A psychological perspective on preterm children: the influence of contextual factors on quality of family interactions

Preterm birth has a critical influence on interactive, communicative, and expressive child behaviour, particularly during the first years of life. Few studies have stressed the assessment of mother-father-child interaction in families with preterm children, generating contradictory results. The present study wished to develop these fields: (i) comparing the quality of family interactions between families with preterm children and families with children born at full term; (ii) observing the development of family interactions after six months in the families with children born preterm; (iii) assessing family and contextual factors, as parental stress and social support, in parents of preterm children in order to observe their influence on the quality of family interactions. 78 families are recruited: 39 families with preterm children ( = 19,8 months, SD = 11,05) and 39 families with full-term children ( = 19,66 months; SD = 13,10). Results show that families with preterm children display a low quality of mother-father-child interactions. After six months, family interactions result is generally stable, except for some LTP-scales reflecting a hard adjustment of parenting style to the evolution of the child. In families with preterm children, the parenting stress seemed to be correlated with the quality of mother-father-child interactions

Intergenerational transmission of attachment. Family interactive dynamics and psychopathology: what kind of relationship in adolescence?

Introduction: this work is an example of empirical research. The aim was to look to the possible transgenerational influence between parents and adolescents attachment bond to their respective parents, infant armonic and/or disarmonic development and functional or dysfunctional family interactions. Methodology: 40 families with adolescents aged from 12 to 18 years (μ = 14.575, σ = 1.716) coming for a psychodiagnostic evaluation were tested with Lausanne Trilogue Play, Parental Bonding Instrument, Child Behaviour Checklist and Youth Self Report. Hypothesis: a) is there an association between the adolescent’s perceived attachment relationship with his parents and his psychopathological symptoms? In this case a non parametric test for k independent groups was performed. b) is there an association between parents-adolescent interactive dynamics and the parents’ perceived attachment relationship with their parents (adolescent’s grand-parents). In this case correlations and non-parametric test for k independent groups were performed. Results: a) we found significant statistical differences (p < .05) between adolescent psychopathology and the quality of perceived relationship with both the mother and the father. b) we found positive correlations between quality of relationship between the mother and her father (adolescent grandfather) and the scores of some LTP scales concerning normative function; moreover we found negative correlations between the father and his mother (adolescent’s grandmother) and the scores of some LTP scales concerning affective function. Conclusion: these results underline a significant association between the internal working model of the mother and her ways to interact and manage the relation with her adolescent son; this is a clinical evidence too. Another relevant result is the association between adolescent’s psychopathology and his internal working model. Clinical applications regarding these findings should be taken in account when psychotherapeutically working with adolescents and their families

Emotional Difficulties in Adolescence: Psychopathology and Family Interactions.

Introduction. Several studies on developmental age have investigated aspects relating to emotional competence, and alexithymia in particular, showing that it is associated with behavioral problems in childhood and adolescence. Some such research has focused on the relationship between emotional difficulties and family interactions assuming a link between the quality of family relationships and a child\u2019s emotional competence. Subjects and Methods. The aims of the present study were: 1) to compare a group of psychiatric adolescents with a group of \u201chealthy\u201d adolescents in terms of any alexithymia and its relationship with the former\u2019s psychopathological issues; 2) to clarify the relationship, if any, between psychopathology, alexithymia and family interaction patterns in our sample of psychiatric adolescents. The experimental group consisted of 41 psychiatric adolescents and the control group of 41 students matched for gender and age. The Toronto Alexithymia Scale (TAS-20) was used to identify any alexithymic traits, the Youth Self Report (YSR) 11-18 and the CBCL to detect any psycho-behavioral problems, and the Lausanne Trilogue Play (LTP) to analyze family interactions. Results. There was a higher prevalence of alexithymia among the adolescents with mental health problems than in the control group, and a correlation between their scores for internalizing problems and alexithymia. In the experimental group, adolescents with internalizing problems, somatic complaints and attention difficulties belonged to families revealing high levels of parental conflict. As for alexithymia, adolescents\u2019 difficulty identifying emotions correlated significantly with the same trait in their mothers. This feature also seemed to be associated with better family interactions. Conclusion. Our study confirms the importance of family relationships in the development of emotional skills, and highlights how deficiencies in the development of emotional competence are strongly associated with psychopathologies in adolescence. In the light of these findings, it is advisable in clinical practice to provide psychotherapeutic interventions for teens and their parents

