Children's total blindness as a risk factor for early parent-child relationships: preliminary findings from an Italian sample.

Background: Vision provides crucial information for parent-child attunement that scaffolds social development from the first months of life. Congenital blindness might affect both parental wellbeing and children's behavior during parent-child interaction. In this study, we compared families of young children with total versus partial blindness to understand the link between residual vision, parenting stress and perceived social support, and children's behavior during parent-child interaction. Methods: Participants were 42 white parents (21 fathers and 21 mothers) and their congenitally blind children (14 females, mean age = 14.81 months, SD = 10.46) with no co-occurring disability, recruited at the Robert Hollman Foundation rehabilitation centers in Italy. Parents' scores on the Parenting Stress Index and Multidimensional Scale of Perceived Social Support questionnaires, as well as children's behaviors signaling joint engagement during video-recorded episodes of parent-child interaction, were compared between the Total Blindness (TB, n = 12 children with no light perception or light perception in the dark but no quantifiable visual acuity) and Partial Blindness (PB, n = 9 children with a residual visual acuity below 3/60) groups. Results: We found that parents of TB children had higher parenting stress and lower perceived social support scores than parents of PB children. In fathers, total stress and stress linked to perceiving the child as difficult negatively correlated with perceived support from friends. There was no difference in the time TB and PB children spent displaying joint engagement behaviors during parent-child interaction. However, TB children directed their gaze and face less often toward their parents than PB children. We observed a trend of association between this behavior and maternal stress. Conclusion: These preliminary results suggest that the complete absence of vision from birth has adverse effects on stress linked to parenting and parental perceived social support. These findings support the importance of early family-centered interventions that extend to the parents' communities and facilitate the parent-child dyad's communication through non-visual behaviors. Replication is warranted in larger and more diverse samples.

Perception of Changing Habits among Italian Children and Adolescents during COVID-19 Quarantine: An Epidemiological Study.

We used an epidemiological study to explore the perception of change in several psychosocial dimensions during the COVID-19 quarantine. We focused on emotions, use of social network sites (SNSs), family life, important relationships, body functions, and school life. Using snowball recruitment, N = 1047 Italian children, pre-adolescents, and adolescents (M = 13.74 ± 3.59) were selected to complete ad hoc online questionnaires. A differential semantic inventory plot was prepared to analyze the emotional experience of children, pre-adolescents, and adolescents during quarantine compared to the pre-quarantine period. The Kruskal-Wallis test was run to assess gender and age differences in emotions experienced, habitual SNS use, and the experience of attending classes remotely. A post hoc Wilcoxon test was performed to compare such differences. Results showed that most of the sample (93.1%) attended classes using technological devices and reported missing their classmates very much (59.3%). Adolescents experienced more negative emotions (M = 3.69 ± 1.33) than pre-adolescents (M = 4.64 ± 1.32), who experienced negative emotions more than children (M = 5.11 ± 1.24). Females were more prone to experience negative emotions compared to males. Adolescents were also the most prolific SNS users (78.1%), particularly female adolescents. Overall, these finding highlight the necessity of preserving the emotional state and relational well-being of youth in these developmental phases by considering their school and social lives.

Maternal anxiety and previous anaphylaxis are associated with alexithymia in young patients with food allergy.

BACKGROUND: Alexithymia is a multifaceted personality construct described as "a lack of words to express emotions" that includes difficulty identifying feelings, difficulty describing feelings and a concrete, externally oriented cognitive style. Among patients with food allergy (FA) alexithymia has been found higher than in general population and associated with dysfunctional coping strategies. Childhood traumatic experiences and/or dysfunctional parent-child relationship can contribute to alexithymia. The study aimed to explore possible associations between child alexithymia and mother alexithymia and anxiety, as well as previous anaphylaxis. METHODS: Sixty-five mother-child pairs have been recruited. Children had a medical diagnosis of FA. The Toronto Alexithymia Scale-20 was used to assess alexithymia in participants. The State-Trait Anxiety Inventory was used to assess trait anxiety in mothers. Statistical analysis was performed to investigate the influence of variables sex, previous anaphylaxis, and adrenaline auto-injector prescription on child and mother's alexithymia and to explore possible association between maternal and child alexithymia. RESULTS: A substantial percentage of children were alexithymic (21.5%) or borderline (33.8%), while mothers' frequencies were lower and in line with prevalence in general population. Child alexithymia was positively associated with previous anaphylaxis and mothers' trait anxiety (p < .05). Mother trait anxiety was also associated with maternal alexithymia. Furthermore, a positive association between child and mother alexithymia has been found. CONCLUSIONS: Clinicians must be aware of the role of alexithymia and its association with maternal anxiety and previous anaphylaxis in children with FA, encouraging seeking psychological support when needed. A multidisciplinary patient-centered approach should be put in place for the effective care of FA.

