Irene Messina

• PhD
• Professor (Associate) at Universitas Mercatorum

Emotion regulation plays a crucial role in mental health, and difficulties in regulating emotions can contribute to psychological disorders. While reappraisal and suppression are well-studied strategies, the combined contributions of gray matter (GM) and white matter (WM) to these strategies remain unclear due to methodological limitations in previ...

Interpersonal Emotion Regulation (IER) may serve as a critical link between the established roles of social support and emotion regulation in mitigating academic burnout. This study explored the hypothesis that IER influences academic burnout through its impact on social support. 156 undergraduate students were involved in the study, with measures...

Objectives Acceptance is an adaptive emotion regulation strategy characterized by an open and non-judgmental attitude toward mental and sensory experiences. While a few studies have investigated the neural correlates of acceptance in task-based fMRI studies, a gap remains in the scientific literature regarding dispositional use of acceptance, and h...

Borderline personality disorder (BPD) is one of the most frequently diagnosed disorders in psychiatric settings. Beyond the categorical diagnosis, borderline personality traits (BPT) are common in the general population and vary along a continuum from mild to severe. While prior research has reported functional connectivity alterations in the Defau...

Anger can be deconstructed into distinct components: a tendency to outwardly express it (anger-out) and the capability to manage it (anger control). These aspects exhibit individual differences that vary across a continuum. Notably, the capacity to express and control anger is of great importance to modulate our reactions in interpersonal situation...

Background The abandonment of psychotherapeutic treatments is influenced by various factors, including patient characteristics, therapist traits, and the therapeutic relationship. Despite the well-documented importance of these factors, limited empirical research has focused on the role of the therapeutic relationship and the characteristics of the...

The role of the therapist has received growing attention in psychotherapy research, suggesting that training effectiveness may also depend on the person of the trainees, with relevant implications in terms of candidate selection or tailoring training to the person. In the present study, we focused on how and how much psychotherapy training can be e...

Acceptance and reappraisal are considered adaptive emotion regulation strategies. While previous studies have explored the neural underpinnings of these strategies using task-based fMRI and sMRI, a gap exists in the literature concerning resting-state functional brain networks’ contributions to these abilities, especially regarding acceptance. Anot...

Academic burnout is a condition characterized by exhaustion, cynicism, a distant attitude toward studying, and diminished self-efficacy in academic activities. Preliminary scientific findings indicate that interventions designed to alleviate work burnout also hold promise for mitigating academic burnout, however clear evidence based on randomized c...

Background and Method The experiences of 454 psychotherapy trainees when providing therapy to patients were surveyed in a multinational sample largely from European countries, as part of the collaborative SPRISTAD study, using established measures of trainees' Healing Involvement (HI) and Stressful Involvement (SI). Results The results of cross‐se...

The present study investigated the relations between dispositional mindfulness (MD), perceived stress and psychopathological symptoms in healthcare professionals (N = 104) and control participants (N = 125). Participants completed an online survey including the Mindful Attention Awareness Scale, the Perceived Stress Scale, and the Symptom Check Lis...

Binge-watching (BW; i.e., watching multiple episodes of a TV series in a row) has become a popular way of TV consumption, leading to concerns about its potentially addictive features. Yet, few data are available regarding the psychological determinants of BW in young adults. Thus, the present study investigated the associations between BW, emotion...

Anger can be deconstructed into distinct components: a temporary emotional state (state anger), a stable personality trait (trait anger), a tendency to outwardly express it (anger-out), or to internally suppress it (anger-in), and the capability to manage it (anger control). These aspects exhibit individual differences that vary across a continuum....

The concept of emotional intelligence (EI) refers to the ability to recognize and regulate emotions to appropriately guide cognition and behaviour. Unfortunately, studies on the neural bases of EI are scant, and no study so far has exhaustively investigated gray (GM) and white matter (WM) contributions to it. To fill this gap, we analysed trait mea...

Acceptance and reappraisal are both considered adaptive emotion regulation strategies. While a few studies have explored the neural underpinnings of acceptance and reappraisal in task-based fMRI and sMRI, there is a gap in the literature regarding the resting state functional brain networks associated with the individual differences to apply these...

Acceptance is an adaptive emotion regulation strategy characterized by an open and non-judgmental attitude toward mental and sensory experiences. While a few studies have investigated the neural correlates of acceptance in task-based fMRI studies, a gap remains in the scientific literature in dispositional use of acceptance, and how this is sedimen...

Borderline personality disorder (BPD) is one of the most diagnosed disorders in clinical settings. Besides the fully diagnosed disorder, borderline personality traits (BPT) are quite common in the general population. Prior studies have investigated the neural correlates of BPD but not of BPT. This paper investigates the neural correlates of BPT in...

