The permanence of the setting modifications adopted during the covid-19 pandemic in the clinical practice of Italian psychoanalysts.

The research aims to verify if the remote modality, introduced widely by Italian psychoanalysts at the lockdown, remains in clinical practice today, with specific reasons and characteristics. The authors hypothesize that the use of such modality, beyond health limitations, is a point of no return compared to the classical setting. Based on this hypothesis, an ad hoc online questionnaire was proposed; the subjects were also called upon to express an opinion on taleanalysis. Two hundred sixty-seven subjects responded. The results confirm a wide use of remote analysis even in the current situation; they also seem to indicate recognition by psychoanalysts of the emergence of new psychic phenomena in this type of setting, for example, childhood traumas that in the face-to-face analysis were unknown or inelaborate, usable in the treatment process.

A scoping review on innovative methods for personality observation.

Background: Personality's investigation has always been characterized as a central area of research for psychology, such that it was established in the 1920s as an autonomous scientific-disciplinary field. Identifying and observing the people's typical ways of "being in the world" has made possible to define the predictability of a pattern of behavioral responses related both to the possession of distinct characteristics of the agent subject and to specific environmental situations. In the actual scientific landscape, there is a strand of research that makes a description of personality through methodologies and indicators not usually used by psychology, but scientifically validated through standardized procedures. Such studies seem to be significantly increasing and reflect the emerging need to have to consider the human being in his or her complexity, whose existential and personal dimensions can no longer be traced to classification systems that are divorced from the epochal reference. Objective: In this review, attention is focused on highlighting publications in the literature that have included the use of unconventional methods in the study of nonpathological personality, based on the Big Five theoretical reference model. To better understand human nature, an alternative based on evolutionary and interpersonal theory is presented. Design: Online databases were used to identify papers published 2011-2022, from which we selected 18 publications from different resources, selected according to criteria established in advance and described in the text. A flow chart and a summary table of the articles consulted have been created. Results: The selected studies were grouped according to the particular method of investigation or description of personality used. Four broad thematic categories were identified: bodily and behavioral element; semantic analysis of the self-descriptions provided; integrated-type theoretical background; and use of machine learning methods. All articles refer to trait theory as the prevailing epistemological background. Conclusion: This review is presented as an initial attempt to survey the production in the literature with respect to the topic and its main purpose was to highlight how the use of observational models based on aspects previously considered as scientifically uninformative (body, linguistic expression, environment) with respect to personality analysis proves to be a valuable resource for drawing up more complete personality profiles that are able to capture more of the complexity of the person. What has emerged is a rapidly expanding field of study.

A new tool to assess the occurrence of personality traits: the Phenomenological Personality Factor questionnaire.

BACKGROUND: Personality traits are patterns of thoughts, feelings and actions that are usually assessed by means of psychometric questionnaires. In the present study we described the Phenomenological Personality Factor (PPF), a short questionnaire assessing the personality traits, taking into account the different interpretative models of personality. METHODS: A sample of 554 healthy subjects (357 female; 197 males) aged 18-60 years were enrolled. Each participant was required to complete PPF, by indicating the presence/absence of the individual personality trait, and the Italian version of the Affective Neuroscience Personality Scale (ANPS). RESULTS: The principal component analysis showed that seven factors explained the 35.07% of the total variance. Moreover, the correlation analysis revealed that the PPF components were significantly and positively associated with the ANPS scales. CONCLUSIONS: Our findings suggest that the PPF is a useful questionnaire to assess the personality traits, and the adaptive functioning, in healthy individuals.

Exploring the Question: "Does Empathy Work in the Same Way in Online and In-Person Therapeutic Settings?"

Providing remote psychotherapy using technology is a growing practice, especially since the outbreak of the COVID-19 pandemic. Even if in numerous studies video conferencing psychotherapy (VCP) was found to be clinically effective, some doubts continue to exist about how the psychotherapeutic alliance works in the online setting, and the characteristics of the empathic process are still poorly understood. This is an exploratory study aimed at analyzing the degree of empathy between the psychotherapist and client pair, and the degree of support perceived by the client who shall be referred to as the patient interchangeably in this study, comparing the sessions in person with those online, during the current pandemic, in order to discriminate the impact of empathy in the digital setting. The sample analyzed was composed of 23 patients with different severity of pathology engaged in online and in-person therapeutic sessions with five psychotherapists of different theoretical leanings. The scores of the support and empathy scale, obtained by both members of the psychotherapeutic couple in the two settings, were analyzed and compared. The test used belongs to an Italian adaptation of the Empathic Understanding (EU) of the Relationship Inventory. What emerged from comparing the scores was interesting: Unlike the psychotherapists, the patients perceived their therapists as significantly more empathic and supportive in the remote setting. These are rather important data, because the literature documents that client empathic perception measures represent a more accurate measure of the empathic relationship and, in general, can predict a good treatment outcome. Although these results need further investigation, they represent an important contribution in filling the scientific gap in the understanding of digital empathy. Also, this study provides new insights for future research on the characteristics and impact empathy has on the practice of remote psychotherapy.

