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Corso CB, Hoppe R, Kliewer W, Wike T, Winter MA. Emotion Regulation in Families: Exploring the Link between Parent-Child Alexithymia and Child Post-Traumatic Stress Symptoms Amidst the COVID-19 Pandemic. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01728-9. [PMID: 38874751 DOI: 10.1007/s10578-024-01728-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 06/15/2024]
Abstract
The COVID-19 pandemic comprises a mass trauma for children and families, and children may face particular vulnerability to post-traumatic stress symptoms (PTSS) through processes of parent and child emotional dysregulation, such as alexithymia. With 88 U.S. children (Mage = 9.94 years; 54.5% female; 59.1% White) and their parents/caregivers (68.2% female; 59.1% White), a path model was tested in which child alexithymia symptoms partially mediated the association between parent alexithymia symptoms and child COVID-19-related posttraumatic stress symptoms (PTSS). We also tested an alternative model in which child alexithymia symptoms moderated the association between parent alexithymia symptoms and child PTSS. The hypothesized mediation model was supported (β = 0.15, SE = 0.05, 95% CI: [0.07, 0.25], p < 0.001), whereas the hypothesized moderator model was not (β = 0.06, p = 0.44). Findings highlight the importance of parents' emotional understanding and regulation for child mental health during mass traumas such as pandemics.
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Affiliation(s)
- Casey B Corso
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA
| | - Rebecca Hoppe
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA
| | - Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA
| | - Traci Wike
- School of Social Work, Virginia Commonwealth University, Box 842027, Richmond, VA, 23284-2027, USA
| | - Marcia A Winter
- Department of Psychology, Virginia Commonwealth University, 808 West Franklin St, Box 842018, Richmond, VA, 23284-2018, USA.
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2
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Baradel G, Provenzi L, Chiappedi M, Orlandi M, Vecchio A, Borgatti R, Mensi MM. The Family Caregiving Environment Associates with Adolescent Patients' Severity of Eating Disorder and Interpersonal Problems: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020237. [PMID: 36832366 PMCID: PMC9955592 DOI: 10.3390/children10020237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023]
Abstract
The quality of family interactions may be a critical factor for restrictive eating disorders (REDs). Adolescent patients with RED have interpersonal problems that can be inferred by observing their behaviours during family interactions. To date, the assessment of the association among RED severity, interpersonal problems, and patients' interactive behaviours in the family is partially explored. This cross-sectional study aimed to explore how adolescent patients' interactive behaviours observed during the Lausanne Trilogue Play-clinical version (LTPc) were associated with both RED severity and interpersonal problems. Sixty adolescent patients completed the EDI-3 questionnaire to assess RED severity using the Eating Disorder Risk Composite (EDRC) and Interpersonal Problems Composite (IPC) subscales. Moreover, patients and their parents took part in the LTPc, and patients' interactive behaviours were coded as participation, organization, focal attention, and affective contact in all the LTPc four phases. A significant association emerged between patients' interactive behaviours during the LTPc triadic phase and both EDRC and IPC. Better patients' organization and affective contact significantly correlated with lower RED severity and fewer interpersonal problems. These findings suggest that investigating the quality of family relationships and patients' interactive behaviours may contribute to better identifying adolescent patients at risk for more severe conditions.