Psychological and behavioral disease during developmental age: the importance of the alliance with parents

The aim of the study is to analyze the clinician’s alliance with parents during the diagnostic process in relation to therapeutic compliance and clinical evolution of individuals aged 0–11 years. The sample was formed by 84 individuals aged 0 to 11 years (18 < 6 years, 66 aged 6 to 11 years; 62 males and 22 females) who came to the Neuropsychiatric Unit for Children and Adolescents for a consultation regarding psychorelational and behavioral problems. Neuropsychiatric consultation took place in five diagnostic interviews with child and parents, separately. The last session was devoted to communication of psychiatric diagnosis (according to ICD 10) and therapeutic suggestions, if any. The clinician’s relationship with parents and patients’ participation were evaluated in terms of collaboration and quality of interaction, on the basis of pre-established criteria. Data about patients’ therapeutic compliance and clinical outcome were collected during a follow-up visit eight months after the last session. Results suggest that the better the alliance between parents and clinician, the higher the therapeutic compliance and the likelihood of a positive outcome for patients. Our data suggest that good communication with parents benefits child patients, both in terms of response to the parents’ need to report their children’s worrying behavior and as a response to the discomfort expressed by children when they come in for consultation

alexithymia psychopathology and alcohol misuse in adolescence a population based study on 3556 teenagers

Objectives: To analyze the association between alexithymia and alcohol intake during adolescence, also in relation to psychopathology, in order to identify psychological risk factors for alcohol misuse. Method: 3556 students [mean age (range) 14.5 years (11-18)] were recruited in the Padua area. Each was administered a set of three questionnaires: the Toronto Alexithymia Scale for children (TAS-20) to measure alexithymia, the Questionnaire Adolescent Saturday evening (QAS) to estimate of alcohol intake, and the Youth Self-Report (YSR 11-18) to value psychopathology. Results: Externalizing problems appeared to increase with age and with the amount of alcohol consumed, unlike internalizing problems. The prevalence of alexithymia was 18%, decreasing with age, and it was not associated with alcohol consumption, and used except in younger subjects (≤13), for whom a positive correlation was observed between alexithymia, internalizing problems and alcohol intake. Conclusions: Younger adolescents are more psycho-emotionally vulnerable (internalizing problems and alexithymia) and at a greater risk of alcohol misuse

An integrated approach to child psychotherapy with co-parental support: a longitudinal outcome study

Studies about the effectiveness of psychodynamic psychotherapy interventions with children and adolescents suggest potential adverse effects of this treatment when not supported by a parallel work with parents: it seems that it could damage family functioning and affect family balances. This research aims to assess psychopathological outcomes after two years of psychodynamic psychotherapy by comparing two groups (G) of children and adolescents, related to a Childhood Adolescence Family Service: G1 – individual therapy for child/adolescent only; G2 - therapy for child/adolescent and a separate session of co-parenting support. 21 families with children aged between 6 and 17 years completed the entire treatment. The research protocol involves: Lausanne Trilogue Play, Children Behavior Check List and Family Empowerment Scale. Results show a positive effect of the treatment on the child/adolescent psychopathological profile with a significant improvement concerning the reduction of both internalizing and externalizing problems. Results show the effectiveness of the integrated intervention in the improvement of parents’ abilities to validate the children emotional state. Our results suggesting that parenting support increase parental sensitivity, helping the parents to become more able to recognize the children’s emotional state and to validate it

Is there any relationship between children psychopathology and interactive family pattern?

