Fabiola Bizzi

When parenting fails: alexithymia and attachment states of mind in mothers of female patients with eating disorders

Introduction: In recent years alexithymia and attachment theory have been recognized as two parallel research lines trying to improve the information on the development and maintenance of eating disorders (EDs). However, no research has analyzed these constructs among patients’ families. In this study we compared alexithymia and attachment in mothers of patients with EDs and a control group. Further, we hypothesized that mothers of daughters with EDs with insecure and unresolved states of mind will reported high levels of alexithymia. Lastly, we explored the daughters’ evaluations of maternal alexithymia. Methods: 45 mothers of ED women and 48 mothers of healthy controls (N = 93) matched for age and socio-demographic variables were administered by the Toronto Alexithymia Scale-20 (TAS-20) (S), while two sub-groups of “ED” mothers (n = 20) and “non-ED” ones (n = 22) were assessed by the Adult Attachment Interview (AAI). Moreover, the Observer Alexithymia Scale (OAS) was administered to the daughters for evaluating maternal alexithymia. Results: Regarding alexithymia, no differences were found between ED and non-ED mothers according to the TAS-20, while ED mothers showed more unresolved AAI classifications than non-ED mothers. No correlations were found between the TAS-20 and the AAI. Lastly, ED mothers were evaluated more alexithymic by their daughters with the OAS than those in the control group, and their alexithymic traits were significantly correlated with dismissing states of mind (idealization and lack of memory) in the AAIs. Discussion: Our results highlighted an interesting discrepancy among mothers with ED daughters between the low level of alexithymia provided by their self-reports and the high level of alexithymia observed by their daughters, although the OAS showed severe methodological limitations. Maternal attachment states of mind characterized by the lack of resolution of past losses could be connected to a confusing and incoherent quality of parenting.

Children’s mental representations with respect to caregivers and post-traumatic symptomatology in Somatic Symptom Disorders and Disruptive Behavior Disorders

Introduction: In line with literature, the quality of adult–infant interactions and mental representations of the caregivers play an essential role in influencing the children’s well-being. Many studies focused the attention on the role of attachment for a better evaluation of child psychopathological outcomes. The flexibility of the child’s attachment model gives the opportunity to parents to be helped in modifying their own caregiving quality, encouraging the reflection on the children’s state of mind with respect to attachment. The aims of this study were to evaluate: (1) the attachment models in young patients diagnosed with Disruptive Behavior Disorders (DBDs) and Somatic Symptoms Disorders (SSDs); (2) the levels of post-traumatic symptomatology; (3) the association between the attachment models and post-traumatic symptomatology. Methods: Forty Italian patients, aged from 8 to 15, recruited at Gaslini Paediatric Hospital of Genoa, previously diagnosed with SSD (N = 20) and DBD (N = 20) were assessed using the Child Attachment Interview (CAI), the Separation Anxiety Test (SAT), the Trauma Symptom Checklist for Children (TSCC-A). Socio-demographic data were collected. Results: In both the clinical samples, the findings on the distribution of attachment models showed a significant presence of insecure attachment with respect to both parents in more than a half of the patients and high levels of disorganized attachment. No significant differences between DBD and SSD samples were found on post-traumatic symptomatology (Post-Traumatic Stress and Dissociation). Significant differences were found on Depression, Anxiety, and Fantasy subscales. Discussion: This study can provide a detection of dysfunctional aspects in clinical populations. The findings suggest that the quality of the attachment to parents may be a fundamental element to better assess SSD and DBD in children and adolescents. Clinical implications of this study aimed at improving parental caregiving are highlighted.

A Long-Term Psychological Observation in an Adolescent Affected with Gardner Diamond Syndrome.

Gardner-Diamond syndrome (GDS) is an uncommon disease clinically characterized by a wide spectrum of psycho-emotive symptoms associated with painful ecchymoses/purpuric lesions and positivity of auto-erythrocyte sensitization skin test. Herein, a perspective clinical and psychological observation of an adolescent GDS is firstly reported focusing on her psychological features long-term monitored for a 1-year period. The administration of a standardized tools battery allowed us to define psychological features of the young patient over time and to monitored clinical course and response to treatment.

Domestic Violence in Separated Couples in Italian Context: Communalities and Singularities of Women and Men Experiences

Relationship breakdown and separation represent a critical aspect in domestic violence. Few studies have investigated domestic violence in separated couples. Moreover, there is a need for a more in depth analysis of gender differences that could enhance the comprehension of the phenomenon. The primary aim of this research was to analyze, through a qualitative approach, which kinds of domestic violence are characteristic or major in separated couples in the Italian context, where this phenomenon has not yet been sufficiently investigated. Participants are 60 separated couples (mean age: M = 48; F = 44) who attended a Family Mediation Center. A descriptive study was conducted using grounded theory methodology. A brief narrative task was administered to both ex-partners separately. The transcriptions were analyzed using NVivo 11 software. From data analysis, some themes emerged regarding typology of domestic violence specific of the separation context and shared by both men and women. The analyses of gender differences showed that there is a gender specific experience of domestic violence. Results highlight that women narrate both physical and psychological violence, while men relate only psychological abuse focused on limiting access to children. We discuss these findings in relation to possible appropriate gender specific intervention and prevention efforts.

Percorsi individuali e spirituali nella risposta al cancro

The oncological disease represents an interruption of the normal existential path of a subject. The authors, starting from the biopsychosocial model, consider the importance of spirituality and religiosity as a support when facing this difficult experience. Research in this field is included in the psychosocial studies that analyze the way in which subjects react to stressful events. An analysis of the literature shows that religiosity and spirituality affect differently the coping process. Spirituality seems more related to a decrease of anxiety and depression and with more chances to have shared and more realistic choices in the care pathway, while religiosity seems to have less significant impact on the components linked to emotional state and decisions in the care pathway. However, the results of the researches are not univocal and emphasize that this research area needs to be improved, paying particular attention to both constructs and methodological aspects.

PO-0939 Post-traumatic Symptomatology And Attachment Models Among Children And Adolescents With Somatic Symptom Disorders

Background In line with a consistent literature, somatic symptom disorders (having pronounced somatic symptoms without objective somatic signs) in childhood and adolescence have experienced traumatic events, such as physical or sexual abuse, major loss, natural disasters or who have been witnesses to violence. Recent studies are focusing the attention on the role of attachment and post-traumatic symptomatology for a better evaluation of this disorder. Objective The following objectives are set by the present study: 1) to evaluate the post-traumatic stress and related psychological symptomatology in a group of children diagnosed with somatic symptom disorders; 2) to evaluate their attachment models; 3) to test the extent of the association between post-traumatic symptomatology and attachment organisation in somatic symptom disorders. Method Twenty consecutive Italian patients aged from 8 to 15 (m = 11,9; ds = 1,48), previously diagnosed with somatic symptom disorders, were administered the Trauma Symptom Checklist for Children (TSCC-A) and the Child Attachment Interview (CAI). Results Post-traumatic symptomatology, evaluated in 9 subscales, showed clinically significant scores about anxiety, depression and post-traumatic stress; dissociation symptomatology was seen only in 5% of the patients. Insecure attachment was found in more than half of the patients diagnosed with somatic symptom disorders. Conclusions This study suggests that attachment organisation may be a fundamental element to be assessed in the evaluation of somatic symptom disorders in children and adolescents. Finally, methodological limitations restricting causal inferences between attachment and dissociation are discussed.