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Affiliation(s)
- Giorgia Baradel
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
| | - Livio Provenzi
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Matteo Chiappedi
- Vigevano Child Neurology and Psychiatry Unit, ASST Pavia, 27100 Pavia, Italy
- Correspondence:
| | - Marika Orlandi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Arianna Vecchio
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Martina Maria Mensi
- Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
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3
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Harland MAJ, Brown LJ, Bond MJ. A moderated-mediation model of disordered eating behavior using family functioning, alexithymia, and rational processing style. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2095723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Matthew A. J. Harland
- College of Education, Psychology, and Social Work, Flinders University Adelaide, Adelaide, South Australia, Australia
| | - Lynsey J. Brown
- College of Medicine and Public Health, Flinders University Adelaide Australia, Adelaide, South Australia, Australia
| | - Malcolm J. Bond
- College of Medicine and Public Health, Flinders University Adelaide Australia, Adelaide, South Australia, Australia
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4
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Mannarini S, Kleinbub JR. Parental-Bonding and Alexithymia in Adolescents with Anorexia Nervosa, Their Parents, and Siblings. Behav Sci (Basel) 2022; 12:123. [PMID: 35621420 PMCID: PMC9137782 DOI: 10.3390/bs12050123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 12/17/2022] Open
Abstract
Anorexia nervosa (AN) patients and their family-members share alexithymia, anxiety, depression, and other psychological symptoms, in the context of altered attachment. These domains have been individually studied in the context of eating disorders; few attempts have been made to study their interaction, especially including family members. In this study, alexithymia, parental-bonding, and psychopathology were assessed in 32 Italian families consisting of an adolescent AN patient, a sibling, and their parents. We aimed to (a) describe a sample of Italian families with a child affected by AN, notably including siblings; (b) investigate interactions between assessed constructs in patients and their siblings; and (c) investigate possible intergenerational effects. Results showed high alexithymia and psychopathological symptoms in patients but not in siblings, although the latter reported high obsession-compulsion and paranoid ideation scores. Patients' and siblings' alexithymia correlated with psychopathology. Parents reported generally low alexithymia. Perceived parental bonding was found to be suboptimal in most participants, yet no clear relationship was found between specific parenting styles and other measured traits, nor did we find any other relevant intergenerational effect. Anorexia nervosa implies psychological difficulties for all family members. Siblings' psychopathological traits are especially concerning and currently understudied. Implications for future research and clinical interventions are discussed.
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Affiliation(s)
- Stefania Mannarini
- Interdepartmental Center for Family Research (CIRF), University of Padova, Via Venezia, 14-35131 Padova, PD, Italy;
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Via Venezia, 14-35131 Padova, PD, Italy
| | - Johann Roland Kleinbub
- Interdepartmental Center for Family Research (CIRF), University of Padova, Via Venezia, 14-35131 Padova, PD, Italy;
- Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Via Venezia, 14-35131 Padova, PD, Italy
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5
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Polloni L, Ferruzza E, Ronconi L, D'Ovidio G, Bonaguro R, Lazzarotto F, Toniolo A, Guarnaccia A, Muraro A. Maternal anxiety and previous anaphylaxis are associated with alexithymia in young patients with food allergy. Pediatr Allergy Immunol 2022; 33:e13680. [PMID: 34655502 DOI: 10.1111/pai.13680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/24/2021] [Accepted: 09/30/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Alexithymia is a multifaceted personality construct described as "a lack of words to express emotions" that includes difficulty identifying feelings, difficulty describing feelings and a concrete, externally oriented cognitive style. Among patients with food allergy (FA) alexithymia has been found higher than in general population and associated with dysfunctional coping strategies. Childhood traumatic experiences and/or dysfunctional parent-child relationship can contribute to alexithymia. The study aimed to explore possible associations between child alexithymia and mother alexithymia and anxiety, as well as previous anaphylaxis. METHODS Sixty-five mother-child pairs have been recruited. Children had a medical diagnosis of FA. The Toronto Alexithymia Scale-20 was used to assess alexithymia in participants. The State-Trait Anxiety Inventory was used to assess trait anxiety in mothers. Statistical analysis was performed to investigate the influence of variables sex, previous anaphylaxis, and adrenaline auto-injector prescription on child and mother's alexithymia and to explore possible association between maternal and child alexithymia. RESULTS A substantial percentage of children were alexithymic (21.5%) or borderline (33.8%), while mothers' frequencies were lower and in line with prevalence in general population. Child alexithymia was positively associated with previous anaphylaxis and mothers' trait anxiety (p < .05). Mother trait anxiety was also associated with maternal alexithymia. Furthermore, a positive association between child and mother alexithymia has been found. CONCLUSIONS Clinicians must be aware of the role of alexithymia and its association with maternal anxiety and previous anaphylaxis in children with FA, encouraging seeking psychological support when needed. A multidisciplinary patient-centered approach should be put in place for the effective care of FA.
