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Medically Unexplained Physical Symptoms (MUPS) are physical symptoms without a medical explanation. This study collected data from hospitalized patients presenting MUPS, aiming to draw a clinical and socio-demographic profile of patients with MUPS, to explore psychopathological correlations of Somatic Symptoms Disorder (SSD) diagnosis, and to estimate economic costs related to hospital management for MUPS. The cross-sectional study consisted in the evaluation of data referring to hospitalized patients admitted between 2008 and 2018 in a teaching hospital in Northern Italy. A total of 273 patients presenting MUPS have been hospitalized. The sample showed a prevalence of female, married and employed patients. The most frequent wards involved are Neurology, Internal Medicine and Short Unit Stay. The most common symptoms found are headache, pain, syncope and vertigo. There is no evidence that a history of medical disease is associated with a diagnosis of SSD. A personality disorder diagnosis in patients with MUPS was associated with increased probability of having a diagnosis of SSD. A marginally significant positive association emerged with anxiety disorders, but not with depressive disorder. The overall estimated cost of hospitalization for patients with MUPS is 475'409.73 €. The study provides the investigation of a large number of patients with MUPS and a financial estimate of related hospitalization costs.

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Empirical literature has shown that narcissism is often associated with limited empathy, but the mechanism underlying this association is still unclear. The present study investigated the role of identity instability as a mediator of the relationship between narcissistic traits and empathic capabilities. Narcissistic traits, identity instability, and cognitive and emotional empathic capabilities were assessed among 462 nonclinical participants through self-report measures. Results showed a positive association between narcissistic traits and cognitive empathy. On the other hand, a negative association between narcissistic traits and emotional empathy emerged. Furthermore, the study showed that the association between narcissistic traits and impairments in emotional empathy was partially explained by identity instability. Results thus demonstrated that narcissistic traits were associated with higher identity instability, and this, in turn, was associated with decreased abilities to be emotionally involved in others’ affect states. These findings are discussed in the context of an object relations formulation of narcissistic personality.

The first Italian lockdown during COVID-19 pandemic constituted an example of strong situation. Under this context, we investigated associations of HEXACO personality with COVID-19 mitigation behaviors (self-reported hygiene, distancing, going out). We tested unique associations through regularized regressions and out-of-sample prediction after establishing the best level of analysis (HEXACO traits, facets, items). Personality always explained out-of-sample variance over and above demographics, COVID-related knowledge, concern, impacts, and goals. Hygiene and distancing were best predicted by HEXACO traits, whereas facets constituted the best level for the prediction of going out. In general, honesty-humility (trait or facets) was the clearest predictor of safer behaviors. Results corroborate the relevance of personality even in strong situations, as well as its importance for COVID-19 mitigation.

The Pathological Narcissism Inventory (PNI) is extensively used in recent empirical literature on pathological narcissism. However, most studies using the PNI are community-based, and no studies have used the PNI to investigate narcissistic presentations in personality disordered patients. This study investigates measurement invariance of the PNI in community participants and patients with personality disorders, and examines differences of narcissistic presentations in these samples through a multimethod approach. Results show that the PNI can be used reliably to measure and compare traits of pathological narcissism in community participants and patients with personality disorders. Personality disordered patients show higher traits reflecting vulnerable narcissism and overt manifestations of grandiose narcissism, compared with controls. Finally, network analysis indicates that traits of grandiose fantasies and entitlement rage have a central role in defining manifestations of PNI pathological narcissism, regardless of the presence of an underlying personality disorder. Research and clinical implications are discussed.