A sample of Italian psychotherapists express their perception and opinions of online psychotherapy during the covid-19 pandemic.

The covid-19 lockdown forced psychotherapists to use videoconferencing psychotherapy (VCP). There is little literature on the relationship between VCP and the theoretical orientation of the psychotherapist. The aim of our research work is to explore to what extent the Italian therapists used VCP and how they experienced the change in setting during lockdown. A sample of psychotherapists completed an on-line questionnaire including data about any previous experience of remote work, information on changes in setting during lockdown and their opinions on this experience. In the second phase, a statistical analysis of the data collected was performed with SPSS. The most represented theoretical orientations are psychoanalytic, Gestalt, systemic-relational and psychodynamic. Almost all the respondents had chosen to change the setting, opting for remote work via video calls, with no differences in terms of theoretical orientation and age group. Psychotherapeutic orientation seems to affect the type of difficulties encountered. The scientific literature on remote psychotherapy (VCP) so far does not correlate it with any specific theoretical-clinical model. Our research work offers some preliminary hypotheses about potential correlations between setting variations with the theoretical-clinical models.

Lying to patients with dementia: Attitudes versus behaviours in nurses.

BACKGROUND: Using lies, in dementia care, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. OBJECTIVES: In this article, we report results about the attitude and the behaviour of nurses towards the use of lies to patients with dementia. RESEARCH DESIGN: An epidemiological cross-sectional study was conducted between September 2016 and February 2017 in 12 elderly residential facilities and in the geriatric, psychiatric and neurological wards of six specialised hospitals of Italy's Campania Region. PARTICIPANTS: In all, 106 nurses compiled an attitude questionnaire (A) where the main question was 'Do you think it is ethically acceptable to use lies to patients with dementia?', instead 106 nurses compiled a behaviour questionnaire (B), where the main question was 'Have you ever used lies to patients with dementia?' ETHICAL CONSIDERATIONS: Using lies in dementia care, although topic ethically still controversial, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. FINDINGS: Only a small percentage of the interviewed nurses stated that they never used lies/that it is never acceptable to use lies (behaviour 10.4% and attitude 12.3%; p = 0.66). The situation in which nurses were more oriented to use lies was 'to prevent or reduce aggressive behaviors'. Indeed, only the 6.7% in the attitude group and 3.8% in the behaviour group were against using lies. On the contrary, the case in which the nurses were less oriented to use lies was 'to avoid wasting time giving explanations', in this situation were against using lies the 51.0% of the behaviour group and the 44.6% of the attitude group. CONCLUSION: Our results, according to other studies, support the hypothesis of a low propensity of nurses to ethical reflection about use of lies. In our country, the implementation of guidelines about a correct use of lie in the relationship between health operators and patients would be desirable.

A standardized antenatal class reduces the rate of cesarean section in southern Italy: A retrospective cohort study.

Italy, along with Poland and Hungary, has the highest cesarean section rate (35.7%) in Europe. Among Italian regions, Campania has the highest rate of cesarean section (58.4%).We developed a standardized antenatal class to evaluate whether women who attend this class during pregnancy have a lower cesarean section rate. This antenatal class was developed according to the indication of the Italian Ministry of Health and the World Health Organization. We selected a cohort of women who participated in this antenatal class and a cohort of women who did not participate. We collected information on the mode of delivery, and other characteristics, of these women from certificate of birth assistance form available in 2 hospitals where the women gave birth.Among women who participated in the antenatal class, there were more Italians, the women were more educated, more women were employed and there were more primiparas compared with those who did not participate. Non-participants of antenatal class showed a higher rate of cesarean section than those who participated (56.2% vs 23.1%; relative risk [RR] = 2.43; 95% confidence interval [CI] 1.95-3.03; P < .0001), as well as after adjustment for other variables. This difference was stronger in 1 hospital (RR = 2.88; 95% CI 2.13-3.89; P < .0001) than in the other hospital (RR = 1.86; 95% CI 1.36-2.55; P < .0001).Our standardized antenatal class, which was performed in an area with a high rate of cesarean section, significantly reduced this rate, and this was still significant after adjustment for potential confounders.

