Le conflittualità nelle separazioni coniugali: aspetti psicopatologici e rischi per i minori

This article examines the complex situations caused by ex-partners’ difficulties in “mentalizing” the distress of their separation and their tendency to “act it out” with interminable struggles which perpetuate destructive behaviours and which increase their own grief, as well as that of their children. The minors involved have a higher probability of emotional and behavioral maladjustment because they are involved in relationships which interfere in their psychic development (e.g. conflicts of loyalty, difficulties in the parent-child relationship, inversion of roles between parents and children), and in more serious cases, they are exposed to psychological abuse. Described here are the various forms of psychic hardships that the family separated by conflict may assume: described by some authors as downright “syndromes”, they represent the changing face of a pathological family dynamic of which each member plays his role and has his own good reasons for standing in the way of the dramatic changes which he faces. G. Giordano defines “parental mobbing” as the collection of hostile and persecutory behaviours started by a separated parent against the other with the aim of preventing him or her from exercising their role as a parent by means of devaluing and destroying the relationship with the child. This may include sabotaging visitations; marginalizing the decision making processes; use of threats; campaigns of denigration; familial and social elegitimization. I.D. Turkat describes mothers (“Malicious Mother Syndrome”) who, although they are free of other mental disorders and seem to have a good relationship with their children, exhibit damaging behaviours toward the exhusband with the intention of impeding a normal and affectionate relationship with his children. This behaviour may include true violations of the law, or excessive legal actions in order to burden the ex-spouse. G.L. Rowles speaks of the “Disenfranchised Father Syndrome” as a disorder of fathers who are partially or totally “paralyzed” by the distress of separation. They can do nothing to avoid it, and try to fight on in order to remain present in the lives of their children. But after having struggled in vain to stand up for their legal rights, they finally come to realize that they have been delegitimized in their parental role. Symptoms include those of depression, and those of Post traumatic Stress Disorder. Of great interest are the studies of R. Gardner on “Parental Alienation Syndrome” (PAS), a pathology which arises primarily from the context of child custody disputes. Its principle manifestation is the child’s seemingly motiveless refusal to maintain his or her relationship with the non-custodial parent, accompanied by an exacerbated and unjustified campaign of denigration; the latter being the result of direct and indirect programming on the part of the alienating parent, as well as the active and personal contribution of the child in question. The “singular relationship” which results between the minor and the parent deliberately aims to exclude the other, and in more serious cases, may represent a clear and powerful mental health risk factor for the child.Il presente lavoro prende in esame le complesse problematiche legate alla difficile “mentalizzazione” del disagio da separazione da parte degli ex-coniugi e alla tendenza ad “agirlo” attraverso interminabili “battaglie” che non fanno altro che perpetuare all’infinito comportamenti distruttivi e cronicizzati il proprio malessere e, soprattutto, quello dei figli. Coinvolti in processi relazionali disfunzionali per il loro sviluppo psichico (conflitti di lealtà, genitorializzazione, inversione di ruoli) ed esposti, nei casi più gravi, al rischio di abuso psicologico, i minori hanno elevate probabilità di andare incontro a disadattamento sul piano emotivo e comportamentale. Vengono, infine, descritte le variegate forme che il disagio psichico della famiglia separata conflittuale può assumere: definite da vari autori come vere e proprie “sindromi”, esse rappresentano i volti cangianti di una dinamica familiare patologica in cui tutti i membri della famiglia giocano il proprio ruolo ed hanno le loro buone ragioni per opporsi al cambiamento drammatico che li attraversa. G. Giordano definisce “mobbing genitoriale” l’insieme di comportamenti ostili e persecutori messi in atto da un genitore separato nei confronti dell’altro allo scopo di impedirgli l’esercizio della propria genitorialità, svilendo e distruggendo la sua relazione con il figlio: sabotaggi delle frequentazioni, emarginazione dai processi decisionali, minacce, campagne di denigrazione, delegittimazione familiare e sociale. I.D.Turkat descrive madri (“Sindrome della Madre Malevola”) che, pur rimanendo esenti da altre psicopatologie accertabili e mantenendo con i figli (almeno in apparenza) un efficace rapporto di accudimento, attuano nei confronti dell’ex-marito un comportamento lesivo, teso ad impedirgli un normale ed affettuoso rapporto con i figli. L’alterazione della condotta può comprendere vere e proprie violazioni della legge, oppure può trasformarsi in un eccesso di azioni legali con cui vessare l’ex-coniuge. G. L. Rowles parla di “Sindrome del Padre Interdetto” a proposto di padri parzialmente o del tutto paralizzati dalla sofferenza della separazione: essi non possono far nulla per evitarla, cercano di lottare per rimanere presenti nella vita dei figli ma, dopo aver tentato inutilmente di far valere i loro diritti in campo giuridico, si rendono conto di essere delegittimati nel loro ruolo genitoriale. La loro sintomatologia è costituita da sintomi depressivi e del disturbo posttraumatico da stress. Di grande interesse, infine, gli studi di R. Gardner sulla “Sindrome di Alienazione Genitoriale” (PAS), patologia relazionale che insorge essenzialmente nel contesto delle controversie per l’affidamento dei figli. La sua principale manifestazione consiste nel rifiuto immotivato del figlio a mantenere rapporti con il genitore non affidatario, accompagnato da un’esacerbata ed ingiustificata campagna di denigrazione: quest’ultima è frutto della programmazione diretta e indiretta da parte del genitore alienante e del contributo attivo e personale del figlio. La “relazione singolare” che viene così a configurarsi tra il minore e uno dei due genitori è deliberatamente mirata all’esclusione dell’altro e, nei casi più gravi, può rappresentare un potente e diretto fattore di rischio per la salute mentale del minore

