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Despite the proven effectiveness of cancer prevention, the literature highlights numerous obstacles to the adoption of screening, even at a young age. In cancer discourse, the metaphor of war is omnipresent and reflects an imperative demand to win the war against disease. From the psychodynamic perspective, the risk of cancer forecasts an emotionally critical experience for which it is important to study mental representations concerning illness and health care. Through the creation of an invented story that offers a framework for imagination, our aim is to understand what the relationship with preventive practices in oncology means for young women and how this relationship is revealed by their metaphors. A total of 58 young women voluntarily participated in the present research, answering a narrative prompt. The stories written by the participants were analyzed using qualitative methodology to identify construct, themes and metaphors. Our findings identify four constructs: the construction of a defense: youth as protection; the attribution of blame about cancer risk; learning from experience as a prevention activator; and from inaccessibility to access to preventive practices: the creation of engagement. The construction of an invented story allows us to promote a process of prefiguration on the bodily, affective and thought planes invested in preventive practice and brings out the use of metaphors to represent cancer risk and self-care. The results allow us to think about the construction of interventions to promote engagement processes in prevention from an early age.

Health programs offer screening activities for the early detection of cancer in vulnerable population, but record very low participation rates. The authors have a theoretical framework to investigate the complexity of the phenomenon, in the psychodynamic and ethical dimensions, specific to women. In this study, the authors used semi-structured interviews and interpretative phenomenological analysis to explore the meaning-making processes of women who do not practice breast and cervical cancer prevention in Southern Italy neither in the public health-care system, nor in private health facilities. Three superordinate themes have emerged: taking care of oneself would be to love oneself; difficult contact with a sexual body;at the end, the fate decides. We highlight three levels in the psychism that underlie the behavior of not doing prevention: body- affects- thought. Understanding these psychic level mechanisms permits to support women's health policy, reducing costs and promoting health., Mediterranean Journal of Clinical Psychology, Vol 8, No 3 (2020)

To date few studies deepen the construct of meaning-making at the base on the resilience process for adolescent with multiple sclerosis. Starting from a mixed-method of analysis our aim is to fill the gap in the literature by qualitatively exploring the narrative articulation of meaning-making processes highlighting specificities and differences within groups of narratives with high/medium/low resilience measured through the CYRM-28. We collected 29 narratives. The qualitative analysis shows five meaning-making processes at the base of the resilience process: Dependence vs Autonomy; Reconstruction of the time lines; Integration of limits; Enlarging personal assumptive worldview; Connecting emotions and thought. Compared to narratives with low/high scores, differences were evident in the way such processes were articulated. We propose a framework of central issues in the lives of adolescents with multiple sclerosis and a way to determine how these issues can be useful for developing practices and trajectories to support resilient processes., Mediterranean Journal of Clinical Psychology, Vol 7, No 2 (2019)

Le autrici presentano un contributo teorico-clinico sull’affetto della gelosia giovanile tra normalità e patologia. Individuano una terza area, al limite tra le due, caratterizzata dal diritto al controllo come elemento scontato nella relazione di coppia. Il controllo del partner diviene coatto e intrusivo fino a marcare un terreno a rischio psicopatologico che trova nel virtuale un modo privilegiato per esprimersi. Le potenzialità insite nelle nuove tecnologie colludono con l’eccesso geloso, amplificando fantasie che l’incorporeità del mezzo rende fittiziamente reali., La camera blu. Rivista di studi di genere, N° 15 (2016): Legami 2.0. Il genere alla prova della contemporaneità

In una prospettiva teorica psicodinamica le autrici riflettono sulla trasmissione della mutazione dei geni BRCA1/2. Mutazione che, com’è noto, predispone le donne che ne sono portatrici al rischio di poter sviluppare, nel corso della vita, una forma di cancro al seno e/o alle ovaie. Spesso questa malattia ha già colpito diverse donne nella propria famiglia, generando ferite dolorose nella psiche e nel corpo che, nell’attualità, portano la donna a rischio a dover decidere le strade preventive da intraprendere. Curarsi ferite inscritte nella propria storia e che diventano una minaccia per i luoghi contraddistintivi della femminilità, diventa impresa ardua. Le autrici assumono le narrazioni delle donne in vari contesti come materiale testuale da analizzare al fine di evidenziare i significati attribuiti alla mutazione tra dimensioni identitarie, gruppali e generazionali., La camera blu. Rivista di studi di genere, N° 14 (2016): Ferite

Il lavoro offre una prospettiva psicodinamica sul tema della prevenzione oncologica dei tumori femminili, discutendo della possibilità, interna e fattuale per una donna, di occuparsi della propria salute. Si riflette sul dilemma prevenzione-non prevenzione articolando tra loro tre assi teorici: narcisismo di vita e narcisismo di morte; rapporto mente, corpo e affetti; sviluppo dell' identità sessuale femminile. I tre studi di ricerca qualitativa permettono di esplorare le rappresentazioni simboliche e le costruzioni di significato delle donne intorno al tema del rischio e della diagnosi precoce dei tumori al seno e alla cervice uterina. I risultati ottenuti evidenziano aspetti importanti per pensare ad efficaci interventi di sensibilizzazione rivolti alle donne.

