Eye Movement Desensitization and Reprocessing (EMDR) as a Possible Evidence-Based Rehabilitation Treatment Option for a Patient with ADHD and History of Adverse Childhood Experiences: A Case Report Study.

BACKGROUND: Children with Attention Deficit Hyperactivity Disorder (ADHD) having a history of adverse childhood experiences (ACEs) could be very difficult to treat with standard psychotherapeutic approaches. Some children diagnosed with ADHD may have Post-Traumatic Stress Disorder (PTSD) or have had experienced a significant traumatic event. Trauma and PTSD could exacerbate ADHD core symptoms and be a risk factor of poor outcome response. OBJECTIVE: to report for the first time the history of a patient with ADHD and ACE successfully treated with an EMDR approach. CONCLUSION: EMDR could be a promising treatment for ADHD children with a history of traumatic experiences in addition to pharmacological treatments.

Integrating Psychophysiology within Clinical Practice: A Pilot Cross-sectional Study on Prodromal Symptoms of Schizophrenia, Emotion Regulation, and Personality Functioning.

OBJECTIVE: To investigate the association between prodromal symptoms of schizophrenia, autonomic activity, and personality functioning. METHOD: 10 adolescents underwent semi-structured interviews assessing prodromal symptoms of schizophrenia and personality functioning. Cardiac activity was recorded at baseline, during the clinical interviews, and at recovery to assess concurrent changes in autonomic functioning. RESULTS: During the assessment of prodromal symptoms of schizophrenia, participants increased sympathetic activation compared to the recovery condition, and reduced vagal activation compared to the assessment of interpersonal functioning. CONCLUSIONS: The findings highlight the importance of integrating the autonomic assessment in clinical psychiatric and psychological practice.

Trauma e vulnerabilità nei migranti richiedenti protezione internazionale / Trauma and vulnerability in international protection migrant seekers

INTRODUZIONE: I rifugiati richiedenti protezione internazionale mostrano un'alta vulnerabilità e Disturbo Post-Traumatico da Stress (PTSD). OBIETTIVI: abbiamo utilizzato un approccio integrato multidisciplinare per valutare la loro vulnerabilità e psicopatologia. METODI: sono stati valutati 180 rifugiati politici secondo i criteri del DSM-IV-TR. RISULTATI: in un'alta percentuale di rifugiati politici la diagnosi principale è stata di PTSD associata con disturbi di personalità e/o altri disturbi psichici. CONCLUSIONI: i rifugiati politici hanno più difficoltà nel gestire le proprie emozioni, questo probabilmente è dovuto alla propria storia personale intrisa di vissuti traumatici, tuttavia attraverso un lavoro sia psicoterapico che farmacologico è stato possibile migliorare le proprie condizioni.(AU).

INTRODUCTION: The refugee international protection seekers show high vulnerability and Post-Traumatic Stress Disorder (PTSD). OBJECTIVES: We used an integrated multidisciplinary approach to assess their vulnerability and psychopathology. METHODS: 180 refugees were assessed according to the criteria of the DSM-IV-TR. RESULTS: in a high percentage of political refugees the primary diagnosis of PTSD was associated with personality disorders and/or other mental disorders. CONCLUSION: Political refugees have more difficulty managing their emotions, this is probably due to one's personal history steeped in traumatic experiences, however, through a work both psychotherapeutic and pharmacological, it was possible to improve their conditions.(AU).

Health care for immigrant women in Italy: are we really ready? A survey on knowledge about female genital mutilation.

BACKGROUND: Because of immigration, female genital mutilation (FGM) is an issue of increasing concern in western countries. Nevertheless operators without a specific training may ignore the health condition of women subjected to this practice and fail to provide them adequate assistance. The purpose of the study was to estimate the current knowledge about FGM among social and health care assistants working with asylum seeker. MATERIAL AND METHODS: From October to December 2012, a questionnaire was used to interview 41 operators working in CARA (Shelter for Refugees and Asylum Seekers) in central and southern Italy. RESULTS: Only 7.3% of respondents states to know well FGM, while 4.9% do not know it at all. 70.7% declare to have never met or assisted a woman with FGM, nevertheless all respondents work with asylum seeker from countries where FGM are performed. CONCLUSIONS: Migration fluxes to Italy over the past decade created a healthcare challenge: women with FGM have specific medical and psychological problems that doctors, nurses and social assistants without specific training are not usually able to manage.

Identity and eating disorders (IDEA): a questionnaire evaluating identity and embodiment in eating disorder patients.

BACKGROUND: In this paper we tested the hypothesis that persons with eating disorders (EDs) are affected by disturbances of the way they experience their own body (embodiment) and shape their personal identity, assuming that the various kinds of anomalies of eating behavior are consequences thereof. SAMPLING AND METHODS: We developed and validated a new self-reported questionnaire named IDEA (IDentity and EAting disorders), which was administered to 147 ED patients and 187 healthy controls. Test-retest reliability, internal consistency, psychopathological correlates, and concurrent validity were evaluated. A factor analysis was performed to verify the distribution of items into subscales. RESULTS: The questionnaire showed good test-retest reliability, and internal consistency. IDEA scores were specifically associated with ED psychopathology, and they did not show any correlation with sociodemographic and general clinical variables. Four factors were extracted, which were related to the following phenomena: 'feeling oneself only through the gaze of the other and defining oneself only through the evaluation of the other', 'feeling oneself only through objective measures', 'feeling extraneous from one's own body', and 'feeling oneself through starvation'. CONCLUSIONS: IDEA represents a multidimensional, brief, versatile, easy-to-perform instrument for clinical evaluation, assessing abnormalities in lived corporeality, and of personal identity, which appeared to be specifically associated with the core features of ED psychopathology. The main limitations of the study are the cross-sectional design. Also, it is impossible to ascertain whether the domains we assessed are specific traits of patients with EDs, or state-related features. To answer this question, a longitudinal study is needed.

The body as a simulacrum of identity: the subjective experience in the eating disorders.

This study aims at better understanding the subjective experience, the so-called Erlebnis, in individuals diagnosed with Eating Disorders (ED). We shall highlight the particular way in which people with such disorders perceive their own bodies and specifically how they perceive their bodies in the presence of other people. To this end we shall analyze the subjective experience by means of two concepts as described by French philosopher Jean-Paul Sartre: "body-self" and "body-forothers". Our hypothesis is that some people suffering from eating disorders, especially those with a diagnosis of Eating Disorders Not Otherwise Specified (EDNOS), experience their body mainly as body-for-others. Rather than a diagnostic category, EDNOS could be conceived as an anthropological configuration vulnerable to ED. Eating disorders appear as an "identity disorder" characterized by a suspension of the experiential polarity between self and other-than-self.

Relating with migrants: ethnopsychiatry and psychotherapy.

After an historical review of cultural anthropology, transcultural psychiatry and ethno psychiatry, we will examine the literature on intervention with migrants within mental health system. In the first part, we will consider the therapeutic relationship with Arab-Muslim patients and look at specific issues such as gender differences, individualism, sociality, stigma, religion. The second part will be focused on cultural mediation, migration and family intervention and post-traumatic stress disorder and, finally, the experience of being a foreign therapist. Conclusions will discuss the importance of culture, individuality and universality of human suffering, when treating a foreign patient.