Self-Narrative in a Therapeutic Group Pathway for Cancer Patients: Discussion of the Group Narrative Psychotherapy Intervention Initiated at the Veneto Institute of Oncology: IOV IRCCS of Padua

The following article proposes a reflection on the experience of Narrative Therapy of a group of cancer patients, non-homogeneous for sites and stages of disease, participating to a therapeutic writing path, in order to process the trauma reactive to cancer and to reflect on themselves. Taking inspiration from the assumption that “writing helps when people are faced with a stumble”, facilitating the process of distancing from life-events, each writer establishes either context, in a more intimate and true way, or memories and emotions connected to it, in order to express them to the group and to themselves too, and to identify new adaptation styles. The therapeutic path lasted eight meetings, during which some themes were chosen to guide the written reflection, which was carried out at home, and then shared with the group. The therapeutic path is an opportunity to adjust the perspective with which the specialist accompanies patients during the adaptation process to the disease, moving from the “explanation” to “comprehension”; from symptom to “sense”. The group narration is based on a relational perspective of co-construction of the meaning of experiences, highlighting the different roles and relevance of the factors involved

Pulling the lever in a hurry: the influence of impulsivity and sensitivity to reward on moral decision-making under time pressure

Background: Making timely moral decisions can save a life. However, literature on how moral decisions are made under time pressure reports conflicting results. Moreover, it is unclear whether and how moral choices under time pressure may be influenced by personality traits like impulsivity and sensitivity to reward and punishment. Methods: To address these gaps, in this study we employed a moral dilemma task, manipulating decision time between participants: one group (N = 25) was subjected to time pressure (TP), with 8 s maximum time for response (including the reading time), the other (N = 28) was left free to take all the time to respond (noTP). We measured type of choice (utilitarian vs. non-utilitarian), decision times, self-reported unpleasantness and arousal during decisionmaking, and participants’ impulsivity and BIS-BAS sensitivity. Results: We found no group effect on the type of choice, suggesting that time pressure per se did not influence moral decisions. However, impulsivity affected the impact of time pressure, in that individuals with higher cognitive instability showed slower response times under no time constraint. In addition, higher sensitivity to reward predicted a higher proportion of utilitarian choices regardless of the time available for decision. Conclusions: Results are discussed within the dual-process theory of moral judgement, revealing that the impact of time pressure on moral decision-making might be more complex and multifaceted than expected, potentially interacting with a specific facet of attentional impulsivity

Mindfulness Meditation as Psychosocial Support in the Breast Cancer Experience: A Case Report

In the last decade, Mindfulness-based interventions have been increasingly used in health care settings, particularly in the context of cancer. Research documents the efficacy of these interventions for decreasing the burdens of stress, anxiety, depression, fatigue, sleep disorders, and other symptoms. This article describes the case report of a patient with breast cancer, highlighting her personality, defense mechanisms, and traumatization connected with the disease. General information about the patient’s personal and medical history is presented in addition to the trajectory of psychoncological support, focusing on objectives, intervention strategies based on Mindfulness, and outcomes. The intervention is a combination of individual and group therapies, with particular reference to the use of Mindfulness in a group setting. The goal is to provide the patient with both a peer sharing experience as well as the tools to manage psychoemotional reactions through the development of awareness and a better relationship with herself. The main hypothesized consequences are an increase in self-esteem and coping strategies, which are necessary for a successful adaptation to cancer. The objective of the Mindfulness intervention is to promote the maintenance of an adequate Quality of Life (QoL) and psychological well-being, during and after treatment, transferring these skills into daily life

Framing the outcome of moral dilemmas: effects of emotional information

The present study was aimed at investigating whether and how the explicit representation of the decision outcome, framed in terms of lives saved or lost, could affect decision choices, emotional experience, and decision times in the course of a moral dilemma task. Decision outcomes were framed in a between-group design by means of smiling (POS group) or injured faces (NEG group) depicting, respectively, the lives saved or lost with each choice. A control condition with no frame and no outcome (NOF group) was included. Results showed that behavioral choices were highly resistant to the framing manipulation in both dilemma types. However, an overall reduction in the number of utilitarian choices and in the decision times, associated with an increase in unpleasantness during decision-making, was found, suggesting a progressive increase in aversive emotional activation favoring the rejection of utilitarian resolutions. Interestingly, at the beginning of the task, the POS group showed a delay in decision times as compared with the NOF group, specifically for footbridge-type dilemmas. This result might be interpreted as an interference effect temporarily slowing decision-making during the resolution of dilemmas in which the internal representation is spontaneously focused on the personal cost of causing intentional harm to others

Assessment of self-efficacy for caregiving in oncology: Italian validation of the caregiver inventory (CGI-I)

Background: The Caregiver Inventory (CGI), a measure of self-efficacy for caregiving that takes into account aspects of caregiving that are neglected by current measures of caregiving, was translated into Italian and validated. Methods: Ninety-one caregivers from a variety of locations in Italy completed the CGI-Italian (CGI-I) as well as the Hospital Anxiety and Depression Scale (HADS) and the Family Strain Questionnaire - Short Form (FSQ-SF). Results: A confirmatory factor analysis based on the original CGI factor structure resulted in an adequate fit of the CGI-I using standard fit indices. Thus, the original factor structure was validated in the CGI-I: Managing Medical Information (α = 0.87), Caring for Care Recipient (α = 0.68), Caring for Oneself (α = 0.78), and Managing Difficult Interactions/Emotions (α = 0.55). The CGI-I total score was inversely related to anxiety (HADS, r = − 0.35, p = <.05), and depression (HADS, r = − 0.45, p = <.05). In addition, the CGI-I was inversely related to caregiver stress (FSQ-SF, r = − 0.39, p = <.05). Care of Oneself and Managing Difficult Interactions/Emotions emerged as the strongest and most robust negative relationships with anxiety, depression, and caregiver stress, which replicated, with similar constructs, findings from the original CGI. Conclusions: The results of this study established the CGI-I as a reliable and valid measure of self-efficacy for caregiving. This study also confirms the importance of self-care and managing difficult communication in the process of successfully navigating the demands of caregiving and in constructing interventions for caregivers who need support

Inter-Relationship between Platelet-Derived Microparticles and Oxidative Stress in Patients with Venous Thromboembolism

Background: Hypercoagulative conditions play a key role in venous thromboembolism (VTE). Inflammation is currently linked to VTE, but the potential role of circulating microparticles and oxidative stress (OxS) must be elucidated. The aim of this study was to evaluate platelet-derived microparticles and surrogate OxS biomarkers in patients diagnosed with VTE through a case&ndash;control study. Methods: Platelet-derived microparticles (MPs), pro-thrombinase-induced clotting time assay (PiCT), phospholipids (PLPs), malondialdehyde (MDA), 4-hydroxynonenale (4-HNE), thiobarbituric acid reactive substances (TBARs), superoxide dismutase (SOD), and galectin-3 (Gal-3) were measured in VTE patients and in healthy controls. Results: PLPs, 4-HNE, TBARs, and Gal-3 were higher in VTE patients compared to controls; conversely, SOD was lower. A significant non-linear regression between OxS biomarkers and the markers of platelet degranulation was found. Conclusion: Our results suggest that OxS and platelet degranulation are concomitant pathophysiological mechanisms in VTE