Behavioral disorders have been defined as a “health crisis” of modern times that has a significant impact on the parent-child relationship. In this scenario, the emotional regulation (ER) of each partner plays a central role and serves a protective factor, configuring as an area to intervene. The Connect Parent Group, an attachment-based intervention for parents, has shown evidence of effectiveness. However, its online version (e-Connect) has not yet garnered specific evidence related to emotional and physiological regulation in parents and preadolescents.

This study aimed to explore changes in the short and medium term regarding ER abilities - both self-reported and measured through physiological indices - in parents and preadolescents with behavioral disorders, building upon initial findings from an online parenting intervention.

28 parents (82.1% mothers, 17.9% fathers, M_age = 47.48, SD = 4.73) and their 28 preadolescents with behavioral disorders (M_age = 11.22 years, SD = 2.69, 35.7% girls) were recruited from child neuropsychiatry services in Northern Italy and subsequently took part in the pilot study. They were assessed at three time points: before intervention (T1), one months after the intervention (T2) and at 6-months follow-up (T3). ER were assessed with a multimethod approach: parents and children completed a self-report questionnaire (i.e., Difficulties in Emotion Regulation Scale and How I Feel, respectively) and then they interact during a stress-task in which physiological parameters (i.e., Galvanic Skin Response, GSR; Heart Rate/Beat per Minute, BPM) have been measured.

Regarding self-reported ER, mixed-effects regression models showed an improvement in parent emotion dysregulation between T1 and T3 (p=0.004), a decrease in preadolescents’ negative emotions (p=.012) between T1 and T2 and a lower emotion intensity in preadolescents between the three-time points (p=.003). Regarding physiological ER, the two overall models of GSR and BPM were not significant for both parents and children. Yet GSR correlations within three-time points were positive and significant for children (T1-T2: r=.58; T1-T3: r=.68) but not for parents, while BPM correlations between T1 and T2 were significant for parents (r=.49) but not for children.

The online attachment-based parenting program appears to have contributed to a reduction in emotional dysregulation in parents and preadolescents, which seems to persist to some extent in the medium term. The non-significant results at the physiological level may suggest that changes reported by parents and children through self-report questionnaires do not align with changes in the physiological response to interpersonal stress experienced after an online intervention. Clinical and research implications will be discussed.

None Declared

Many studies linked expression and regulation of emotions as transdiagnostic variables involved in the emergence of psychopathological disorders. However, few studies investigated such processes during middle childhood, a critical period of life defined by significant psychological, physical, and social changes.

Explore the relationship between child’s emotion regulation – both emotional subjective experience and physiological reactivity – and child’s psychological difficulties.

20 children (Mage=10.7, SD=1.25; 65% males) and their mothers were recruited from general population. Emotion regulation was assessed with (1) How I Feel (HIF) and Positive and Negative Affect questionnaires (PANAS) and (2) Heart Rate (i.e., Beats Per Minute, BPM) and Heart Rate Variability (i.e., High Frequency and Low Frequency ratio, LF/HF). Child’s psychological difficulties were measured with the parent report Child Behavioral Checklist 6-18 (CBCL-6/18).

Statistically significant correlations emerged between the HIF-Positive emotions scale and both externalizing (rs = -.51) and internalizing (rs = -.46) difficulties; the HIF-Negative emotions scale and internalizing difficulties (rs = .49); LF/HF and internalizing difficulties (rs = -.58). Finally, a non-significant but moderate effect was found between the HIF-Negative emotions scale and externalizing difficulties (rs = .33).

Although the limited number of participants, data suggest an interesting role played by both child’s emotional experience and physiological reactivity on internalizing and externalizing difficulties as reported by mothers. More specifically, child’s experience of positive emotions is associated with fewer internalizing and externalizing difficulties, while child’s experience of negative emotions illustrates an opposite relationship, implying the relevance of looking at child’s emotional subjective experience in understanding psychological difficulties. Moreover, LF/HF ratio – labeled as the child’s sympathovagal balance – seems like it might be higher in children with less internalizing difficulties. Although doubts about LF/HF interpretation, several studies share this view showing a decrease in autonomic reactivity in internalizing problems, such as depression, in adults. Overall, our preliminary results underline the importance of studying the emergence of psychopathological outcomes in middle childhood connected to both psychological and physiological emotional processes.

