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La psicologia clinica ha affrontato nel suo sviluppo questioni come la felicità, la resilienza e il funzionamento ottimale individuale. Tuttavia, l’approccio tradizionale alla salute mentale si è attenuto strettamente al modello medico di benessere e disagio psicologico, dove il benessere è considerato come l’assenza di malattia. D’altro canto, la psicologia positiva si è focalizzata sullo studio delle risorse e della positività negli individui, nei gruppi e nelle istituzioni, spesso trascurando i fattori di rischio per la salute e la psicopatologia. Questo volume si propone di integrare le tradizionali prospettive della psicologia clinica con quelle nuove emergenti dalla psicologia positiva, e propone un approccio clinico integrato in cui la definizione e la promozione della salute mentale positiva sono in linea con una concezione biopsicosociale dell’individuo. Viene così presentato un modello di psicologia clinica positiva dove il benessere, il disagio psicologico e la psicopatologia risultano reciprocamente interconnessi. Un testo utile a psicologi, psicoterapeuti, medici, operatori sanitari, pedagogisti ed educatori.

Optical coherence tomography (OCT) has been able to establish itself in recent years not only in academic-scientific, but also in everyday dermatological practice. Its focus lies on epithelial tumors of the skin, which can be diagnosed intuitively and within a few seconds. Thus, basal cell carcinomas, actinic keratoses, and different stages of field cancerization can be diagnosed and monitored for response to therapy or possible recurrence. This often helps to avoid invasive sample extraction. Recently, the field of OCT and its latest advancement, dynamic OCT (D-OCT), has been expanded to include non-oncologic dermatological diseases. This encompasses inflammatory dermatoses and the analysis of physiological skin parameters such as hydration. Thanks to automated vascular imaging and the measurement of objective parameters such as epidermal thickness, blood flow at depth, optical attenuation coefficient, and skin roughness, more and more characteristics of the skin can be studied in a noninvasive and standardized way. New potential areas of application are eczema, contact allergic dermatitis, psoriasis, rosacea, telangiectasia, acute and chronic wounds, melasma and nevus flammeus but also melanocytic lesions.Die optische Kohärenztomographie (OCT) konnte sich in den letzten Jahren nicht nur im akademisch-wissenschaftlichen, sondern auch im dermatologischen Alltag etablieren. Hierbei liegt ihr Hauptfokus auf epithelialen Hauttumoren, deren Diagnostik intuitiv und innerhalb weniger Sekunden gelingt. Dadurch können Basalzellkarzinome, aktinische Keratosen und unterschiedliche Stufen der Feldkanzerisierung diagnostiziert und auf Therapieansprechen oder ein eventuelles Rezidiv überwacht werden. Dies ermöglicht häufig einen Verzicht auf eine invasive Probeentnahme. Seit Kurzem wurde das Einsatzgebiet der OCT und ihrer neuesten Weiterentwicklung, der dynamischen OCT (D-OCT), um weitere nichtonkologische dermatologische Krankheitsbilder, vor allem entzündliche Dermatosen, erweitert. Analysiert werden können ebenso physiologische Hautparameter, wie die Hydratisierung. Dank der automatischen Gefäßdarstellung und der Messung objektiver Parameter, wie Epidermisdicke, Blutfluss in unterschiedlichen Tiefen, Abschwächungskoeffizient und Rauheit, können immer mehr Charakteristika der Haut nichtinvasiv und standardisiert untersucht werden. Neue potenzielle Einsatzgebiete sind Ekzeme, kontaktallergische Dermatitis, Psoriasis, Rosazea, Teleangiektasien, akute wie chronische Wunden, Melasma und Naevus flammeus, aber auch melanozytäre Läsionen.

Optical coherence tomography (OCT) and confocal laser microscopy (CLSM) are established non-invasive methods in clinical dermatological routine diagnosis. Whereas CLSM is especially useful to distinguish between nevi and melanoma, OCT is suitable for the diagnosis and differentiation of non-melanoma skin cancer. Line-field confocal optical coherence tomography (LC-OCT) is a new innovative device, which has better cellular resolution than OCT and a higher penetration depth than CLSM. Similar to CLSM, LC-OCT also allows 3D images in real time to be taken. Therefore LC-OCT is very useful for the examination of skin lesions of all kinds, since it unites the features of CLSM and OCT.Die optische Kohärenztomographie (OCT) und die konfokale Lasermikroskopie (KLM) sind in der klinischen dermatologischen Routinediagnostik bereits etablierte nichtinvasive Methoden. Während die KLM insbesondere hilfreich bei der Unterscheidung von Naevi und Melanomen ist, eignet sich die OCT vor allem zur Diagnostik und Differenzierung von nichtmelanozytärem Hautkrebs. Die LC-OCT („line-field confocal optical coherence tomography“) hingegen ist ein neues innovatives Verfahren, das über eine bessere zelluläre Auflösung als die OCT und höhere Eindringtiefe als die KLM verfügt. Mit der LC-OCT sind im Vergleich zur KLM auch 3‑D-Aufnahmen in Echtzeit möglich. Sie eignet sich sehr gut zur Untersuchung von Hautläsionen aller Art, da sie die Vorteile von KLM und OCT vereint.

