Search

l contributo mette a tema la centralità del concetto di salute, un costrutto complesso dal momento che la salute non può non essere con- siderata un bene comune, come l’approccio One Health, oggi invocato dai più e focalizzato sulla salute come condizione unica e onnicomprensiva, in- segna. La Psicologia trova la sua coerente collocazione all’interno di questa cornice, dove è centrale la figura di psicologo di prossimità per contribuire ad un welfare di comunità, promuovendo in modo attivo salute e benessere e lavorando sul piano preventivo e di intercettazione precoce del disagio. In un momento storico che vede un costante incremento nel ricorso all’utilizzo di psicofarmaci e un Sistema Salute Mentale in affanno, è opportuno indirizzare lo sguardo verso le esperienze europee, che segnalano la via del potenziamento delle Cure Primarie anche nella prospettiva di combattere la lotta allo stigma. Se è ormai assodato che la presenza dello psicologo costituisca un investimento per la qualità delle Cure Primarie, l’articolo sottolinea l’impor- tanza di mantenere attivo sia il piano clinico che l’attenzione alla dimensione della collettività. Lo psicologo delle Cure Primarie, come previsto dalla Funzione di Psicologia Aziendale, avrà il compito di assicurare l’offerta di un accesso tempestivo all’assistenza psicologica e, in partnership con i diversi stakeholders, la promozione del benessere psicologico nei contesti di vita reale e nelle comunità. Qualora ritenuto utile, sarà suo compito gestire l’invio a servizi, quali psichiatria, neuropsichiatria infantile, serd o altri, per l’offerta di competenza.

Con “sincronia” intendiamo un fenomeno complesso da definire e delimitare. Tuttavia, lo studio dei processi che costituiscono le “precondizioni” di tale fenomeno necessita di un approccio multidisciplinare. In questo senso, questa tesi esplora come le differenze individuali modulano i processi alla base della coordinazione e della sincronia interpersonali. Gli studi presentati nella prima sezione di questa tesi si fondano sulle prospettive teoriche relativi al disturbo borderline di personalità (BPD). Nello specifico, ci concentreremo sul ruolo psicopatologico di alti tratti BPD. Il Capitolo 1 esplora se alti tratti BPD potrebbero influenzare la capacità di coordinarsi e sincronizzarsi con un partner più o meno adattivo e l’esperienza emotiva dell’interazione. I nostri risultati hanno rivelato che alti tratti BPD erano associati a una maggiore asincronia e variabilità comportamentale anche quando il partner era moderatamente adattivo. Inoltre, questi individui hanno riportato una bassa percezione di sintonia e un affetto negativo più elevato rispetto a quelli con bassi tratti BPD. Tali risultati rivelano che gli schemi cognitivi e affettivi patologici potrebbero svolgere un ruolo nella modulazione della sincronia interpersonale e degli affetti negativi, suggerendo maggiori vulnerabilità nella modulazione emotiva in individui con tratti BPD elevati rispetto a tratti BPD bassi. Nel Capitolo 2, utilizzando lo stesso compito comportamentale presentato nel capitolo 1, abbiamo osservato se le rappresentazioni mentali di sé e dell’altro in associazione al livello di tratto modulassero il ritmo mu durante interazioni sincronizzate o individuali e l'esperienza soggettiva dell’interazione. Parzialmente in linea con la nostra ipotesi, abbiamo ottenuto che gli individui con alti tratti BPD mostravano un'alterata soppressione del mu (10 Hz) durante tutte le condizioni come segno di ridotta integrazione sensomotoria durante l’attivazione del loop percezione-azione. Inaspet, “Synchrony” is still complex to define and delimit. However, studying the processes that are the “pre-conditions” of synchrony needs a multidisciplinary approach. To fill this gap, this thesis explores how individual differences modulate the processes underpinning interpersonal coordination and synchrony. The studies presented in the first section of this thesis are grounded within the theoretical clinical frameworks related to borderline personality disorder (BPD). Specifically, we would focus on the psychopathological role of high BPD traits resulting from a developmental trajectory. In this sense, Chapter 1 explores whether high BPD traits would affect the ability to coordinate and synchronize with a variable adaptive partner and the emotional experience of the interaction. Our findings revealed that high BPD traits were associated with higher behavioral asynchrony and variability even when the partner was moderately adaptive. Furthermore, those individuals reported a low perception of “feeling with” and a higher negative affect than those with low BPD traits. Such findings reveal that pathological cognitive and affective schemas might play a role in modulating interpersonal synchrony and negative affect, suggesting higher impairments in emotional modulation in individuals with high BPD traits than low BPD traits. In Chapter 2, using the same behavioral task, we investigated whether self and other mental representational disturbances would modulate mu rhythm during self and other synchronized interactions and the subjective experience. Partially in line with our hypothesis, we found that individuals with high BPD traits showed altered mu suppression at a specific component of mu rhythm (10 Hz) during all the conditions as a sign of reduced sensorimotor integration within the action-perception loop. Unexpectedly, individuals with high BPD traits perceived higher cooperation at increasing the partner’s adaptivity, suggesting alternative but coherent clinical interp

Quella tra i 18 e i 28/30 anni è una fase di transizione, fra la turbolenza dell’adolescenza e la relativa stabilità della giovane età adulta, che costituisce un punto di svolta nel ciclo di vita. I giovani adulti devono fronteggiare scelte significative che riguardano autonomia, relazioni e carriera, con l’obiettivo di definire la propria identità e i processi di soggettivazione iniziati nell’adolescenza. Il volume illustra le caratteristiche di questa fase, considerando i processi di costruzione di nuove relazioni e di trasformazione identitaria; evidenzia inoltre gli indicatori di rischio per la salute mentale e le problematiche psicopatologiche più frequenti. Propone poi un innovativo approccio psicoterapeutico a indirizzo psicodinamico, volto ad aiutare il giovane adulto ad acquisire maggiore consapevolezza delle proprie risorse e inclinazioni. Attraverso esemplificazioni cliniche approfondite vengono illustrate sia psicoterapie psicoanalitiche a lungo termine sia consultazioni brevi focalizzate sul counselling psicodinamico condotte con giovani soggetti.

