La sintomatologia ansiosa materna nel periodo prenatale risulta influire negativamente non sullo stato materno ma anche sul successivo sviluppo infantile, Tuttavia, sono limitati gli studi che hanno considerato lo specifico contributo dei disturbi d’ansia nel periodo prenatale. L’obiettivo generale dello studio è quello di indagare nel primo periodo post partum la relazione tra psicopatologia ansiosa materna e: temperamento e sviluppo neonatale, qualità del caregiving materno e dei pattern interattivi madre-bambino. 138 donne sono state intervistate utilizzando SCID-I (First et al., 1997) durante il terzo trimestre di gravidanza. 31 donne (22,5%) presentano disturbo d’ansia nel periodo prenatale. A 1 mese post partum il comportamento del neonato è stato valutato mediante NBAS (Brazelton, Nugent, 1995), mentre le madri hanno compilato MBAS (Brazelton, Nugent, 1995). A 3 mesi postpartum, una sequenza interattiva madre-bambino è stata videoregistrata e codificata utilizzando GRS (Murray et al., 1996). La procedura dello Stranger Episode (Murray et al., 2007) è stata utilizzata per osservare i pattern interattivi materni e infantili nell’interazione con una persona estranea. I neonati di madri con disturbo d’ansia manifestano alle NBAS minori capacità a livello di organizzazione di stati comportamentali, minori capacità attentive e di autoregolazione. Le madri ansiose si percepiscono significativamente meno sicure nell’occuparsi di loro, valutando i propri figli maggiormente instabili e irregolari. Nell’interazione face to face, esse mostrano comportamenti significativamente meno sensibilI, risultando meno coinvolte attivamente con il proprio bambino. Durante lo Stranger Episode, le madri con fobia sociale presentano maggiori livelli di ansia e incoraggiando in modo significativamente inferiore l’interazione del bambino con l’estraneo. I risultati sottolineano l’importanza di valutare in epoca prenatale la psicopatologia ansiosa materna. Le evidenze confermano la rilevanza che può assumere un modello multifattoriale di rischio in cui i disturbi d’ansia prenatali e la qualità del caregiving materno possono agire in modo sinergico nell’influire sugli esiti infantili. / Maternal antenatal anxiety has been shown to be associated with adverse consequences for the mother and the child. However, studies considering the effect of DSM-IV anxiety disorders during pregnancy are lacking. The general aim was to investigate, in the early postpartum, the relationship between maternal prenatal anxiety psychopathology and: neonatal behavioral development, quality of caregiving, maternal and infant’s interactive behaviors. 138 women completed the clinical interview SCID-I for DSM-IV (First et al., 1997) during the third trimester of pregnancy to assess anxiety disorders. 31 women (21,5%) showed an anxiety disorders during antenatal period. At one month postpartum, the neonatal development was assessed using NBAS (Brazelton, Nugent, 1995) and the mothers completed the MBAS (Brazelton, Nugent, 1995). At 3 months postpartum, mother-infant interactions were video-recorded and coded using GRS (Murray et al., 1996). Stranger Episode procedure (Murray et al., 2007) was used to assess maternal and infant’s interactive pattern with an unfamiliar person. Anxious mothers’ babies had poorer performances on NBAS regarding attention, self-quieting, examiner facilitation, state regulation (p<0.05). Anxious mothers perceived themselves as having a greater lack of confidence in caretaking and they consider their babies as more unsettled-irregular (p<0.05). Mothers with anxiety disorder showed less sensitive interactive behavior, resulting more withdrawal and less engaged with their infants than controls. During Stranger Episode, mothers with social phobia appeared more anxious, engaged less with the stranger themselves, and were less encouraging of the infant’s interaction with an unfamiliar person. Results underline the importance of assessing and monitoring maternal antenatal anxiety. These findings are consistent with a cumulative risk model suggesting that maternal prenatal anxiety and quality of maternal caregiving could act in concert to shape infant outcomes.

No description available.

Microcredit, a small lending system, invests on an individual's creativity by stimulating the development of their own potential. This process leads to the attainment of various objectives which in turn allow individuals to develop their skill awareness. Consequently, this process also increases an individual’s self-esteem and self-confidence. These factors play an important role in the aetiology of a number of mental disorders. Namely, those characterized by a series of psychological conditions which impede the full development of a person’s personal, relational and social sphere. Furthermore, since Microcredit is thought to produce tangible goods, such as income, and intangible goods, such as self-esteem and mutual trust, it could also represent an innovative socio-economic tool. We therefore also hypothesize that, Microcredit would be valuable in maximizing abilities/skills in those subjects who are financially excluded and rarely perceived as a ‘resource’ for the Community The longitudinal study set the impact of the Grameen Bank microcredit program on new borrowers women from Noakhali District at the south Bangladesh. The impact evaluation assessment has been structured to detect individual, family and social changes. Manova Analysis allowed distinguishing from women with positive or negative outcomes related to the loan performance. Data revealed consistent differences in terms of economical outcomes and psychological well being amongst the groups of subject analyzed. The data gathered in relation to the changes arisen in the individuals should be looked into through future, continuous and systematic, monitoring.