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Affiliation(s)
- Laura Polloni
- Department of Women and Children Health, Food Allergy Referral Centre Veneto Region, Padua University Hospital, Padua, Italy
| | - Emilia Ferruzza
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Lucia Ronconi
- IT and Statistical Services, Multifunctional Pole of Psychology, University of Padua, Padua, Italy
| | - Giorgia D'Ovidio
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Roberta Bonaguro
- Department of Women and Children Health, Food Allergy Referral Centre Veneto Region, Padua University Hospital, Padua, Italy
| | - Francesca Lazzarotto
- Department of Women and Children Health, Food Allergy Referral Centre Veneto Region, Padua University Hospital, Padua, Italy
| | - Alice Toniolo
- Department of Women and Children Health, Food Allergy Referral Centre Veneto Region, Padua University Hospital, Padua, Italy
| | - Alberto Guarnaccia
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonella Muraro
- Department of Women and Children Health, Food Allergy Referral Centre Veneto Region, Padua University Hospital, Padua, Italy
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6
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Mannarini S, Taccini F, Rossi AA. Women and Violence: Alexithymia, Relational Competence and Styles, and Satisfaction with Life: A Comparative Profile Analysis. Behav Sci (Basel) 2021; 11:147. [PMID: 34821608 PMCID: PMC8615153 DOI: 10.3390/bs11110147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background: This research investigates the two sides of violence by profiling female interpersonal violence offenders (IVO) and female interpersonal violence victims (IVV). These groups of women have been compared on three key variables within the context of violence: satisfaction with life (SWL), alexithymia, and relational styles-defined according to the Relational Competence Theory (RCT). Regarding the latter, the experience of functional or dysfunctional relational styles in childhood and adult relationships has been evaluated and compared with both groups of women. Methods: This study involved 131 women: IVO (n = 41; enrolled in a penitentiary), IVV (n = 41; enrolled in an anti-violence center), and a control group (CG; n = 49; enrolled from the general population). Profile analysis was performed. Results: Female IVO showed low SWL, high levels of alexithymia, and a pattern of mixed relational styles with both parents and the current partner. Female IVV revealed low SWL, low levels of alexithymia and dysfunctional relational styles with both parents and current partner. Women from the CG showed high SWL, absence of alexithymia and functional relational styles with both parents and current partner. Conclusions: The profiles outlined in this study are extremely informative regarding alexithymia, relational styles, and SWL in both female IVV and IVO. Clinical interventions for both groups of women should be developed relying on these results.
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Affiliation(s)
- Stefania Mannarini
- Section of Applied Psychology, Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35131 Padova, Italy; (S.M.); (F.T.)
- Interdepartmental Center for Family Research, University of Padova, 35131 Padova, Italy
| | - Federica Taccini
- Section of Applied Psychology, Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35131 Padova, Italy; (S.M.); (F.T.)
- Interdepartmental Center for Family Research, University of Padova, 35131 Padova, Italy
| | - Alessandro Alberto Rossi
- Section of Applied Psychology, Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35131 Padova, Italy; (S.M.); (F.T.)
- Interdepartmental Center for Family Research, University of Padova, 35131 Padova, Italy
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7
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Taccini F, Rossi AA, Mannarini S. Intergenerational Transmission of Relational Styles: Current Considerations. Front Psychol 2021; 12:672961. [PMID: 34658997 PMCID: PMC8514634 DOI: 10.3389/fpsyg.2021.672961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Federica Taccini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
| | - Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy
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8
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The Role of Alexithymia in Social Withdrawal during Adolescence: A Case-Control Study. CHILDREN-BASEL 2021; 8:children8020165. [PMID: 33671559 PMCID: PMC7926933 DOI: 10.3390/children8020165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022]
Abstract
Although social withdrawal is becoming increasingly common among adolescents, there is still no consensus on its definition from the diagnostic and psychopathological standpoints. So far, research has focused mainly on social withdrawal as a symptom of specific diagnostic categories, such as depression, social phobia, or anxiety disorders, or in the setting of dependence or personality disorders. Few studies have dealt with social withdrawal in terms of its syndromic significance, also considering aspects of emotion control, such as alexithymia. The present case-control study aimed to further investigate the issue of social withdrawal, and try to clarify the part played by alexithymia in a sample of Italian adolescents diagnosed with psychological disorders (n = 80; Average Ageg = 15.2 years, SD = 1.49). Our patients with social withdrawal (cases) scored significantly higher than those without this type of behavior (controls) in every domain of alexithymia investigated, using the Toronto Alexithymia Scale (TAS-20) and with the scales in the Youth Self-Report (YSR) regarding internalizing problems, anxiety-depression, social problems, and total problems. Internalizing problems and total levels of alexithymia also emerged as predictors of social withdrawal. These variables may therefore precede and predispose adolescents to social withdrawal, while social problems may develop as a consequence of the latter.