ObjectiveThis study aims to longitudinally investigate the effects of individual's factors on subsequent burn-out/psychological distress in a sample of mental health practitioners, testing if higher attachment anxiety and avoidance and lower reflective functioning (i.e., certainty and uncertainty of mental states) and well-being at baseline may lead to a greater psychological distress and burn-out 1 year later. MethodsThe sample consisted of 40 experienced psychotherapists (females: 72.5%; mean age: 47.40 +/- 9.48 years) who completed a battery of questionnaires at baseline and 1 year later. Statistical analyses were conducted with Bayesian multiple linear regressions. ResultsGreater attachment anxiety and certainty about mental states and lower individual's well-being at baseline predicted greater burn-out 1 year later. Similarly, greater attachment anxiety and lower individual's well-being at baseline predicted psychological distress at 1 year follow-up. Of note, uncertainty of mental states and avoidant attachment were not associated with outcomes. ConclusionThese findings suggest that the levels of burn-out and psychological distress among psychotherapists may be alleviated with interventions targeting attachment insecurity, specific aspects of reflective functioning (i.e., certainty about mental states) and well-being.

Tools for assessing object relations (ORs) are fundamental for psychodynamic theory, research, and practice. ORs play an important role in diagnostic and therapeutic processes, helping therapists to better understand and manage complex relational functioning in their patients. The clinical relevance of OR is also recognized by the first criterion of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition Alternative Model for Personality Disorders. Our goal is to provide clinicians and researchers with an updated review of the available empirical tools to assess OR. We conducted a systematic search on APA PsycInfo and Pubmed and retrieved 42 instruments from the existing literature. Some of these assessment tools are well established in the scientific community. Among the less popular ones, we identified some instruments that show good potential and may be granted a further round of validation. We encourage the development of existing and new instruments within the framework of Kernberg’s theory of personality organization, and a further inquiry into qualitative aspects of ORs dyads, which may help therapists obtain more sophisticated information on their patients’ relational functioning.

As COVID-19 continues to incur enormous personal and societal costs, widespread vaccination against the virus remains the most effective strategy to end the pandemic. However, vaccine hesitancy is rampant and has been steadily rising for decades. Seeking to remedy this, personality psychologists have begun to explore psychological drivers of vaccine hesitancy, including the Big Five. Openness to Experience presents itself as a vexing case as previous attempts to study its association with vaccine hesitancy have yielded mixed findings. In this prereg-istered study, we hypothesise that the impact of Openness to Experience on Vaccine Hesitancy depends on its interplay with other factors, namely conspiracy beliefs. To test this, we apply logistic regressions, simple slopes analyses, and propensity score matching to a nationally representative sample of 2500 Italian citizens, collected in May 2021. Contrary to our original hypothesis (i.e., Openness will have a positive association with Vaccine Hesitancy at high - and a negative at low - levels of Conspiracy Beliefs) we find that high Openness diminishes the impact of Belief in Conspiracy Theories on Vaccine Hesitancy. Consistent with previous research, we propose that Openness serves as a buffer against extreme positions by allowing individuals to be exposed to a greater diversity of information.

Time perspective (TP) influences various aspects of human life. We aimed to explore the associations between TP, daily time use, and levels of functioning among 620 patients (313 residential patients and 307 outpatients) with a diagnosis of Schizophrenia Spectrum Disorders (SSD) recruited from 37 different centres in Italy. The Brief Psychiatric Rating Scale and the Specific Levels of Functioning (SLOF) were used to assess psychiatric symptoms severity and levels of functioning. Daily time use was assessed using an ad hoc paper and pencil Time Use Survey. The Zimbardo Time Perspective Inventory (ZTPI) was used to assess TP. Deviation from Balanced Time Perspective (DBTP-r) was used as an indicator of temporal imbalance. Results showed that the amount of time spent on non-productive activities (NPA) was positively predicted by DBTP-r (Exp(0): 1.36; p .003), and negatively predicted by the Past-Positive (Exp(0): 0.80; p .022), Present-Hedonistic (Exp(0): 0.77; p .008), and Future (Exp(0): 0.78; p .012) subscales. DBTP-r significantly negatively predicted SLOF outcomes (p .002), and daily time use, in particular the amount of time spent in NPA and Productive Activities (PA), mediated their association. Results suggested that rehabilitative programs for individuals with SSD should consider fostering a balanced time perspective to reduce inactivity, increase physical activity, and promote healthy daily functioning and autonomy.

