The impact of family on Obsessive Compulsive Disorder in children and adolescents: Development, maintenance, and family psychological treatment

It is widely recognized that some parental characteristics can influence obsessive compulsive disorders in children and adolescents. Family involvement and parental style characterized by high expressed emotion, over-protection, over-control are associated with the development of obsessive compulsive disorders in children. As a consequence, family involvement in the treatment of youth with obsessive compulsive disorders has been widely suggested. Although various forms of family therapy are used, cognitive behavioural treatment is widely recognized as the first-line treatment of paediatric obsessive compulsive disorders. Despite several studies reveal efficacy of family therapy, it has been underlined that more than an half of children remain symptomatic post-treatment. In order to improve treatments for children with obsessive compulsive disorders, research has identified personal and familiar predictors of response to treatment. The clinical implications of these studies are discussed

Romantic relationships in adolescents with internalizing and externalizing problems

The main focus of this study was to examine the influence that individual’ psychological problems have on involvement and quality of adolescents’ romantic relationships. A sample of 621 adolescents (308 males and 313 females) aged from 14 to 17 years was recruited for this study. Psychological problems were assessed by means of Youth Self-Report that assessed externalizing (aggressive, disruptive, hyperactive, antisocial, and delinquent behaviours) or internalizing (depression, anxiety, and social withdrawal) problems. Differently from previous studies, it has been differentiated “pure” externalizing or internalizing problems from comorbidity forms of psychological problems. Total number of partners and the mean of relationships’ duration were used to explore the quantitative aspects of romantic relationships. Network of Relationships Inventory and a Relationship Satisfaction Scale were employed to measure the positive (companionship, intimacy, reliable alliance and Support) and negative (Conflict, Antagonism, and Reliable Power) qualities. Results showed that both adolescents with pure externalizing or with comorbidity problems reported a higher total number of partners than adolescents with pure internalizing problems did. Furthermore, they had romantic relationships characterized by more negative qualitative features

Shyness and Psychological Adjustment During Adolescence: The Moderating Role of Parenting Style

Although shyness constitutes a risk factor for maladjustment, parenting style may influence these developmental trajectories during childhood. Little is known about the role of parental style in the relationship between shyness and psychological adjustment during adolescence.Aims: To explore the relationship between shyness and parenting style and to analyse the moderating role of the quality of parenting in the relationship between shyness and internalizing difficulties during adolescence.Method: 787 11 to 19 year-old participants (divided in early and late adolescents) were recruited for this study. Participants completed Revised Cheek and Buss Shyness Scale, Parental Bonding Instrument and internalizing scale of Youth Self Report.Results: Shy adolescents perceived parents to be less warm and close, less encouraging of their autonomy and independence, and more overprotective and intrusive than did other participants. During early-adolescence participants who perceived their parents as supportive and not intrusive showed significantly fewer internalizing problems related to shynes

The impact of Covid-19 restrictions on depressive symptoms in low-risk and high-risk pregnant women: a cross-sectional study before and during pandemic

Background: The COVID-19 social restrictions have increased the risk for depression compared to the previous period in Italian women with Low-Risk Pregnancy (LRP). lLess is known about the impact of COVID-19 restrictions on High-Risk Pregnancy (HRP). This study aimed: 1) to explore levels of depression in women who become pregnant before and during COVID-19 pandemic, distinguishing between LRP and HRP; 2) to analyze the impact of COVID-19 restrictions on pregnancy experience in LRP and HRP. Methods: A before-during COVID-19 pandemic cross-sectional study was carried out on 155 pregnant women (Mean age = 34.18), between 23 and 32 weeks of gestation. 77 women were recruited before COVID-19 pandemic (51.9% LRP; 48.1% HRP) and 78 women were recruited during COVID-19 pandemic (51.3% LRP; 48.7% HRP). HRP group was enrolled during hospitalization for high-risk pregnancy. Participants filled out Edinburgh Postnatal Depression Scale. Moreover, only COVID-19 group answered an open-ended question about the impact of restriction on pregnancy experience. Results: HRP women reported higher levels of depressive symptoms than LRP. No difference emerged for COVID (before/during) but an interaction effect between COVID-19 and obstetric condition was found. The qualitative results showed the impact of restrictions on emotions and concerns. Conclusion: Respect to the previous period, LRP women during COVID-19 presented an increased risk for depressive symptoms than HRP. The HRP women during COVID-19 seemed to use hospitalization as a resource to find a social support network with other pregnant women and to be reassured on the clinical ongoing of pregnancy

