The aesthetic and affective matrix of pre-reflective sensemaking at the origins of the relationship between subject and world: A dialogue between Kant's Third Critique and psychoanalysis.

The authors discuss the relevance of aesthetic and affective experience at the heart of the human being's capability to relate to the world and to found relations of sense. Faced with anguish that the world can be meaningless and with fear of uncertainty/chaos, trust and hope are needed for the world to be a hospitable place for existence. Such experience is aesthetic, sensitive and affective before being rational, reflective and deliberative. Through a dialogue between Kant, Winnicott and Bion, it is shown how foundation of trust is based on two essential aspects: (1) The illusion that reality was created to allow us to live in it (namely, the fictionality is a prerequisite for each possible development of psyche) and (2) this illusion is not generated by a solipsistic activity of the human mind; rather, it is made possible starting from the primordial relationship with the other, by containing anguish, nourishing trust and hope, and supporting psychic development and elaboration of progressive forms of symbolisation. The authors discuss how these points have a profound aesthetic implication through deepening the reflection on the ontogenetic development of the psyche, the complex intertwining between primary and secondary processes, and clinical implications.

Beyond Therapeutic Adherence: Alternative Pathways for Understanding Medical Treatment in Type 1 Diabetes Mellitus.

Given the psychosocial and economic costs of behaviors of patients who seem not to benefit from the medications, technologies, and medical therapies available for chronic diseases such as Type 1 Diabetes Mellitus, therapeutic adherence has been identified as one of the main focuses in the intervention. This paper presents contributions from semiotic cultural clinical psychology for understanding problems associated with the implementation of medical treatment in patients with Type 1 Diabetes Mellitus to explore psychological dimensions not yet reported in depth. A narrative review of 24 scientific articles published between 2012 and 2023 is carried out. The information is produced through thematic analysis, and the results are presented in three themes: 1. illness characteristics, 2. adherence and associated concepts, and 3. modes of intervention. It concludes with the development of a two-axis proposal for understanding the experience of patients that privileges psychological aspects involved in the disease and its treatment, considering the approach to the goals of treatment as dynamic and fluctuating rather than as final states.

Parental Quality of Life and Impact of Multidisciplinary Intervention for Children with Autism Spectrum Disorders: A Qualitative Study.

The presence of a child with Autism Spectrum Disorder (ASD) in the family can have a negative impact on parental Quality of Life (QoL), but evidence on how treatments for children with ASD can affect parental QoL is currently limited. In this qualitative study, we develop a semi-structured interview in order to investigate the impact of ASD on the QoL of mothers and fathers from a subjective perspective, as well as the effect of the intervention on their QoL and adjustment process. The sample consisted of 31 parents of children with ASD severity 2 or 3, aged 5 to 11 years, undergoing a multidisciplinary intervention. In order to identify emerging themes from the interview transcripts, a Thematic Analysis was conducted using a bottom-up approach. We identified three main themes relating to parental QoL (ASD impact on QoL, useful external resources, QoL improvement-related factors) and five themes relating to parents' views on the intervention (positive impact on parent, dissatisfaction with previous interventions, parental involvement, useful features, critical issues). The results provide indications of the process of parental adaptation and the components of interventions that foster an improvement in their QoL. In conclusion, living with a child with ASD can have a significant influence on a parents' QoL, not just physically and emotionally, but also in terms of general goals, family structure, and social interactions.

Parental quality of life, child adjustment and adult attachment in parents of children and adolescents with Autism Spectrum Disorder.