Il concetto di fiducia epistemica è stato recentemente posto al centro del dibattito accademico e clinico, venendo considerato un costrutto centrale nello sviluppo relazionale, la cui compromissione potrebbe sottostare allo sviluppo psicopatologico. Definita come la capacità mentale dell’individuo di filtrare le informazioni condivise dagli altri, permette di percepirle come affidabili, generalizzabili e rilevanti. Questo costrutto è alla base dei processi di apprendimento culturale, grazie ai quali l’individuo è in grado di muoversi all’interno del mondo sociale e a regolare la propria esperienza interna. Data la natura regolatoria e relazionale di questo costrutto, risulta evidente la rilevanza che assume in un momento evolutivo caratterizzato da affetti intensi e nuove modalità relazionali: l’adolescenza. In questa fase del ciclo di vita, l’individuo è chiamato ad affrontare alcuni compiti evolutivi, tra cui il consolidamento dell’identità, il processo di separazione-individuazione rispetto alle figure genitoriali, e lo sviluppo di capacità regolatorie emotive efficaci. Tutte queste sfide conducono l’adolescente al bisogno di apprendere dal contesto sociale, e di conseguenza la concettualizzazione di ciò che avviene nello scambio relazionale di apprendimento risulta centrale. Obiettivo di questa dissertazione di dottorato risulta quindi l’esplorazione del costrutto di fiducia epistemica durante l’adolescenza, attraverso l’identificazione di strumenti specificatamente sviluppati per la valutazione del costrutto e l’indagine delle relazioni che la fiducia epistemica ha con altre variabili di funzionamento psicologico. Questo permette di delineare in quali forme la fiducia epistemica possa essere considerata un fattore protettivo nei confronti dello sviluppo psicopatologico e in quali forme assuma invece un ruolo di fattore di rischio. L’obiettivo viene raggiunto attraverso le indagini di 4 studi: un’investigazione preliminare del costrutto e del suo ruolo, The concept of epistemic trust has recently been placed at the center of both academic and clinical debate, being considered a central construct in social-relational development, the impairment of which could underlie psychopathological development. Defined as the individual's mental ability to filter culturally shared knowledge from others, it allows them to perceive it as reliable, generalizable, and relevant. This construct underlies the cultural and relational learning processes by which the individual is able to move within the social world and to regulate their own internal experience. Given the regulatory and relational nature of this construct, it assumes great relevance in a developmental moment characterized by intense affect and new relational modes: adolescence. At this stage of the life, the individual is challenged to face certain developmental tasks, including the consolidation of identity, the process of separation-individuation from parental figures, and the development of effective emotional regulatory skills. All these challenges lead the adolescent to the need to learn from the social context, and consequently the conceptualization of what takes place in the relational exchange of learning turns out to be central. The goal of this doctoral dissertation therefore is to explore the construct of epistemic trust during adolescence, through the identification of specifically developed instruments for assessing the construct and the investigation of the relationships that epistemic trust has with other variables of psychological functioning. This makes possible to delineate in what forms epistemic trust can be considered a protective factor against psychopathological development and in what forms it instead takes on a role as a risk factor. The aim is achieved through the investigations of 4 studies: a preliminary investigation of the construct and its role as a protective factor toward emotional dysregulation during the lockdown for the COVID-19 pande

Sixty women with a diagnosis of endometriosis (30 with low pain severity - LP; 30 with high pain severity - HP) were evaluated at study entry (T0) and after three months (T1). At T0 they were compared for different psychological dimensions to sixty-two age-paired healthy women (CG). HP group had significantly higher scores on depressive symptomatology, sexual distress, and catastrophizing than CG, and higher scores on worry traits than LP. Metacognitive beliefs predicted sexual distress at T1, over and above pain severity. Pain affects different domains of mental health in this population. Coping strategies, metacognitive beliefs, and worry traits may modulate pain experience and psychological distress.

Background: Object relations (OR) are a key construct for psychodynamic theory and practice: they allow to accurately describe complex relational phenomena in normal and pathological personalities, serving as a diagnostic and clinical tool. The accurate assessment of OR is relevant to both researchers and clinicians willing to better understand interpersonal dynamics. Method: I conducted a systematic review of the empirical instruments that assess OR on PsycInfo and Pubmed. Results: The search yielded 49 instruments: 31 were patient-based instruments, such as self-reports, projective tests, and interviews, and 18 were clinician-rated instruments. Many of these tools are well known in the scientific community; some instruments among the less popular show interesting potential and might benefit from further empirical support. Discussion: The assessment of OR rests on several valid instruments, yet there is room for improvement. The development of new and existing tools referring to Kernberg’s theory of personality organization could contribute to an up-to-date, empirically informed assessment of object relations; also, the inquiry of qualitative aspects of object relations could advance the understanding of pathological interpersonal functioning.

In the TFP conceptualization, object relations (OR) dyads play a crucial role in understanding and treating patients with borderline personality organization (BPO) at different levels. To our knowledge, there has been no attempt yet to classify OR dyads. Our research goal is to obtain an exhaustive collection of the most clinically relevant OR dyads, as to validate a clinical assessment tool for the benefit of TFP practitioners. As a first step, we conducted a systematic review of the existing tools for OR assessment. Among the many valid instruments we retrieved, none was focused on object relations dyads as conceptualized by the TFP approach. Subsequently, we collected the OR dyads mentioned in the pertaining literature, through careful reading of the published TFP manuals. Such a list of dyads will soon be submitted to TFP therapists through an online survey. Respondents will be asked to evaluate the relevance of each dyad for their clinical work with BPO patients, and to indicate to which degree each dyad refers to five affective themes: Aggression/Hostility, Control/Power, Worth, Care, and Sexuality. After having analyzed such data, we will obtain a reduced list of dyads that are recognized as clinically useful in TFP practice; on such basis, we will validate both a patient-centered and a clinician-rating instrument that will allow TFP therapists to evaluate the dyadic functioning of their patients at any stage of treatment. Such understanding of patients’ OR dyads may help clinicians better identify maladaptive self and other representations and manage complex transference-countertransference patterns.

