Cinzia Guarnaccia

Environmental factors that distinguish between clinical and healthy samples with childhood experiences of abuse and neglect

Background: Childhood maltreatment is associated with a wide range of problems in adulthood. However, specific environmental factors (either positive or negative) influence mental health outcomes in maltreated children. The present study investigated the effect of environmental factors by comparing a group of clinical participants with experiences of abuse/neglect with a healthy group with similar patterns of experiences. Environmental factors selected were: separation from parents, financial hardship, parental psychiatric disorders, and low social involvement. Method: The study included 55 mixed clinical participants and 23 healthy participants. All participants were investigated using the Childhood Experience of Care and Abuse (CECA) interview. The two groups were specifically matched with regard to patterns of childhood maltreatment. Results: The findings indicated that psychopathological outcome was associated with a greater presence of negative environmental factors (p < 0.001). In particular, lack of social support seemed to be the only one predictor (OR = 27.86). Conclusion: This study is the first to investigate the influence of specific environmental factors in two groups with similar childhood experiences of abuse/neglect but different mental health outcomes. These findings suggest that efforts should be made to incorporate both familial and external sources of social support in promoting mental health for maltreated children.

Dipendenza da sostanze ed esperienze sfavorevoli infantili: uno studio empirico condotto con la Childhood Experiences of Care and Abuse Interview (CECA)

Numerose ricerche rilevano l’impatto che esperienze sfavorevoli infantili possono avere sulla dipendenza da sostanze. 32 tossicodipendenti maschi in trattamento presso comunita e 32 soggetti appartenenti a un gruppo non clinico sono stati intervistati attraverso la Childhood Experience of Care and Abuse (CECA). La maggior parte dei soggetti del gruppo clinico ha esperito maggiori esperienze (p < 0.05) di negligenza, abuso fisico e psicologico, e ha ricevuto forme piu inadeguate di supervisione e disciplina. Inoltre, i soggetti del gruppo clinico sono stati esposti a un numero piu elevato (p = 0.01) di esperienze sfavorevoli. I risultati suggeriscono la presenza di specifiche forme di abuso e maltrattamento legate allo sviluppo di dipendenza da sostanze.

Does Childhood Psychological Abuse Contribute to Intimate Partner Violence Victimization? An Investigation Using the Childhood Experience of Care and Abuse Interview

Although psychological abuse is recognized as a particularly insidious form of child abuse, research on the impact of this type of abuse related to intimate partner violence (IPV) is scant. This study examined the contribution of childhood psychological abuse to IPV in female victims and non-victims. Furthermore, it investigated the role of cumulative abuse in predicting IPV. The study included 38 women victims of IPV and 40 non-IPV women. All participants were investigated using the Childhood Experience of Care and Abuse Interview (CECA); the Revised Conflict Tactics Scale (CTS2) and the IPV History Interview were used to assess IPV in the last year and lifetime, respectively. Results indicated that psychological abuse was a stronger predictor of IPV than other maltreatment types. Furthermore, dose-response effects of cumulative abuse on IPV are well evidenced. Future research should continue examining impacts of psychological abuse on IPV so as to further inform clinical practice and intervention planning.

Environmental Dysfunctions, Childhood Maltreatment and Women’s Intimate Partner Violence Victimization

Childhood maltreatment is considered a crucial explanatory variable for intimate partner violence (IPV) in adulthood. However, a developmental multifactorial model for the etiology of IPV is not shared by researchers yet. This study has investigated the role of a wide range of childhood maltreatments and family and social dysfunctions in predicting IPV; furthermore, it tests a model where childhood maltreatment mediates the relationship between environmental dysfunctions and IPV. The sample included 78 women: IPV (38) and non-IPV (40). The Italian version of the Childhood Experience of Care and Abuse (CECA) Interview was used to assess the presence of adverse childhood experiences. The Revised Conflict Tactics Scale (CTS-2) and the IPV History Interview were used to assess IPV in the last year and lifetime, respectively. The results of a multivariate logistic regression model have indicated that only sexual (odds ratio [OR] = 4.24) and psychological (OR = 3.45) abuse significantly predicted IPV; with regard to association between IPV and environmental dysfunctions, only poor social support (OR = 8.91) significantly predicted IPV. The results of a mediation model have shown that childhood psychological and sexual abuse, in association with each other, partially mediate the relationship between poor social support and IPV. The findings from this study pinpoint poor social support as an important predictor of IPV so far neglected in the literature on the developmental antecedents of IPV. They also support the theoretical assumption according to which dysfunctional environmental variables and types of childhood maltreatment interacting with each other may influence development outcomes.

The patient-physician relationship in the face of oncological disease: A review of literature on the emotional and psychological reactions of patients and physician

The Cancer diagnosis, as Cianfarini (2007) affirmed, often arrives like “a bolt from the blue” that puts a strain on the search for a relational continuity and is substantiated such an extremely difficult time which nobody is prepared for. It represents a very stressful event for both patient and physician, albeit with a different emotional: for the patient it represents an existential challenge that destabilizes all his own certainties and his life’s features like, for example, the relationship with his body, with his feelings and the meaning given up to them, to suffering, disease and death. On the other hand, instead, physician feels suffocated by the unremitting requests of patients and the responsibilities he is not sometimes able to hold up because of his own personal, technical and scientific limits with consequent frustrations and demotivation. This confirms the truth of results of many researches, that in recent years showed how to consider the cancer in its own complexity is important, not only being limited to the analysis of biological factors, but considering it as a disease involving both psyche and body. Therefore, it requires a multidisciplinary approach that is able to assess its different features and implications. A good physician-patient relationship depends on the physician’s ability to demonstrate a clinical expertise that is not limited only Acta Medica Mediterranea, 2016, 32: 1827