PurposeConsistent with current literature, which highlights the role of narration as a key tool for exploring the processes by which people construct the meaning of their critical experiences the authors propose a theoretical and methodological model to analyse the narratives of illness and identify any innovative aspects. The generative model of mind presented refers to a semiotic, narrative and socio-constructivist perspective according to which narration constitutes one of the possible processes by which the affective and pre-verbal sense of experience is transformed into a meaning that can be symbolized and shared.Design/methodology/approachThe onset of an illness represents a critical event which interrupts a person's life narrative, shattering his/her biographical continuity and undermining any assumptions of him/herself and the world. In particular, the model proposes a method of analysis, currently absent in literature, of the narrative interview Narrative Function Coding System (NFC) in order to grasp the ways by which four main narrative functions, namely psychic functions, are classified: the search for meaning, the expression of emotions, the temporal organization and the orientation to action.FindingsNFC appears to be able to capture the complexity of the narrative process of construction of illness' sense-meaning making process, identifying both representative modalities of good functioning, which express a gradual process of connection with the variability of the experience, and modalities that express moments of disorganization and rigidity, which can persist throughout the time of treatment. The NFC represents not only a method for analysing illness narratives but also a method for tracking and monitoring the process of clinical intervention and change.Originality/valueThe sense-meaning making process perspective within the narrative socio-constructivist and semiotic framework of analysis proposed by NFC is currently absent in the literature. NFC can be a device for analysing the narrative process of sense-meaning making both for its use for clinical and preventive purposes. In addition we believe that this method, which focuses on the “form” and “way” of narratively constructing the subjective experience, rather than on the specific thematic content, can be used with all types of illness narratives, in particular the longitudinal one to explore the changes in sense-meaning making process.

Breast cancer (BC) in younger age is a critical and potentially traumatic experience that can interrupt the continuity of self-narrative during a crucial phase. In the Narrative Identity framework the translation of memories into autobiographical narratives is an internal and external process that plays a key role in meaning-making, social relationships and self-coherence. The aim of this study is to examine the role and function that autobiographical memory narratives (AMN) play in the process of adaptation to BC medical treatment. Seventeen BC women below 50 years received prompts to provide autobiographical memory narratives at four phases during their treatment (pre-hospitalization-T1-post-surgery-T2-chemo-radio therapy-T3-follow-up-T4). The Emotional Processing Scale (EPS) was also administered. In all, 68 AMN were collected. A three step procedure of data analysis was conducted. The first one, an empirically-derived memory coding manual to analyze key dimensions of AMN was developed: Agency; Emotional Regulation and Interpersonal Relations. Findings show a particular vulnerability in narrative identity faced by BC women during the shift from T1-T3. In the second one, an emotional coping profile for each woman focusing on the shift from T1-T3 was created. For the third step, these profiles were compared with the EPS scores. The final results suggest the capacity of the AMNs to differentiate the women’s emotional adaptation over the course of the BC treatment. Despite the study’s limitations, it supports the use of AMN as clinical device to construct a deeper knowledge and profiling trajectory of how women have internalized and elaborated past encounters with illness and help providers, as well as their prior experience of bodily/psychological health and integrity. This information adds to an understanding of their current efforts at recovery and adaptation. In this way we believe that the recollection of narrative memories, not only at the end of the cancer treatment but also during its process, could help the women to mend the broken continuity of their narrative self, as they seek to maintain a healthy balance of internal resources across their past, present, and projected future.

Cancer screening programs are public health interventions beneficial to early diagnoses and timely treatments. Despite the investment of health policies in this area, many people in the recommended age groups do not participate. While the literature is mainly focused on obstacles and factors enabling access to health services, a gap from the point of view of the target population concerns healthcare providers. Within the “Miriade” research–action project, this study aims to explore the dimensions that mediate the relationship between healthcare providers and preventive practices through the narrations of 52 referents and healthcare providers involved in breast, cervical and colorectal cancer screening. We conducted ad hoc narrative interviews and used theory-driven analysis based on Penchansky and Thomas’ conceptualization and Saurman’s integration of six dimensions of healthcare access: affordability, availability, accessibility, accommodation, acceptability and awareness. The results show that 21 thematic categories were representative of the access dimensions, and 5 thematic categories were not; thus, we have classified the latter as the dimension of affection. The results suggest trajectories through which psychological clinical intervention might be constructed concerning health, shared health decisions and access to cancer screening.