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9
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Bloch C, Burghof L, Lehnhardt FG, Vogeley K, Falter-Wagner C. Alexithymia traits outweigh autism traits in the explanation of depression in adults with autism. Sci Rep 2021; 11:2258. [PMID: 33500523 PMCID: PMC7838249 DOI: 10.1038/s41598-021-81696-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/08/2021] [Indexed: 01/13/2023] Open
Abstract
When contemplating the alarming depression rates in adults with autism spectrum disorder (ASD), there is a need to find factors explaining heightened symptoms of depression. Beyond the impact of autism traits, markedly increased levels of alexithymia traits should be considered as a candidate for explaining why individuals with ASD report higher levels of depressive symptoms. Here, we aim to identify the extent to which autism or alexithymia traits indicate depressive symptoms in ASD and whether the pattern of association are specific to ASD. Data of a large (N = 400) representative clinical population of adults referred to autism diagnostics have been investigated and split by cases with a confirmed ASD diagnosis (N = 281) and cases with a ruled out ASD diagnosis (N = 119). Dominance analysis revealed the alexithymia factor, difficulties in identifying feelings, as the strongest predictor for depressive symptomatology in ASD, outweighing autism traits and other alexithymia factors. This pattern of prediction was not specific to ASD and was shared by clinical controls from the referral population with a ruled out ASD diagnosis. Thus, the association of alexithymia traits with depression is not unique to ASD and may constitute a general psychopathological mechanism in clinical samples.
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Affiliation(s)
- Carola Bloch
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany. .,Department of Psychiatry and Psychotherapy, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany.
| | - Lana Burghof
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Fritz-Georg Lehnhardt
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Institute of Neuroscience and Medicine (INM3), Research Center Jülich, Leo-Brandt-Str, 52428, Jülich, Germany
| | - Christine Falter-Wagner
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU Munich, Nussbaumstr. 7, 80336, Munich, Germany.,Department of Psychology, University of Cologne, Gronewaldstr. 2, 50931, Cologne, Germany
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10
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Tang W, Xu D, Xu J. The mediating role of alexithymia between earthquake exposure and psychopathology among adolescents 8.5 years after the wenchuan earthquake. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.109881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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11
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Gatta M, Miscioscia M, Svanellini L, Spoto A, Difronzo M, de Sauma M, Ferruzza E. Effectiveness of Brief Psychodynamic Therapy With Children and Adolescents: An Outcome Study. Front Pediatr 2019; 7:501. [PMID: 31956643 PMCID: PMC6951412 DOI: 10.3389/fped.2019.00501] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/19/2019] [Indexed: 11/22/2022] Open
Abstract
Studies on the effectiveness of child and adolescent psychotherapy treatments provided by the Italian National Health Service lag behind, while the scientific community has rather focused on the value of cognitive-behavioral psychotherapeutic approaches. This paper evaluates the effectiveness of a one year psychodynamically-oriented intervention with children and adolescents-aged between 6 and 18 years (M = 12.08, SD = 3.7)-and their parents, carried out in a Child and Adolescent Neuropsychiatric Service (SCIAF), part of the Italian National Health System. Following a psychodiagnostic assessment, two types of therapeutic intervention were offered: children and adolescents allocated to Group 1 (N = 26) were offered individual psychodynamic psychotherapy alone, whilst youths in Group 2 (N = 31) were offered individual psychotherapy, accompanied by parental support. This study examines the effects of this time-limited (12 month) psychodynamically-oriented psychotherapy in terms of improvements in patients' symptoms (measured on the Achenbach's questionnaires: Child Behavior Checklist and Youth Self-Report 11-18). This study also examines the effects of treatment on parents' perception of their family empowerment. This domain is measured on the Family Empowerment Scale (FES). Our findings seem to be partly in line with published studies according to which poor parenting (i.e., characterized by lack of warmth, a rigid and/or negative parenting style, poor monitoring of the children, etc.) would be positively associated with Externalizing problems in childhood. Our preliminary findings suggest that brief psychodynamic therapy seemed to show positive outcomes in both "Internalizing" and "Externalizing" difficulties, accounting for age-related differences, ICD-10 (1) diagnoses, and the types of treatment offered. However, no statistically significant changes were detected in the parents' perceptions of empowerment at 12 months.
