Supporting bereaved people: a qualitative study on the experience of informal support providers, before and during the pandemic scenario.

The COVID-19 outbreak has further highlighted the need to strengthen support networks to sustain grieving people. However, we know very little about the experience of those who, because of their emotional connection with the bereaved person or of their social function, find themselves supporting people in grief. The current study aimed to analyze the experience of grievers' informal support providers (relatives and friends, teachers, religious leaders, funeral providers, pharmacists, volunteers, and social service workers). 162 in-depth interviews were collected (meanage = 42.3, SD = 14.9; women = 63.6%). Findings highlight two different ways of talking about one's experience and two different ways of offering support. Such dissimilarities do not relate to the period in which support was offered (before or during the pandemic). The results will be discussed in order to highlight emerging training needs to support bereaved people in their difficult transition.

Psychological Impact in Healthcare Workers During Emergencies: The Italian Experience With COVID-19 First Wave.

Background: The COVID-19 outbreak imposed an overwhelming workload as well as emotional burdens on Healthcare workers (HCWs). In May 2020, an online survey was administered to HCWs in Italy to assess the pandemic's psychological impact and to investigate possible predictive factors that led to individual differences. Methods: The psychological experience was measured based on the prevalence of self-reported feelings during the pandemic, including negative and positive emotional states. We analyzed the relationship between factors of gender, age, geographic region, professional role, and operational unit, and the four-point scale used to rate the frequency of each emotional state experienced by performing several multinomial logistic regressions, one for each emotion. Results: Our findings suggest that more than half of HCWs experienced psychological distress during the first COVID-19 outbreak in Italy. Female and younger respondents, especially those operating in northern Italy experienced more frequently negative emotional states such as irritability, anxiety, loneliness, and insecurity. However, positive feelings, first of all solidarity, were also reported especially by female and older workers. The majority of the negative as well as positive emotional states were experienced almost equally by both doctors and nurses, and independently of the operational unit in which they operated. Conclusions: This study can be very useful as a contribution to the current literature on the psychological effects of this pandemic on health workers. Moreover, our findings can provide useful information in planning more tailored psychological interventions to support this category of workers in the ongoing and future emergencies.

Does Childhood Psychological Abuse Contribute to Intimate Partner Violence Victimization? An Investigation Using the Childhood Experience of Care and Abuse Interview.

Although psychological abuse is recognized as a particularly insidious form of child abuse, research on the impact of this type of abuse related to intimate partner violence (IPV) is scant. This study examined the contribution of childhood psychological abuse to IPV in female victims and non-victims. Furthermore, it investigated the role of cumulative abuse in predicting IPV. The study included 38 women victims of IPV and 40 non-IPV women. All participants were investigated using the Childhood Experience of Care and Abuse Interview (CECA); the Revised Conflict Tactics Scale (CTS2) and the IPV History Interview were used to assess IPV in the last year and lifetime, respectively. Results indicated that psychological abuse was a stronger predictor of IPV than other maltreatment types. Furthermore, dose-response effects of cumulative abuse on IPV are well evidenced. Future research should continue examining impacts of psychological abuse on IPV so as to further inform clinical practice and intervention planning.

Environmental Dysfunctions, Childhood Maltreatment and Women's Intimate Partner Violence Victimization.

Childhood maltreatment is considered a crucial explanatory variable for intimate partner violence (IPV) in adulthood. However, a developmental multifactorial model for the etiology of IPV is not shared by researchers yet. This study has investigated the role of a wide range of childhood maltreatments and family and social dysfunctions in predicting IPV; furthermore, it tests a model where childhood maltreatment mediates the relationship between environmental dysfunctions and IPV. The sample included 78 women: IPV (38) and non-IPV (40). The Italian version of the Childhood Experience of Care and Abuse (CECA) Interview was used to assess the presence of adverse childhood experiences. The Revised Conflict Tactics Scale (CTS-2) and the IPV History Interview were used to assess IPV in the last year and lifetime, respectively. The results of a multivariate logistic regression model have indicated that only sexual (odds ratio [OR] = 4.24) and psychological (OR = 3.45) abuse significantly predicted IPV; with regard to association between IPV and environmental dysfunctions, only poor social support (OR = 8.91) significantly predicted IPV. The results of a mediation model have shown that childhood psychological and sexual abuse, in association with each other, partially mediate the relationship between poor social support and IPV. The findings from this study pinpoint poor social support as an important predictor of IPV so far neglected in the literature on the developmental antecedents of IPV. They also support the theoretical assumption according to which dysfunctional environmental variables and types of childhood maltreatment interacting with each other may influence development outcomes.

Group treatment for substance use disorder in adults: A systematic review and meta-analysis of randomized-controlled trials.

BACKGROUND AND AIMS: From residential programs to outpatient services, group therapy permeates the clinical field of substance misuse. While several group interventions for substance use disorders (SUDs) have demonstrated effectiveness, the existing evidence on group therapy has not been systematically reviewed. The current meta-analysis aims to provide estimates of the efficacy of group therapy for SUDs in adults using rigorous methods. METHODS: We included studies comparing group psychotherapy to no treatment control groups, individual psychotherapy, medication, self-help groups, and other active treatments applying no specific psychotherapeutic techniques for patients with substance use disorder. The primary outcome was abstinence, and the secondary outcomes were frequency of substance use and symptoms of substance use disorder, anxiety, depression, general psychopathology, and attrition. A comprehensive search was conducted in Medline, Web of Science, CENTRAL, and PsycINFO, complemented by a manual search. Random-effects meta-analyses were run separately for different types of control groups. RESULTS: Thirty-three studies were included. Significant small effects of group therapy were found on abstinence compared to no treatment, individual therapy, and other treatments. Effects on substance use frequency and SUD symptoms were not significant, but significant moderately sized effects emerged for mental state when group therapy was compared to no treatment. There were no differences in abstinence rates between group therapy and control groups. These results were robust in sensitivity analyses and there was no indication of publication bias. CONCLUSIONS: The current findings represent the best available summary analysis of group therapy for SUDs in adults, however cautious interpretation is warranted given the limitations of the available data.