Research has identified a wide range of psychosocial factors associated to choosing to engage in ongoing cancer screenings. Nevertheless, a systematic review of the theoretical frameworks and constructs underpinning studies on breast, cervical, and colorectal cancer screening participation has yet to be conducted. As part of the action-research project “Miriade,” the present study aims to identifying the main theoretical frameworks and constructs adopted in the literature over the past five years to explain cancer screening participation. According to the PRISMA guidelines, a search of the MEDLINE/PubMed and PsycINFO databases was made. Empirical studies conducted from 2017 to 2021 were included. The following keywords were used: breast OR cervical OR colorectal screening AND adhesion OR participation OR engagement AND theoretical framework OR conceptual framework OR theory. Overall, 24 articles met the inclusion criteria. Each theoretical framework highlighted clinical and psychosocial constructs of cancer screening participation, focusing on the individuals (psycho-emotional functioning and skills plan) and/or the health services perspectives. Findings from the present study acknowledge the plurality of the theoretical frameworks and constructs adopted to predict or promote breast, cervical, and colorectal cancer screening adhesion and the need for new research efforts to improve the effectiveness of cancer screening promotion interventions.

Objective: The present study aims at systematically reviewing research conducted on factors promoting breast, cervical and colorectal cancer screenings participation. Methods: A literature search in MEDLINE/PubMed and PsycInfo from January 2017 to October 2021 was performed. Data extraction, researchers' full agreement and the inclusion criteria produced 102 eligible studies. Data were narratively synthesized and critically interpreted. Results: Multiple factors favoring or hindering breast, cervical and colorectal cancer screenings were identified and summarized as factors operating at the individual level (background information, individual characteristics, emotions related to screening procedure and to cancer, knowledge and awareness), at the relational level (relationships with healthcare staff, significant others, community members), and at the healthcare system level (systems barriers/policy, lack of staff). A critical appraisal of studies revealed a fragmentation in the literature, with a compartmentalization of studies by type of cancer screening, country and specific populations of destination. Conclusions: Overall findings indicated that greater integration of research results obtained independently for each cancer diagnosis and within the different countries/populations could foster a more comprehensive understanding of factors potentially enhancing the participation in breast, cervical and colorectal cancer screenings worldwide. This review, which is grounded in the current context of globalization and superdiversification in population, can help to enhance a better integration between research and practices, by supporting the development of more effective and inclusive evidence-based interventions and health-promotion campaigns worldwide. Research and practical implications are highlighted and discussed.

During the COVID-19 outbreak, individuals with or without mental disorders may resort to dysfunctional psychological strategies that could trigger or heighten their emotional distress. The current study aims to explore the links between maladaptive daydreaming (MD, i.e., a compulsive fantasy activity associated with distress and psychological impairment), psychological symptoms of depression, anxiety, and negative stress, and COVID-19-related variables, such as changes in face-to-face and online relationships, during the COVID-19 lockdown in Italy. A total of 6,277 Italian adults completed an online survey, including socio-demographic variables, COVID-19 related information, the 16-item Maladaptive Daydreaming Scale (MDS-16), and Depression, Anxiety, and Stress Scales-21 Items (DASS-21). Based on an empirically derived cut-off score, 1,082 participants (17.2%) were identified as probable maladaptive daydreamers (MDers). A binary logistic regression revealed that compared to controls, probable MDers reported that during the COVID-19 lockdown they experienced higher levels of anxiety and depression, decreased online social relationships, and, surprisingly, stable or increased face-to-face social relationships. Given the peculiar characteristics of the pandemic context, these findings suggest that the exposure to the risk of contagion had probably exacerbated the tendency of probable MDers to lock themselves inside their mental fantasy worlds, which in turn may have contributed to further estrangement from online social relationships and support, thus worsening their emotional distress.

The recent literature shows an increase of breast cancer in women under 50, however still few are the studies which analyse the impact of the disease in this specific target age. This study aims at exploring the most prevalent topics in Italian cancer blogs of women who have received a breast cancer diagnosis before the age of 50, in order to understand their experience of illness and the characteristics of women’s narrations at different times after diagnosis (1 year, 2 years, 3 years). We collected the textual corpus of 4 Italian breast cancer blogs and performed a thematic analysis. Five themes resulted, which, after interpretation using factorial mapping, fall into 3 sense vectors: toward the thought of the experience; from the external to the internal world; breast cancer: from rigidity to mobility. The blog analysis allows to build a first step of the scientific knowledge about the traumatic specificity of this experience, showing a need for processing the emotions. This allows to think about clinical support practices tailored to this group, in order to develop a diachronic processing of the experience and the construction of a new continuity of life.