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Affiliation(s)
- Michela Gatta
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Marina Miscioscia
- Department of Women's and Children's Health, University of Padua, Padua, Italy
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Lorenza Svanellini
- Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Andrea Spoto
- Department of General Psychology, University of Padua, Padua, Italy
| | | | | | - Emilia Ferruzza
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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12
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Palmieri A, Kleinbub JR, Mannarini S, Molinaro S, Castriotta C, Scocco P. Rorschach Assessment in Suicide Survivors: Focus on Suicidal Ideation. Front Public Health 2019; 6:382. [PMID: 30687692 PMCID: PMC6336920 DOI: 10.3389/fpubh.2018.00382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/21/2018] [Indexed: 12/12/2022] Open
Abstract
Background: The study of Suicidal ideation (SI) in people bereaved through suicide (Suicide Survivors, SSs) could be hampered by the person's willingness to admit it, or by their limited awareness of it. Our main hypothesis is that SI is common in these people, especially if they are parents or children of the victim. For its potential in shedding light on specific unconscious processes, Rorschach test was chosen for our investigation, for the first time in SSs literature. Rorschach suicide ideation and selected variables were further analyzed to better delineate their psychological profile. Method: Rorschach according to Exner's Comprehensive System was administered to 21 people bereaved through suicide presenting as outpatients at SOPROXI Project Service-Padova Mental Health Center- and 23 healthy controls. Beck Depression Inventory (BDI) was routinely administered to SSs and considered in the study. Results: T-tests showed significantly higher mean SI score (S-Con) as it emerged from the Rorschach test S-Con scores in SSs compared to control participants. SI found only weak correlation with the BDI item in which SSs can explicitly state the desire for their death. Within-group analysis revealed higher S-Con mean scores in bereaved children and parents of the victim compared to other kind of kinships. Morbid content (MOR) has been fund as the most characterizing variable in SSs' S-Con in terms of effect size, followed by a low number of responses with an ordinary form (X +%). Human movements (M), Special Scores related to thought slippage (ALOG, FABCOM2, INCOM2, and CONTAM) and poor human representations (PHR) have been shown to be more significantly present in SSs compared controls. Discussion: Psychodynamic interpretations of our results are provided. Clinical practice should consider Rorschach as one of eligible tools of investigation on this field.
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Affiliation(s)
- Arianna Palmieri
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Johann Roland Kleinbub
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy.,Interdepartmental Center for Family Research, University of Padova, Padova, Italy
| | - Sara Molinaro
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | | | - Paolo Scocco
- Soproxi Onlus, Padova, Italy.,Mental Health Center, ULSS 6 Euganea, Padova, Italy
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13
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Mannarini S, Rossi A. Assessing Mental Illness Stigma: A Complex Issue. Front Psychol 2019; 9:2722. [PMID: 30687177 PMCID: PMC6336735 DOI: 10.3389/fpsyg.2018.02722] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 12/18/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stefania Mannarini
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy.,Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
| | - Alessandro Rossi
- Interdepartmental Center for Family Research, University of Padova, Padova, Italy.,Section of Applied Psychology, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy
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14
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Mannarini S, Balottin L, Palmieri A, Carotenuto F. Emotion Regulation and Parental Bonding in Families of Adolescents With Internalizing and Externalizing Symptoms. Front Psychol 2018; 9:1493. [PMID: 30174638 PMCID: PMC6107795 DOI: 10.3389/fpsyg.2018.01493] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 07/30/2018] [Indexed: 12/04/2022] Open
Abstract
Parental bonding and emotional regulation, while important to explain difficulties that may arise in child development, have mainly been studied at an individual level. The present study aims to examine alexithymia and parental bonding in families of adolescents with psychiatric disorders through different generations. The sample included a total of 102 adolescent patients with psychiatric disorders and their parents. In order to take a family level approach, a Latent Class Analysis was used to identify the latent relationships among alexithymia (Toronto Alexithymia Scale), perceived parental bonding (Parental Bonding Instrument) and the presence of adolescent internalizing or externalizing psychiatric symptoms (Youth Self-Report). Families of internalizing and externalizing adolescents present different and specific patterns of emotional regulation and parenting. High levels of adolescent alexithymia, along with a neglectful parenting style perceived by the adolescent and the father as well, characterized the families of patients with internalizing symptoms. On the other hand, in the families with externalizing adolescents, it was mainly the mother to remember an affectionless control parental style. These results suggest the existence of an intergenerational transmission of specific parental bonding, which may influence the emotional regulation and therefore the manifestation of psychiatric symptoms.