Intimate partner violence (IPV) is a serious social, physical and mental health issue. Women victims of IPV can develop short- and long-term consequences such as depression and post-traumatic stress disorder (PTSD). Where trauma has been incurred, standard psychotherapies may usefully be complemented by interventions based on expressive writing (EW). Numerous studies have explored the mechanisms underpinning improvement after writing, focusing on the cognitive and emotional processing of traumatic experiences. The aims of this study were to evaluate changes in PTSD and depression symptoms following EW and to examine the mediating effect of emotional and cognitive processing on symptom reduction in subjects who engaged in EW. Seventy-seven abused women (mean age = 41.43, SD = 10.75) were randomly assigned to a three-session expressive writing condition (n = 43) or a neutral writing condition (n = 34). Psychological distress (PTSD and depression) was assessed both before and after the writing sessions. Linguistic inquiry word count software was used to analyze the women’s narratives in relation to emotional processing (positive and negative emotions) and cognitive processing (insight and causal attributions). The mediation model indicated that the reduction in depression was fully mediated by negative emotion processing and partially mediated by cognitive processing, while the reduction in PTSD was partially mediated by negative emotion processing and fully mediated by cognitive processing. No effect of positive emotion processing was found. The clinical implications are discussed.

Il presente lavoro di tesi ha un duplice scopo: da un lato indagare le rappresentazioni che gli studenti italiani hanno rispetto all’omosessualità e rispetto all’unione tra persone dello stesso sesso, dall’altro valutare l’efficacia di alcuni interventi di sensibilizzazione volti a migliorare le rappresentazioni degli adolescenti stessi. Il lavoro si compone di tre diversi studi e il campione coinvolto è di circa 1500 partecipanti, di età compresa tra i 14 e i 21 anni. Gli strumenti che abbiamo utilizzato sono l’Attitudes Toward Lesbian and Gay men (ATLG), la Modern Homonegativity Scale (MHS), l’ Attitudes Toward Same-Sex Marriage (ATSM) e la Couple Rating Scale (CRS). I risultati del primo e del secondo studio suggeriscono che gli studenti maschi mostrano una rappresentazione più negativa delle femmine rispetto all’omosessualità femminile e maschile. In più, i partecipanti con una rappresentazione più tradizionale del ruolo di genere maschile, con un’assenza di contatto diretto personale con persone omosessuali e coloro i quali affermano di avere un credo religioso, hanno rappresentazioni meno positive rispetto alle minoranze omosessuali e rispetto ai matrimoni tra persone dello stesso sesso. I risultati del terzo studio indicano, invece, che dopo tre diverse attività di sensibilizzazione, sia i maschi, sia le femmine hanno rappresentazioni più positive dell’omosessualità maschile. I partecipanti con atteggiamenti iniziali più negativi, invece, hanno migliorato la propria rappresentazione sia dell’omosessualità maschile, sia di quella femminile, sia quella relativa alle coppie dello stesso sesso. In accordo con Herek et al. (2015), possiamo spiegare i risultati che abbiamo ottenuto grazie a una cornice teorica che ci permette di capire come, sia l’eterosessismo, sia lo stigma sessuale siano ancora radicate all’interno delle principali istituzioni sociali, ma che le cose stiano cambiando al di fuori delle istituzioni stesse. Da un lato in Italia le coppi, This thesis has a double aim: on the one hand, it investigates the attitudes of Italian high school students toward gay men and lesbians and same-sex marriage; on the other hand, it assesses the efficacy of some outreach interventions aimed at improving adolescents’ attitudes toward homosexuality. The research consists of three different studies, and the sample involved is approximately 1500 participants, aged 14-21 years. The instruments used are the Italian version of the Attitudes Toward Lesbians and Gay Men (ATLG), the Modern Homonegativity Scale (MHS), the Attitudes Toward Same-Sex Marriage (ATSM), and the Couple Rating Scale (CRS). The first two studies suggest that male students show a more negative attitude than females toward lesbians and gay men. Furthermore, multivariate analyses reveal that respondents with more traditional male role attitudes and a lack of direct personal contact with gay people and those professing a religious faith have less positive attitudes toward homosexual minorities and same-sex marriage. The results of the third study indicate that after three different activities, both male and female participants have more positive attitudes toward gay men. On the other hand, participants with more negative initial attitudes improved their representations of male homosexuality, female homosexuality, and same-sex couples. According to Herek, we can explain our results through a theoretical framework that allows us to understand that heterosexism and sexual stigma are still embedded in social institutions but that things are changing in the social context. On the one hand, in Italy, gay and lesbian couples still do not have the same civil rights as heterosexual ones, but today’s adolescents seem to have more positive attitudes than in the past. So, we can hypothesize that things may also change at an institutional level in the future. The hope is that more and more awareness-raising interventions could change the most negative attitudes, leadin