Continuità delle cure e gestione ambulatoriale dei pazienti con malattie primitive del miocardio durante la pandemia COVID-19: l’esperienza della Unit Cardiomiopatie dell’Azienda Ospedaliero-Universitaria di Careggi

Le misure restrittive imposte dalla pandemia COVID-19 hanno reso necessario una veloce riorganizzazione del lavoro dei sanitari per garantire una continuità delle cure per i pazienti affetti da malattie croniche, spesso cambiando strategie in corso d’opera. Riportiamo un'esperienza nel complesso molto positiva vissuta presso la Unit Cardiomiopatie dell’Azienda Ospedaliero-Universitaria di Careggi durante il recente lockdown

The Italian language postpartum specific anxiety scale [PSAS-IT]: translation, psychometric evaluation, and validation.

Introduction: While often positive, the lifecourse transition to motherhood is susceptible to the risk for developing mood disorders. Postpartum anxiety has often been overshadowed by other perinatal-specific mental health disorders, such as postpartum depression, and therefore has not been at the forefront or center of as much empirical study. This has meant there is a lack of effective and reliable tools with which to measure it, despite growing evidence suggesting its detrimental impact on mothers, their babies, wider family and social contacts, and on healthcare systems. This current study aimed to translate and validate the Postpartum Specific Anxiety Scale [PSAS] into the Italian language, and to validate the tool for its use in detecting anxiety specific to motherhood. Methods: The study (N = 457) comprised 4 stages: English-Italian translation and back-translation to obtain the Italian version [PSAS-IT]; a preliminary pilot study to adapt the PSAS to the characteristics of the Italian population; measurement invariance; and internal reliability of subscales. Results: The PSAS-IT demonstrates similar psychometric properties as the original English-language PSAS, with acceptable acceptability, construct and convergent validity, and internal consistency. Confirmatory factor analysis for multiple groups (Italy and United Kingdom) showed that the factor structure of the PSAS was valid for both groups [χ2 (2436) = 4679.481, p < 0.001, TLI = 0.969, CFI =0.972, RMSEA = 0.045, SRMR =0.064]. Discussion: The resulting findings offer a reliable measure of postpartum anxiety in Italian language up to six months after birth

Medical successes and couples' psychological problems in Assisted Reproduction Treatment: A narrative based medicine approach

Objective: 1) To explore the psychological processes that develop in women and men during their first pregnancy obtained with assisted reproduction treatment; 2) to individuate the main plot that women and men use to recount their transition to parenthood. Methods: A face-to-face semi-structured autobiographical interview was administered. The interview was aimed to investigate the story of pregnancy. Interviews were transcribed verbatim and analyzed in order to merge principal themes. Participants: 15 Italian couples waiting for the first child after a conception with assisted reproductive technologies. Results: Medically assisted pregnancy constitutes an extremely stressful, highly medicalised experience, that the couple, however, narrated according to a basic plot consisting in four phases: doubt, final sentence, victory, monitoring. Conclusions: Results suggest that physicians can benefit from knowing the phases that infertile couples experience during pregnancy because these can serve as a framework to use in monitoring their transition to parenthood and in planning psychological support and health interventions for them. Objective: 1) To explore the psychological processes that develop in women and men during their first pregnancy obtained with assisted reproduction treatment; 2) to individuate the main plot that women and men use to recount their transition to parenthood. Methods: A face-to-face semi-structured autobiographical interview was administered. The interview was aimed to investigate the story of pregnancy. Interviews were transcribed verbatim and analyzed in order to merge principal themes. Participants: 15 Italian couples waiting for the first child after a conception with assisted reproductive technologies. Results: Medically assisted pregnancy constitutes an extremely stressful, highly medicalised experience, that the couple, however, narrated according to a basic plot consisting in four phases: doubt, final sentence, victory, monitoring. Conclusions: Results suggest that physicians can benefit from knowing the phases that infertile couples experience during pregnancy because these can serve as a framework to use in monitoring their transition to parenthood and in planning psychological support and health interventions for them

Expectation toward future, social self-efficacy in adolescents after bone cancer treatment

