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Liliana Dell’Osso, Daniela Toschi, Barbara Carpita, Giulia Amatori Key words: Vincent van Gogh, autism spectrum, autistic traits, bipolar disorder, catatonia Objective: An increasing body of literature suggests that autism spectrum disorder (ASD) exists along a continuum, with higher prevalence among individuals affected by other mental disorders. Vincent van Gogh, one of the most universally celebrated artists and a timeless icon, may provide a compelling case for exploring the role of autism spectrum in the development of psychopathological trajectory throughout life. The present report debates the possibility that van Gogh’s ASD contributed both to his frenetic artistic production and his severe mental illness, ultimately complicated by catatonia and to his premature death. Method: The analysis is based on a review of scientific papers, biographies, artwork, and van Gogh’s extensive correspondence (902 letters, including 820 to his brother Theo), along with numerous contemporary eye-witness accounts. Throughout the psychobiographical exploration of van Gogh’s life, we reference a series of historical elements that align with DSM-5-TR ASD criteria (APA, 2022). Rather than imposing a rigid categorical diagnosis, we use these criteria to highlight the transdiagnostic nature of his symptoms, acknowledging the limitations of modern nosology when applied to historical figures. Results: This study reconstructs a hypothetical illness trajectory for van Gogh, originating from ASD and culminating in severe catatonia, followed by his premature death whose cause remains unclear. We also address potential comorbidities (e.g., bipolar disorder, substance use), emphasizing the non-specific, transdiagnostic features of many psychopathological symptoms. Conclusions: We propose Vincent van Gogh as a potential prototypical case of ASD with catatonia, as described in DSM-5-TR (2022), in an adult without intellectual impairment or language developmental delays. This retrospective hypothesis underscores the complexities of retrospective diagnosis and the possible weaknesses of strictly categorical models, given the overlapping nature of neurodevelopmental, affective, and psychotic symptoms in real-world clinical practice.
Roberto Pedone Key words: metacognition, problematic gambling, personality disorder, levels of personality functioning Objective: This study investigates the role of metacognition and personality functioning levels as mediators in the relationship between maladaptive personality traits and the risk of problematic gambling (PG) within a non-clinical adult sample. Method: A cross-sectional design was employed with 619 participants who completed self-report questionnaires assessing maladaptive personality traits, metacognitive abilities, personality functioning levels, and gambling-related behaviors. Instruments included the South Oaks Gambling Screen, the Assessment of DSM-IV Personality Disorders, the Metacognition Self-Assessment Scale, and the Levels of Personality Functioning Scale–Self Report. Data were analyzed using linear regression and serial mediation analyses. Results: The findings revealed that the risk of PG was positively associated with maladaptive personality traits, particularly Antisocial, Narcissistic, and Borderline traits, and negatively associated with metacognitive abilities and personality functioning levels. Serial mediation analyses demonstrated that metacognitive functions, especially Critical Distance and Self-Reflexivity, along with personality functioning levels, mediated the relationship between maladaptive personality traits and PG risk. Notably, in individuals with pronounced Cluster B traits, metacognition alone served as the primary mediator, while in those with Cluster C traits, the mediation effect involved both metacognitive abilities and personality functioning levels, indicating a dual mediation pathway. These findings highlight distinct mechanisms across personality profiles. Conclusions: The results underscore the critical role of metacognition and personality functioning in linking maladaptive personality traits to the risk of PG. Clinically, these findings suggest that interventions enhancing specific metacognitive abilities, such as perspective-taking and self-reflection, along with addressing impairments in personality functioning, could mitigate the risk of problematic gambling. These insights contribute to the development of tailored therapeutic strategies for preventing and managing gambling-related behaviors in at-risk populations.
Maristella Scorza, Michela Camia, Erika Benassi, Damiano Angelini, Angela Ciaramidaro and Sara Giovagnoli Key words: specific learning disorder, worry, rumination, gender, university students, assessment Objective: To date, the literature on repetitive negative thinking (RNT), rumination and worry, in students with Specific Learning Disorder (SLD) is still scant. This study seeks to deeply examine those variables in university students with and without SLD, focusing on the differences between males and females. Method: A survey was administered to 107 university students between 18 and 31 years (mean age=21,56; SD=2,60). Of these, 65 were typically developing (TD) and 42 had a diagnosis of SLD. Participants responded to the Ruminative Response Scale (RRS) and the Penn-State Worry Questionnaire (PSWQ). Anxious and depressive symptoms were also assessed. Results: Significant differences were found between university students with and without SLD on all the scales except for PSWQ. Regression analyses reported that rumination significantly affected depression and anxiety whereas worry seemed to have a role only in anxiety. Finally, female students with SLD showed higher levels of internalizing symptoms among all the subjects. Conclusions: The results give psychologists a greater understanding of RNT in university students with SLD, suggesting the importance of including those psychological processes in the clinical assessment.
