Emerging adults facing the COVID-19 pandemic: emotion dysregulation, mentalizing, and psychological symptoms

Settled in the context of the COVID-19 pandemic, the present short-term longitudinal study aims to investigate the relation between emotion dysregulation, mentalizing (both certainty and uncertainty about mental states), and psychological symptoms in a sample of 83 emerging adults (M-age = 22.18 years, SD = 4.36) over a continuous period started with COVID-19 spreads. Results display significant positive associations between psychological symptoms and both emotion dysregulation and uncertainty about mental states, while an inverse association with certainty about mental states was found. A moderation model was also performed, showing a significant negative association between emotion dysregulation and psychological symptoms at low levels of uncertainty about mental states. Conversely, a marginally significant positive association occurs at high levels of uncertainty about mental states. In other words, the presence of individual impairments in perceiving one's own/others mind may increase the negative consequences of emotion dysregulation on reported psychological symptoms. To sum up, our findings highlight the importance of considering mentalizing as a possible key factor for the promotion of emerging adults' mental health also in the context of the ongoing COVID-19 pandemic

Which Space for Fathers’ Mentalizing? A Systematic Review on Paternal Reflective Functioning, Mind-Mindedness and Insightfulness

Over the past twenty years research interest has been focused on deepening the role of parental mentalizing. Nevertheless, few studies have specifically addressed the role played by fathers’ mentalizing. This systematic review aims to bridge this gap by offering an exploration of paternal mentalizing within attachment theory considering three different operationalizations: Reflective Functioning, Parental Insightfulness and Mind-Mindedness. Starting from this, the main goals of this systematic review are: (1) to show the effect of paternal mentalizing on child’s outcomes or paternal role within the family system, (2) to increase research exchange between different theoretical frameworks, enhancing the knowledge of the mentalization construct, (3) to explore under-researched areas and implications for research and clinical practice. PsycInfo, PsycArticle, Web Of Science, Scopus, Medline, PubMed and EMBASE were systematically searched for articles published until February 7, 2021. In total, 6311 studies were considered for the systematic review; of these, thirty-six met the inclusion criteria. The included studies were subsequently split on the basis of the specific mentalizing operationalization. Overall, the data showed significant associations between paternal mentalizing and both fathers’ parenting features and variables related to the paternal broader functioning within the family context. This systematic review also confirms the role of fathers’ mentalizing processes in relation to paternal features and child’s outcomes. In conclusion, further studies aimed at examining paternal mentalizing specific influences, exploring the causal pathways related to paternal mentalizing and investigating the relationship between different mentalizing dimensions and their diverse effects are recommende

Efficacy of ketamine in refractory convulsive status epilepticus in children: A protocol for a sequential design, multicentre, randomised, controlled, open-label, non-profit trial (KETASER01)

Introduction: Status epilepticus (SE) is a lifethreatening neurological emergency. SE lasting longer than 120 min and not responding to first-line and second-line antiepileptic drugs is defined as 'refractory' (RCSE) and requires intensive care unit treatment. There is currently neither evidence nor consensus to guide either the optimal choice of therapy or treatment goals for RCSE, which is generally treated with coma induction using conventional anaesthetics (high dose midazolam, thiopental and/or propofol). Increasing evidence indicates that ketamine (KE), a strong N-methyl-D-aspartate glutamate receptor antagonist, may be effective in treating RCSE. We hypothesised that intravenous KE is more efficacious and safer than conventional anaesthetics in treating RCSE. Methods and analysis: A multicentre, randomised, controlled, open-label, non-profit, sequentially designed study will be conducted to assess the efficacy of KE compared with conventional anaesthetics in the treatment of RCSE in children. 10 Italian centres/ hospitals are involved in enrolling 57 patients aged 1 month to 18 years with RCSE. Primary outcome is the resolution of SE up to 24 hours after withdrawal of therapy and is updated for each patient treated according to the sequential method. Ethics and dissemination: The study received ethical approval from the Tuscan Paediatric Ethics Committee (12/2015). The results of this study will be published in peer-reviewed journals and presented at international conferences

