Advancement in the child attachment interview and the child and adolescent reflective functioning scale using a PDM-2 framework: case reports

open5siThe Child Attachment Interview (CAI) is a well-established semi-structured interview, widely used to identify attachment representations in middle childhood and adolescence. The application of the Child and Adolescent Reflective Functioning Scale (CRFS) to CAI narratives allows for an assessment of child mentalization, considered a strong predictor of attachment security. The 2nd edition of the Psychodynamic Diagnostic Manual (PDM-2) includes CAI and CRFS as valid and reliable assessment measures in order to assess the dominion of the Mental Functioning axis. The aim of the present paper is to investigate the informative power of CAI and CRFS for the overall understanding of mental functioning and personality in a PDM-2 framework. The present report includes the discussion of two clinical cases of school-aged children in applying the Psychodiagnostic Chart-Second Edition (PDC-2) to the CAI transcript. The first case concerns a young male, aged 10, suffering from Oppositional-Provocative Disorder (externalizing disorder), while the second case concerns a young female, aged 15, suffering from Somatic Symptoms Disorder (internalizing disorder). PDC-2 for children and adolescents was used. Data from the scoring of CAI and CRFS were combined with a systematic evaluation of the qualitative contents emerging from CAI transcripts. A detailed analysis suggests that both the CAI and CRFS are useful attachment-oriented measures, able to explore a child's mental states, and together with the application of PDC-2 they provide an essential contribution in the understanding of developmental psychopathology. Implications of this innovative approach for clinical assessment, treatment design, and interventions are further discussed.openBizzi, Fabiola; Locati, Francesca; Parolin, Laura; Shmueli-Goetz Yael; Brusadelli, EmanuelaBizzi, Fabiola; Locati, Francesca; Parolin, Laura; Shmueli-Goetz, Yael; Brusadelli, Emanuel

Jeremy Safran’s impact on Italian psychotherapy research and practice: a window into the processes involved in therapeutic alliance

Not available

How Can I Trust You? The Role of Facial Trustworthiness in the Development of Epistemic and Interpersonal Trust

Recently, researchers from developmental and clinical psychology highlighted epistemic trust (ET) as a key factor for personality disorders. ET is intended as the mental openness to information coming from others during social exchanges. ET develops from signals called ostensive cues, delivered through facial expressions during interactions in a secure attachment context. Similarly, interpersonal trust (IT) refers to the perception of others as not harmful, which is also developed through secure attachment relationships. Our purpose was to suggest a conceptualization of ET as a specific facet of IT. We hypothesize that positive experiences of caregiving promote IT development that includes a specific sense of trust toward others’ knowledge. Moreover, we suggest that the early ability to infer a judgment of trustworthiness from facial cues is the starting point for developing both IT and ET. This conceptualization supports the role of considering both IT and ET in the development of borderline pathology. Our purpose is to suggest a conceptualization of ET as a specific facet of IT. We hypothesize that positive experiences of caregiving promote IT development that includes a specific sense of trust toward others’ knowledge. Moreover, we suggest that the early ability to infer a judgment of trustworthiness from facial cues is the starting point for developing both IT and ET. This conceptualization supports the role of considering both IT and ET in the development of borderline pathology

Beyond the mask of deference: exploring the relationship between ruptures and transference in a single-case study

The relationship between transference and therapeutic alliance has been long discussed. It is only recently, however, that empirical evidence has provided support for a tight correspondence between several transference dimensions and rupture and resolution processes. In the present single-case study, we used alliance ruptures as a key dimension to understand patient’s transference dynamics. This was achieved in a particular form of patient’s behavior, i.e., patient’s deference and acquiescent behavior, which describes a significant submission to assertions, skills, judgments and point of views of another person. Therapeutic process was measured by means of the Rupture Resolution Rating Scale, the Core Conflictual Relationship Theme and the Defense Mechanism Rating Scales, whereas therapeutic outcome was measured by means of the Shedler-Westen Assessment Procedure-200. Results of sequential analysis yielded a significant correspondence between rupture markers, characterized by avoidance and shifting of session’s topic, and patient’s narrations. Furthermore, a systematic correspondence between alliance ruptures and patient’s avoidant functioning, which emerged both in transference relationship and in the quality of the defense structure, was found. Together, these findings indicate that patient’s deference inhibits the expression of relational themes, with ruptures in alliance that seem to be supported by a strong defensive structure. In particular, patient’s avoidance played a double role in the treatment. On the one hand, avoidance was the main characteristic of her transference structure, based on extreme intellectualization and emotional closure. On the other hand, it contributed to create an impasse in the treatment, based on a withdrawal ruptures model and on obsessive level defences