The indirect effect of a focus group for psoriatic patients on their caregivers.

Psoriasis is a chronic skin disease involving not only epidermic damages but also psychological distress for patients and their family caregivers. Little is known about the effects of a psychological support for psoriatic patients on their caregivers' well-being. The goal of the present study was to investigate the indirect effects of the participation in a dynamic focus group reserved for psoriatic patients on their caregivers in terms of quality of life. The study involved 52 psoriatic patients and 41 family caregivers. Patients' wellbeing was assessed using the dermatology quality of life index, hospital anxiety and depression scale. The impact of the disease on caregivers was assessed using the family dermatology life quality index (FDLQI). Data were analyzed with linear mixed models. The caregivers of psoriatic patients involved in the psychodynamic focus group reported levels of FDLQI that decreased over time, therefore showing an improvement in their quality of life in relation to the pathology of their relatives; the caregivers of patients who did not participate in the psychodynamic focus group, instead, had levels of FDLQI that were stable over time. The results provide preliminary evidence that the group setting of the Psychodynamic Focus Group may alleviate the negative impact of psychosomatic disease on the caregivers.

Emozioni, comportamenti e relazioni: uno studio caso-controllo sul self-cutting in adolescenza.

Scopo. Lo scopo del presente studio caso-controllo è di approfondire i correlati psicopatologici e alcuni tratti psicologici come alessitimia e impulsività inerenti al self-cutting. È stato anche approfondito il tema dell'ideazione suicidaria nei soggetti con tale forma di autolesionismo. Metodi. Lo studio caso-controllo ha coinvolto 55 pazienti con self-cutting non suicidario, di età compresa tra i 12 e i 18 anni, e un gruppo di controllo composto da 277 adolescenti di età compresa tra i 13 e i 19 anni. La batteria testale utilizzata è stata composta da YSR 11-18 anni, CBCL 6-18 anni, SCL-90-R, TAS-20, CDI e BIS-11. Risultati. Dalle analisi effettuate sono emerse differenze statisticamente significative tra casi e controlli in relazione alla maggioranza delle scale psicopatologiche considerate. È risultata una differenza significativa tra i due gruppi anche in merito all'ideazione suicidaria. Infine, tra i self-cutter si sono evidenziate differenze significative di alcune variabili psico-relazionali (alessitimia e competenze sociale) in relazione alla frequenza di attuazione dell'atto autolesivo. Conclusioni. Il self-cutting correla con un'ampia varietà di quadri psichiatrici, senza presentare legami specifici con una particolare categoria psicopatologica. Gli elementi di alessitimia, impulsività e difficoltà relazionali degli adolescenti self-cutter dicono di come la programmazione di interventi di prevenzione primaria e secondaria dovrebbero mirare alla psico-educazione all'affettività, all'autocontrollo e ai social skill. Nello specifico, i nostri dati suggeriscono che la focalizzazione dell'intervento, in termini di lavoro sull'emotività piuttosto che sulla socializzazione, dovrebbe tener conto della frequenza degli agiti. Nella gestione clinica di questi pazienti non va esclusa a priori la possibilità di passaggio all'atto suicidario, con relative attenzioni anamnestico-cliniche da avere sia al momento della valutazione diagnostica sia lungo il follow-up della presa in carico.

Effectiveness of Brief Psychodynamic Therapy With Children and Adolescents: An Outcome Study.

Studies on the effectiveness of child and adolescent psychotherapy treatments provided by the Italian National Health Service lag behind, while the scientific community has rather focused on the value of cognitive-behavioral psychotherapeutic approaches. This paper evaluates the effectiveness of a one year psychodynamically-oriented intervention with children and adolescents-aged between 6 and 18 years (M = 12.08, SD = 3.7)-and their parents, carried out in a Child and Adolescent Neuropsychiatric Service (SCIAF), part of the Italian National Health System. Following a psychodiagnostic assessment, two types of therapeutic intervention were offered: children and adolescents allocated to Group 1 (N = 26) were offered individual psychodynamic psychotherapy alone, whilst youths in Group 2 (N = 31) were offered individual psychotherapy, accompanied by parental support. This study examines the effects of this time-limited (12 month) psychodynamically-oriented psychotherapy in terms of improvements in patients' symptoms (measured on the Achenbach's questionnaires: Child Behavior Checklist and Youth Self-Report 11-18). This study also examines the effects of treatment on parents' perception of their family empowerment. This domain is measured on the Family Empowerment Scale (FES). Our findings seem to be partly in line with published studies according to which poor parenting (i.e., characterized by lack of warmth, a rigid and/or negative parenting style, poor monitoring of the children, etc.) would be positively associated with Externalizing problems in childhood. Our preliminary findings suggest that brief psychodynamic therapy seemed to show positive outcomes in both "Internalizing" and "Externalizing" difficulties, accounting for age-related differences, ICD-10 (1) diagnoses, and the types of treatment offered. However, no statistically significant changes were detected in the parents' perceptions of empowerment at 12 months.