Parents' childhood experiences of bonding and parental psychopathology predict borderline personality disorder during adolescence in offspring.

Previous studies on borderline personality disorder (BPD) development suggest a transgenerational transmission of parent-child relationship quality, which may also be influenced by parents' mental health status. The aim of this study was twofold. First, we aimed to investigate the transgenerational effect of parental bonding experiences on the development of BPD in their offspring. Second, we examined the association between parents' mental health status and BPD in offspring. Ninety-one female adolescent psychiatric inpatients along with 87 mothers and 59 fathers were enrolled in the study. Adolescent BPD was assessed with the Structured Clinical Interview for DSM-IV-II, parental bonding with the Parental Bonding Instrument, and parents´ psychiatric symptoms with the Patient Health Questionnaire. We found that low parental care produced a transgenerational effect from mother to BPD in offspring. Further, significant associations were found between paternal psychiatric symptoms and adolescent BPD. High paternal stress levels mediated the association between maternal affect reported by fathers and BPD in daughters. There is evidence of a transgenerational effect of parental bonding specifically for female adolescents with BPD, compared with other clinical control subjects. Our findings highlight the importance of including both parents in future research and in early clinical treatment in adolescents with BPD.

Associations between depression and specific childhood experiences of abuse and neglect: A meta-analysis.

BACKGROUND: Research documents a strong relationship between childhood maltreatment and depression. However, only few studies have examined the specific effects of various types of childhood abuse/neglect on depression. This meta-analysis estimated the associations between depression and different types of childhood maltreatment (antipathy, neglect, physical abuse, sexual abuse, and psychological abuse) assessed with the same measure, the Childhood Experience of Care and Abuse (CECA) interview. METHOD: A systematic search in scientific databases included use of CECA interview and strict clinical assessment for major depression as criteria. Our meta-analysis utilized Cohen's d and relied on a random-effects model. RESULTS: The literature search yielded 12 primary studies (reduced from 44), with a total of 4372 participants and 34 coefficients. Separate meta-analyses for each type of maltreatment revealed that psychological abuse and neglect were most strongly associated with the outcome of depression. Sexual abuse, although significant, was less strongly related. Furthermore, the effects of specific types of childhood maltreatment differed across adult and adolescent samples. LIMITATIONS: Our strict criteria for selecting the primary studies resulted in a small numbers of available studies. It restricted the analyses for various potential moderators. CONCLUSION: This meta-analysis addressed the differential effects of type of childhood maltreatment on major depression, partially explaining between-study variance. The findings clearly highlight the potential impact of the more "silent" types of childhood maltreatment (other than physical and sexual abuse) on the development of depression.

The Specific Role of Childhood Abuse, Parental Bonding, and Family Functioning in Female Adolescents With Borderline Personality Disorder.

This study examined a broad variety of adverse childhood experiences in a consecutive sample of female adolescent inpatients with borderline personality disorder (BPD; n = 44) compared with a clinical control (CC; n = 47) group with mixed psychiatric diagnoses. BPD was diagnosed using a structured clinical interview; different dimensions of childhood adversity were assessed using the Childhood Experiences of Care and Abuse Questionnaire, the Parental Bonding Instrument, and the Family Assessment Device. A history of childhood adversity was significantly more common in patients with BPD than in the CC group. Using a multivariate model, sexual abuse (OR = 13.8), general family functioning (OR = 8.9), and low maternal care (OR = 7.6) were specific and independent predictors of adolescent BPD. The results increase our knowledge of the specific role of different dimensions of childhood adversity in adolescent BPD. They have important implications for prevention and early intervention as they highlight the need for specific strategies for involving the family.

Environmental factors that distinguish between clinical and healthy samples with childhood experiences of abuse and neglect.

BACKGROUND: Childhood maltreatment is associated with a wide range of problems in adulthood. However, specific environmental factors (either positive or negative) influence mental health outcomes in maltreated children. The present study investigated the effect of environmental factors by comparing a group of clinical participants with experiences of abuse/neglect with a healthy group with similar patterns of experiences. Environmental factors selected were: separation from parents, financial hardship, parental psychiatric disorders, and low social involvement. METHOD: The study included 55 mixed clinical participants and 23 healthy participants. All participants were investigated using the Childhood Experience of Care and Abuse (CECA) interview. The two groups were specifically matched with regard to patterns of childhood maltreatment. RESULTS: The findings indicated that psychopathological outcome was associated with a greater presence of negative environmental factors (p < 0.001). In particular, lack of social support seemed to be the only one predictor (OR = 27.86). CONCLUSION: This study is the first to investigate the influence of specific environmental factors in two groups with similar childhood experiences of abuse/neglect but different mental health outcomes. These findings suggest that efforts should be made to incorporate both familial and external sources of social support in promoting mental health for maltreated children.