Background: During Coronavirus Disease 2019 (COVID-19) outbreak in Lombardia, people were recommended to avoid visiting emergency departments and attending routine clinic visits. In this context, it was necessary to understand the psychological reactions of patients with chronic diseases. We evaluated the psychological effects on patients with chronic respiratory conditions and inflammatory bowel disease (IBD) through the analysis of their spontaneous contacts with their referral centres. Methods: Cross-sectional study was conducted from February 23 to April 27, 2020 in patients, or their parents, who contacted their multidisciplinary teams (MDT). E-mails and phone calls directed to the MDT of the centre for cystic fibrosis (CF) in Milano and for paediatric IBD in Bergamo, were categorised according to their contents as information on routine disease management, updates on the patient's health status, COVID-19 news monitoring, empathy towards health professionals, positive feedback and concern of contagion during the emergency. Results: One thousand eight hundred and sixteen contacts were collected during the study period. In Milano, where the majority of patients were affected by CF, 88.7% contacted health professionals by e-mail, with paediatricians receiving the largest volume of emails and phone calls compared with other professionals (P<.001). Compared with Milano, the centre for IBD in Bergamo recorded more expression of empathy towards health professionals and thanks for their activity in the COVID-19 emergency (52.4% vs 12.7%, P<.001), as well as positive feedback (64.3% vs 2.7%, P =.003). Conclusion: One of the most important lessons we can learn from COVID-19 is that it is not the trauma itself that can cause psychological consequences but rather the level of balance, or imbalance, between fragility and resources. To feel safe, people need to be able to count on the help of those who represent a bulwark against the threat. This is the role played, ev

La fase del ciclo di vita dell’emerging adulthood, propria delle società industrializzate, si estende dai 19 ai 28/30 anni ed è definita da Arnett (2004) come età self-focused, caratterizzata da esplorazione identitaria, instabilità, pluri-possibilità e da una sensazione di feeling in between tra adolescenza ed età adulta. Nell’elaborato viene descritto il Servizio di Counselling ad orientamento psicodinamico dell’Università degli Studi di Milano-Bicocca. Il profilo dell’utenza che accede al Servizio è caratterizzato da alcuni fattori di rischio, quali presenza di sintomatologia, insicurezza nell’attaccamento, soddisfazione di vita non elevata ed esperienze avverse infantili. Nel corso degli studi, si evidenzia l’effectiveness dell’intervento di counselling psicodinamico proposto, sia a breve termine, portando ad una diminuzione dei livelli sintomatologici, sia a lungo termine, mantenendo stabili nel tempo i miglioramenti raggiunti. L’effectiveness dell’intervento emerge anche nello studio con il gruppo di controllo in waiting list, che non mostra miglioramenti, a differenza degli studenti che effettuano i colloqui di counselling. Infine, nello studio esplorativo di confronto tra studenti dell’Università degli Studi di Milano-Bicocca e studenti dell’Università Rupert Karl di Heidelberg, emergono similitudini tra i due gruppi, quali medesime motivazioni alla base della richiesta di aiuto e simili livelli sintomatologici, mentre vi sono differenze rispetto agli stili di attaccamento e alla soddisfazione di vita. I dati evidenziano l’importante ruolo di protezione dell’attaccamento sicuro rispetto alla psicopatologia e alla soddisfazione di vita, a differenza dell’attaccamento insicuro che si configura come potenziale fattore di rischio, a prescindere dal paese di provenienza degli studenti., Typical of industrialized societies, the emerging adulthood’s lifecycle phase (from 19 to 28/30 years old) is defined by Arnett (2004) as a self-focused age, characterized by identity exploration, instability, possibilities and a sensation of feeling in between adolescence and adulthood. The psychodynamic Counseling Service of the University of Milano-Bicocca will be described. The profile of the Service’s users is characterized by some risk factors, such as the presence of symptomatology, insecurity in attachment, low life satisfaction and adverse childhood experiences. The effectiveness of the proposed psychodynamic counseling intervention will be highlighted, both in the short term, leading to a decrease in symptom levels, and in the long term, keeping the achieved improvements stable over time. The effectiveness of the intervention also emerges in the study with a control group in the waiting list, who does not show improvements with respect to the students who carry out the counseling intervention. Finally, in the exploratory comparison study between students of the University of Milano-Bicocca and students of the Rupert Karl University of Heidelberg, similarities emerge between the two groups, such as same reasons behind the request for help and similar symptom levels, while there are differences with respect to attachment styles and life satisfaction. The data highlights the important protective role of secure attachment with respect to psychopathology and life satisfaction, unlike insecure attachment that is configured as a potential risk factor, regardless of the students’ country of origin.

Self-report questionnaires based on Harter’s response format (“Some kids . . . but other kids . . . ”) are commonly used in developmental and clinical research settings, but the reliability and validity of this format in middle childhood are still under debate. The current study aimed to test the psychometric proprieties of Harter versus Likert response formats as applied to two attachment questionnaires in a sample of 410 Italian children aged 8 to 10 years. Participants completed the Experiences in Close Relationships–Revised Child version (n = 102, 4-point Likert-type scale; n = 104, adapted Harter version) and the Security Scale (n = 95, Harter’s format; n = 109 adapted 4-point Likert version). Results of multigroup confirmatory factor analyses indicated that the two response formats exhibited comparable reliability and factorial validity, although a slight superiority of Harter’s format emerged for the Security Scale. External validity was supported for both answer formats. Implications for developmental theory and practice are discussed.

