs) have traditionally been studied among heterosexual cisgender women, but recent research highlights a higher prevalence in LGBTQIA+ individuals. Aims: This study aims (1) to investigate the association between different groups based on gender identity and sexual orientation (GISO) and experiencing eating symptoms, and (2) to explore the extent to which self-perceived discrimination and adverse conditions explain this association. Methods: We administered an online survey to assess eating symptoms using the Eating Disorder Examination Questionnaire (EDE-Q 6.0) and measures of self-perceived discrimination and adverse conditions. Multistep logistic regressions were employed to analyze the associations between GISO and eating symptoms, initially unadjusted, then adjusted for sociodemographic variables, and finally adjusted for self-perceived discrimination and/or adverse conditions. Results: A total of 560 adults aged 30 ± 10.9 years old were included. After adjusting for socio-demographics all groups were more likely to experience eating symptoms compared to heterosexual men, with odds ratios (ORs) of 5.7 [95% CI: 1.3, 24.3] for cisgender heterosexual women, 6.7 [95% CI: 1.5, 29.8] for cisgender non-heterosexual women, and 9.3 [95% CI: 1.8, 47.5] for non-cisgender individuals. After adjusting for self-perceived discrimination and adverse conditions, the associations for women were attenuated, while the associations for non-cisgender individuals were no longer significant. Conclusion: This study (1) confirms that sexual and gender minorities may be at higher risk for EDs, and (2) suggests that discrimination and adverse conditions may contribute to the higher prevalence of eating symptoms in this population. Additional research is needed to investigate these minority stressors as they may represent targets for effective interventions to prevent eating symptoms in the LGBTQIA+ community.