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BACKGROUND: While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU. AIM: The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship. METHODS: A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept. OUTCOMES: Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU. RESULTS: Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (ß = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; ß = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged. CLINICAL IMPLICATIONS: Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences. STRENGTHS AND LIMITATIONS: The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors. CONCLUSION: These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.

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According to the Tripartite Influence Model, social media is one of the primary sources influencing women's body dissatisfaction. However, the role of social media influencers as a potential driver for impacting users' body image evaluation when disseminating content on social networks has been little investigated. The present research aims to explore the relationship between following three Instagram influencers (i.e., nutrition, fitness, and entertainment) and eating disorder (ED) symptoms and body dissatisfaction among a group of female users. A sample of 5060 women (mean age = 35.33 ± 9.33) were recruited with the collaboration of three Italian influencers, and self-reported questionnaires were administered. Women who followed the nutritional influencer account reported significantly higher scores on ED symptoms and body dissatisfaction than women who followed the fitness and entertainment influencer accounts (η2 = 0.05 and η2 = 0.02, respectively). Overall, following nutrition and fitness accounts (compared to entertainment accounts) and spending more time daily on social networks positively predicts ED symptoms (ß = 0.28, p < 0.001, ß = 0.10, p < 0.001, ß = 0.11, p < 0.001, respectively) and body dissatisfaction (ß = 0.07, p < 0.001, ß = 0.04, p < 0.001, ß = 0.07, p < 0.001, respectively). Moreover, following nutritional influencers compared to fitness influencers positively predicts ED symptoms (ß = 0.17, p < 0.001) but not body dissatisfaction. The current results suggest that being exposed to dieting and weight loss topics on social media might be particularly harmful for individuals with specific vulnerabilities. Practical implications will be discussed.

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Background and aims Problematic Social Network Sites Use (PSNSU) mirrors substance use disorders with regard to symptoms (e.g., diminished control). Recent theoretical advances in the addiction research field recognize a central role of affective and cognitive processes in the development of addictive behaviors. For example, the metacognitive model of addictive behaviors sustains that cognitive processes like extended thinking, disruption in metacognitive monitoring, and thought suppression are associated with addictive behaviors leading to increased craving. The current study aims to test the mediating role of extended thinking (i.e., worry, rumination, and desire thinking) in the relationship between psychological distress and PSNSU. Methods A community sample of 548 individuals (F = 68.5%, Mage= 29.29 ± 12.04 years) completed an online survey. Structural Equation Modeling (SEM) was utilized to analyze the relationships among the variables under study. Results The assessed structural model adequately fits the data, accounting for 89% of PSNSU variance. Psychological distress predicted PSNSU through the mediation of desire thinking and rumination and the serial mediation of (i) worry and craving (ii) desire thinking and craving The model is gender invariant. Conclusions The current findings provide preliminary evidence for the role of extended thinking in PSNSU. Worry, rumination and desire thinking may be central cognitive processes in eliciting craving and PSNSU for individuals who experience psychological distress.

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Cognitive models of addictive behaviours have highlighted the central role of Desire Thinking (DT) - a conscious and voluntary cognitive process orienting to prefigure images and information about a positive target-related experience - in increasing craving and maintaining addictive behaviors. The metacognitive model of DT and craving posits that metacognition plays a central role in understanding dysregulation in DT. The current study aims to test the role of metacognitions about DT, DT, and craving in the relationship between Fear of Missing Out (FoMo), boredom proneness, negative emotional reactivity and Problematic Social Network Sites Use (PSNSU). A sample of 529 participants (Mage= 32.45 ± 13.33; F = 62.9%) completed an online survey. The hypothesised model produced an adequate fit to the data and accounted for 86% of PSNSU variance. FoMO predicted positive metacognitions about DT (PMDT), which predicted DT that, in association with craving, predicted PSNSU. Boredom proneness positively predicted PSNSU directly and indirectly through the serial mediation of PMDT, DT, and craving. A direct path between negative emotional reactivity and PSNSU was found. The current findings provide preliminary evidence for applying the metacognitive model of DT and craving in PSNSU. PMDT and DT may be central cognitive processes in craving and PSNSU for individuals who experience boredom proneness and FoMo.