The aim of the study was to assess the predictive value of dyspareunia, general chronic pain, and metacognitive beliefs to sexual distress in a sample of women with endometriosis. Ninety-six women (mean age = 34.60 ± 6.44 years) with a diagnosis of endometriosis took part to this cross-sectional study. Sociodemographic and clinical data were collected by means of a structured ad hoc questionnaire. Metacognitive beliefs and sexual distress were assessed by means of the Metacognitions Questionnaire (MCQ30) and the Female Sexual Distress Scale-R (FSDS-r). General chronic pain intensity was collected by means of a Numeric Rating Scale. Data were subjected to Hierarchical logistic regression. We found high percentages of dyspareunia and sexual distress (i.e., 66% and 76%). Findings suggested that dyspareunia and chronic pain did not predict sexual distress, while negative beliefs about worries predicted sexual distress over and above them (p =.040, odd ratio 1.159). In the target population, metacognitive beliefs may have more influence on sexual distress than pain symptomatology.

La Dialectical Behavior Therapy (DBT) è un programma di trattamento cognitivo-comportamentale strutturato, complesso e ricco, messo a punto per pazienti con Disturbo Borderline di Personalità (BPD) e gravi comportamenti disfunzionali (tentativi suicidari, autolesività, instabilità relazionale, comportamenti impulsivi). DBT ha dimostrato la sua efficacia in numerosi studi: i tentativi suicidari e i comportamenti disfunzionali si sono ridotti, mentre la regolazione emotiva e il funzionamento generale dei pazienti sono migliorati. La ricerca presentata i prefigge di valutare l’efficacia e i meccanismi d’azione di DBT, esaminando sia la dimensione di outcome, sia la dimensione di processo. La prima parte dell’elaborato è dedicata alla presentazione del modello DBT. Se ne discutono i fondamenti teorici, gli accordi alla base del trattamento, le modalità del programma terapeutico e le strategie di intervento. La seconda parte dell’elaborato è una valutazione dell’efficacia di DBT, rispetto alle variabili target. Lo studio è di tipo longitudinale ed è stato condotto seguendo le linee guida internazionali. DBT è stata messa a confronto con un programma di trattamento comparabile per tipologia di pazienti, obiettivi e complessità. Il campione è composto da 95 pazienti ambulatoriali, valutati ogni tre mesi. Poiché ci si attendeva che il contributo della variabilità individuale fosse rilevante, sono stati utilizzati modelli lineari gerarchici con effetti casuali. I risultati hanno mostrato che i tentativi suicidari, i comportamenti autolesivi, la disregolazione emotiva e comportamentale sono diminuiti in entrambi i gruppi dopo un anno; i modelli hanno mostrato come i soggetti differissero nella quota di cambiamento. Inoltre, i risultati sul campione dei completer hanno suggerito che il setting di gruppo e l’intensità del trattamento potrebbero agire quali specifici meccanismi terapeutici. La terza parte dell’elaborato si compone di una serie di studi di processo, Dialectical Behavior Therapy (DBT; Linehan, 1993, 2014) is a structured, complex and comprehensive cognitive-behavioral treatment program for patients with Borderline Personality Disorder (BPD) and severe dysfunctional behaviors (repeated suicidal attempts, self-harm behaviors, relational instability, other impulsive behaviors). Up to now, DBT proved its effectiveness in several studies: suicide attempts and dysfunctional behaviors decreased, while emotional regulation and general functioning improved. The present research aimed at assessing the effectiveness of DBT and its mechanisms of action, evaluating both outcome and process dimensions. The first part of the thesis is dedicated to the presentation of the DBT model, examining its theoretical foundations, the agreements underlying the treatment, the modalities of therapeutic program, and the strategies of intervention. The second part of the thesis is an evaluation of the effectiveness of DBT, examining the course over time of the target variables. The study is longitudinal, single-blind, with a two-arm parallel design, conducted following the international guidelines for the outcome studies on intention-to-treat samples. DBT was compared with another treatment program comparable by patient type, objectives, and complexity of interventions. The sample was comprised by 95 outpatients, assigned to groups with the minimisation procedure and assessed every three months. Since the individual variability was expected to be consistent, Hierarchical Linear Models with random effects were used. Results showed that suicidality, self-harm, emotional and behavioral dysregulation decreased in both groups after one year; unconditional growth models indicated that subjects differed in the elevation and in the rate of change. Moreover, results on the completers’ subsample suggested that the group setting and the intensity of treatment could represent specific therapeutic mechanisms. The third part of the thesis is composed by p

Obesity is an important emerging problem in adolescence because it causes psychological distress and social prejudice. Using Ugazio’s theory, this study aims to test if the construct ‘winner/loser’ and its associated meanings are used and considered important among obese adolescents. The personal constructs of 68 participants (young and adult; obese and normal weight) were elicited through the repertory grid test and analysed using the log-linear model. The power dimension was the most used in the obese groups (young and adult) but it was considered the most relevant among adolescents rather than women, regardless of the weight variable. The results allow us to provide several suggestions on a clinical level and on a wider social perspective.

Objective: To assess quality of life and psychological differences between infertile women with endometriosis and without endometriosis. To investigate predictive role of perfectionism, mindful awareness and beliefs about parenthood to quality of life in a sample of women with fertility problems. Methods: 43 infertile women (22 with endometriosis; 21 without endometriosis) who recurred to Assisted Reproductive Treatments (ARTs) in the last 12 months took part to this cross-sectional study. Sociodemographic and clinical data were collected by means of a structured ad hoc questionnaire. Fertility Quality of Life, Fertility Problem Inventory – Need of parenthood subscale, Obsessive Beliefs Questionnaire – Perfectionism subscale, and Cognitive and Affective Mindfulness Scale – Revised were used to assess target outcomes. Results: Any difference in quality of life and psychological condition was found between infertile women with and without endometriosis. Importance given to parenthood (beta = −.60, p <.001) and perfectionism (beta = −.30, p <.05) predicted quality of life related to fertility issues, independently of group. Conclusions: Infertility might elicit self-discrepancy between real-self (i.e. being infertile) and ideal-self (being fertile), which in turn has a negative impact on quality of life. Conclusions about the role of psychologist in ART's team are discussed.