None Declared

The SARS-CoV-2 pandemic has produced an unprecedented clinical situation, causing a direct and indirect impact on the physical and mental health of the population. In Spain, between March 15 and June 21 of 2020, it was decreed a home confinement that caused the interruption of the daily life of millions of people. However, there are few studies that analyze the changes produced in psychiatric care in the Emergency Department (ED).

To analyze the changes produced in psychiatric emergencies, subanalysing paediatric population, during the first year of the pandemic (COV1/Y-COV1) compared to the previous year (NOCOV/Y-NOCOV1). To analyze the clinical features of patients attended during the lockdown period of the pandemic (LOCK) and compare it to the period of the pandemic after the lockdown (NOLOCK).

Through the registry of computerized medical records, patients who attended the psychiatric hospital emergency department between 03/01/2019 and 02/28/2021 were identified. We also identified all attendances from 15/03 to 21/06 in 2019 and in 2020 to obtain variables from the lockdown period.

During period of this study, 2694 psychiatric visits made in the ED (1744 patients - 54.3% women, and 69.5% were between 25 and 64 years-), 1537 in NOCOV and 1157 in COV1. Significant differences were found between COV1 and NOCOV in sociodemographic variables, such as employment status and number of offspring. At a clinical level, in COV1, we observed an increase in attendance due to heteroaggressive behaviors, mania, insomnia and problems due to substance use. An increase in the prescription and/or modification of treatment was observed (59.3% vs 54.3%). During COV1, in terms of discharge follow-up in the month following the ED visit, telematic assistance increased (11.4% vs. 5.3%). During the period of study, 282 ED attendances were performed, 153 in Y-NOCOV and 129 in Y-COV1. At a clinical level, during Y-COV1, a decrease in attendances related to substance use was found significant. The sub-analysis carried out for LOCK and NOLOCK yields similar data to those obtained in the COV1 vs. NOCOV1 comparison. During lockdown, the face-to-face follow-up in the month following the ED was significantly lower (39,5% vs 57,1%) regarding telematic follow-up (24,4% vs 5,8%) In this period, an increase of adolescents without previous mental health follow-up was observed (44% LOCK vs. 22% NOLOCK).

Our work supports the hypothesis that the COVID-19 pandemic caused a change in psychiatric care in the ED. It also shows how lockdown changed the attendance in psychiatric emergencies, and also in the later community care attendance. Changes are detected in emergency care for adolescents during the pandemic compared to the previous year. Strikingly, our study does not reflect a quantitative increase in the demand. It would be of interest to continue collecting data after the time of the present project.

None Declared

The neurobiology of gambling disorder (GD) is not yet fully understood. Although dysfunctional signalling involved in energy homeostasis has been studied in substance use disorders, it should be examined in detail in GD.

To compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC), and to explore endocrine interactions with neuropsychological and clinical variables.

A case-control design was performed in 297 individuals with GD and 41 HC, assessed through a semi-structured clinical interview and a psychometric battery, adding 38 HC in the evaluation of endocrine and anthropometric variables.

Individuals with GD presented higher fasting plasma ghrelin (p<.001) and lower LEAP2 and adiponectin concentrations (p<.001) than HC adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in GD, some impaired cognitive dimensions and lower LEAP2 concentrations significantly predicted GD presence.

This study suggests distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD, predicting GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.

F. Fernandez-Aranda Consultant of: Novo Nordisk , Employee of: editorial honoraria as EIC from Wiley, I. Baenas: None Declared, M. Etxandi : None Declared, B. Mora-Maltas: None Declared, R. Granero : None Declared, S. Tovar : None Declared, C. Diéguez: None Declared, M. Potenza Grant / Research support from: Mohegan Sun Casino and Connecticut Council on Problem Gambling, Consultant of: Opiant Pharmaceuticals, Idorsia Pharmaceuticals, Baria-Tek, AXA, Game Day Data and the Addiction Policy Forum; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders, Employee of: patent application in Yale University and Novartis, S. Jiménez-Murcia: None Declared.