Serum micrornas as novel biomarkers for primary sclerosing cholangitis and cholangiocarcinoma

The diagnosis of primary sclerosing cholangitis (PSC) is difficult due to the lack of sensitive and specific biomarkers, as is the early diagnosis of cholangiocarcinoma (CC), a complication of PSC. The aim of this study was to identify specific serum miRNAs as diagnostic biomarkers for PSC and CC

Rare thyroid malignancies in Europe : data from the information network on rare cancers in Europe (RARECAREnet)

Data will be made available on requestPeer reviewedPostprin

Circulating pre-treatment Epstein-Barr virus DNA as prognostic factor in locally-advanced nasopharyngeal cancer in a nonendemic area

The prognostic value of pre-treatment Epstein-Barr Virus (EBV) DNA viral load for non-endemic, locally-advanced, EBV-related nasopharyngeal cancer (NPC) patients is yet to be defined. All patients with EBV encoded RNA (EBER)-positive NPC treated at our Institution from 2005 to 2014 with chemotherapy (CT) concurrent with radiation (RT) +/- induction chemotherapy (ICT) were retrospectively reviewed. Pre-treatment baseline plasma EBV DNA (b-EBV DNA) viral load was detected and quantified by PCR. Median b-EBV DNA value was correlated to potential influencing factors by univariate analysis. Significant variables were then extrapolated and included in a multivariate linear regression model. The same variables, including b-EBV DNA, were correlated with Disease Free Survival (DFS) and Overall Survival (OS) by univariate and multivariate analysis. A total of 130 locally-advanced EBER positive NPC patients were evaluated. Overall, b-EBV DNA was detected in 103 patients (79.2%). Median viral load was 554 copies/mL (range 50-151075), and was positively correlated with T stage (p= 0.002), N3a-b vs N0-1-2 stage (p= 0.048), type of treatment (ICT followed by CTRT, p= 0.006) and locoregional and/or distant disease recurrence (p= 0.034). In the overall population, DFS and OS were significantly longer in patients with pre-treatment negative EBV DNA than in positive subjects at the multivariate analysis. Negative b-EBV DNA can be considered as prognostic biomarker of longer DFS and OS in NPC in non-endemic areas. This finding needs confirmation in larger prospective series, with standardized and inter-laboratory harmonized method of plasma EBV DNA quantificatio

Lo sviluppo della mentalizzazione in età evolutiva. La relazione tra attaccamento e fiducia epistemica

La mentalizzazione si riferisce alla capacità umana di comprendere il comportamento proprio e altrui intrepretando intenzioni, desideri e motivazioni sottostanti. Tale competenza si sviluppa nel contesto delle relazioni di attaccamento ed è funzionale a garantire il benessere psicologico trasversalmente ad ogni fase del ciclo di vita. Una buona mentalizzazione è garantita dalla fiducia epistemica legata all’apprendimento sociale e all’esplorazione della propria e altrui mente. Il presente studio vuole approfondire il legame tra mentalizzazione, fiducia epistemica e attaccamento sicuro in età evolutiva attraverso compiti di narrazioni autobiografiche e di storytelling interpersonale in un campione di bambini non clinici

The Roberts–2: Italian Validation on a Sample of Children and Adolescents

The Roberts-2 (Roberts & Gruber, 2005) is a narrative test that was specifically designed to assess developmental and clinical functioning in children and adolescents. It was developed with the intent of addressing the lack of objective scoring systems for narrative instruments to assess childhood. The Roberts-2 is characterized by a standardized administration, scoring system, and interpretation guidelines that use a performance-based approach to narrative testing. This instrument has gained wide recognition in clinical practice but is minimally supported by empirical literature. This study aims to decrease this gap between clinical application and research findings through the Italian validation of the Roberts-2. The Italian version of the Roberts-2 was validated in both nonclinical and clinical participants. Study 1 (N = 738) assessed an Italian community sample to validate the Roberts-2. Specifically, interrater reliability, factorial structure, and developmental trends were explored. In Study 2, we compared a community sample with a sample of clinically referred children (N = 86) to test the clinical significance of the Roberts-2 indexes. The test performed well in differentiating between developmental groups as well as between clinical and nonclinical samples. The test is a useful tool for assessing both developmental and clinical aspects of the psychological functioning of children and adolescents