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Wright AJ. Deliberate Context-Driven Conceptualization in Psychological Assessment. J Pers Assess 2021; 104:700-709. [PMID: 34227917 DOI: 10.1080/00223891.2021.1942024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Clinical formulation and case conceptualization in clinical psychological assessment typically organize a client's presenting problems within a psychological framework and narrative that explains the cluster of symptoms, etiological and maintenance factors, and explaining both how and why a client is struggling or suffering. However, many of the most commonly used models of case conceptualization, as well as the preponderance of tests and measures used in psychological assessment, minimize or ignore the impacts of contextual factors, including dominant culture's expectations for normative behavior and the client's history of trauma and adverse and negative events. This paper presents a rationale and model for encouraging psychologists conducting clinical psychological assessment to be deliberate in first considering contextual factors in case conceptualization before relying entirely on primarily intrapsychic models. While contextual conceptualizations will not always replace (or join) intrapsychic models of case formulation, being deliberate and explicit about at least considering them is an important way to mitigate some of psychologists' biases and has the potential to situate a narrative of client difficulties in a way that takes at least some of the burden off the client.
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Giachero A, Quadrini A, Pisano F, Calati M, Rugiero C, Ferrero L, Pia L, Marangolo P. Procedural Learning through Action Observation: Preliminary Evidence from Virtual Gardening Activity in Intellectual Disability. Brain Sci 2021; 11:766. [PMID: 34207553 PMCID: PMC8226894 DOI: 10.3390/brainsci11060766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 12/23/2022] Open
Abstract
Intellectual disability (ID) compromises intellectual and adaptive functioning. People with an ID show difficulty with procedural skills, with loss of autonomy in daily life. From an embodiment perspective, observation of action promotes motor skill learning. Among promising technologies, virtual reality (VR) offers the possibility of engaging the sensorimotor system, thus, improving cognitive functions and adaptive capacities. Indeed, VR can be used as sensorimotor feedback, which enhances procedural learning. In the present study, fourteen subjects with an ID underwent progressive steps training combined with VR aimed at learning gardening procedures. All participants were trained twice a week for fourteen weeks (total 28 sessions). Participants were first recorded while sowing zucchini, then they were asked to observe a virtual video which showed the correct procedure. Next, they were presented with their previous recordings, and they were asked to pay attention and to comment on the errors made. At the end of the treatment, the results showed that all participants were able to correctly garden in a real environment. Interestingly, action observation facilitated, not only procedural skills, but also specific cognitive abilities. This evidence emphasizes, for the first time, that action observation combined with VR improves procedural learning in ID.
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Affiliation(s)
- Alberto Giachero
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
- Dipartimento di Psicologia, University of Turin, 10124 Turin, Italy;
| | | | - Francesca Pisano
- Dipartimento di Studi Umanistici, University Federico II, 80133 Naples, Italy;
| | - Melanie Calati
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
| | - Cristian Rugiero
- Aphasia Experimental Laboratory-Fondazione Carlo Molo Onlus, 10121 Turin, Italy; (A.G.); (M.C.); (C.R.)
| | - Laura Ferrero
- Fondazione Agape dello Spirito Santo Onlus-Villa Lauro, 10132 Turin, Italy;
| | - Lorenzo Pia
- Dipartimento di Psicologia, University of Turin, 10124 Turin, Italy;
| | - Paola Marangolo
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Dipartimento di Studi Umanistici, University Federico II, 80133 Naples, Italy;
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Tornali C, Migliore M, Polizzi A, Bragazzi NL, Martini M, Ruggieri M, Praticò AD, Vecchio I. Reconstructive Surgery in Children with Down Syndrome: Bioethical Implications. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0040-1709510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractDown Syndrome is a genetic disorder caused by a third copy of chromosome 21. One of the main feature of the syndrome is the facial dysmorphism, characterized by broad, flat face, oblique eyelid rhymes, skin folds at the inner corner of the eyes (epicanthus), receding chin, protrusion of the tongue. These features are often social and functional obstacles, reducible with surgical interventions. The first facial plastic/cosmetic surgery approaches on Down children were performed in 1960 in Germany, Great Britain and the United States, where plastic surgeons began to reshape the Down patients physiognomy through the surgical correction of the face, tongue, eyes, nose, of the nostrils, of the neck. Recent studies have shown that in spite of the tendency to infections and early pulmonary hypertension in children with DS, surgery is not contraindicated, as previously suggested, but can be performed with very good results. This treatment has aesthetic, functional, rehabilitative, social effects, as well as favorable outcome on the familiar behavior. However different issues emerge in cases of patients presenting intellectual disability and unable to understand the consequences or the side effects related to plastic surgery. In this aspect, different Countries have enacted distinct laws directly regulating the consensuses for such intervention, with the goal to reduce the risks for the affected patients and the respect of their willing and social inclusion.