[Lying in dementia care]. / Mentire nei contesti di cura della demenza.

The indiscriminate use of lying, when communicating with patients with dementia, is questioned in terms of ethics and acceptability. In this article we present the concept of "therapeutic lying", to describe those situations where a "non-truth" is used in the patient's interest and not that of the healthcare professional. The debate is still open, so it is necessary to better clarify risks and benefits of lying in the context of care, both to safeguard patients and to allow healthcare professionals to respect ethical and moral standards.

Can antenatal classes reduce the rate of cesarean section in southern Italy?

BACKGROUND: Among European Countries, Italy has the highest rate of cesarean section (36.8%), and in the Campania region this rate reaches 60.0%. QUESTION: We conducted a retrospective cohort study to evaluate whether participation in antenatal classes during pregnancy reduces the rate of cesarean delivery in southern Italy. METHODS: We selected three local health authorities, with the lowest, the highest, and an intermediate rate of cesarean delivery. The study included 1893 mothers who brought their children for vaccination and were interviewed about their participation in antenatal classes and their obstetric history. FINDINGS: The main causes of cesarean section given in the interview were clinical indications (61.0%), previous cesarean section (31.0%) and woman's request (8.0%). When we excluded emergency cesarean delivery, we found a moderate association between participation in antenatal classes and cesarean section reduction (relative risk=1.27; 95% CI=1.08-1.49; in percentage values from 49.3% to 38.8%). Private hospitals and the two local health authorities with higher baseline rates of cesarean section showed an enhanced reduction of these rates. CONCLUSION: Our paper shows moderate efficacy of antenatal classes, which reduced the occurrence of cesarean section by about 10%. However, the cesarean section rate remained high. As it is possible that different classes have a different level of efficacy, a further study on a standardized model of an antenatal classes is in progress, to assess its efficacy in term of cesarean section reduction, with the purpose of its widespread implementation to the whole region.

[A survey on publicly funded antenatal courses for pregnant women in the Campania region (Italy)]. / Indagine conoscitiva sui Corsi di Accompagnamento alla nascita in strutture pubbliche della regione Campania.

An annual report is published in Campania (Italy) presenting useful data on the characteristics of births in the region, but this does not include information on all aspects of prenatal care. For example, data on availability and utilization of prenatal care services such as antenatal classes is lacking. A questionnaire survey was therefore undertaken by interviewing managers of health districts and local obstetric hospitals that offered antenatal courses. Overall, in the Campania region, 70 publicly-funded courses were offered in the years 2009-2011 but only 8% of women giving birth in the region in 2011 attended antenatal classes . Course characteristics vary considerably with respect to duration, number of meetings, type of information provided and type of healthcare professionals involved. The courses do not appear to be effectively promoted and course hours are incompatible with working women's schedules.

[Dissociative phenomena in a sample of outpatients]. / Fenomeni dissociativi in un campione di pazienti ambulatoriali.

AIM: The study describes the frequency and the quality of dissociative phenomena and their relationship with axis I disorders and the psychopathological severity in outpatients. METHODS: The sample (N=383) was subjected to MINI diagnostic interview and self-assessment scales DES and SCL-90. The data were analysed using SPSS. RESULTS: The 11,0% of subjects has a score ≥20 on DES. The 5,2% has no dissociative symptoms. The absorption images is the most frequent dissociative phenomenon, the less common is the dissociation amnesia. A relationship between dissociative phenomena and conditions unemployment, marital separation and single parties and an inverse relationship with age founded. Dissociative phenomena are more frequent in participants who have been diagnosed at least one axis I disorder and their severity is positively correlated with the number of diagnosed diseases and scores to the General Symptomatic Index. DISCUSSION: Our results point towards the existence of three types of dissociative experiences. The first type, represented by the factor absorption/imaginative involvement, is expressed along a continuum from normal to pathological; a second type, represented by the factor depersonalization/derealization, occurs in a significantly more intense and specific among subjects with axis I disorders; the latest manifestation dissociative, described by the dissociation amnesia, seems to have a predominantly typological feature that qualifies it as an experience not commonly distributed in the general population. The identifying of dissociative symptoms is necessary for the psychopathologic evaluation and to improve the effectiveness of treatment programs.