La plusdotazione è stata ampiamente esaminata nei bambini e negli adolescenti, mentre un minor numero di articoli è stato pubblicato nello stesso gruppo in età adulta. Come suggerito dalla National Association for Gifted Children (2010), il termine plusdotazione si riferisce a "livelli eccezionali di attitudine (definita come un’eccezionale capacità di ragionare e apprendere) o di competenza (prestazioni documentate o risultati superiori o superiori al 10%) in uno o più domini (come intellettuale, creativo, artistico, leadership o accademico)”. Questa tesi ha esaminato il gruppo dotato di individui con elevate abilità intellettive (cioè punteggi ai test di intelligenza pari o superiori a 130) piuttosto che coloro che hanno raggiunto risultati concreti di vita. Nel corso dell'ultimo secolo, l'intelligenza elevata è stata spesso considerata una “carta vincente” perché forti relazioni sono state trovate con la salute fisica, l’adattamento psicologico e posizioni lavorative più prestigiose. Recentemente, questa posizione è stata contestata perché prove empiriche hanno dimostrato che le persone con straordinarie capacità intellettuali riportavano anche livelli più elevati di disregolazione affettiva, deficit di attenzione e iperattività, disturbi dello spettro autistico e disordini immunitari. La presente tesi mira ad affrontare questi problemi, esplorando le abilità cognitive, la personalità e il funzionamento emotivo di individui adulti plusdotati, applicando i principi del Multimethod Assessment. Nel Capitolo 1, la plusdotazione intellettiva è stata definita secondo il modello CHC. Quindi, ho esaminato il profilo cognitivo di questi soggetti; i pattern delle loro prestazioni (cioè quale fosse il miglior indicatore di intelligenza superiore); e la variabilità dei punteggi nei diversi domini. Nel Capitolo 2, ho esaminato i tratti della personalità e la regolazione emotiva dei soggetti gifted adulti secondo le teorie della developmental psychology an, Giftedness has been extensively examined in children and adolescents, whereas fewer papers have been published on the same group in adulthood. As suggested by the National Association for Gifted Children (2010), giftedness refers to “outstanding levels of aptitude (defined as an exceptional ability to reason and learn) or competence (documented performance or achievement in top 10% or rarer) in one or more domains (such as intellectual, creative, artistic, leadership, or academic)”. This dissertation has examined the gifted group composed of individuals with high intellectual aptitude (i.e. intelligence test scores equal to or greater than 130) rather than who have obtained concrete life achievements. Over the last century, high intelligence has been often considered a “winning card” because strong relationships have been found with better physical health, psychological adjustment and more prestigious job position. Recently, this position has been challenged because empirical evidences have shown that people with extraordinary intellectual abilities reported higher levels of affective dysregulation, attentional and hyperactivity deficit, autism spectrum disorders, and immune disorders. The present dissertation aims to approach these issues, exploring cognitive, personality, and emotional functioning of intellectually gifted individuals in adulthood, applying the principles of the Multimethod Assessment Approach. In the Chapter 1, intellectual giftedness has been defined according to the CHC model. Then, I have examined cognitive profile of gifted adults; pattern of their performance (i.e. what is the best indicator of superior intelligence?); and scores variability across different domains. In the Chapter 2, I have examined personality traits and emotional regulation of gifted individuals according to developmental psychology and psychopathology theories. I have considered an updated version of the disharmony hypothesis in order to describe how vulnerabilities and d

Diagnosis and treatment of gynaecological cancer still entail significant impairment in quality of life. The present study aims at monitoring it during chemotherapy treatment and at identifying variables significantly associated with it. Methods. 87 patients who attended the San Raffaele Hospital completed the EORTC QLQ-C30 and the Multidimensional Scale of Perceived Social Support before their first and third chemotherapy infusion. A self-report questionnaire was created in order to collect socio-demographic and medical information. Results. Social and emotional functioning and global quality of life show a significant improvement between the first and third chemotherapy infusion; age and perceived social support appear significantly associated with emotional functioning. A chemotherapy regimen with medium or high emetogenic potential and having a full-time job predict an improvement over time in global quality of life and role functioning, respectively. Discussion. These variables should be taken into consideration in patients care, in order to detect potential difficulties and promote a better adjustment to the disease and its treatment

Personality can be defined as those characteristics of an individual that account for consistent patterns of thinking, feeling, and behaving. The first studies on personality in psycho-oncology focused on the role of personality traits with respect to cancer incidence and survival; in light of virtually no empirical evidence on a personality-cancer causal association, a more consistent line of research later investigated the relationship between personality and adjustment to disease and treatment. Specifically, there is evidence that certain personality traits, such as neuroticism and negative affectivity, predict poorer levels of quality of life in cancer patients, whereas extraversion and optimism dimensions are associated with better outcomes. Research has been far more limited on the topic of personality disorders in the oncological setting, despite the notable implications that personality disorder patients pose in the interaction with healthcare staff, which can in turn result in suboptimal care. Nonetheless, cooperation with mental health professionals is essential in order to manage complications that may arise in the treatment of these patients, thus promoting the implementation of appropriate treatment plans