1Despite a crucial point for the understanding of the link between attachment and emotion regulation concerns the individual tendency in turning to others (both representations of attachment figures or actual supportive others) to alleviate distress, the majority of previous studies in this field have considered almost exclusively intra-personal fo...

Objective Psychotherapist training programmes have arguably a most impactful intervention on the field of psychotherapy, shaping the kinds of therapists their graduates become. Yet, little is known about the structural and organisational similarities and differences of these key learning environments in an international context. Method Ninety psyc...

Introduction In the emotion regulation literature, the amount of neuroimaging studies on cognitive reappraisal led the impression that the same top-down, control-related neural mechanisms characterize all emotion regulation strategies. However, top-down processes may coexist with more bottom-up and emotion-focused processes that partially bypass th...

Borderline personality disorder (BPD) is one of the most diagnosed disorders in clinical settings. Besides the fully diagnosed disorder, borderline personality traits (BPT) are quite common in the general population. Prior studies have investigated the neural correlates of BPD but not of BPT. This paper investigates the neural correlates of BPT in...

Background Insecure attachment is predictive of depression and emotion regulation is largely recognized as a mediator of such association. Despite the ability to refer to the social context to regulate emotions can be considered as a key aspect of depressive dynamics, most studies focused on intrapersonal forms of emotion regulation neglecting its...

Insecure attachment and difficulties in regulating anger have both been put forward as possible explanations for emotional dysfunction in borderline personality (BP). This study aimed to test a model according to which the influence of attachment on BP features in a subclinical population is mediated by anger regulation. In a sample of 302 particip...

In the emotion regulation literature, the amount of neuroimaging studies on cognitive reappraisal led the impression that the same top-down, control-related neural mechanisms characterize all emotion regulation strategies. However, top-down processes may coexist with more bottom-up and emotion-focused processes that partially bypass the recruitment...

Despite the kraepelinian differentiation of schizophrenia and bipolar disorder, several data questioned this net subdivision and suggested a continuity between the two. An expanded continuum hypothesis was suggested, assuming a common psychotic core between the two disorders, as well as cognitive and affective differences. The present study aimed t...

Borderline personality disorder (BPD) is a severe personality disorder whose neural bases are still unclear. Indeed, previous studies reported inconsistent findings concerning alterations in cortical and subcortical areas. In the present study, we applied for the first time a combination of an unsupervised machine learning approach known as multimo...

Borderline Personality Disorder (BPD) is a severe personality disorder whose neural bases are still unclear. Indeed, previous studies reported inconsistent findings concerning alterations in cortical and subcortical areas. In the present study we applied for the first time an unsupervised machine learning approach known as mCCA+jICA, in combination...

Trait anxiety relates to the steady propensity to experience and report negative emotions and thoughts such as fear and worries across different situations, along with a stable perception of the environment as characterized by threatening stimuli. Previous studies have tried to investigate neuroanatomical features related to anxiety mostly using un...

Influential models of cortical organization propose a close relationship between heteromodal association areas and highly connected hubs in the default mode network. The "gradient model" of cortical organization proposes a close relationship between these areas and highly connected hubs in the default mode network, a set of cortical areas deactivat...

Trait anxiety relates to the steady propensity to experience and report negative emotions and thoughts such as fear and worries across different situations, along with a stable perception of the environment as characterized by threatening stimuli. Previous studies have tried to investigate neuroanatomical features related to anxiety mostly using un...

Trait anxiety relates to the steady propensity to experience and report negative emotions and thoughts such as fear and worries across different situations, along with a stable perception of the environment as characterized by threatening stimuli. Previous studies have tried to investigate neuroanatomical features related to anxiety mostly using un...

The goal of this research was to validate an Italian adaptation of the questionnaire Difficulties in Interpersonal Regulation of Emotions (DIRE) and to investigate its associations with psychopathology. An Italian sample (N = 630) completed the DIRE and the Symptom Checklist-90 (SCL-90). We tested the factorial structure of the DIRE using explorati...

The emerging field of interpersonal emotion regulation (IER) is drawing attention to forms of emotion regulation which involve communication and social interaction as part of the regulation process. The availability of instruments to measure IER in different languages represents significant promise for future work in this field. The goal of the pre...

The aim of this paper is to illustrate the main findings and theoretical models on emotional regulation. After clarifying the conceptual framework, and providing an attempt to formalize what emotional regulation is (according to the equation: ye = w*log(xs + t) + h) and why we need a field of research that studies these aspects, the main theoretica...

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While psychotherapists are trained to improve their clients’ quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy...

Previous morphometric studies of Borderline Personality Disorder (BPD) reported inconsistent alterations in cortical and subcortical areas. However, these studies have investigated the brain at the voxel level using mass univariate methods or region of interest approaches, which are subject to several artifacts and do not enable detection of more c...