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Affiliation(s)
- Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Arianna Palmieri
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Francesco Carotenuto
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
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Balottin L, Mannarini S, Mensi MM, Chiappedi M, Balottin U. Are family relations connected to the quality of the outcome in adolescent anorexia nervosa? An observational study with the Lausanne Trilogue Play. Clin Psychol Psychother 2018; 25:785-796. [PMID: 30051637 DOI: 10.1002/cpp.2314] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 11/07/2022]
Abstract
The study aims to explore the connection between the family interactive patterns, investigated with a standardized observational tool based on a recorded play session, the Lausanne Trilogue Play, and the outcome of adolescent patients with anorexia nervosa after a 6 months treatment, based on the Morgan-Russel Outcome Assessment Schedule. Seventy-two parents and adolescent daughters with anorexia nervosa, consecutively referred to an adolescent neuropsychiatric service, participated in the study and underwent an integrated model of treatment, based on constant neuropsychiatric and dietary monitoring, weekly individual psychotherapy for the daughter, and parental counselling and support. A better adolescents' functioning in family relationships, in particular in the triadic ones, at first assessment, was associated with a better outcome. Data on family interactions may help predict the most appropriate intervention for the patient and his family.
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Affiliation(s)
- Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | | | - Matteo Chiappedi
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Umberto Balottin
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.,Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Balottin L, Mannarini S, Candeloro D, Mita A, Chiappedi M, Balottin U. Rorschach Evaluation of Personality and Emotional Characteristics in Adolescents With Migraine Versus Epilepsy and Controls. Front Neurol 2018; 9:160. [PMID: 29615959 PMCID: PMC5869322 DOI: 10.3389/fneur.2018.00160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/05/2018] [Indexed: 01/24/2023] Open
Abstract
The literature examining primary headache, including migraine, in adolescents, has pointed out the key role played by a wide range of psychiatric disorders in reducing the patients’ quality of life. Moreover, pioneering studies showed that preexisting personality characteristics, specific emotion regulation styles and psychological-psychiatric difficulties are likely to increase the risk of the onset, maintenance, and outcome of headache. Still personality issues in migraine have been poorly studied, in particular in children and adolescents. This study aims, therefore, to investigate the specific characteristics of personality, and in particular emotion regulation and coping strategies, in adolescent with migraine, comparing them with age-matched patients with idiopathic epilepsy and healthy adolescents. 52 adolescents (age: 11–17) were assessed using a multi-method test battery, which included a self-report questionnaire (the youth self-report), a proxy-report (child behavior checklist) along with a projective personality test, the Rorschach Test, administered and scored according to the Exner comprehensive system. The results showed specific personality characteristics in adolescents with migraine, revealing a marked difficulty in modulating and regulating affections through thoughts and reflections, resorting instead to impulsive acts and maladaptive coping strategies, thus revealing a vague and immature perception of reality. Differently from adolescents belonging to the general population, but similarly to patients with epilepsy, adolescents with migraine perceive a high situational stress, probably related to the condition of suffering from chronic disease. They have, therefore, a lower self-consideration and self-esteem along with a poorer insight regarding themselves as well as the relations with others. In line with previous findings, these preliminary results suggest the need for further research on ample samples, using also standardized projective test in order to better understand the pathogenesis of psychological difficulties in patients with migraine. As a clinical implication, the results seem to indicate that providing a psychological integrated approach can play a pivotal role in the assessment and treatment of adolescent with migraine, in order to improve the outcome and the quality of life of the young patients.
