Orientarsi per crescere. Riflessioni su un percorso di orientamento al futuro

The article presents the experience of a training and orientation carried out in a lower secondary school. The overall objective of the project was carried out to assist and support the students of the third class in their choice for secondary school degree, within a structured “action path” for the orientation can evaluate and support the individual’s ability to choose, his motivations and aspirations, as well as to develop its transversal skills. The path of the results were evaluated through analysis and quantitative tools, but also with the support of qualitative analysis methods

Mapping Protein Structure Changes with Cysteine Labeling Kinetics by Mass Spectrometry

Currently we observe a gap between theory and practices of patient engagement. If both scholars and health practitioners do agree on the urgency to realize patient engagement, no shared guidelines exist so far to orient clinical practice. Despite a supportive policy context, progress to achieve greater patient engagement is patchy and slow and often concentrated at the level of policy regulation without dialoguing with practitioners from the clinical field as well as patients and families. Though individual clinicians, care teams and health organizations may be interested and deeply committed to engage patients and family members in the medical course, they may lack clarity about how to achieve this goal. This contributes to a wide "system" inertia-really difficult to be overcome-and put at risk any form of innovation in this filed. As a result, patient engagement risk today to be a buzz words, rather than a real guidance for practice. To make the field clearer, we promoted an Italian Consensus Conference on Patient Engagement (ICCPE) in order to set the ground for drafting recommendations for the provision of effective patient engagement interventions. The ICCPE will conclude in June 2017. This document reports on the preliminary phases of this process. In the paper, we advise the importance of "fertilizing a patient engagement ecosystem": an oversimplifying approach to patient engagement promotion appears the result of a common illusion. Patient "disengagement" is a symptom that needs a more holistic and complex approach to solve its underlined causes. Preliminary principles to promote a patient engagement ecosystem are provided in the paper

L'impulsività nei pazienti borderline

Secondo Bateman&Fonagy (2004) un problema fondamentale ascrivibile ai pazienti borderline riguarda l’incapacità a mentalizzare, ovvero pensare ai propri stati mentali come condizioni distinte e potenziali determinanti del comportamento, unitamente alla difficoltà di riconoscimento delle proprie reazioni e di quelle degli altri. Ciò potrebbe trovare origine in episodi di trascuratezza infantile, non necessariamente di natura fisica. Alla luce dei numerosi comportamenti impulsivi che rientrano nella sintomatologia di tale disturbo, si è pensato di verificare la presenza di differenze nell’esibizione dell’impulsività e dei disturbi del comportamento nel campione clinico rispetto a non pazienti, utilizzando il test di Rorschach (siglato secondo il Sistema Comprensivo di Exner) e l’MMPI-2. I risultati rivelanoche, al test di Rorschach,i pazienti con DBP sono effettivamente più impulsivi, meno capaci di controllare la propria reattività ed esibiscono limitate capacità di progettualizzazione e modulazione della risposta emotiva rispetto al gruppo di controllo. Il test di Rorschach appare in grado di evidenziare la disregolazione emotiva dei pazienti come deficit meta-rappresentativo discriminante l’impulsività e l’esibizione di comportamenti aggressivi.According to Bateman&Fonagy (2004), a fundamental problem concerns borderline patients is the inability to mentalizing, that is “the ability to have a thought about mental states as distinct conditions though potential determinants of behavior”, and also the difficulty to recognize their own reactions and those of others. This may be rooted in incident of child neglect, not necessarily physical. By the numerous impulsive behaviors of symptoms of such disorder, it is thought to verify which differences in impulsivity and behavioral problems may emerge by comparing these subjects with a group of non-patients.The experimental design has therefore provided for the administration of the Rorschach Test and the MMPI-2 to the experimental group (borderline patients) and the control group (non-patients)

L’analisi grafologica per la valutazione del tratto antisociale di personalità

Il lavoro espone i risultati di un progetto di ricerca che ha avuto in oggetto l’esame della personalità antisociale ed in particolare i tratti di aggressività, impulsività, autocontrollo, adattamento, disturbo del pensiero ed esame di realtà che di esso ne costituiscono il nucleo psicopatologico. L’indagine ha interessato un campione sperimentale di 20 soggetti con Disturbo Antisociale di Personalità e tratti di Disturbo Borderline di Personalità, ricoverati presso case di cura per disturbi mentali e riabilitazione da abuso di sostanze/alcol, con storia di condotte criminose, e un gruppo di controllo di 52 soggetti normali (profilo negativo al test SCID-II) reclutati casualmente tra studenti universitari, casalinghe, dipendenti di amministrazioni pubbliche e liberi professionisti. Strumento impiegato per lo studio è stata l’analisi grafologica, in qualità di test proiettivo che ben si presta all’esteriorizzazione dei contenuti intrapsichici. Scopo del lavoro, difatti, voleva essere quello di stimare la capacità dell’analisi grafologica di valutare la presenza e l’intensità del tratto Antisociale di Personalità. Al campione clinico è stato altresì somministrato il questionario Millon-III. Le scale dell’analisi grafologica (Aggressività, Impulsività, Autocontrollo, Adattamento, Disturbo del Pensiero ed Esame di Realtà) hanno prodotto risultati significativamente diversi tra i due gruppi di studio. Per il campione clinico, la scala Disturbo del Pensiero è risultata correlata con la scala Disturbo Antisociale del Millon-III.The work presents the results of a research project that examined the antisocial personality traits, particularly aggressiveness, impulsivity, self-control, adaptation, thought disorder and lack of reality perspective. The survey had an experimental sample of 20 subjects with Antisocial Personality Disorder and traits of borderline personality disorder, admitted to clinicsfor mental disorders and rehabilitation for substance or alcohol abuse, with a history of criminal behavior, and a control group of 52 normal subjects (negative profile for SCID-II) randomly recruited among college students, housewives, employees of public authorities and self-employed.The instrument used for the study was the handwriting analysis, as a projective test that can underline the externalization of intrapsychic content. Aim of work, in fact, wanted to be to estimate the capacity of handwriting analysis to evaluate the presence and intensity of the antisocial personality trait. The clinical sample was also administered the questionnaire Millon-III. Handwriting analysis’s scales (Aggressiveness, Impulsivity, Self-control, Adaptation, Thought Disorder and Lack of Reality Perspective) have produced significantly differences: for the patient sample, the scale of Mental Disorder was correlated with the Antisocial scale of the Millon-III