A role for leukocyte-endothelial adhesion mechanisms in epilepsy

The mechanisms involved in the pathogenesis of epilepsy, a chronic neurological disorder that affects approximately 1 percent of the world population, are not well understood1–3. Using a mouse model of epilepsy, we show that seizures induce elevated expression of vascular cell adhesion molecules and enhanced leukocyte rolling and arrest in brain vessels mediated by the leukocyte mucin P-selectin glycoprotein ligand-1 (PSGL-1) and leukocyte integrins α4β1 and αLβ2. Inhibition of leukocyte-vascular interactions either with blocking antibodies, or in mice genetically deficient in functional PSGL-1, dramatically reduced seizures. Treatment with blocking antibodies following acute seizures prevented the development of epilepsy. Neutrophil depletion also inhibited acute seizure induction and chronic spontaneous recurrent seizures. Blood-brain barrier (BBB) leakage, which is known to enhance neuronal excitability, was induced by acute seizure activity but was prevented by blockade of leukocyte-vascular adhesion, suggesting a pathogenetic link between leukocyte-vascular interactions, BBB damage and seizure generation. Consistent with potential leukocyte involvement in the human, leukocytes were more abundant in brains of epileptics than of controls. Our results suggest leukocyte-endothelial interaction as a potential target for the prevention and treatment of epilepsy

Percorsi individuali e spirituali nella risposta al cancro

The oncological disease represents an interruption of the normal existential path of a subject. The authors, starting from the biopsychosocial model, consider the importance of spirituality and religiosity as a support when facing this difficult experience. Research in this field is included in the psychosocial studies that analyze the way in which subjects react to stressful events. An analysis of the literature shows that religiosity and spirituality affect differently the coping process. Spirituality seems more related to a decrease of anxiety and depression and with more chances to have shared and more realistic choices in the care pathway, while religiosity seems to have less significant impact on the components linked to emotional state and decisions in the care pathway. However, the results of the researches are not univocal and emphasize that this research area needs to be improved, paying particular attention to both constructs and methodological aspects

"On the tracks of externalizing symptomatology: the role of attachment coherence and self-regulation " Proceedings XXI National Congress Italian Psychological Association, Clinical and Dynamic Section, Milan-27-29 September 2019, SYMPOSIUM SESSION

Although the role of mentalization has been extensively explored among clinical and normative adult samples, a lack of studies in middle childhood still exists (Bosmans & Kerns, 2015; Ensink et al., 2015). Following these considerations, the present study aims to explore the role of mentalization (operationalized as Reflective Functioning) as a mediator in the link between attachment coherence and psychological maladjustment, here considered as externalizing symptomatology. Child Attachment Interview (CAI; ShmueliGoetz, Target, Fonagy & Datta, 2008; Cavanna, Bizzi, San Martini & Castellano, 2018) was administered to 95 community children (M = 10.4 years, SD = 1.43 years) and then coded with the Child and Adolescent Reflective Functioning Scale (CRFS; Ensink, Target, Duval & Oandasan, 2015; measured as Self- and Other-focused mentalization). Child Behavior Checklist for Ages 6-18 (Achenbach, 2001) was also administered to children\u2019s parents. Results showed that Self-focused mentalization, but not Other-focused mentalization, partially mediates the link between attachment coherence and externalizing symptomatology. Despite the preliminary nature of this study, our findings suggest the importance of considering the dimension of Self-focused mentalization (intended as the capability to recognize and to converse with own mental states) during middle-childhood as a dimension that could promote psychological adjustment. These considerations lead us to consider the need for specific interventions able to capture the specificity of the middle childhood period in which the attachment system changes from seeking proximity to the attachment figure to discovering external social relationships

Assessing mental representatios with respect to parents and post-traumatic symptomatology among children with disruptive behavior disorders.

Introduction: In line with a consistent literature, children with externalizing disorders have experienced some traumatic events, such as experiences of rejection, abuse, violence assisted.Recent studies are examining the role of attachment for a better evaluation of this disorder. Aims of the study: The aims of this study are: 1) to evaluate the post-traumatic symptomatology in a group of children diagnosed withDisruptive Behavior Disorders; 2) to evaluate theirs attachment models; 3) to test the association between post-traumatic symptomatology and attachment organization. Material and methods: Forty consecutive Italian patients aged from 8 to 15 (M=10.7; SD=2.01) were administered the Trauma Symptom Checklist for Children (TSCC-A), a self-report evaluating post-traumatic symptomatology, and the Child Attachment Interview (CAI), a semi-structured interview assessing the attachment representations. Moreover socio-demographic data were collected. Results: Regarding post-traumatic symptomatology, patients with Disruptive Behavior Disorders showed high level of Anger and low level of Dissociation. Findings on the distribution of attachment models showed a significant presence of insecure attachment with respect to both parents and Disorganized attachment was found in more than half of the patients. Conclusions: This study suggests that attachment organization and post-traumatic symptomatology may be fundamental elements to be assessed with Disruptive Behavior Disordersin childhood and to understand the mental state and psychological features of children affected by this disorders. The clinical implications for future research directions and the methodological limitations are discusse