Attachment, as an interpersonal motivational system, is the relational ground that allows emotions to be regulated through action on the Autonomic Nervous System resulting in better psychological outcomes during middle childhood. Emotion dysregulation and autonomic function are often connected to psychiatric symptoms observed in adolescence (e.g. borderline personality disorder traits) and thus middle childhood becomes a critical age for psychopathological trajectories.

Examine the relationship between child’s attachment and both psychological and physiological emotional regulation.

20 children (Mage = 10.7, SD = 1.25; 65% males) were recruited from general population. Attachment was measured through the Child Attachment Interview (CAI), while emotional regulation was assessed with a multimethod approach, using questionnaires i.e. How I Feel (HIF) and Positive and Negative Affect (PANAS), and physiological measurements i.e. Heart Rate Variability (ratio between High Frequency and Low Frequency, HF/LF, labeled as the child’s sympathovagal balance) and Heart Rate (Beats Per Minute, BPM, as an index of physiological reactivity).

Statistically significant correlations emerged between the HIF-Control scale and the Mother and Father Dismissal CAI scale, the PANAS-Negative Affect scale and the Mother and Father Preoccupied Anger CAI scale. Moreover, there was a non-significant but moderate effect (rs > .30) between HF/LF and the Emotional Openness and the Resolution scales of the CAI, and between BPM and the Emotional Openness scale.

Despite the small sample size, more secure children are able to connect with their emotions and properly use them in solving relational problems. Consequently, they are likely to succeed in understanding and regulating emotions as they manage to find more adaptive strategies their own. On the contrary, the presence of dismissal or anger (insecure attachment) towards parents would appear to lead to higher levels of psycho-physiological dysregulation, a core feature of Borderline Personality Disorder dimensions starting to emerge later in adolescence. Future studies should consider physiological dysregulation as an additional factor linked to psychopathological developmental trajectories.

None Declared

The COVID-19 pandemic represents an epidemiological and psychological crisis (APA, 2020). In this context, although emerging adults are less likely to get COVID-19, they might have suffered from the national lockdowns over the last year, as they are indeed involved in a crucial development period wherein interpersonal relationships undertake a fundamental function in their psychological well-being. To this end, mentalizing abilities and emotion dysregulation may play a crucial role as possible salutogenic or pathogenic factors on the onset of psychiatric symptoms during the three waves of the COVID-19 pandemic.

1) To examine the relationship between emotion dysregulation assessed at the end of the first wave of COVID-19, mentalizing assessed during the second wave, and psychiatric symptoms levels assessed during the third wave. 2) To examine the moderation role of mentalizing within the relation between emotion dysregulation and psychiatric symptoms.

Participants were 83 non-clinical emerging adults (Mage=22.18, SD=4.36; 57.8% females). Measures applied were Difficulties in Emotion Regulation Scale (DERS) to examine emotion dysregulation, Reflective Functioning Questionnaire to examine mentalizing (RFQ_uncertainty; RFQ_certainty) and Symptom Checklist-90-Revised (SCL-90) to examine psychiatric symptoms (Global Severity Index, GSI).

DERS_total score (r=.31, p=.03) and both RFQ_uncertainty (r=.41, p<.01) and RFQ_certainty (r=-.33, p=.02) are associated with GSI. Secondly, a significant moderation role by RFQ_u emerged within the relation between DERS_total score and GSI (∆R2=.067, β=.001, SE=.00, CI[.000, .002]).

These results suggest that mentalizing and emotion dysregulation may play a pivotal role in the onset of psychiatric symptoms during the COVID-19 pandemic. Clinical implications are discussed.

No significant relationships.

Difficulties in mentalizing (i.e., the ability to reflect on self and others’ internal mental states, operationalized as reflective functioning [RF]; Fonagy et al., 2012) have been associated with psychological symptoms (Luyten et al., 2020), including somatic symptoms (Bizzi et al., 2019). Therefore, the assessment of its dimensions may be clinically relevant for young patients with somatic symptoms, as with Primary Headache (PH), representing one of the most common somatic complaints in children and adolescents.