Child trauma plays an important role in the etiology of Bordeline Personality Disorder (BPD). Of all traumas, sexual trauma is the most common, severe and most associated with receiving a BPD diagnosis when adult. Etiologic models posit sexual abuse as a prognostic factor in BPD. Here we apply machine learning using Multiple Kernel Regression to th...

Recent meta-analytic studies of social cognition and the functional imaging of empathy have exposed the overlap between their neural substrates and heteromodal association areas. The 'gradient model' of cortical organization proposes a close relationship between these areas and highly connected hubs in the default mode network, a set of cortical ar...

In intensive transactional analysis psychotherapy (ITAP), intensity is obtained with both technical expedients and the relational manner with the patient. In ITAP, the therapist modulates pressure and support commensurately to the patients' ego strength. In the present article, we contrast two clinical cases of young adults in which ego strength pr...

During the coronavirus disease 2019 (COVID-19) pandemic, many psychotherapists who were used to seeing their patients in face-toface setting adapted to providing therapies online. In the present pilot study, we investigated therapist current experiences of online therapy compared to live therapy. Twenty-nine therapists completed Clinical Skills, Di...

The concept of interpersonal emotion regulation (IER) refers to a variety of processes in which emotion regulation occurs as part of live social interactions and includes, among others, also those interpersonal interactions in which individuals turn to others to be helped or to help the others in managing emotions. Although IER may be a concept of...

According to the nosological classification, Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are different syndromes. However, these pathological conditions share a number of affective symptoms that make the diagnosis difficult. Affective symptoms range from abnormal mood swings, characterizing both BD and BPD, to regulation dysfunc...

Emotional acceptance is an important emotion regulation strategy promoted by most psychotherapy approaches. We adopted the Activation Likelihood Estimation technique to obtain a quantitative summary of previous fMRI studies of acceptance and test different hypotheses on its mechanisms of action. The main meta-analysis included 13 experiments contra...

According to psychoanalysis, anxiety signals a threat whenever a forbidden feeling emerges. Anxiety triggers defenses and maladaptive behaviors, thus leading to clinical problems. For these reasons, anxiety regulation is a core aspect of psychodynamic-oriented treatments to help clients. In the present theoretical paper, we review and discuss anxie...

The polymorphic drug-metabolizing enzyme CYP2D6, which is responsible for the metabolism of most psychoactive compounds, is expressed not only in the liver, but also in the brain. The effects of its marked genetic polymorphism on the individual capacity to metabolize drugs are well known, but its role in metabolism of neural substrates affecting be...

Although the efficacy of psychodynamic psychotherapy has been largely demonstrated, the understanding of how therapeutic relationship produces a change in dynamic psychotherapy has been only partially achieved. In the present article, we discuss the hypothesis that the expression of previously avoided impulses inside a relational situation — relati...

The aim of this article is to present recent applications of emotion regulation theory and methods to the field of psychotherapy. The term Emotion Regulation refers to the neurocognitive mechanisms by which we regulate the onset, strength, and the eventual expression of our emotions. Deficits in the regulation of emotions have been linked to most,...

The Interest Section on Therapist Training and Development of the Society for Psychotherapy Research (SPRISTAD) has launched a multisite collaborative longitudinal study of psychotherapy trainees’ development, a large-scale study involving a number of countries all over the world. In the present article, we present an overview of the early Italian...

Intensive Transactional Analysis Psychotherapy (ITAP) is a new therapeutic approach based on the integration of Transactional Analysis and brief psychodynamic approaches. ITAP is based on two key therapeutic tools—the intrapsychic triangle and the interpersonal triangle—which the therapist uses to focus patients’ attention on moment‐by‐moment thera...

The polymorphic drug-metabolizing enzyme CYP2D6, which is responsible for the metabolism of most psychoactive compounds, is expressed not only in the liver, but also in the brain. The effects of its marked genetic polymorphism on the individual capacity to metabolize drugs are well known, but its role in metabolism of neural substrates affecting be...

Introduction: Despite the traditional consideration of schizophrenia and bipolar disorder as separate diagnostic categories, the validity of such categorical approach is now highly controversial. In recent years, the hypothesis of a psychotic continuum for which exist a common pathophysiologic mechanism related to psychotic functioning, has been pr...

Despite the traditional view of Schizophrenia (SZ) and Bipolar disorder (BD) as separate diagnostic categories, the validity of such a categorical approach is challenging. In recent years, the hypothesis of a continuum between Schizophrenia (SZ) and Bipolar disorder (BD), postulating a common pathophysiologic mechanism, has been proposed. Although...

A common altered network in SZ and BD when compared to healthy controls, involving medial parietal and temporal areas, the cerebellum and the middle frontal gyrus. On the other hand, two fronto-parietal networks resulted as reduced in SZ when directly compared to BD, possibly reflecting the greater cognitive impairment of the former.