Rossella Bottaro, Giuseppe Craparo, Palmira Faraci Key words: narcissism, psychometrics, exploratory structural equation model, brief version, assessment Objective: The Narcissistic Personality Inventory (NPI) is the most commonly used psychometric instrument for assessing narcissistic traits in the general population. Despite its widespread adoption, various factorial structures have been proposed. The present study aimed to provide new evidence for the NPI factorial solution using the not-yet-explored Exploratory Structural Equation Modeling (ESEM) approach and to improve understanding of its relationship with other variables. Method:We administered the NPI along with measures of anxiety, depression, stress, self-esteem, and loneliness to 583 participants (50.8% male, M age = 30.96, SD = 12.12) in a survey online. We compared confirmatory factor analyses and ESEMs for both the long and brief versions. Results: The NPI-13 ESEM model was the optimal fitting model (ꭓ2=72.060, df = 42, CFI = 0.979, TLI = 0.961, RMSEA = .035 [.021–.049]) also for its bifactorial solution. Moreover, our findings supported the evidence based on relations to other variables for the NPI-13. Conclusions: In conclusion, our results argued the use of a multidimensional brief version of the NPI and supported the ESEM’s advantages for explaining the factorial structure of complex psychological constructs.
Valentina Iannuzzi, Virginia Giuberti, Debora Formisano, Michele Poletti Key words: autism spectrum disorders, DSM 5, diagnostic stability Objective: The diagnosis of autism is considered more longitudinally stable compared to other diagnoses for children and adolescents, although significant heterogeneity in longitudinal outcomes emerges between studies based on temporal intervals and diagnostic instruments. The introduction of the concept of Autism Spectrum Disorder (ASD) by DSM-5 may have impacted diagnostic stability. The current study aimed to investigate the longitudinal diagnostic stability of different diagnoses of autism according to the ICD-10 diagnostic system before the institutional move towards the utilization of a unique ASD diagnosis according to DSM-5. Method: A retrospective study based on medical records and the ELEA electronic database was performed on children attending the Autism Center of the Child and Adolescent Mental Health Service of the Azienda USL-IRCCS, Reggio Emilia, Italy, from January 1, 2005, to December 31, 2015. Diagnostic stability was evaluated according to the diagnosis at follow-up, which was set at 10 years from baseline or December 31, 2020. Results: A total of 380 children were included at baseline, and 341 were included at follow-up (with a mean temporal interval of 8.74 ± 2.7 years). Among them, 251 individuals maintained a diagnosis within the F84 spectrum, resulting in a diagnostic stability of 73.6%. Specifically, diagnostic stability was 79.8% for the F84.0 diagnosis and 68.2% for the F84.9 diagnosis. Conclusions: Before the adoption of DSM-5 diagnostic criteria for ASD, ICD-10 diagnoses related to autism were relatively stable in the long run, with an 8-year follow-up. The next step is to assess the longitudinal diagnostic stability of ASD after the adoption of DSM-5 criteria.
Allan Abbass, Behnia Haghiri Key words: psychodynamic, somatic symptoms, emotion, unconscious anxiety, psychophysiological disorders Objective: Functional somatic disorders (FSD) are extremely common amongst neuropsychiatric and other specialty medicine referrals. Intensive Short-term Dynamic Psychotherapy (ISTDP) is an emotionally focused form of brief therapy that has been researched and developed specifically for the diagnostic assessment and treatment of FSD, amongst other conditions. Method: In this publication, we review the ISTDP theoretical underpinnings, the diagnostic assessment, treatment approach and evidence base. Results: There are now over 50 publications evaluating ISTDP and its effect and processes in FSD. It has been demonstrated efficacious for the spectrum of functional somatic disorders, including chronic pain, functional gastrointestinal disorders, and functional neurological disorders among others. It has further been found more effective than cognitive behavioral therapy in the treatment of chronic pain. Further there is evidence that it is cost-effective in treating these conditions. Conclusions: ISTDP is a broadly useful clinical tool in the assessment and treatment of FSD.