Urgency and emergency in developmental psychopathology: Analysys of cases' report attending a child and adolescent neuropsychiatric service / Urgence et urgence dans la psychopathologie du developpment: analyse du rapport des cas contensant un service neuropsychiatrique des enfants et des adolescents

Psychiatric emergencies have steadily increased in recent years, but they are still poorly defined and studied, especially in developmental age and outside the Emergency Department context. This retrospective cross-sectional study aims to analyse characteristics of a clinical sample under the light of psychiatric urgency and emergency concepts. Both the 'urgency' and 'emergency' concepts and the Rosenn & Gail's severity classification were applied to 399 first inspection forms to describe different conditions at the arrival. About half of the cases corresponded to urgency/emergency conditions, with a male gender prevalence and an average age of 10 y. Emergency was associated to Behavioural Disorders mainly, while urgency conditions were associated to Somatic sphere Disorders, Self-injured Behaviours, Anxious -Affective Disorders. This research, operating a differentiation between urgency and emergency, allows a clearer identification and a tailored therapeutic plan about cases that are similar on a symptomatic side but different by a psychopathological perspective

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Food allergy and attitudes to close interpersonal relationships: An exploratory study on attachment.

BACKGROUND: Food allergy is a common immunologic disease that includes potentially fatal reactions. It impacts considerably on patients' social life including close interpersonal relationships. Attachment theory provides a theoretic framework to evaluate the quality of close interpersonal relationships in chronic disorders. Attachment insecurity, mainly characterized by attachment avoidance, has been found in a variety of health conditions, but still needs to be investigated in food allergy. The study aimed to investigate attachment, as attitude to close interpersonal relationships, among food-allergic young patients, compared to healthy controls. METHODS: This is a cross-sectional study involving patients suffering from IgE-mediated food allergy sequentially recruited and matched to healthy controls for age and gender. The Attachment Style Questionnaire (ASQ) was used to assess five factors and two attachment dimensions (Anxiety-Avoidance). Associations with anaphylaxis and adrenaline prescription were explored among patients. RESULTS: 174 participants were assessed (female=45%; mean age=17.51; SD=4.26). Food-allergic patients reported significantly higher levels of Discomfort with Closeness (P<.05), Relationships as Secondary (P<.05) and Attachment Avoidance (P<.0001) compared to controls. CONCLUSIONS: Clinicians should be aware of implications of insecure attachment for health and illness. They should support patients in limiting social impairment finding a balance between safety and psychologic well-being.

Alexithymia in food-allergic versus healthy children and young adults.

Alexithymia is a multifaceted personality construct associated with several medical illnesses. However, no studies have focused on food allergy. We investigated alexithymia among food-allergic youths, compared to a matched healthy sample. A total of 220 participants aged 9-25 years were assessed using the Toronto Alexithymia Scale and the Alexithymia Questionnaire for Children. Food-allergic patients reported higher levels of alexithymia compared to a matched healthy sample. Furthermore, an association between alexithymia and a clinical history of anaphylaxis was found among patients. Some possible hypotheses have been discussed considering physiological, psychological, developmental, and cognitive/behavioral factors.

Alexithymia in juvenile primary headache sufferers: a pilot study.

Starting in the 1990s, there has been accumulating evidence of alexithymic characteristics in adult patients with primary headache. Little research has been conducted, however, on the relationship between alexithymia and primary headache in developmental age. In their research on alexithymia in the formative years, the authors identified one of the most promising prospects for research, as discussed here. The aim of this study was to verify whether there is: (a) a link between tension-type headache and alexithymia in childhood and early adolescence; and (b) a correlation between alexithymia in children/preadolescents and their mothers. This study was based on an experimental group of 32 patients (26 females and 6 males, aged from 8 to 15 years, mean 11.2 ± 2.0) suffering from tension-type headache and 32 control subjects (26 females and 6 males, aged from 8 to 15 years, mean 11.8 ± 1.6). Tension-type headache was diagnosed by applying the International Headache Classification (ICHD-II, 2004). The alexithymic construct was measured using an Italian version of the Alexithymia Questionnaire for Children in the case of the juvenile patients and the Toronto Alexithymia Scale (TAS-20) for their mothers. Higher rates of alexithymia were observed in the children/preadolescents in the experimental group (EG) than in the control group; in the EG there was no significant correlation between the alexithymia rates in the children/preadolescents and in their mothers.