New frontiers and applications of attachment theory

Editoriale dell'E-Book internazionale di cui l'autrice \ue8 Topic Editor, introduce e commenta lo stato dell'arte sull'attaccament

Attachment Assessment in treatments, prevention and intervention programs

Attachment theory, assessment and research offers a broad, far-reaching view of human functioning, and it can enrich a psychologist's understanding of subjects and their relational adjustment, both in clinical and non-clinical settings. Ongoing research in attachment has led to a number of individual treatments and prevention and intervention programs. The assessment of an individual's attachment organization, can play a crucial role in explaining and previewing the unfolding treatment, the relational adjustments or concerns, and the psychological well-being. We hope to receive empirical papers that give evidence for the usefulness of attachment assessment in both clinical (e.g., patients with Eating Disorder; or Axis-II; psychotherapy patients…) or not clinical population (e.g. Adoptive and/or foster families or couples, Mother-infant assessment in prevention field…). These papers should include methodological issues and information about the participants, the methods used to assess attachment, the process of scorer training and the availability of the manual used to obtain inter-scorer reliability. Case studies may be of interest to the extent that they demonstrate the value of a systematic approach to attachment material. A range of theoretical perspectives is welcome as well presentation of new emergent tools on attachment. Because Frontiers in Psychology is an international journal, each empirical paper should comment on the international implications of the findings and discuss its cross-cultural use. Such comments may include, for example, its linguistic specificity, its robustness in translation, and the cross-cultural generalizability of the constructs and behaviors of the measure and its usual correlates. Cross-cultural generalizability is not, however, a requirement

A pilot study of the Italian adaptation of the Session Evaluation Questionnaire fourth version

Abstract The Session Evaluation Questionnaire (SEQ) evaluates the impact of counselling and psychotherapy sessions; it may be conceived as a bridge between psychotherapy process and outcome. SEQ is a self-report tool asking patients about their experience with the clinical session just ended; it consists of 27 adjectives in semantic differential scale, divided into three thematic parts: evaluation of the session itself, feelings after the session, and evaluation of the therapist. Even if the original American SEQ has been translated into many languages, only a few translations have been validated. This is a pilot study, which attempted to replicate the five-dimensional structure of the fourth version of the Anglo-American SEQ, for the Italian population. Data were collected on 111 outpatients attending the Psychological Assistance Service (SAP-Dynamic Psychotherapy Service) of Padua University, after their first two clinical interviews. Exploratory factor analyses (PCA with varimax rotation) were performed on each of the three parts of the SEQ. Results confirmed the original factorial structure, showing a substantial agree for Depth, Smoothness, Positivity and Arousal dimensions; Good Therapist dimension overlapped perfectly with the original one. The Italian SEQ showed adequate internal consistency (Cronbach\u2019s alphas ranged .65 to .86 for the five subscales). Convergent validity measured with an index of perceived satisfaction in the counselling process, showed significant positive correlations with Good Therapist, Depth and Positivity scores. The preliminary results of this pilot study show that the Italian SEQ results in a reliable instrument to measure the impact of clinical sessions. Of course, validation studies are needed, especially to replicate the factor structure of the instrument and to better assess its validity

From research to clinical settings: validation of the Affect in Play Scale \u2013 Preschool Brief Version in a sample of preschool and school-aged Italian children

Affect in Play Scale-Preschool (APS-P) is one of the few standardized tools to measure pretend play. APS-P is an effective measure of symbolic play, able to detect both cognitive and affective dimensions which classically designated play in children, but often are evaluated separately and are scarcely integrated. The scale uses 5 min standardized play task with a set of toys. Recently the scale was extended from 6 to 10 years old and validated in Italy preschool and school-aged children. Some of the main limitations of this measure are that it requires videotaping, verbatim transcripts, and an extensive scoring training, which could compromise its clinical utility. For these reasons, a Brief version of the measure was developed by the original authors. This paper will focus on an APS-P Brief Version and its Extended Version through ages (6\u201310 years), which consists \u201cin vivo\u201d coding. This study aimed to evaluate construct and external validity of this APS-P Brief Version and its Extended Version in a sample of 538 Italian children aged 4-to-10 years. Confirmatory factor analysis yielded a two correlated factor structure including an affective and a cognitive factor. APS-P-BR and its Extended Version factor scores strongly related to APS-P Extended Version factor scores. Significant relationships were found with a divergent thinking task. Results suggest that the APS-P-BR and its Extended Version is an encouraging brief measure assessing pretend play using toys. It would easily substitute the APS-P and its Extended Version in clinical and research settings, reducing time and difficulties in scoring procedures and maintaining the same strengths