Giuseppe Femia, Isabella Federico, Guyonne Rogier, Francesca D’Olimpio, Francesco Mancini, Andrea Gragnani Key words: goals, anti-goals, self-report, validation, assessment, personality Objective: The clinical and empirical investigation of the role of investment in goals and anti-goals is limited by the lack of an easy-to-use tool. This is critical, as psychopathology, and specifically pathological personality, is characterized by an overinvestment in goals and anti-goals, rigidity in these investments and, consequently, by a poor existential plan that generates suffering and resistance to change. To develop a preliminary version of a self-report questionnaire measuring investment levels in goals and anti-goals, described as core features of the most common psychopathological conditions. To test the factorial structure of the tool and examine preliminary data on its construct validity. Method: The Inventory of Goals and Anti-Goals (IGAG) was developed. A total of 572 participants (Mage= 33.05 years; SD= 10.01; 61.62 % females), including community participants (n =424) and patients (n =148), was asked to complete a battery of questionnaires including the IGAG, the Personality Inventory for DSM-5 and the Symptom-Checklist-90-Revised. Exploratory factor analysis, Mann-Whitney U tests and correlations were computed. Results: Analyses identified an eight-factor structure and significant differences between groups on several factors. IGAG scores were largely significantly and positively correlated with the PID-5 and SCL-90-R in the expected directions. Conclusions: The IGAG appears to be a promising instrument for both research and clinical practice. Results suggest a strong relationship between overinvestment in goals and anti-goals and psychopathology. Several limitations necessitate future modifications of its content and additional efforts for validation.
Noa Beiman, Renana Eitan, Doron Todder, Eldad Keha, and Eyal Kalanthroff Key words: attention-deficit/hyperactivity disorder (ADHD), transcranial direct current stimulation (tDCS), impulsivity, attention, cognition Objective: Attention deficit/hyperactivity disorder (ADHD) is among the most prevalent neurodevelopmental disorders in children, often persisting into adulthood. It is characterized by two symptom domains: impulsivity and inattention, both associated with underlying neural and cognitive deficiencies. This study is the first to investigate the potential effects of transcranial direct current stimulation (tDCS) targeting the left DLPFC on cognitive functions related to both symptom domains in adults with ADHD compared to typically developed controls. Method: This pre-registered clinical trial enrolled 55 participants, 25 of whom were diagnosed with ADHD. Participants completed a series of cognitive tasks before and after receiving either tDCS or sham treatment. Results: In the ADHD group, tDCS treatment improved measures associated with inattention, but not measures related to impulsivity. In the control group, tDCS treatment had no benefits. Conclusions: The discrepancy in treatment response observed between inattentive and impulsive symptoms has implications for understanding the neurobiological mechanisms of ADHD. Our findings offer new evidence supporting the positive impact of tDCS on cognitive functions linked to inattention.
Rosaria De Luca, Andrea Calderone, Maria Grazia Maggio, Antonio Gangemi, Francesco Corallo, Gianluca Pandolfo, Carmela Mento, Maria Rosaria Anna Muscatello, Mirjam Bonanno, Angelo Quartarone, Rocco Salvatore Calabrò Key words: neurorehabilitation, TBI, suicidal risk Objective: Traumatic brain injury (TBI) significantly increases the risk of suicidal ideation (SI) and behaviors due to neurobiological changes, cognitive impairments, and emotional dysregulation. This review consolidates current evidence on the relationship between TBI and suicide, identifying key risk factors and underlying mechanisms, and highlights the need for further research, especially in civilian populations. Method: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, Embase, and Scopus databases with studies published from 2014 to 2024. This review has been registered on Prospero (number CRD42024574643). Results: Factors indicated such as external causes of injury, comorbidities like depression and substance use disorders, and post-TBI symptoms consistently influence suicide risk. Advanced predictive models emphasize the role of psychological symptoms, particularly depressive features, in forecasting SI post-TBI, underscoring the need for targeted interventions and early symptom management. Conclusions: The seriousness of TBI significantly impacts the probability of SI and suicide attempts (SA). Research consistently shows that patients with more severe TBIs tend to have higher rates of SI and SA. Psychological disorders, such as depression and substance abuse disorders, greatly increase the likelihood of suicidal actions after a TBI. These conditions not only raise the occurrence of SI but also lead to earlier and more regular SA.
