ObjectiveClinical theories suggest that narcissists have a compromised self-concept. However, empirical investigation on attributes of the self that would be impaired in pathological narcissism is limited and inconsistent. The present study aims at detecting distinctive profiles of narcissistic manifestations on facets of the self that have been indicated as relevant in clinical and empirical literature on narcissism.MethodWe measured adaptive and pathological narcissistic traits in a community sample of adults (N = 539). Participants also completed measures of self-uniqueness, self-authenticity, self-consistency, and self-other comparisons on agentic and communal domains.ResultsResults indicate distinctive profiles of adaptive and pathological narcissistic manifestations on these facets of the self. Among the set of distinctive facets for each narcissistic manifestation, however, some showed to have a more prominent role. Adaptive and pathological narcissism were captured mostly by a greater sense and need for uniqueness that was primarily expressed by public exposure. Sense of superiority over others in the agentic domain, however, showed to have an essential role only in adaptive narcissism. Moreover, self-concept in adaptive grandiose narcissism was qualified by high levels of self-authenticity and a consistent sense of self. Self-concept in vulnerable pathological narcissism revealed greatest impairment, especially in facets of high concern regarding others’ reactions and feeling of a tenuous existence.ConclusionsThe study points out that adaptive and pathological manifestations of narcissism can be profiled based on specific facets of self. Theoretical and research implications are discussed.

ObjectiveHallucinogenic substances or psychedelic drugs have been historically used by humans worldwide for centuries, and interest grows around them because of the therapeutic potential that they pose for mental disease. Virtual Reality (VR), has been highly developed and improved in the last decade, and it is also gaining importance due to their potential as therapeutic tools. In this article, the most recent and relevant information regarding the medical applications of both VR and psychedelics was highlighted, and diverse potential therapeutic uses were explored in hope to set the ground for further research on this topic.MethodA systematic literature review using the PRISMA methods was conducted in PubMed, Medline, Embase, Cochrane Library, Scopus and Web of Science, including only peer-reviewed clinical trials or case studies written in English, that address the use of psychedelics and/or VR for the treatment of psychiatric disorders and that measure the success of the therapies. A final selection of 23 manuscripts were used in this systematic review.ResultsVR showed security and significant efficacy in the management of special cases of phobias (social, motion pain and spiders), eating disorder, post-traumatic stress disorder (PTSD), gambling disorder, preoperative anxiety and schizophrenia.ConclusionsThe hallucinogenic drugs evaluated exhibited positive effects in treatment of depressive and anxiety disorders, alcohol dependence and PTSD. More research is needed in order to test the effectiveness of these therapies (alone or together) in different mental illnesses and different populations.

The COVID-19 pandemic has created an unprecedented situation demanding a rapid response to a barrage of unknown risks. Issues around infection control, resource allocation and treatment delivery have threatened the viability and accessibility of Electroconvulsive Therapy (ECT) services. Additionally, there are unquantified risks around the delivery and effect of ECT in patients who have had COVID-19. We discuss two cases where ECT was restarted in older-adults who had had symptomatic COVID-19. We consider the importance of clinical assessment, multi-speciality team involvement, and comprehensive risk assessment in making high stakes treatment decisions around ECT in patients with COVID-19. Although more research and international multi-speciality collaboration is required to develop evidence-based guidance, it is vital that we maintain equitable access to safe, effective and potentially life-saving ECT during this pandemic.