Impulsiveness and metarepresentative functions of borderline patients with psychopathic conducts: an experimental study with the Rorschach test

The Borderline Personality Disorder (BDP) is defined as “a pervasive pattern of instability which affects regulation, impulse control, interpersonal relationships, and self-image”. Bateman model & Fonagy model, being a connection between the psychoanalytic tradition – especially the attachment theories and the cognitive approach, identifies the inability to mentalize as a fundamental problem of borderline patients, which is meant as “the capacity to make sense of ourselves and others, implicitly and explicitly, in terms of subjective states and mental processes”. Due to the considerable number of empirical evidence on the connection between mentalization and attachment, the authors defined the obstacles related to interpersonal relationships, which represent the distinctive feature of patients with BDP and which give rise to their typical impulsive behaviours. Such behaviours can be selfinflicted by means of self-destructive acts and attempted suicide and other-directed by means of aggressiveness and violence.This study aims to verify the differences related to impulsiveness and behavioural disorder, which can emerge from the comparison between an experimental group of borderline patients and a control group of non-patients. The experimental plan considered the administration of the Rorschach test and MMPI-2. The scoring of the Rorschach test, conducted according to the Comprehensive System has showed that patients with BDP proved to be clearly more impulsive than normal individuals and less capable to control their responsiveness on the personality level. Furthermore they have fewer abilities to plan and modulate the emotional response than the control group. In this study the Rorschach test had well identified the emotional dysregulation as a meta-representative distinguishing deficit, by pointing out the BDP patients who could more probably act impulsively by means of aggressive behaviours

An Integrated Medical-Psychological Approach in the Routine Care of Patients with Type 2 Diabetes: A Pilot Study to Explore the Clinical and Economic Sustainability of the Healthcare Intervention

The economic burden of Type 2 Diabetes Mellitus (T2DM) is a challenge for sustainability. Psychological factors, healthy behaviors, and stressful conditions are predictive and prognostic factors for T2DM. Focusing on psychological factors can reduce costs and help ensure the sustainability of diabetes care. The study aimed to support an integrated medical-psychological approach in the care of patients with T2DM. A group of patients undergoing usual healthcare treatment was compared to patients who received a psychotherapeutic intervention in addition to standard treatment. The study’s outcomes were: physical health (blood glucose, glycated hemoglobin, blood lipids, blood pressure); lifestyle (cigarettes, alcoholic drinks, physical activity, body mass index); mental health (anxiety, depression, stress, coping styles, alexithymia, emotion regulation, locus of control); costs (number of referrals to a specialist, standard cost of each visit). We examined the change from baseline to 24-week follow-up. Compared to the Standard Group, the Integrated Group reported a reduction in blood lipids and triglycerides, chronic depressive and anxious mood states, patient emotional coping, and the number of specialist visits and diagnostic tests. Close collaboration between diabetologists and psychologists is feasible, and it is worth considering integrated care as an option to contain and make healthcare spending more sustainable

Draw-a-person for the evaluation of antisocial personality trait

Introduction: the analysis of criminal personality is the field of common interest both for criminology and forensic psychiatry. It takes in great consideration an assessment of psychological, constitutive and environmental factors predisposing to antisocial behavior. The goal is to estimate the power of the DAP in evaluating the presence and intensity of the Antisocial Personality trait. Materials and Methods: the sample consists of 20 subjects with antisocial personality disorder with a history of crime, drug abuse and alcohol addiction, instability in emotional relationships, who are admitted to nursing homes for mental disorders; a control group of 52 normal subjects randomly recruited among university students and government employees. In the control group, subjects had no previous psychiatric or psychological signs. Their age is between 25 and 45 years old equally distributed by sex. They were recruited for the study of DAP scales and the MCMI-III test. Results: the scales and the DAP (acting out, good adaption, aggression, narcissism, negativity-oppositionality, psychosis, paranoia, pulsionality and Interpersonal relationships) have produced significantly different results between the two study groups. Within the pathological sample, the acting out and negativity- oppositionality scales proved to be associated with the MCMI-III scale of antisocial disorder. Discussion: the antisocial subjects turn out to have a significant tendency towards acting out, poor ability to manage and sublimate their aggression, and a negativistic-oppositional behaviour. Within the sample of pathological subjects, the DAP differentiates only in relation to the area of impulsivity; the tests used have discriminating ability within the group, while losing efficacy in relation to the aggression variable