BACKGROUND: Parents of children and adolescents with Autism Spectrum Disorder (ASD) may experience a lower quality of life (QoL) than parents of offspring with typical development. However, factors associated with parental QoL are not yet fully understood. AIMS: This study aimed to investigate the relationships between parental QoL, child adjustment and adult attachment among parents of children and adolescents with ASD. METHODS AND PROCEDURES: One hundred and eighty-eight parents of children and adolescents diagnosed with ASD completed a group of self-report questionnaires on sociodemographic variables, QoL (i.e., overall QoL and ASD symptoms-related parental QoL), child adjustment (i.e., offspring's total problems and prosocial behaviors) and adult attachment. OUTCOMES AND RESULTS: Structural equation modeling revealed that the overall parental QoL was negatively related to children's total problems and positively associated with prosocial behaviors, as well as with higher levels of secure attachment and lower levels of fearful attachment styles. Additionally, ASD symptoms-related parental QoL was negatively associated with the offspring's total problems. CONCLUSIONS AND IMPLICATIONS: This suggests that child characteristics may interact with parental characteristics to either enhance or compromise the QoL of parents of children and adolescents with ASD. Implications of these findings for promoting parental QoL are discussed.

Viktor von Weizsäcker's Gestaltkreis Theory. The Dynamic and Subjective Relationship of Perception and Movement.

The paper presents Victor von Weizsäcker's theory of Gestaltkreis (i.e. 'circle of form'), which offers an original theoretical contribution. It is rich of fruitful stimuli for understanding the relationship of the living organism with its environment, recognizing a dynamic unity between perception and the movement. The paper first provides some biographical, scientific and clinical professional life elements of Viktor von Weizsäcker, then it presents the dynamic theory of Gestaltkreis with its principles and key elements, and finally discusses the epistemological and methodological implications. Von Weizsäcker's Gestaltkreis theory - systematically published in 1939 - represents the effort of a theoretical synthesis of the experiments conducted in the field of neurology, of studies of perception and voluntary movement. It is based on the complementary and simultaneous unity of perception and movement, and it establishes a substantial contribution against the mechanism of physiology, by overcoming the notion of automatic reflex. Such a theory consolidates von Weizsäcker's systematic commitment to his epistemological, methodological and ethical project for the 'introduction of the subject in the biological sciences'.

Viktor von Weizsäcker's Notion of Pathic: Affective Liminality, Modalization of Experience and Illness.

The work presents and discusses Viktor von Weizsäcker's notion of pathic. This concept developed over the course of thirty years represents the culmination of his theoretical thought. The pathic (das Pathische) is closely related to the meaning of 'pathological' and to the meaning of 'suffering'. Yet the pathic does not designate neither a condition of mere illness nor a condition of passivity. Pathic can be considered as the essential nature of the becoming in contrast with the ontic existence. The pathic assumes the changing form of five modal expressions ('will', 'can', 'may', 'shall' and 'must'). The pathic refers the way through which the liminal relationship of the living being with the world and its becoming is expressed. Life is a modal tension between the coming into the world and the coming out of it, so the pathic is the mutable subjective form of this tension. The pathic is the core notion at basis of the foundation of a new medical anthropology where the intersubjective doctor-patient relationship is of the most importance.

What Adolescents Have to Say about Problematic Internet Use: A Qualitative Study Based on Focus Groups.

In this paper, the study presented is designed to gain a deeper insight into how adolescents describe, understand, and suggest dealing with Problematic Internet Use (PIU). Eight focus groups were activated with a total of 70 students from the 9th and 11th grades (Mean Age = 15.53 ± 1.202; Female = 44.4%) in four different schools in Southern Italy. A Thematic Analysis was applied to the verbatim transcripts, and seven macro-categories were identified throughout the discourses collected: definition of PIU, symptomatology, impact, determinants, intervention strategy, opportunities and limits of the digital world, and needs that adolescents try to satisfy by surfing the net and which the offline world does not fulfill. Participants converge in seeing PIU in terms of addiction but adopt heterogeneous viewpoints in talking about the reasons for problematic engagement and possible preventive intervention strategies. In the overall picture emerging from the responses, PIU appeared to be the outcome of a psychological dynamic emerging from the interaction of individual, interpersonal, and sociocultural dimensions.

The Relationships between Compulsive Internet Use, Alexithymia, and Dissociation: Gender Differences among Italian Adolescents.

Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person's functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than females. People can use the internet to avoid or alleviate negative affects; in fact, problematic internet use is associated with alexithymia and dissociation. Few studies have focused on the different stages of adolescence, gender differences, and the relationships between the aforementioned variables. This research aims to fill this gap. Five hundred and ninety-four adolescents aged between 13 and 19 filled in the Compulsive Internet Use Scale, the Toronto Alexithymia Scale, the Adolescents Dissociative Experiences Scale, and other ad hoc measures. Surprisingly, females reported higher compulsive internet use compared with males. Moreover, they referred more difficulties/symptoms and greater levels of alexithymia than males. No differences across the stages of adolescence were found. Different strengths in the relationships between variables were found according to gender. Moderated mediation analyses indicated that dissociation is an important mediator in the relation between alexithymia and Compulsive Internet Use only among females. This study shed new light on gender differences around problematic internet use and some related risk factors, in order to identify and develop prevention and treatment programs to face this topical and relevant issue.

A Theoretically Informed Critical Review of Research Applying the Concept of Liminality to Understand Experiences with Cancer: Implications for a New Oncological Agenda in Health Psychology.

Liminality was described more than 20 years ago as a major category explaining how cancer is experienced. Since then, it has been widely used in the field of oncology research, particularly by those using qualitative methods to study patient experience. This body of work has great potential to illuminate the subjective dimensions of life and death with cancer. However, the review also reveals a tendency for sporadic and opportunistic applications of the concept of liminality. Rather than being developed in a systematic way, liminality theory is being recurrently 're-discovered' in relatively isolated studies, mostly within the realm of qualitative studies of 'patient experience'. This limits the capacity of this approach to influence oncological theory and practice. In providing a theoretically informed critical review of liminality literature in the field of oncology, this paper proposes ways of systematizing liminality research in line with a processual ontology. In so doing, it argues for a closer engagement with the source theory and data, and with more recent liminality theory, and it sketches the broad epistemological consequences and applications.

Giving Meaning to Non-Communicable Illness: Mixed-Method Research on Sense of Grip on Disease (SoGoD).

When people receive a diagnosis of chronic or non-communicable disease, they need to reorganize their lives to understand and accommodate the changes associated with the new health condition. This reorganization, which involves the activation of a process through which meaning is given to the illness, could be fostered by narrative methods also in the context of Primary Care. The Sense of Grip on Disease (SoGoD) model intends to focus on the role of sense-meaning-making processes in the psychological adjustment to non-communicable illness, emphasizing the patients' role in managing their own health condition. In this study, the authors propose a mixed-method research method which implies the adaptation of the narrative interview on the Sense of Grip on Disease. The interview was administered to 31 adults suffering from non-communicable diseases and has been analyzed with a theory-driven approach, which aims to explore the modalities of five narrative functions: organization of temporality, integration of illness, expression of emotions, social sharing and orientation to action. Through a Multiple Correspondence Analysis and a Cluster Analysis, the authors have identified two different 'Grip Profiles', called "Dynamic Profile" and "Compliant Profile", representative of different degrees of flexibility, integration and adjustment to disease.

The Role of Affective Sensemaking in the Constitution of Experience. The Affective Pertinentization Model (APER).

The paper outlines a model of the basic cognitive process of the constitution of experience - the Affective Pertinentization Model (APER). The constitution of experience is intended as the basic cognitive process underpinning the meaning-maker's experience of mental representations as self-contained, stable, substantive entities standing for something in the external reality. Framed within the general family of theories highlighting the embodiment of cognition, the APER model claims that affects are the basic mechanism at the basis of the constitution of human experience. The first part of the paper outlines the APER model; the second part reviews some preliminary evidence supporting it.

The experience of living with a chronic disease in pediatrics from the mothers' narratives: The Clinical Interview on Parental Sense of Grip on the Disease.