Purpose of the article: to assess expectations toward future in adolescents after bones cancer treatment and to deep relationship between expectations toward future, resilience and social self-efficacy. Method, 32 adolescents with past bone cancer experience and 48 adolescents selected in a normative sample, were requested to fill a questionnaire about Expectations for future, Egoresiliency, Social Self-efficacy. Results, adolescents with cancer experience had more optimistic expectations toward future and were less open to experience compared to normative sample. In clinical sample expectations toward future were negatively related to global ego-resiliency and positively to impulse control; conversely in normative sample expectations toward future were positively correlated to global ego-resiliency, openness to new experience and social self-efficacy. Conclusions, in the period immediately following bones cancer treatment, patients’ positive expectations toward future could express an unrealistic optimism rather than a correct evaluation

Il ruolo della famiglia nella genesi e nel trattamento del Disturbo Ossessivo-Compulsivo nell’infanzia: la prospettiva cognitivo-comportamentale

The role of family in the development and treatment of obsessive compulsive disorders: The cognitive behavioral perspective. It is widely recognized that specific parental attitudes and parental style defined by high expressed emotion (Renshaw et al., 2003), overprotection, overcontrol (Alonso et al., 2004), low affection (Alonso et al., 2004) and low support (Valleni-Basile et al., 1996) can influence obsessive compulsive disorders in children (Waters, Barrett, 2000). It has also been underlined that the family involvement in the patient’s rituals tends to perpetuate and reinforce the child’s obsessive compulsive symptoms (Cooper, 1996; Geller, MBBS, FRACP, 2006). As a consequence, cognitive behavioural family treatment is largely suggested for these patients (Pollock, Carter, 1999). In this treatment both parents and children attend separate group sessions and some concurrent family therapy (Mendlowitz et al., 1999). Overall, the treatment literature reveals that a substantial percentage of patients remains symptomatic post-treatment (POTS, 2004). In order to improve treatment for children with obsessive compulsive disorders, several studies identified personal and family predictors of response to treatment (Ginsburg, Kingery, Drake, Grados, 2008; Keeley, Storch, Merlo, Geffken, 2008). Results displayed that family attitudes defined by high expressed emotion (Leonard et al.,1993), hostile criticism, emotional overinvolvement (Chambless, Steketee, 1999) and high family accommodation were associated with greater dropout and/or poor cognitive behavioural treatment outcome for children with obsessive compulsive disorders (Merlo, Lehmkuhl, Geffken, Storch, 2009;Van Noppen, Steketee, 2003). Clinical implications of these studies are discusse

Adolescents’ struggle against bone cancer: An explorative study on optimistic expectations of the future, resiliency, and coping strategies

The present study aims to assess adolescents’ expectations of the future after bone cancer treatment and to investigate in greater depth the relationship between expectations of the future, resilience and coping strategies. Thirty-two adolescents with cancer experience (11–20 years old), who had a complete first remission at least 1 month after the end of successful treatment, were requested to respond to the Expectations for Future Scale, the Ego-Resiliency Scale and Coping Strategy Indicators. Forty-eight gender- and age-matched control adolescents were randomly selected from a normative sample (NORMs). Adolescents with cancer experience had more optimistic expectations of the future and were less open to experience compared to NORMs. They had lower global ego-resiliency, higher impulse control and tended to use more avoidance strategies than NORMs. In adolescents with cancer experience, expectations of the future were negatively related to global ego-resiliency and positively related to impulse control and avoidance. Expectations of the future were positively correlated with global ego-resiliency and openness to new experience and negatively correlated with impulse control in NORMs. Patients’ positive expectations of the future may relate to positive adjustment to cancer events; however, they could also express unrealistic optimism. The present study aims to assess adolescents’ expectations of the future after bone cancer treatment and to investigate in greater depth the relationship between expectations of the future, resilience and coping strategies. Thirty-two adolescents with cancer experience (11–20 years old), who had a complete first remission at least 1 month after the end of successful treatment, were requested to respond to the Expectations for Future Scale, the Ego-Resiliency Scale and Coping Strategy Indicators. Forty-eight gender- and age-matched control adolescents were randomly selected from a normative sample (NORMs). Adolescents with cancer experience had more optimistic expectations of the future and were less open to experience compared to NORMs. They had lower global ego-resiliency, higher impulse control and tended to use more avoidance strategies than NORMs. In adolescents with cancer experience, expectations of the future were negatively related to global ego-resiliency and positively related to impulse control and avoidance. Expectations of the future were positively correlated with global ego-resiliency and openness to new experience and negatively correlated with impulse control in NORMs. Patients’ positive expectations of the future may relate to positive adjustment to cancer events; however, they could also express unrealistic optimism