Introduction The study “LTP used as a psychodiagnostic and therapeutic tool for psychiatric children and adolescents” is part of a Neuropsychiatric Unit project (NPU), aiming to find out significant relationships between children psychopathology and interactive families pattern in order to set up a functional therapeutic intervention. Method The target group evaluated by the NPIA was composed of 20 families with school-age children. During the evaluation psychodiagnostic assessment the Child Behavior Checklist (CBCL, Achenbach 2000-2001) and the LTP (Fivaz-Depeursinge and Corboz-Warnery, 1999) were administered. In order to test the hypothesis we have made the following statistical analysis: a) LTP score flow (during the different phases) comparison between the clinical-borderline and non-clinical CBCL groups (generalized linear model). b) parental LTP variable scores (in each phases) comparison between clinical-borderline and non-clinical CBCL groups (t-test for independent groups). c) correlations between LTP and CBCL scores. Results Statistical differences both in LTP scores flow and in LTP variables scores in each part between clinical-borderline and non- clinical CBCL groups only in some specific psychopathological areas (attention, social and total problems, externalizing, anxious- depressed, withdrawn-depressed and somatic complaints). It is interesting that these differences are due to some of the LTP variables concerning parental abilities (co-construction, scaffolding, conflict and interferences, affective warmth, validation, activities errors). Finally better parental abilities in LTP affective warmth and validation, activities errors, parental support, scaffolding and co-construction are related to elevated scores in somatic complaints, total and social problems or viceversa (positive correlations). Conclusions These results indicated a relationship between psychopathological children symptoms and parental abilities to manage triadic interactions supporting recent developmental theories which stressed the importance to involve the global family system in diagnostic assessment in order to propose an intervention that could best fit to the patient family context

A picture of infant, parents and family peculiarities in a group of families with premature babies.

Introduction: parent-preterm infant relationship is complex, and some relational patterns forecast greater psychological risk than others. Both temperamental infant peculiarities and quality of caregiving (positive parenting and parental stress) seem to be important predictors for later outcomes in preterm infants ,and may be considered as foci for developmental interventions. Aims of the study: (a) to investigate the quality of family interactive dynamics; (b) to draw a picture of the peculiarities of these families in terms of child temperament, self perception of parenting skills and parental stress. In order to analyze these variables we have performed descriptive and correlational statistics. Method: the target group is recruited at S.C.I.A.F. (Padua, Italy) and is composed by 29 families with premature infants. The correct age mean is 23.50 months (SD 13.5) and the chronological age mean is 26.03 months(SD 13.53). At the beginning the families were involved in a psychodiagnostic assessment which included: Lausanne Trilogue Play(Fivaz-Depeursinge & Corboz-Warnery, 1999), Italian Questionnaire of Temperament (Axia, 2002), Family Empowerment Scale (Koren, De Chillo & Friesen, 1992) and Parent Stress Index- Short Form (Abidin, 2008). Results: families'recruitment is still ongoing, then complete results will be available by 2016. From the preliminary analysis on the initial subgroup (6 families) we have noticed that (a) descriptives statistics indicate an appropriate quality of family interactive dynamics; (b) scores about child temperament and parental stress are in line with those of non clinical population. Conclusions: preliminary results indicate the absence of significant peculiarities both in preterm children and parents in terms of variables investigated.Results are discussed for their implications for preventive interventions in families with premature infants in terms of parental support intervention

Alcohol and emotions in adolescence

Background. Alcohol consumption among adolescents is becoming an increasingly widespread phenomenon in Italy, even among the younger population (Italy ranks first in Europa) with consequent negative effects on neurologic and psychic health. Alcohol dependence in adult age seems to be related to the inadequate way emotions and affects are perceived and managed since they are still not mentalized and poorly differentiated from physical states (alexithymia). Although evidence exists of a relationship between alexithymia and alcohol abuse in adults, there are no such studies on an adolescent sample. Objectives. Assess the potential correlation between alcohol consumption, alexithymia and the ability to attribute emotional states to others. Methods. Two samples were used for this study: one comprising high school students enrolled in the province of Padua and the other psychiatric patients affected by a Mixed Disturbance of Emotions and Conduct treated in the neuropsychiatric service of the local Hospital Unit n 16 in Padua. The mean age of adolescents was 15.5 years. Adolescents were given the QASS (Questionario Adolescenti Sabato Sera ), the TAS-20 (Toronto Alexithymia Scale) and the Emotion Attribution Test. Results. Our study seems to confirm some of the data contained in literature, namely that as adolescents get older there is an increase in alcohol consumption and a decrease of alexithymic traits. While studies on adults seem to confirm the relationship between alexithymia and alcohol abuse, in our study results were inverse. With regard to emotional attribution, there was a negative correlation between the former and alcohol consumption in the control group, which did not turn up in the case group, although the latter was significantly less capable to attribute an emotional state to others. Conclusions. This study is a valid preliminary contribution on the theme of adolescents, alcohol consumption and emotions, considering that its scarce visibility in literature. Additionally, from the perspective of its applicability, our study can be used to design preventive interventions which seek to reduce the use of alcohol among adolescents by working on emotional management as a risk factor