Lo studio ha valutato l'effetto della maternità in adolescenza sulla disponibilità emotiva nelle interazioni madre-bambino, considerando la qualità dei Modelli Operativi Interni di attaccamento della madre. Hanno preso parte alla ricerca 50 diadi con madri adolescenti-bambino (et. della madre = 15-21 anni) e 50 diadi con madri adulte-bambino (et. della madre = 25-40 anni). A 3 mesi di vita del bambino, le interazioni diadiche sono state videoregistrate e codificate con l'Emotional Availability Scales e l'Adult Attachment Interview . stata somministrata alle madri. Le analisi hanno mostrato che le madri adolescenti erano meno sensibili, pi. intrusive e ostili e avevano una minore capacità di strutturazione dell'attività di gioco del bambino rispetto alle madri adulte. I bambini di madri adolescenti erano meno coinvolti e responsivi nelle interazioni con le loro madri rispetto ai bambini di madri adulte. Non . stato trovato un effetto di interazione tra l'et. e l'attaccamento materno rispetto alla disponibilità emotiva di madre e bambino. I risultati indicano che la maternità in età precoce è un importante fattore di rischio per la qualità della disponibilità emotiva di madre e bambino a 3 mesi, evidenziando rispetto ad altri studi come anche lo scarso coinvolgimento e la bassa responsività del bambino appaiono correlate precocemente alla giovane età materna., The study evaluated the effect of motherhood in adolescence on emotional availability in mother-infant interaction, considering maternal attachment Internal Working Models. Participants were 50 adolescent mother-infant dyads (maternal age range = 15-21 years olds) and 50 adult mother-infant dyads (maternal age range = 25-40 years olds). At infant 3 months, mother-infant interaction was video-recorded and coded with the Emotional Availability Scales and the Adult Attachment Interview was administered to the mothers. Analysis showed that adolescent mothers were less sensitive, more intrusive and hostile and less adequate in scaffolding their infant’s orientation towards objects than adult mothers; infants of adolescent mothers were less involved and responsive towards their mothers than infants of adult mothers. No interaction effect between maternal age and maternal attachment on maternal and infant emotional availability was found. The results suggest that early motherhood is an important risk factor for the quality of the emotional availability of mother and infant at three months, showing with respect to other studies that the poor involvement and the low responsiveness of the infant is also correlated to young maternal age in that period.

Emotional maltreatment is proved to be related to, or even predictive of, several psychological and physical later impairments. Somatization has a higher incidence among individuals with a history of maltreatment, and among females. Studies highlighted the importance to investigate the role of mediating factors between childhood maltreatment and adult sympto-matology. Although little is known about the specific case of somatic unexplained symptoms, its relation with childhood maltreatment seems to be influenced by the role of romantic attachment. The main objective of our study is to check the effect of emotional maltreatment on early-adult somatization through the mediation of avoidance and anxiety levels of romantic attachment in a female group. Participants were 346 female students (mean age = 23.17) who completed a self-report protocol composed by the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Experiences in Close Relationships Scale-Revised (ECR-R) and the Symptom Check-List (SCL-90). A structural equation modelling has been applied in order to test the mediation of romantic attachment (ECR-R) in the relation between emotional maltreatment (CTQ-SF) and somatic symptoms (SCL-90). The total model fit resulted adequate and it proved that romantic attachment mediates the relation between emotional maltreatment and adult somatization (b = 0.15, SE = 0.05, z = 2.76, p = 0.006, 95% CI [0.04, 0.25]). Our results stress the importance to consider the relational level within intervention programs for female victims of adverse childhood experiences. Addressing the treatment of these individuals towards the adult relational functioning might prevent negative effects of maltreatment and thus reduce public health costs.

We evaluate 11 Rorschach variables with potential for assessing grandiosity and narcissism. Seven of these variables were drawn from previous literature: Omnipotence, Idealization, Reflection, Personal Knowledge Justification, Exhibitionism, Magic, and Elevated Mood States; four were developed for this research: Expanded Personal Reference, Narcissistic Devaluation, Narcissistic Deflation, and Narcissistic Denial. Using Rorschach protocols from American normative adults and Italian adult outpatients, the dimensional structure of these variables was evaluated by principal components analysis, and validity was tested by correlations with clinician ratings of narcissism on two scales from the Shedler–Westen Assessment Procedure–200 that were made after at least five sessions with the primary clinician. A cohesive dimension was found in both data sets defined by Expanded Personal Reference, Personal Knowledge Justification, Omnipotence, and Idealization, and it was meaningfully correlated with the clinician ratings of narcissism (M r =.41). Implications of the findings include the applicability of these variables in clinical practice and research for assessing narcissistic personality dynamics.

The Italian version of the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) – was standardized using a sample of 2,174 participants, aged between 16 and 90 years. The WAIS-IV consists of 10 core subtests and 5 supplemental subtests. While the 70–90 yr group is usually excluded from three of the five supplemental subtests (Letter-Number Sequencing, Figure Weights, and Cancellation), we administered all 15 subtests both to adults and elderly people. The aim of the present study was to investigate the factorial invariance of the Weiss and colleagues’ hierarchical five-factor CHC (Cattell-Horn-Carroll) model in Italian adults and elders. The overall results of this study generally support both the configural and factorial invariance of the WAIS-IV, and hence the five-factor CHC model of Weiss is equivalent in adults and elderly people. However, for the elderly sample we found higher loadings of WAIS-IV subtests on the second-order g factor.