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Problematic Social Media Use (PSMU) has been defined as the lack of regulation of one's use of social media associated with negative outcomes in everyday functioning. Previous meta-analyses reported PSMU prevalence before the beginning of the COVID-19 pandemic and based the estimates on the cut-off scores, which are debatable in the current fields. The present meta-analysis aims to explore whether PSMU, as assessed by the most used self-report scale (i.e., the Bergen Social Media Addiction Scale; BSMAS), increased across the world (i) since the first published study on this topic (i.e., in the last seven years), (ii) since the beginning of the COVID-19 pandemic, and (iii) depending on age, gender and the income level of the countries. The meta-analysis involved 139 independent samples with 133,955 respondents from 32 countries spanning seven world regions. The results show that PSMU: (i) is significantly higher in low-income countries (LIC); (ii) did not increase in the last 7 years overall and after the beginning of the COVID-19 pandemic, except for LIC; (iii) did not vary depending on age and gender. The higher prevalence of PSMU reported during the COVID-19 pandemic by some single studies may have been a transient phenomenon to cope with physical distances in some countries, whilst, in others, an overall increase of PSMU occurred. High levels of PSMU in LIC might be explained based on socio-cultural differences between countries, but also with the higher prevalence of mental disorders in LIC since PSMU might be a symptom of other, more primary psychiatric disorders.

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The COVID-19 pandemic and the resulting societal restrictions have had negative implications for mental health in the general population. The aims of the present longitudinal study were (i) to investigate changes in psychopathological symptoms and psychological well-being in a sample of Italian individuals surveyed at different points of the pandemic and (ii) to evaluate the potential risk and protective factors associated with the psychopathological outcomes. Self-reported data on psychiatric symptoms, and psychological well-being were collected in March 2020 (T0, the lockdown phase), in May 2020 (T1, the end of the lockdown phase), and in November 2020 (T2, the second wave of COVID-19 infection). 1258 participants (Mage=23.43, SDage=6.45; 75.4% female) were recruited at T0. Of these, 712 also completed the T1 survey, and 369 also completed the T2 survey. A significant decrease in anxiety, depressive, posttraumatic, and obsessive-compulsive symptoms and a significant increase in psychological well-being were observed from T0 to T1. All psychopathological symptoms increased, and psychological well-being decreased significantly from T1 to T2. Several demographic, psychological and COVID-19-related factors emerged as predictors over the course of the pandemic. The current findings indicated that psychological health covaried with the intensity of the COVID-19 pandemic and the associated societal restrictions.

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Mobile health platforms have shown promise in the management of various mental health conditions (including stress, anxiety, and depression) and cognitive behavioral strategies emerged as a popular and effective option offered by the platforms. This paper presents the protocol of a study aimed to test the effectiveness of a mobile platform that uses cognitive-behavioral strategies for stress self-management in the Tuscany region (Italy). The mobile app is adapted to the specific needs of each vulnerable population for which it is designed: young and older people, healthcare professionals, entrepreneurs. The app will be evaluated on the following outcomes: (i) perceived susceptibility and severity of the pandemic situation, perceived benefits, and costs of preventive health behaviors, (ii) knowledge about Covid-19 preventive behaviors and negative consequences of social distancing, (iii) stress and psychopathological symptoms (i.e., anxiety, depression, and post-traumatic stress symptoms) and cognitive distortions. If successful, we expect that the platform could give various groups clinical benefits by providing symptom self-monitoring and early intervention, consolidating the number of mental health programs available, and decreasing barriers to treatment-seeking. This population-level approach has the potential to improve mental health outcomes in pandemic periods for many people.

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Nursing requires a complex set of skills encompassing professional clinical judgment, values and attitudes. In order to outline the future career path of the specialist nurse, the European Federation of Nurses Association compared the EU Directive 2013/55/EU with the Competency Framework, an important document on guidelines written by a group of experts and focusing on the recognition of nurses' educational requirements. The aim of our research is to identify the special skill set required from nurses on haemodialysis wards through the development of an exploratory survey and the comparison of its results with the EFN guidelines and the Directive 2013/55/EU. The survey was conducted across eighteen dialysis centers in Tuscany. Through focus groups, debates and reflections, 28 skills were identified as pertaining exclusively to nurses working with haemodialysis patients. This preliminary study aims at demonstrating the need to define and recognize these specialist skills in order to ensure an effective and integrated nursing leadership in disease management.

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