Sindrome di alienazione genitoriale (PAS) e abuso sessuale intrafamiliare: criteri di differenziazione e matrici comuni

The aim of this work is discussing a very important problem that may emerge as a spin-off of the Parental Alienation Syndrome in the context of the child custody diputes after marital separation: the false sexual abuse allegations. More and more frequently we can observe, in fact, judiciary cases with a typical development: a parent is accused of abuse and cruelty to his/her child and the judge provides his/her removal, interrupting his/her relationship with the child; the long investigating and judiciary course doesn’t confirm the accusation but, in the meantime, the parentchild relationship is irremediably damaged. Therefore it’s very important differentiating correctly between bona fide abuse allegations and the accusations resulting from Parental Alienation Syndrome: for this purpose Gardner (1999) presents a long list of criteria referring both to minors’ behavioural patterns and to parents’ psychological characteristics, behaviours and family history. When really abused by the refused parent, children generally exhibit symptoms seen in the Post-traumatic Stress Disorder (A.P.A., 2001) and aren’t likely to exhibit the typical manifestations of PAS. With regard to parents, alienating parents are typically uncooperative with examiners and their reports aren’t very credible; they need to provide continually “refresher courses” in order to remind their children of the abuse experienced; they’re overprotective of their children from the alienated parent, even in protected contexts; their accusations of alleged abuse emerge only after the separation. Parents of children who are genuinely abused, instead, let their children rember spontaneously the abuse experienced; they recognize the risk of an attenuation of the child’s bond with the abuser parent and most often they do everything in their power to restore it in protected conditions; their accusations of child abuse date back long before the separation. Targeted parents in PAS are generally credible in their reports and very much concerned for the physical and financial well-being of the family; in these cases the abuse accusations regard only the children, not the other family members. Abuser parents are, on the contrary, uncredible in their affirmations, not very or not at all concerned for the physical and financial well-being of the family; they’re inclined to impulsivity, acting-out of anger and paranoia; in these cases the abuse accusations extend also to the other family members. It’s finnaly proposed an interesting reading (Villa, 2006) of the psychic dynamics acting in the families from which rises an accusation of alleged abuse, observing that Parental Alienation Syndrome, incestual relations and incest cases have the same psychodynamic origins: they take rise from family relations that are primitive and concrete, narcissistic and excluding, typical of “pre-oedipical” conditions, in which there’s no space for the symbolic and its representations.Il presente lavoro intende affrontare un fenomeno di particolare rilevanza che può emergere, nel contesto delle dispute tra genitori separati per l’affidamento dei figli, in qualità di derivato o effetto della Sindrome di Alienazione Genitoriale: le false accuse di abuso sessuale intrafamiliare. Si assiste, infatti, sempre più di frequente a vicende giudiziarie che