Marta Sisti

Contribution of Analyses on Triadic Relationships to Diagnostics and Treatment Planning in Developmental Psychopathology

Recent clinical and theoretical research in the field of developmental psychopathology has focused on the importance of interactions in a child’s development. The literature has investigated how children’s early relationships contribute to the structure and expression of any subsequent psychological problems. The main focus of this pilot study is the application of the Lausanne Trilogue Play paradigm as part of psychodiagnostic assessments to elucidate family functioning in clinical settings. The research aims particularly to observe the characteristics of a family’s interactions in the light of their child’s psychopathological symptoms, based on a sample of 38 families with school-age children referred to a Neuropsychiatry Unit for Children and Adolescents for emotional or behavioral problems. The children’s psychopathological symptoms were assessed by administering the Child Behavior Check List to their parents. Triadic family interactions were observed using the Lausanne Trilogue Play procedure. Statistically significant relationships emerged between the family’s interaction patterns and the child’s externalizing and internalizing problems, suggesting an interdependence between these relational and individual factors in the development of the young person’s psychopathology. The clinical and therapeutic implications of these findings are discussed.

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.

Interactive family dynamics and Non-Suicidal Self-Injury in psychiatric adolescent patients: a single case study

Non-Suicidal Self-Injury (NSSI) is a common, multifaceted phenomenon among adolescents. Recent researchers have shown that a number of psychological and psychiatric correlates are implicated in the onset/repetition of NSSI, but those previous studies did not directly observe the family interaction patterns of this clinical population. In this paper, the quality of family interactions was observed using the Lausanne Trilogue Play procedure to deepen the specific interactive dimensions associated with NSSI in adolescents. The results of a single case study showed a lack of positive emotional exchanges, a parenting style expressing hostility, a high level of control and difficulties in triangulation. Through this method, the authors show that a better understanding of the role of family interactions is crucial and could improve the assessment and treatment of Non-Suicidal Self-Injurious behaviors. Research and clinical implications are discussed.

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 Short Research Article Gatta et al.; INDJ, 4(2): 84-91, 2015; Article no.INDJ.2015.029 85 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.