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Affiliation(s)
- Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Daniela Candeloro
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Alda Mita
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Matteo Chiappedi
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Umberto Balottin
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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Miscioscia M, Blavier A, Pagone PR, Simonelli A. The Desire of Parenthood: Intuitive Co-parental Behaviors and Quality of Couple Relationship among Italian and Belgian Same-Sex and Opposite-Sex Couples. Front Psychol 2017; 8:110. [PMID: 28261120 PMCID: PMC5306294 DOI: 10.3389/fpsyg.2017.00110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 01/16/2017] [Indexed: 11/13/2022] Open
Abstract
Studies that focused on family issues have allowed a great understanding of the aspects related to its subsystems, such as parenting desire and its expectations, couples’ satisfaction and quality of child’s outcomes. All these aspects are greatly interconnected and contribute to the creation of specific family dynamics, such as the quality of family interactions. The present study focuses on intuitive co-parental behaviors and the quality of couple relationship observed during the decision process (intention and desire) to be (or become) parents. Our first goal was to explore these aspects in a cross-national sample made of Italian and Belgian heterosexual, lesbian and gay couples. We then aimed to evaluate if the degree of internalized homophobia affects co-parental alliance. The quality of couple relationship and co-parental behaviors have been evaluated through the recruitment of a group of 115 stable heterosexual, gay and lesbian couples (230 individuals, 20–50 years of age) without children, who wanted to become parents. We used the Prenatal Lausanne Trilogue Play to evaluate the Co-parental Alliance; the couple’s satisfaction was assessed with the Dyadic Adjustment Scale and the Internalized Homophobia with the MISS-LG. In line with the existent literature, the analysis did not find any difference between lesbian, gay and heterosexual couples in terms of co-parental alliance. High levels of couple adjustment lead to better parental performances among both Italian and Belgian couples. The results suggest also that sexual stigma differs from one country to another, and it has an impact on the capability of managing co-parenting. Clinical implications should be verified in further longitudinal studies in order to observe the impact on the inter-generational transmission of psychopathology.
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Affiliation(s)
- Marina Miscioscia
- Department of Psychology and Clinics of Human Systems, University of LiègeLiège, Belgium; Department of Developmental and Social Psychology, University of PadovaPadova, Italy
| | - Adelaide Blavier
- Department of Psychology and Clinics of Human Systems, University of Liège Liège, Belgium
| | - Paolo R Pagone
- Department of Developmental and Social Psychology, University of Padova Padova, Italy
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padova Padova, Italy
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Balottin L, Mannarini S, Mensi MM, Chiappedi M, Gatta M. Triadic Interactions in Families of Adolescents with Anorexia Nervosa and Families of Adolescents with Internalizing Disorders. Front Psychol 2017; 7:2046. [PMID: 28119647 PMCID: PMC5221675 DOI: 10.3389/fpsyg.2016.02046] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 12/19/2016] [Indexed: 11/23/2022] Open
Abstract
The latest studies and practice guidelines for the treatment of adolescent patients with anorexia nervosa agree in pointing out the key role played by parents in determining the young patients’ therapeutic possibilities and outcomes. Still family functioning has usually been studied using only self-reported instruments. The aim of the present study is therefore to investigate the triadic interactions within the families of adolescents with anorexia nervosa using a semi-standardized observational tool based on a recorded play session, the Lausanne Trilogue Play (LTP). Parents and adolescent daughters, consecutively referred to adolescent neuropsychiatric services, participated in the study and underwent the observational procedure (LTP). The 20 families of adolescent girls with anorexia nervosa (restricting type) were compared with 20 families of patients with internalizing disorders (anxiety and depression). The results showed different interactive patterns in the families of adolescents with anorexia nervosa: they had greater difficulties in respecting roles during the play, maintaining the joint attention and in sharing positive affect, especially in the three-together phase (third phase). The majority of these families (12) exhibited collusive alliances. The parental subsystem appeared frequently unable to maintain a structuring role, i.e., providing help, support and guidance to the daughters, while the girls in turn often found it hard to show independent ideas and develop personal projects. Parents experienced difficulty in carving out a couple-specific relational space, from which the ill daughter was at least temporarily excluded also when they were asked to continue to interact with each other, letting the daughter be simply present in a third-part position (fourth phase). The study of the triadic interactions in the families of adolescents with anorexia nervosa may help to shift the attention from the exclusive mother–daughter relation to the involvement of the father, and of the parental couple as a whole. The family functioning is in fact well established as a maintaining factor of anorexia nervosa or vice versa as a facilitating factor in the therapeutic process.
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Affiliation(s)
- Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova Padova, Italy
| | - Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova Padova, Italy
| | - Martina M Mensi
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia Pavia, Italy
| | - Matteo Chiappedi
- Child Neuropsychiatry Unit, C. Mondino National Neurological Institute Pavia, Italy
| | - Michela Gatta
- Childhood, Adolescence and Family Unit, Department of Woman's and Child's Health, ULSS 16 and University of Padova Padova, Italy
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Gatta M, Spoto A, Colombo E, Penzo M, Battistella PA. The Dysfunction of Emotional Expression as a Related Factor for Alcohol Misuse in Young Adolescents. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2016.1184599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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