seguono un iter caratteristico: un genitore viene accusato di abusi o gravi maltrattamenti ai danni del figlio e viene allontanato, sospendendo ogni relazione con il bambino; il lungo percorso investigativo e giudiziario non conferma la denuncia ma, nel frattempo, il rapporto genitore-figlio è compromesso irrimediabilmente. Si desume, dunque, l’importanza di un’accurata differenziazione tra accuse bona fide di abuso e denunce frutto di una PAS: a tale scopo Gardner (1999) fornisce un lungo elenco di criteri che fanno riferimento sia ai pattern comportamentali dei minori che alle caratteristiche psicologiche, agli atteggiamenti e alla storia familiare dei genitori. In caso di abuso realmente subito dal genitore rifiutato, i sintomi dei figli rientrano solitamente nell’area del Disturbo Post-traumatico da Stress (A.P.A., 2001), e difficilmente si riscontrano le manifestazioni tipiche della PAS. Quanto alle figure parentali, solitamente i genitori alienanti sono poco collaborativi nel sottoporsi a valutazioni, poco attendibili nei loro resoconti, bisognosi di fare continue “iniezioni di richiamo” per ricordare ai figli i maltrattamenti subiti, premurosi nel proteggere i figli dal genitore bersaglio, anche in contesti protetti; denunciano, inoltre, i presunti abusi solo dopo la separazione. I genitori di minori realmente abusati, invece, lasciano che i figli ricordino spontaneamente gli abusi subiti, riconoscono il rischio dell’indebolimento del rapporto tra il genitore abusante ed i figli e fanno di tutto per ripristinarlo in condizioni protette; la denuncia degli abusi risale, infine, ad un periodo di molto precedente alla separazione. I genitori bersaglio della PAS, abitualmente, sono attendibili nei loro resoconti; si sono sempre preoccupati del benessere familiare; le denunce di abuso mosse loro riguardano solo i figli, non gli altri familiari. I genitori realmente abusanti, al contrario, sono poco attendibili nei loro resoconti, poco o affatto interessati al benessere della famiglia, tendono all’impulsività, all’esplosione violenta della rabbia e alla paranoia; la denuncia di abuso si estende, in questi casi, anche ad altri membri della famiglia. Viene, infine, offerta un’interessante lettura (Villa, 2006) delle dinamiche psichiche profonde operanti nelle famiglie da cui nasce la denuncia di sospetto abuso, osservando come la Sindrome di Alienazione Genitoriale, le relazioni incestuose e i casi di incesto condividano una stessa matrice psicodinamica che affonda le sue radici in relazioni familiari primitive e concrete, narcisistiche ed esclusive, proprie di condizioni “pre-edipiche”, in cui non c’è spazio per il simbolico e le sue rappresentazioni

Environmental monitoring and building simulation application to Vasari Corridor: Preliminary results

Abstract The Vasari Corridor has been used in the past and present for storage and presentation of works of art which require control of microclimate for optimal preservation. To this end, it was started the collaboration between the Uffizi Gallery and Laboratory of Environmental Physic of the Florence University for the environmental monitoring of microclimatic parameters, of which this work presents the preliminary results. It's was also created a three-dimensional model of the building in the stretch from the Uffizi Gallery to Ponte Vecchio, for the dynamic simulation of the energy behavior of the building validated by on-field measured values