Intensive Transactional Analysis Psychotherapy (ITAP) integrates Transactional Analysis and brief psychodynamic approaches for the intensification of therapist intervention based on the moment-by-moment analysis of intrapsychic and interpersonal process of the patient. We present a quantitative and qualitative, time series study to evaluate ITAP th...

One of the main objectives of psychotherapy is to address emotion dysregulation that causes pathological symptoms and distress in patients. Following psychodynamic theory, we propose that in humans, the combination of emotions plus conditioned anxiety due to traumatic attachment can lead to dysregulated affects. Likewise, defenses can generate and...

Therapists’ unresolved conflicts might be the source of countertransference phenomena. To investigate the origins of countertransference, the aim of this supervision single-case study was to identify conflictual areas that characterize private life relationships and therapeutic relationships of one therapist in training. With this aim, we applied t...

Background Therapist characteristics seem to be a key factor in clinical effectiveness. Trainees’ personal and professional background, motivation, and interpersonal style have been shown to deserve attention in previous research concerning therapist development and warrant further study due to their potential implications for psychotherapy trainin...

Physiological synchronization (PS) is a phenomenon of simultaneous activity between two persons’ physiological signals. It has been associated with empathy, shared affectivity, and efficacious therapeutic relationships. The aim of the present study was to explore the possible connections between PS and the attachment system, seeking preliminary evi...

Accepted poster at EWCN Bressanone 2018, January 21-26

This study presents a pilot contribution to the new collaborative, multinational study of psychotherapy trainee development that was undertaken by the Society for Psychotherapy Research Interest Section on Therapist Training and Development (see Orlinsky, Strauss, Rønnestad, et al., 2015). Although the main project is longitudinal in design, this p...

Influential neurobiological models of the mechanism of action of psychotherapy attribute its success to increases of activity in prefrontal areas and decreases in limbic areas, interpreted as the successful and adaptive recruitment of controlled processes to achieve emotion regulation. In this article, we review the behavioral and neuroscientific e...

Depression is widely seen as the result of difficulties in regulating emotions. Based on neuroimaging studies on voluntary emotion regulation, neurobiological models have focused on the concept of cognitive control, considering emotion regulation as a shift toward involving controlled processes associated with activation of the prefrontal and parie...

Countertransference management is a central feature of therapists’ relational competences (Hayes et al., 2011). In this poster we present early results of a study which evaluated training efficacy in developing countertranference management in therapist in training. Moreover, we provide a qualitative description of trainees’ conflictual themes (ori...

In the present study we found interesting associations between empathy, countertransference and electrodermal concordance in dyads during simulations of psychotherapy sessions.

Review of neuroimaging studies concerning abnormal default system functioning in depression. The results are intriguingly consistent with psychodynamic models of psychotherapy action.

Neuroimaging reveals that infant cries activate parts of the premotor cortical system. To validate this effect in a more direct way, we used event-related transcranial magnetic stimulation (TMS). Here, we investigated the presence and the time course of modulation of motor cortex excitability in young adults who listened to infant cries. Specifical...

Neuroimaging investigations have identified the neural correlates of reappraisal in executive areas. These findings have been interpreted as evidence for recruitment of controlled processes, at the expense of automatic processes when responding to emotional stimuli. However, activation of semantic areas has also been reported. The aim of the presen...

Eric Berne’s energy theory describes free cathexis and unbound cathexis as two forms of psychic energy. The authors suggest possible links between Berne’s theory of cathexis and recent models of brain functioning. They propose that neural systems involved in mental processes associated with voluntary attention may be connected to free cathexis. The...

Several studies have used neuroimaging methods to identify neural change in brain networks associated to emotion regulation after psychotherapy of depression and anxiety. In the present work we adopted a meta-analytic technique specific to neuroimaging data to evaluate the consistence of empirical findings and assess models of therapy that have bee...

Emotion regulation is a key concept in psychopathology and psychotherapy theoretical models (Aldao et al., 2012; Greemberg & Pascual-Leone, 2006). It has been taken into consideration as an important issue in the debates about the possibilities and limits of neuroimaging techniques application in studying complex clinical phenomena (Westen & Gabbar...

Patients' perceptions of therapeutic empathy have been found to be predictive of its outcome. De-spite the implications of these findings, there are no instruments available in Italian capable of measur-ing empathy in clinical contexts. The aim of this study was to validate the Empathic Understanding subscale (EU) of Relationship Inventory (Barrett...

Abstract This study investigated the somatic underpinning of empathy using an interpersonal physiology approach. Thirty-nine dyads were formed by a "pseudo-patient" and a "listener" (a therapist, a psychologist, or a non-therapist). Dyadic physiological concordance in electrodermal responses and listeners' empathy were evaluated during simulations...