This chapter describes the application of a well-being promoting strategy (child Well-being Therapy) in a 14 year old girl, who was referred to counselling for dealing with a stressfull family environment. After describing the role of hedonic and eudaimonic well-being in influencing children psychological developmental processes, the chapter describes the clinical articulation of the intevention, ant its main clinical outcomes. This chapter describes a clinical case where the implemetation of well-being promoting staregies yielded beneficial effects in this young girl and promoted her resilience.

Background: In vivo reflectance confocal microscopy (RCM) is a novel non-invasive diagnostic tool, which is used to differentiate skin lesions. Even in lesions with similar dermatoscopic images, RCM may improve diagnostic accuracy. Methods: Three sets of false ‘’twin lesions’’ with similar macroscopic and dermatoscopic images are matched. All lesions are evaluated with RCM and lesions are excised for further evaluation. Corresponding features in confocal images, dermatoscopy and histopathology are discussed. Results: In all matched pairs, one of the lesions was diagnosed as melanoma with the observation of melanoma findings such as: epidermal disarray, pagetoid cells in epidermis and cellular atypia at the junction. Benign lesions were differentiated easily with RCM imaging. Conclusion: Examining dermatoscopically difficult and/or similar lesions with RCM facilitates diagnostic and therapeutic decision making. Using RCM in daily practice may contribute to a decrease in unnecessary excisions.

Background: The aim of our study was to evaluate how sociodemographic factors, psychosocial adaptation to pregnancy and well-being levels are associated with the onset of preterm uterine contractions allowing symptomatic preterm labor. Methods: In a prospective case-control design, 51 consecutive women admitted for threatened preterm labor were enrolled. The patients received standard care. The day before discharge, once contractions had been stopped, the patients were administered 2 questionnaires: the Prenatal Self-Evaluation Questionnaire of Lederman and the Psychological Well-Being Scales. Controls were enrolled among asymptomatic, healthy women attending routine prenatal care. They were matched for parity and gestational age. Results: Gestational age at inclusion ranged from 25 to 34 weeks. Fourteen cases and 4 controls delivered preterm. Cases were less educated than controls, showed a lower acceptance of pregnancy and worse relationship with others, namely with the husband, compared to controls. They also displayed a reduced environmental mastery. Conclusion: Having a low education, poor relationship with others, including the husband, and impaired coping skills appeared to be independent risk factors for the development of symptomatic preterm labor in urbanized women.

The concept of psychological well-being has been neglected for a long time in scientific literature. In the last decades, however, many psychometric instruments have been developed to measure it. The aim of the present paper was to analyze the concept of psychological well-being and its relationship to distress and personality traits, with particular emphasis on its implications in clinical settings. A new psychotherapeutic strategy for improving psychological wellbeing (Well-Being Therapy) is introduced. Well-being therapy is based on Ryff's multidimensional model of psychological well-being, encompassing six dimensions: autonomy, personal growth, environmental mastery, purpose in life, positive relations and self-acceptance. It may be applied as a relapse-preventive strategy in the residual phase of affective (mood and anxiety) disorders, as an additional ingredient of cognitive-behavioral packages, in patients with affective disorders who failed to respond to standard pharmacological or psychotherapeutic treatments and in body image disturbances. The clinical studies supporting its efficacy are illustrated

There is insufficient research on rating psychological well-being and distress in clinical populations. The aim of this study was to evaluate the differential characteristics of instruments assessing well-being and distress in 20 remitted patients with affective (mood and anxiety) disorders and 20 healthy control subjects matched for sociodemographical variables. Remitted patients displayed significantly higher levels of psychological distress - as measured by Paykel's Clinical Interview for Depression (CID), Van Pragg's Scale for Personality Disturbances and Kellner's Symptom Questionnaire (SQ) - and significantly less well-being - as measured by Ryff's Scales of Psychological Well-Being (PWB) and the SQ - than control subjects. The correlations between scales of psychological distress and well-being were found to be complex in both patients and controls. Psychotherapeutic treatment of residual symptomatology in patients disclosed a differential sensitivity of the scales to change. The results thus suggest that well-being cannot be equated to lack of distress (as implicitly endorsed by current psychiatric paradigms), and the need for a multidimensional assessment in stress medicine