ObjectiveSeveral studies have found neurocognitive deficits in adolescents following substance abuse. Predisposing risk factors may further impact vulnerability to neurocognitive deficits. Little is known about the cognitive performance of adult onset substance users compared to earlier onset users. This study aims to explore differences in neuropsychological functioning between early (EOAs) and late onset substance abusers (LOAs) when the effects of confounding factors are controlled.MethodData for this cross-sectional study was collected from hospital patients. A total of 164 patients with substance use disorder (SUD) aged 19 to 65, 76 with single-drug diagnosis and 88 with multidrug diagnosis, underwent neuropsychological tests for verbal capacity, attention, speed of processing, perceptual reasoning, memory and learning, executive functioning, and inhibitory capacity. Associations between regular onset age and neuropsychological measures were analysed using in multi-way ANCOVA, and the effect of age, multiple substance abuse, education level and learning difficulties were controlled.ResultsCompared with LOAs, EOAs had weaker performance in the Digit Symbol test for mono-substance users. Meanwhile, compared with EOAs, LOAs had weaker performance in the Delayed Visual Memory test and the Raven test for mono-substance users, and the Block Design test for poly-substance users. From the confounding factors, early onset age of substance use is heightened among individuals with learning disabilities.ConclusionsOnset age of substance use is related to the deterioration of performance in neuropsychological tests. Premorbid poor learning and inhibitory capacity may be important predisposing risk factors of SUD. Conversely, high level of education may be a protective factor for cognitive performance in patients with SUD.

Aggression issues experienced on the workplace has been globally recognized as a public health issue. Nurses are exposed to a very high risk of becoming victims of workplace aggression.ObjectiveThe study describes this phenomenon from nurses perspective in two units resulted to be the more exposed to aggressive behaviour at San Raffaele Hospital in Milan.MethodWe applied a semi-structured interview to volunteer staff members of the rehabilitative psychiatric and neurological wards of San Raffaele Hospital in Milan. We collected general data on 55 workers, their previous experiences of suffered or witnessed aggression, locations and timing of attacks, methods used to report attacks, subjective opinion about drives, management modalities of aggressive phenomena and any physical and/or psychological impacts.Results85% suffered and 80% witnessed aggressions, especially non-physical, mostly in the corridor at 7.00-8.00 pm. The 78.7% reported no emotional trauma whereas the 21.3% reported physical injury. Aggressive behaviours linked to the patient’s pathology were more easily tolerated. According to participants opinion, the interaction between psychopathological aspects and environmental features increase the risk of an aggressive behaviour. The 81% of interviewed reported to be able to manage patients’ aggressiveness considering their previous experiences more helpful than training.DiscussionWe confirm literature data about high percentage of witnessed and suffered aggression and the well-known healthworkers tendency to consider violent and aggressive behaviours as “part of the job” . Professional figures need to be formed with specific trainings focused on early identification, communication strategies, and de-escalation techniques.

Coronavirus Disease 2019 (COVID-19) has disrupted virtually every aspect of daily living, engendering forced isolation and social distance, economic hardship, fears of contracting a potentially lethal illness and feelings of helplessness and hopelessness. Unfortunately, there is no formula or operating manual for how to cope with the current global pandemic. Previous research has documented an array of responses to mass crises or disasters, including chronic anxiety and posttraumatic stress as well as resilience and recovery. Much can be learned from this research about how people have coped in the past in order to identify strategies that may be particularly effective in managing distress and cultivating resilience during these perilous times. We delineate multiple coping strategies (e.g., behavioral activation, acceptance-based coping, mindfulness practice, loving-kindness practices) geared to decrease stress and promote resilience and recovery. These strategies may be especially effective because they help individuals make meaning, build distress tolerance, increase social support, foster a view of our deep human interconnectedness, and take goal-directed value-driven actions in midst of the COVID-19 pandemic.

Psychological resources, such as defense mechanism and mindfulness practice, can mediate the individual reaction to traumatic experiences as the ongoing COVID-19 pandemic outbreak. A novel self-reported measure based on the DMRS (DMRS-SR-30), has been developed with the aim of assessing potential adaptive defensive strategies against the traumatic experience of COVID-19. Preliminary validation of the DMRS-SR-30 showed good internal consistency in both overall defensive functioning and subscales. Combining adaptive defense mechanisms and mindfulness practice could prevent psychological distress due to the effect of COVID-19 losses and quarantining.