Dyadic adjustment and parenting stress in internationally adoptive mothers and fathers: the mediating role of adult attachment dimensions.

Previous research has shown that a positive marital functioning represents a resource in adoptive families, leading to a decrease in parenting stress, but little is known about the factors mediating such a relationship. This study aimed to explore whether adult attachment avoidance and anxiety mediate the effect of dyadic functioning on parenting stress in 90 internationally adoptive couples (mothers and fathers) who had adopted a child (aged 3–10 years) in the last 36 months. Participants completed self-report measures of dyadic adjustment, adult attachment, and parenting stress. A series of path analyses supported the mediation hypothesis, but differentially for mothers and fathers. Among mothers, there was a direct and negative relationship between dyadic adjustment and parenting stress. In addition, a better dyadic adjustment was related to lower levels of attachment anxiety, which in turn were associated with less parenting stress. Among fathers, increased dyadic adjustment was related to lower levels of attachment avoidance, which in turn were associated with reduced parenting stress. These findings suggest the importance of including both mothers and fathers in adoption research. Adoptive parents could benefit from specific interventions aimed at reducing attachment avoidance and anxiety by supporting parental sense of competence and involvement for mothers and fathers, respectively

The Efficacy of Digital Cognitive–Behavioral Interventions in Supporting the Psychological Adjustment and Sleep Quality of Pregnant Women with Sub-Clinical Symptoms: A Systematic Review and Meta-Analysis

The present meta-analysis investigated the overall and differential efficacy of digital cognitive-behavioral therapies (CBTs) vs. third-generation CBTs deployed to pregnant women in reducing sub-clinical depression, anxiety, and stress symptoms while fostering sleep quality and quality of life. A PRISMA-guided systematic search was used, including randomized controlled trials (RCTs) evaluating the above-mentioned interventions. Data were pooled using either the mean difference (MD) or standardized MD (SMD). Sub-group analyses were carried out when appropriate. The primary outcomes were depression, anxiety, and stress symptoms, as well as sleep quality and quality of life. The interventions' acceptability was evaluated through the odds ratio (OR) of drop-out rates. Seven RCTs were included, comprising 1873 pregnant women. The results showed the interventions' efficacy in terms of reducing depression symptoms (SMD = -0.36, CI = 0.61, -0.11, k = 9) at the endpoint, although it was not maintained at follow-up during the postpartum period. The interventions' efficacy in terms of reducing anxiety symptoms (SMD = 1.96, CI = -2.72, -1.21, k = 3) at the endpoint was also significant, while having no effect on sleep quality. The interventions were well accepted (OR = 1.68; 95% CI = 0.84, 3.35; k = 7). Although no sound conclusions can be drawn concerning the joint or differential efficacy of the considered interventions, this study was useful in highlighting the need to develop evidence-based digital prevention programs for pregnant women with sub-clinical symptoms

Parent\u2019s perception of children\u2019s fear: from FSSC-IT to FSSC-PP

Studies involving parents' reports about children's fears and multiple informant comparisons are less extended than investigations on children's self-reporting fear schedules. Starting with the Italian version of FSSC-R, the FSSC-IT, the main aims of this study were to adapt a schedule for parents' perception of their children's fear: the FSSC-Parent Perception. Its psychometric properties were examined in a large sample of parents (N = 2970) of children aged 8-10 years. Exploratory and confirmatory factorial structures were examined and compared with the Italian children's ones. Mother vs. father, children's gender and school age group effects were analyzed. The confirmatory factor analysis confirmed a four correlated factors solution model (Fear of Danger and Death; Fear of Injury and Animals; Fear of Failure and Criticism; Fear of the unknown and Phobic aspects). Some effects related to child gender, age group, mother vs. father, were found. The FSSC-PP properties supported its use by parents to assess their children's fears. A qualitative analysis of the top 10 fears most endorsed by parents will be presented and compared with children's fears. Clinical implications about the quality of parent-child relationships where discussed, comparing mothers and fathers, and parents' perception about daughters' and sons' most endorsed fears