Alessio Gori, Eleonora Topino, Laura Muzi, Vittorio Lingiardi, Giovanni Stanghellini Key words: factor analysis approach, M axis, mental capacities, mental functioning, network analysis approach, personality organization, psychodynamic diagnostic manual Objective: Within the realm of international diagnostic systems, the Psychodynamic Diagnostic Manual – 2nd edition (PDM-2) stands out as a particularly effective instrument for evaluating mental functioning based on a psychodynamic perspective. This research aimed to explore the psychometric properties of the M Axis and to investigate the dynamics among its 12 capacities for individuals with Cluster B personality disorders. Method: A sample of 285 psychotherapists who regularly use the PDM-2 in their professional practice was involved in this research. The collected data were analysed using an integrated approach combining factor and network analyses. Results: The factor analytic approach supported the strong psychometric properties of the M Axis for the 4-factor model. Good indications of internal consistency emerged, along with evidence of both convergent and divergent validity. The network analysis approach suggested that the psychotherapists perceived the capacity for mentalization and reflective functioning as the most influential one within the network of capacities in Cluster B personality disorders. Conclusions: The M Axis emerged as a psychometrically solid assessment measure with strong theoretical and empirical bases, which can provide valuable support for enhancing both research and clinical practice.
Nikolaos Liaskopoulos, Andreas S. Lappas, Myrto T. Samara, Nikolaos Christodoulou Key words: transcranial magnetic stimulation, transcranial direct current stimulation, BMI, body weight, overeating, binge-eating This review of reviews aims to investigate the effectiveness of non-invasive brain stimulation (NIBS) methods, i.e., transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), in reducing elevated body mass index (BMI) and overeating behavior (food cravings, binge eating, increased food consumption). Systematic reviews and meta-analyses in the English language were included. A search was conducted in PubMed and EMBASE until January 2024. The quality of all included reviews was assessed using the “A Measurement Tool to Assess Systematic Reviews” (AMSTAR-2). Quality assessment and data extraction were conducted by two independent reviewers, while all reviewers participated equally in article synthesis. Twenty-four systematic reviews were included, most of which show promising results regarding the effectiveness of NIBS on overeating and increased BMI. For weight reduction, rTMS is more effective, and tDCS can improve food cravings and food consumption. However, the critically low quality of most included studies and the heterogeneity of the intervention parameters are strong limitations against drawing any safe conclusions. More studies are needed with stable NIBS parameters.
Mario Miniati, Laura Palagini, Giulia Righi, Donatella Marazziti Key words: CBT, cardiac disease, depression Objective: Objective of this review is to summarize current knowledge on Cognitive Behavioural Therapy (CBT), as treatment for depression in coronary artery disease (CAD). Method: A systematic search was conducted on the PUBMED database for the last ten years, in accordance with the PRISMA guidelines, following PICOS criteria, and applying specific queries in the 'PubMed Advanced Search Builder'. Results: Twenty-one studies were selected and included in the systematic review, with a total number of 2498 patients enrolled, excluding patient samples analysed multiple times, with results published in different papers. The mean/SD age of the enrolled patients was 56.9±7.7 years (range: 30.3-63.0). The mean/SD number of scales used was 4.2±2.0 (range: 2-9). The psychological intervention included CBT in 8/21 (38.1%) studies, Internet-Delivered CBT (I-CBT) in 8/21 (38.1%), and CBT + Activity in 1/21 (4.8%) Monitor (AM), 1/21 (4.8%) Stress Management CBT-based, 1/21 (4.8%) CBT-WBT Sequential Approach, 1/21 (4.8%) e-IMPACT CBT (CBT delivered via internet o' by phone'), 1/21 (4.8%) Group-CBT. The control groups underwent 'treatment as usual' (TAU) in 5/21 (23.8%) studies, 'online discussion forum' (ODF) in 5/21 (23.8%) studies, 'clinical management' (CM) in 4/21 (19.0%) studies, pharmacological treatment with SSRIs (2/21; 9.5%), 'waiting list condition' (WLC), 'educational support' or ‘simple monitoring’ in the remaining 4/21 (19.0%) studies; in one study (4.8%), this information was not available. Conclusions: Efficacy of CBT as a treatment for depressive syndromes in patients with CD is still under discussion, partly due to the heterogeneity of the outcome measures, partly due to methodological issues, such as therapist supervision and allegiance. CBT seems to be irrelevant to biological variables, such as inflammatory markers and heart rate variability and not ever superior to other interventions, in the treatment of depressive symptoms.