This study aimed to assess RF with a multi-method approach, exploring its relation with somatic symptoms.

48 adolescents diagnosed with PH (Mage=14.83, SD=2.81; 67% females) were recruited from an Italian Child Neuropsychiatry Clinic. RF was measured both through the Child and Adolescent Reflective Functioning (CRFS) applied to the Child Attachment Interview transcripts and the self-report Reflective Functioning Questionnaire (RFQ), while the Children’s Somatization Inventory (CSI-24) was used to measure the perceived severity of somatic symptoms.

Different relations with somatic symptoms depended on the method used to evaluate RF: no significant correlations were found with the CRFS subscales (General, Other, Self), while a negative significant correlation was found with the RFQ subscale Certainty about mental states (RFQ_C) (r=-.46, p=.016). All subscales of CRFS were negatively correlated with RFQ_C (p=.05), but not with the other RFQ subscale (Uncertainty about mental states; RFQ_U).

This suggests that two measures may lead to different dimensions of the same construct, thus a multi-method assessment of RF would be advisable in clinical practice.

No significant relationships.

Primary Headache, including Tension-Type Headache (TTH), represents one of the most common somatic disorders in children and adolescents with a strong impact on quality of life. Several risk factors, as environmental, familiar, and psychological features, including personality traits, are related to the development of Primary Headache. However, studies on specific subgroups of TTH are relatively few in early adolescents.

Therefore, this cross-sectional pilot study aims at exploring the role of anxiety and alexithymia in early adolescents with and without TTH.

A sample of 70 early adolescents (Mage=14.59, SD=1.85; 71% females) consisting of a clinical group (31 with TTH) enrolled in an Italian Child Neuropsychiatry Clinic and a comparison group (38 without TTH) enrolled in schools, matched on gender and age, completed: 1) Multidimensional Anxiety Scale for Children (MASC) to detect the Total levels of Anxiety, also in their factor of Physical Symptoms, Social Anxiety, Harm Avoidance, and Separation Anxiety; 2) the Toronto Alexithymia Scale (TAS-20) to detect the Total levels of Alexithymia, also in their factor of Difficulty to Identifying and to Describing Feelings and Externally Oriented Thinking.

TTH outcome positively correlated with Harm Avoidance (rho=.68, p<.001) and Total Alexithymia (rho=.72, p<.001). In a logistic regression, Harm Avoidance and Total Alexithymia predicted 69% of the variance in TTH outcome (p<.032).

This disorder may be a maladaptive strategy to cope with problems and feeling emotions, then early adolescents could be fostered in the acquisition of more adaptive emotion regulation abilities.

No significant relationships.

To examine children’s exposure to food and beverage advertising across a year of Colombian television based on whether products exceed Pan-American Health Organization (PAHO)-defined nutrient thresholds.

Nutritional information was obtained for all foods and beverages advertised and used to categorise each product according to the product category (e.g. beverage, snack food) and nutritional quality based on the PAHO model for identifying products in excess of free sugars, Na or saturated fat or containing non-caloric sweeteners or trans-fat. Television audience ratings data were used to derive the average child audience (unique child viewers) per ad and the number of times ads were seen by children in a single week (weekly impressions) based on product category and nutritional quality.

All food and beverage ads on cable and over-the-air TV in Colombia in 2017.

N/A.

Of all instances of TV ads, 89·3 % were of unhealthy products. A larger proportion of male and female children, as well as children from low (88·01 %), mid (89·10 %) and high (89·10 %) socio-economic status, are exposed to advertising of unhealthy products, but no significant difference was found between these proportions.

The majority of foods and beverages advertised to Colombian children are unhealthy. These findings highlight a need to implement statutory measures to reduce children’s exposure to unhealthy food advertising in Colombia, as obesity and overweight have been increasing among school-age children in Colombia, and exposure to television advertising of unhealthy foods is a known contributor to children’s food intake and obesity.