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Affiliation(s)
- Cristina Tornali
- Department of Biomedical and Biotechnological Sciences, Section of Neurology, University of Catania, Catania, Italy
| | - Marcello Migliore
- Department of Surgical Sciences, Section of Thoracic Surgery, University of Catania, Catania, Italy
| | - Agata Polizzi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | - Mariano Martini
- Department of Health Sciences, Section of History of Medicine and Ethics, University of Genoa, Genoa, Italy
| | - Martino Ruggieri
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy
| | - Andrea D. Praticò
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy
| | - Ignazio Vecchio
- Department of Clinical and Experimental Medicine, Section of History of Medicine, University of Catania, Catania, Italy
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Villani ER, Vetrano DL, Damiano C, Paola AD, Ulgiati AM, Martin L, Hirdes JP, Fratiglioni L, Bernabei R, Onder G, Carfì A. Impact of COVID-19-Related Lockdown on Psychosocial, Cognitive, and Functional Well-Being in Adults With Down Syndrome. Front Psychiatry 2020; 11:578686. [PMID: 33192717 PMCID: PMC7655916 DOI: 10.3389/fpsyt.2020.578686] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/02/2020] [Indexed: 12/19/2022] Open
Abstract
People with Down Syndrome (DS) have a high prevalence of physical and psychiatric comorbidities and experience early-onset dementia. With the outbreak of CoVID-19 pandemic, strict social isolation measures have been necessary to prevent the spreading of the disease. Effects of this lockdown period on behavior, mood and cognition in people with DS have not been assessed so far. In the present clinical study, we investigated the impact of CoVID-19-related lockdown on psychosocial, cognitive and functional well-being in a sample population of 46 adults with DS. The interRAI Intellectual Disability standardized assessment instrument, which includes measures of social withdrawal, functional impairment, aggressive behavior and depressive symptoms, was used to perform a three time-point evaluation (two pre-lockdown and one post-lockdown) in 37 subjects of the study sample, and a two time point evaluation (one pre- and one post-lockdown) in 9 subjects. Two mixed linear regression models - one before and one after the lockdown - have been fitted for each scale in order to investigate the change in the time-dependent variation of the scores. In the pre-lockdown period, significant worsening over time (i.e., per year) was found for the Depression Rating Scale score (β = 0.55; 95% CI 0.34; 0.76). In the post-lockdown period, a significant worsening in social withdrawal (β = 3.05, 95% CI 0.39; 5.70), instrumental activities of daily living (β = 1.13, 95% CI 0.08; 2.18) and depression rating (β = 1.65, 95% CI 0.33; 2.97) scales scores was observed, as was a significant improvement in aggressive behavior (β = -1.40, 95% CI -2.69; -0.10). Despite the undoubtful importance of the lockdown in order to reduce the spreading of the CoVID-19 pandemic, the related social isolation measures suggest an exacerbation of depressive symptoms and a worsening in functional status in a sample of adults with DS. At the opposite, aggressive behavior was reduced after the lockdown period. This finding could be related to the increase of negative and depressive symptoms in the study population. Studies with longer follow-up period are needed to assess persistence of these effects.
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Affiliation(s)
- Emanuele Rocco Villani
- Centro Medicina Dell'Invecchiamento, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Davide Liborio Vetrano
- Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Cecilia Damiano
- Centro Medicina Dell'Invecchiamento, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonella Di Paola
- Centro Medicina Dell'Invecchiamento, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Aurora Maria Ulgiati
- Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen, Groningen, Netherlands
| | - Lynn Martin
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - John P Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Laura Fratiglioni
- Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Roberto Bernabei
- Centro Medicina Dell'Invecchiamento, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Graziano Onder
- Centro Medicina Dell'Invecchiamento, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Angelo Carfì
- Centro Medicina Dell'Invecchiamento, Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
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