Riadh Abed Key words: human egalitarianism, human mating system, male reproductive skew, personality traits, division of labour The human, species-typical reproductive system is distinctive and unique among the great apes. It involves pair-bonding and long-term mating as well as male investment in both mate and offspring. Studies have demonstrated that this mating system produces the lowest male reproductive skew known in primates as well as in mammals generally which entails the lowest level of reproductive failure among human males compared to other primate/mammalian species. It is argued that this low reproductive skew leads to an increase in the effective population size and to a greater diversification/variation in personality and behavioural traits in the population compared to other species. The implications of this Reproductive Egalitarian Model for human mating are discussed with regard to the emergence of human personality traits, social complexity, division of labour and risk of mental disorder.
Alfonso Troisi Key words: neurodiversity, evolutionary psychiatry, organic pathology; disability; fitness disadvantage; cultural relativism When advocating to fight stigma and promote acceptance of neurodivergent individuals, the current debate on neurodiversity does not present a major challenge to psychiatric theory and research. The controversy arises when neurodiversity is taken to its extreme, denying the existence of neurodevelopmental disorders. Evolutionary psychiatry has recently contributed to the neurodiversity debate by providing adaptive explanations. These explanations are based on the unproven assumption that neurodiversity has been shaped by natural selection, as some atypical neurocognitive profiles increased inclusive fitness in the ancestral environment. Evolutionary psychiatry recognizes the heterogeneity of neurodiversity, acknowledges the existence of neurodevelopmental disorders, and establishes fitness disadvantage as the criterion of morbidity. The evolutionary definition of pathological neurodiversity is based on an objective criterion, but it has limited utility in clinical practice. Cultural relativism has always played a role in the history of medicine and psychiatry, often overshadowing scientific analysis. Therapeutic concerns are influenced by cultural trends that can lean towards either medicalization or diagnostic nihilism.
Thales Marcon Almeida, Marsal Sanches
Martine Bouvard, Arnaud Carré, Nathalie Fournet, Céline Douilliez, Céline Baeyens, Pierre Philippot Key words: ideal self, Self-Discrepancies Scale, socially prescribed self, unwanted trait, wanted trait Objective: The Self-Discrepancies Scale (S-DS) is a multiple-subscore instrument designed to assess discrepancies between mental representations of the self: the actual self on one hand, and the ideal and socially prescribed selves on the other. Its idiographic subscores rely on the endorsement of self-descriptive traits, while its abstract subscores form an overall judgement of felt self-discrepancies. The objectives of the present study were to (i) evaluate the S-DS in a new non-clinical population, (ii) expand the body of data on the S-DS’s convergent validity, (iii) study the idiographic data for the S-DS, and (iv) establish a nomothetic list of traits with a better choice of unwanted traits. Method: We administered the S-DS to a non-clinical sample (N= 422, mean age = 23.26, 90% female), along with a questionnaire measuring personality traits. Results: Two internal reliability results were different to those observed in the primary research. The wanted ideal self (WIT%) was weakly linked to overall measures of discrepancy and distress. The correlations between the two indices of ideal self (WIT% and ideal discrepancy) were weak. One result differs from the literature findings (moderate correlation between the two discrepancy indices). Neuroticism was found to be the highest predictor of ideal discrepancy. The abstract discrepancy subscores (ideal and socially prescribed discrepancies) were better correlated with personality traits than the idiographic subscores (wanted ideal (or socially prescribed) traits). Our present results suggest that the ideal and socially prescribed selves encompassed the same categories of wanted and unwanted traits. Conclusions:There were small quantitative differences (in the number of traits cited) between the two selves. In general, the two types of traits (wanted and unwanted) belonged to different categories. The wanted traits were more strongly endorsed in the ideal self. In conclusion, the present data provided a better assessment of the idiographic aspects of self-discrepancy and add to a grow body of evidence on the convergent validity of the S-DS.