Therapists' clinical work between sessions: A preliminary study of the Post Session Therapist Questionnaire

Objective: In this paper, we present the development of a new self-report questionnaire to assess a characteristic of clinical work that has not been considered in the literature: the mental (affective and rational) work that therapists do between clinical sessions. The resulting instrument is the Post Session Therapist Questionnaire. Method: After consulting the literature and conducting in-depth discussions of the dimensions to be investigated, we generated 40 items through brainstorming. We had 16 experts carefully examine the questionnaire\u2019s content validity at various stages and thus obtained 38 pertinent, clear, and unambiguous items. The experts also provided positive evaluations of the questionnaire\u2019s instructions and response mode. We then carried out a pilot study with 27 clinicians, who filled out the questionnaire twice, referring to 100 patients in each case. To assess the structural validity of the new instrument, we conducted an exploratory factor analysis using the session (N = 200) as the unit of analysis. Result: Three factors substantially supported the theoretical dimensions that we conceptualized in the first stage of the research: We called the factors Positive Regard, Comprehension, and Diagnostic Effort. These dimensions have good internal consistency. Conclusion: The study\u2019s results suggest that these clinical dimensions are meaningful in the development of clinical processes, which encourages further study of the psychometric properties of the questionnaire, with larger samples, so as to consider these results in relationship to the outcomes of the following sessions

The Action of Verbal and Non-verbal Communication in the Therapeutic Alliance Construction: A Mixed Methods Approach to Assess the Initial Interactions With Depressed Patients

In psychodynamic psychotherapy, verbal (structures and intents) and non-verbal (voice and interruptions) dimensions of communication intertwine conveying information and determining the mutual regulation between therapist and patient through conversational sequences. The communication components interplay is the foundation for building the therapeutic alliance, a relational dimension that predicts a psychotherapy outcome and change, influenced by patient-therapist exchanges from the initial stages of their encounter. Depressed patients present specific verbal and non-verbal communication and show difficulties in developing and maintaining the therapeutic alliance. Based on the reviewed literature, the main aim of this study was to analyze how the action of specific communicative modes, implemented by the therapist and depressed patients, affect the reciprocal construction of the early therapeutic alliance by each participant during the mutual regulation processes. We employed a mixed methods approach based on a systematic observation of communication and alliance ruptures and repairs within the audio recordings and verbatim transcripts of 20 psychotherapy sessions (6,232 speaking turns) with seven depressed patients. The observational design was nomothetic, follow-up, and multidimensional. The choice of methodology is justified because we developed a comprehensive procedure that integrates an ad hoc indirect observation system (the Communicative Modes Analysis System in Psychotherapy), analyzing verbal and non-verbal communication, and an observational tool with deductive categories (the Collaborative Interactions Scale-Revised), assessing the therapeutic alliance construction. Once we confirmed the intra-and inter-observer reliability for the ad hoc system and the inter-rater reliability for the tool with deductive (or theoretical) categories, we performed descriptive statistics (to describe quantitatively communicative modes and alliance ruptures and repairs), lag sequential analysis (to detect stable patterns in communication-alliance interactions), and polar coordinate analysis (to identify significant relationships between communicative modes and alliance ruptures and repairs). Results confirm that the therapist's verbal (asking and exploring) and non-verbal (elaborating and cooperatively interrupting) modes and the depressed patients' verbal (asserting and exploring) and non-verbal (expressing emotions and cooperatively interrupting) modes determine stable patterns and significant associations with collaborative behaviors connected to the reciprocal construction of alliance by each participant. All this may provide professionals with useful information to increase the psychotherapy effectiveness with depressed patients

Introduction to the Special issue on Qualitative and Quantitative Research in Child and Adolescent Psychotherapy

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