The Clinical Interview on the Sense of Grip on Chronic Disease has been administered to 68 mothers of children affected by Hereditary Angioedema (C1-Inh HAE), Type 1 Diabetes (T1D), Juvenile Rheumatoid Arthritis (JRA). The objectives are to detect general features of the experience of parenting children with chronic illness as well as the specificities of this experience related to the different conditions. Four Profiles of Sense of Grip were identified: Adempitive, Controlling, Reactive, Dynamic. The Sense of Grip Interview is an effective clinical tool for understanding the characteristics of the disease in daily life, which can help clinicians to encourage family adjustment to disease.

The Semiotic Paradigm in Psychology. A Mature Weltanschauung for the Definition of Semiotic Mind.

The author discusses the relevance of the semiotic perspective for the psychological studies in order to deal with some critical issues. In the view of the author, the presumed weakness of psychology, its difficult to be acknowledged among hard sciences, and the lack of worldwide acceptance of its constructs cannot be solved by an evolutionary perspective that risk to cut off many relevant features of living beings and human beings as well. The core of the issue remains untouched. Assuming a wide semiotic paradigm, the mind can be considered a situated, recursive and contextual process of sensemaking engaged in articulating a flow of signs. The process of semiotic mediation is a crucial point at stake: the use of signs is not only to refer/point something or to communicate a message in coded forms, but it is to create models of world in order to think, to act and to share experiences. By a wide range of semiotic processes (iconic, indexical, symbolic), each living specie create its own world. Continuities and discontinuities with humang beings are presented and discussed.

The Semiotic Construction of the Sense of Agency. The Modal Articulation in Narrative Processes.

The sense of agency is an ongoing process of semiotic construction of the action starting from the affective, cognitive, intersubjective and cultural matrix of experience. A person narratively constructs the sense of her agentive experience and in doing so does not refer exclusively to the "what", but also to the "how". There is always a specific "modus" to experience one's own action. We present the psychological notion of the Modal Articulation Process (MAP), namely the way through which a person orients and configures in a contextual frame the sense of her actions by means of modal operators of necessity, possibility, impossibility, contingency, but also knowledge, will, capability, constrain and opportunity. The notion of Modal Articulation Process is proposed as a semiotic, dynamic and recursive process that articulates narratively many aspects of the agency: the relational positionings and the way of experiencing them, the constraints and the resources present in the socio-symbolic context, the inherent temporality of every human phenomenon. Although the study of modal operators has an ancient and solid tradition of research in the fields of modal logics, analytical philosophy and narrative semiotic disciplines as well, yet in the field of the psychological sciences - except for a few authoritative isolated cases (Kurt Lewin, Rom Harrè, Jaan Valsiner) - there is not a great deal of attention on the relevance of these symbolic devices and their function in constructing the sense of action in a narrative way. Indeed modal articulation processes are at stake both during daily common routines and during exceptional turning point experiences that request a reconfiguration of the sense of one's own agency (e.g. the experiences of illness demand a new modal re-articulation). Our discussion is aimed at deepening and developing the notion of modal articulation, its functions and its specificities.

Emotional processes and stress in children affected by hereditary angioedema with C1-inhibitor deficiency: a multicenter, prospective study.

BACKGROUND: Hereditary angioedema with C1-inhibitor deficiency (C1-INH-HAE) is characterized by recurrent edema of unpredictable frequency and severity. Stress, anxiety, and low mood are among the triggering factors most frequently reported. Impaired regulation and processing of emotions, also known as alexithymia, may influence outcomes. The aim of this study was to confirm the presence of alexithymia and stress in children with C1-INH-HAE, to determine whether they are also present in children affected by other chronic diseases, and to investigate their relationship with C1-INH-HAE severity. Data from children with C1-INH-HAE (n = 28) from four reference centers in Italy were compared with data from children with type 1 diabetes (T1D; n = 23) and rheumatoid arthritis (RA; n = 25). Alexithymia was assessed using the Alexithymia Questionnaire for Children scale; perceived stress was assessed using the Coddington Life Event Scale for Children (CLES-C). RESULTS: Mean age (standard deviation [SD]) in the C1-INH-HAE, T1D, and RA groups was 11.8 (3.3), 11.7 (2.9), and 11.1 (2.6) years, respectively. Mean C1-INH-HAE severity score was 5.9 (2.1), indicating moderate disease. Alexithymia scores were similar among disease groups and suggestive of difficulties in identifying and describing emotions; CLES-C scores tended to be worse in C1-INH-HAE children. C1-INH-HAE severity was found to correlate significantly and positively with alexithymia (p = 0.046), but not with perceived stress. Alexithymia correlated positively with perceived stress. CONCLUSIONS: Alexithymia is common in children with chronic diseases. In C1-INH-HAE, it may result in increased perceived stress and act as a trigger of edema attacks. Comprehensive management of C1-INH-HAE children should consider psychological factors.