Constraining primordial non-Gaussianity with future galaxy surveys

We study the constraining power on primordial non-Gaussianity of future surveys of the large-scale structure of the Universe for both near-term surveys (such as the Dark Energy Survey - DES) as well as longer term projects such as Euclid and WFIRST. Specifically we perform a Fisher matrix analysis forecast for such surveys, using DES-like and Euclid-like configurations as examples, and take account of any expected photometric and spectroscopic data. We focus on two-point statistics and we consider three observables: the 3D galaxy power spectrum in redshift space, the angular galaxy power spectrum, and the projected weak-lensing shear power spectrum. We study the effects of adding a few extra parameters to the basic LCDM set. We include the two standard parameters to model the current value for the dark energy equation of state and its time derivative, w_0, w_a, and we account for the possibility of primordial non-Gaussianity of the local, equilateral and orthogonal types, of parameter fNL and, optionally, of spectral index n_fNL. We present forecasted constraints on these parameters using the different observational probes. We show that accounting for models that include primordial non-Gaussianity does not degrade the constraint on the standard LCDM set nor on the dark-energy equation of state. By combining the weak lensing data and the information on projected galaxy clustering, consistently including all two-point functions and their covariance, we find forecasted marginalised errors sigma (fNL) ~ 3, sigma (n_fNL) ~ 0.12 from a Euclid-like survey for the local shape of primordial non-Gaussianity, while the orthogonal and equilateral constraints are weakened for the galaxy clustering case, due to the weaker scale-dependence of the bias. In the lensing case, the constraints remain instead similar in all configurations.Comment: 20 pages, 10 Figures. Minor modifications; accepted by MNRA

Consumption of energy drinks among Italian University students : a cross-sectional multicenter study

Purpose The aim of the study was to evaluate the caffeinated Energy Drinks (EDs) consumption among a large sample of Italian undergraduates and its association with some of the major lifestyle risk factors. Methods Students attending twelve public Italian universities were involved between October 2021 and May 2022. Information on socio-demographic characteristics, ED consumption, and on health-related behaviors of participants was collected by the use of a web-based questionnaire. Results A total of 2165 students participated in the study and 15.2% of them reported having used caffeinated EDs in the last six months, mainly once a month (41.5%). In comparison with non-users, ED users showed a higher proportion of males (p < 0.001) and a higher father’s educational level (p = 0.003), came mainly from Northern universities (p = 0.004) and life sciences degree courses (p < 0.001). Besides, ED users reported higher BMI values (p = 0.003), more particular dietary regimens (p < 0.001), higher levels of weekly moderate–vigorous physical activity (p < 0.001) and participation in sports (p < 0.001) and in team sports (p = 0.003), and higher proportion of smokers (p < 0.001) and alcohol drinkers (p = 0.005). ED use was negatively related with female gender (OR 0.546; 95% CI 0.374–0.798), the Mediterranean diet (OR 0.587; 95% CI 0.362–0.951) and coming from the center of Italy (OR 0.500; 95% CI 0.275–0.909) and positively associated with tobacco smoke (OR 1.712; 95% CI 1.176–2.492) and participation in a team sport (OR 1.686; 95% CI 1.051–2.707). Conclusion These findings could encourage figures engaged in education to increase the students’ awareness on this issue in order to prevent the excessive use of EDs and associated unhealthy behaviors, especially in the most interested subgroups

Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale

© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design: Instrument development and cross-sectional study for psychometric testing. Methods: A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results: Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50–1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third-year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second-year students

Evolution of liver fibrosis in diabetic patients with NAFLD in a follow-up study: Hepatoprotective effects of sodium-glucose co-transporter-2 inhibitors

Background and aims: Patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are at high risk of hepatic fibrosis. To prospectively evaluate changes in fibrosis in diabetic patients with NAFLD, predisposing factors and sodium glucose cotransporter 2 inhibitors (SGLT2i) influence. Methods: 237 T2DM outpatients (mean age 67 ± 9 years, 54% male) were enrolled and re-evaluated after 52 ± 10 months. At baseline and follow-up NAFLD and liver fibrosis (LSM) were detected by ultrasonography and Fibroscan®. Results: During follow-up an increase in LSM (6.0 ± 2.8 vs 5.8 ± 2.7 kPa, p = 0.02) and in the prescription of SGLT2i (20% vs 6%, p<0.001) was registered, despite stability of diabetic control. LSM worsened in 133(56%) subjects, 92 (39%) with worsening >10% from baseline. Patients with worsening versus non worsening of LSM had higher prevalence of increase in BMI during follow-up (45% vs 32%, p = 0.06) and lower SGLT2i prescription (15% vs 27%, p = 0.034). In multivariate analysis use of SGLT2-inhibitors at follow-up reduced the risk of LSM worsening (HR 0.34, 95% CI 0.13-0.88), even when considered>10% from baseline. Conclusions: A high prevalence of fibrosis progression was observed in diabetic subjects with NAFLD over a nearly 5-years follow up and SGLT2-inhibitors seem to reduce the risk of worsening of liver stiffness