Roberto Nava, Beatrice Benatti, Nicolaja Girone, Monica Macellaro, Cristian Pellicioli, Laura Maggioni, Matteo Marcatili, Bernardo Dell’Osso, Massimo Clerici Key words: covid19, mentalhealth, psychiatry, fear Objective: Even though the COVID-19 emergency has concluded, its consequences are still relevant. Recent evidence suggests that a significant proportion of individuals experience persistent symptoms long after the initial infection has resolved, classified as “Long COVID” condition. Fear of COVID-19 increases anxiety and stress levels in healthy individuals and exacerbates the symptoms of those with pre-existing psychiatric disorders; therefore understanding the impact of the pandemic on psychiatric disorders remains of utmost importance. The present study aimed at assessing the prevalence and predictive factors of fear of COVID-19 in a sample of patients with different psychiatric conditions. Method: A sample of 269 psychiatric patients were recruited from two different tertiary clinics in Italy and assessed with the Fear of COVID-19 Scale (FCV-19S). In order to compare patients with a significant fear of COVID-19 or without (Fear+ vs. Fear-) and to identify the main features in terms of clinical dimension, exploratory and predictive analysis were performed. Results. Female gender, age at illness onset, and insight levels emerged as positive predictors of FCV-19S. Conversely, current substance abuse emerged as a negative predictor of fear levels. Moreover, significantly lower FCV-19S scores were observed in patients with a diagnosis of schizophrenia spectrum disorders. Conclusions. Specific sociodemographic and clinical factors predicted higher levels of fear of COVID-19 in psychiatric patients. Further studies are warranted to determine the potential long-term consequences of the COVID-19 impact on mental health.
Maria Chiara Bazzini, Antonio Narzisi, Gaia Scarpini, Emilia Scalona, Gianina Bruzzi, Angela Russo, Valentina Viglione, Gabriele Masi, Giacomo Rizzolatti, Cristina Berchio, Maddalena Fabbri-Destro Key words: action planning, motor abnormalities in autism, endophenotype, atypical motor developmental trajectories, preschoolers Objective: it is well known that during an intentional behavior, the final goal of the action shapes the entire sequence of motor acts. This chained organization has been previously demonstrated to be altered in school-age autistic children, who modulate only the final motor act according to the action goal. Here, we investigate the temporal modulation during the intentional action in three groups of preschoolers: neurotypical, autistic, and non-autistic siblings of autistic children. Method: the participants engaged in a simple task of reaching and grasping an object and placing it into two containers of different sizes. Results: neurotypical children adjusted both reaching and placing times according to the width of the containers, indicating an action-chained organization. In contrast, both autistic children and non-autistic siblings adapted only the placing - but not the reaching- time according to the container size, exhibiting an unchained organization of intentional actions. Conclusions: despite not being included among the diagnostic criteria, motor alterations are present in a large number of autistic individuals, detectable from an early age. Being motor signs also expressed by non-autistic siblings, our findings suggest a potential link between motor abnormalities and the pathogenesis of autism. Thereby, tasks similar to the one employed here could be valuable for screening children with an increased likelihood of atypical neurodevelopment.
Roberta Igliozzi, Romina Cagiano, Marta Berni, Chiara Pecini, Valentina Viglione, Gabriele Masi, Filippo Muratori, Sara Calderoni, Raffaella Tancredi Key words: executive functions, autism spectrum disorder, adaptive behavior, ASD symptoms, behavioral and emotional profile, preschoolers Objective: To describe the relationship between executive functions (EF) and symptom’s severity, behavioral problems, and adaptive functioning in autistic preschoolers. Method: Seventy-six autistic preschoolers (age-range: 37-72 months; SD: 8.67 months) without intellectual disability were assessed. Executive functions were measured by both performance-based (Battery for Assessment of Executive Functions -BAFE-) and indirect measures (Behaviour Rating Inventory of Executive Function – Preschool Version -BRIEF-P); adaptive skills were assessed using the Vineland Adaptive Behavior Scales Second Edition (VABS-II); ASD severity was evaluated through the ADOS-2 and the SCQ; the Child Behavior Checklist (CBCL ½-5) questionnaire was used to describe the emotional/behavioral profile. Results: A considerable rate of autistic preschoolers showed weaknesses in one or more measures of EF, in particular in inhibition and working memory at both performance-based and parent report measures. EF measures explained a significant proportion of variance in the emotional/behavioral profile, and in the adaptive skills, particularly in the socialization domain. Specifically, the most relevant EF predictors are Inhibition, Emotional Control and Cognitive Flexibility subscales of the BRIEF-P. Conclusions: Assessment of EF in autistic preschoolers may identify those children at higher risk for emotional/behavioral problems and adaptive difficulties. EF are a crucial target for early intervention in preschoolers with autism with the potential to improve child outcomes.