Psychological Functions of Semiotic Borders in Sense-Making: Liminality of Narrative Processes.

In this paper we discuss the semiotic functions of the psychological borders that structure the flow of narrative processes. Each narration is always a contextual, situated and contingent process of sensemaking, made possible by the creation of borders, such as dynamic semiotic devices that are capable of connecting the past and the future, the inside and the outside, and the me with the non-me. Borders enable us to narratively construct one's own experiences using three inherent processes: contextualization, intersubjective positioning and setting of pertinence. The narrative process - as a subjective articulation of signs in a contingent social context - involves several functions of semiotic borders: separation, differentiation, distinction-making, connection, articulation and relation-enabling. The relevant psychological aspect highlighted here is that a border is a semiotic device which is required for both maintaining stability and inducing transformation at the same time. The peculiar dynamics and the semiotic structure of borders generate a liminal space, which is characterized by instability, by a blurred space-time distinction and by ambiguities in the semantic and syntactic processes of sensemaking. The psychological processes that occur in liminal space are strongly affectively loaded, yet it is exactly the setting and activation of liminality processes that lead to novelty and creativity and enable the creation of new narrative forms.

Borders and Modal Articulations. Semiotic Constructs of Sensemaking Processes Enabling a Fecund Dialogue Between Cultural Psychology and Clinical Psychology.

The notion of the border is an interesting advancement in research on the processes of meaning making within the cultural psychology. The development of this notion in semiotic key allows to handle with adequate complexity construction, transformation, stability and the breakup of the relationship between person/world/otherness. These semiotic implications have already been widely discussed and exposed by authors such Valsiner (2007, 2014), Neuman (2003, 2008), Simão (Culture & Psychology, 9, 449-459, 2003, Theory & Psychology, 15, 549-574, 2005, 2015), with respect to issues of identity/relatedness, inside/outside, stability/change in the irreversible flow of the time. In this work, after showing some of the basics of such semiotic notion of border, we discuss the processes of construction and transformation of borders through the modal articulation, defined as the contextual positioning that the person assumes with respect to the establishment of a boundary in terms of necessity, obligation, willingness, possibility, permission, ability. This modal subjective positioning acquires considerable interest from the clinical point of view since its degree of plasticity vs that of rigidity is the basis of processes of development or stiffening of relations between person/world/otherness.

The Idiographic Approach in Psychological Research. The Challenge of Overcoming Old Distinctions Without Risking to Homogenize.

In this paper I discuss the relevance of the single-case approach in psychological research. Based upon work by Hurtado-Parrado and López-López (Integrative Psychological and Behavioral Science, 2015), who outlined the possibility that Single-Case Methods (SCMs) could be a valid alternative to Null Hypothesis Significance Testing (NHST), I introduce the idiographic approach (Salvatore and Valsiner Theory & Psychology, 20(6), 817-833, 2010; Valsiner Cultural & Psychology, 20(2), 147-159, 2014; Salvatore Culture & Psychology, 20(4), 477-500, 2014) based on the logic of abductive generalization, rather than the logic of inductive generalization. I present the theoretical, epistemological and methodological assumptions that this approach proposes; in particular, I discuss the re-conceptualization of some now obsolete rigid opposition, the inconsistency of sample use in psychological research, the relationship between uniqueness and general, the relationship between theory and phenomena, and finally the validation process.