A dimensional approach to personality disorders in a sample of juvenile offenders / Uma abordagem dimensional a distúrbios de personalidade em uma amostra de menores infratores / Une approche dimensionnelle aux troubles de la personnalité dans un échantillon de mineurs délinquants / Un abordaje dimensional de los trastornos de personalidad en una muestra de delincuentes juveniles

In a sample of 60 male Italian subjects imprisoned at a juvenile detention institute (JDI), psychopathological aspects of the AXIS II were described and the validity of a psychopathological dimensional approach for describing criminological issues was examined. The data show that the sample has psychopathological characteristics which revolve around ego weakness and poor management of relations and aggression. Statistically these psychopathological characteristics explain 85% of criminal behavior.(AU)

Em uma amostra de 60 sujeitos italianos do sexo masculino presos em un instituto de detenção para menores (JDI), descreveram-se os aspectos psicopatológicos do Axis II e examinou-se a validade de uma abordagem de dimensão psicopatológica para a descrição das questões criminológicas. No conjunto, os dados apontam que a amostragem apresenta características psicopatolócas que dizem respeito à debilidade do Ego e a uma má gestão das relações e da agressão. Estatísticamente, essas características psicopatológicas explicam 85% do comportamento criminal.(AU)

Un échantillon de 60 sujets italiens de sexe masculin détenus dans un établissement pénitentiaire pour mineurs (JDI) nous a servi de base pour décrire les aspects psychopathologiques de l'Axe II et pour examiner la validité d'une approche à dimensions psychopathologique pour décrire les questions criminologiques. Dans l'ensemble, les données indiquent que l'échantillon présente des caractéristiques psychopathologiques qui relèvent de la faiblesse de l'ego et de la mauvaise gestion des relations et de l'agression. Statistiquement, ces caractéristiques psychopathologiques expliquent à 85% le comportement criminel.(AU)

En una muestra compuesta por 60 sujetos italianos de sexo masculino encarcelados en un instituto correccional para jóvenes (ICJ), se hizo la descripción de los aspectos psicopatológicos de los trastornos de personalidad (AXIS II) y se examinó la validez del abordaje dimensional psicopatológico para describir las cuestiones criminológicas. Los datos demuestran que la muestra tiene características psicopatológicas que giran alrededor de la debilidad del ego y de gestión deficiente de las relaciones y de la agresión. Estadísticamente, esas caracteristicas psicopatológicas explican el 85% del comportamiento criminal.(AU)

A dimensional approach to personality disorders in a sample of juvenile offenders / Uma abordagem dimensional a distúrbios de personalidade em uma amostra de menores infratores / Une approche dimensionnelle aux troubles de la personnalité dans un échantillon de mineurs délinquants / Un abordaje dimensional de los trastornos de personalidad en una muestra de delincuentes juveniles

In a sample of 60 male Italian subjects imprisoned at a juvenile detention institute (JDI), psychopathological aspects of the AXIS II were described and the validity of a psychopathological dimensional approach for describing criminological issues was examined. The data show that the sample has psychopathological characteristics which revolve around ego weakness and poor management of relations and aggression. Statistically these psychopathological characteristics explain 85% of criminal behavior.

Em uma amostra de 60 sujeitos italianos do sexo masculino presos em un instituto de detenção para menores (JDI), descreveram-se os aspectos psicopatológicos do Axis II e examinou-se a validade de uma abordagem de dimensão psicopatológica para a descrição das questões criminológicas. No conjunto, os dados apontam que a amostragem apresenta características psicopatolócas que dizem respeito à debilidade do Ego e a uma má gestão das relações e da agressão. Estatísticamente, essas características psicopatológicas explicam 85% do comportamento criminal.

Un échantillon de 60 sujets italiens de sexe masculin détenus dans un établissement pénitentiaire pour mineurs (JDI) nous a servi de base pour décrire les aspects psychopathologiques de l'Axe II et pour examiner la validité d'une approche à dimensions psychopathologique pour décrire les questions criminologiques. Dans l'ensemble, les données indiquent que l'échantillon présente des caractéristiques psychopathologiques qui relèvent de la faiblesse de l'ego et de la mauvaise gestion des relations et de l'agression. Statistiquement, ces caractéristiques psychopathologiques expliquent à 85% le comportement criminel.

En una muestra compuesta por 60 sujetos italianos de sexo masculino encarcelados en un instituto correccional para jóvenes (ICJ), se hizo la descripción de los aspectos psicopatológicos de los trastornos de personalidad (AXIS II) y se examinó la validez del abordaje dimensional psicopatológico para describir las cuestiones criminológicas. Los datos demuestran que la muestra tiene características psicopatológicas que giran alrededor de la debilidad del ego y de gestión deficiente de las relaciones y de la agresión. Estadísticamente, esas caracteristicas psicopatológicas explican el 85% del comportamiento criminal.