Microcredit has been a tool to alleviate poverty since long. This research is aimed to observe the efficiency of microcredit in the field of social exclusion. The development of questionnaires and use of existing tools was used to observe the tangible and intangible intertwining of microcredit and by doing so the effort was concentrated to observe whether microcredit has a direct effect on social exclusion or not. Bangladesh was chosen for the field study and 85 samples were taken for the analysis. It is a time period research and one year time was set to receive the sample and working on the statistical analysis. The tangible aspect was based on a World Bank questionnaire and the social capital questionnaire was developed through different well observed tools. The borrowers of Grameen Bank in Bangladesh, is the research sample whish shows a strong correlation between their tangible activity and social life. There are significant changes in tangible aspect and social participation observed from the research. Strong correlation between the two aspects was also found taking into account that the borrowers themselves have a vibrant social life in the village.

La prematurità rappresenta un fattore di rischio per la qualità delle interazioni precoci e la sintomatologia materna, soprattutto in caso di nascita VLBW (peso ≤ 1500 grammi) ed ELBW (≤1000 grammi). Scopo dello studio è valutare a 3 e 9 mesi di età corretta le modalità interattive delle diadi madre-bambino e lo stato affettivo materno in due campioni di prematuri, ELBW e VLBW, confrontandoli con un gruppo di bambini nati a termine (GC). Un campione di 119 diadi madre-bambino, di cui 71 nati prematuri (30 VLBW e 21 ELBW) e 68 a termine, sono stati valutati all'età di 3 e 9 mesi. Durante gli assessment, è avvenuta la videoregistrazione dell’interazione madre-bambino, codificata mediante le Global Rating Scales (a 3 mesi) ed il CARE Index Infant (a 9 mesi), e la valutazione della sintomatologia materna, attraverso Edinburgh Postnatal Depression Scale, Penn State Worry Questionnaire, Social Interaction and Anxiety Scale, Social Phobia Scale, Parenting Stress Index-Short Form, Questionari italiani del Temperamento. A 3 mesi, le madri di ELBW appaiono più demanding e meno sensibili rispetto a quelle di VLBW; più intrusive rispetto a quelle di GC. Tali madri, inoltre, sono significativamente meno sensibili di quelle del GC anche a 9 mesi. In entrambi gli assessment, tali madri presentano livelli significativamente maggiori di depressione, ansia generalizzata e stress, rispetto a quelle di entrambi gli altri gruppi. Non emergono differenze rispetto all'ansia sociale nè alla percezione del temperamento. Le analisi della correlazione hanno evidenziato specifiche relazioni tra la sintomatologia materna e i pattern interattivi nei tre gruppi. La nascita pretermine rappresenta un fattore di rischio solo per le madri di ELBW, che presentano difficoltà interattive ed elevata sintomatologia; quelle dei VLBW, infatti, tendono a presentare pattern interattivi affini a quelle del GC, mostrando adeguata sensibilità e bassi livelli di depressione, ansia e stress. / Background and aim. Preterm birth can affect the quality of early interactions and the maternal symptoms, especially in case of VLBW (≤1500 grams) and ELBW infants (≤1000 grams). Aim of the study was to evaluate the interactive patterns and maternal affective state in two samples of preterm infants, VLBW and ELBW, in comparison with a full-term infants group (GC) at 3 and 9 months of corrected age. Method. A sample of 119 mother-infant dyads, including 71 healthy premature infants (30 VLBW and 21 ELBW) and 68 full-term infant was assessed at 3 and 9 months of corrected age. Mother-child interaction was recorded and later coded using the Global Rating Scales (3 months) and the CARE Index Infant (9 months). In each assessment, maternal symptoms was evaluated through Edinburgh Postnatal Depression Scale, Penn State Worry Questionnaire, Social Interaction and Anxiety Scale, Social Phobia Scale, Parenting Stress Index-Short Form, Italian Temperament Questionnaire. Results. At 3 months c.a., interactive patterns of mothers of ELBW infants was more demanding and less sensitive than those of VLBW, and more intrusive than those GC. Moreover, at 9 months, mothers of ELBW, appear to be significantly less sensitive than those of the GC. In both assessments, these mothers showed significantly higher levels of depression, generalized anxiety and stress, in relation to both those of VLBW than those born at term. No difference emerged about social anxiety nor the perception of infant temperament. The correlation analysis showed specific relations between the symptoms and maternal interactive patterns in each groups. Discussion. Preterm birth can represent a factor of risk for mother of ELBW infants: these women showed difficulties in interactive behaviour and high level of affective symptoms; mothers of VLBW have interactive patterns similar to those of GC, showing adequate sensitivity and low levels of depression, anxiety and stress.

L'obiettivo generale di questa tesi è chiarire il modo in cui alcune variabili, prossimali e distali, influenzano lo sviluppo psicofisico del bambino all' interno di un campione di madri a rischio del progetto Scommettiamo sui giovani. Qualora i risultati descritti in questo lavoro confermassero i dati presenti in letteratura, la Provincia Autonoma di Trento potrebbe applicare sul territorio una serie di servizi rivolti alle madri a rischio e non, e attuare interventi di supporto alla genitorialità. L'organizzazione della tesi prevede una parte teorica introduttiva, la presentazione di quattro articoli scientifici, in corso di pubblicazione, riguardanti diverse aree di interesse (articolo 1: Le madri a rischio e il quoziente di sviluppo dei bambini; articolo 2: L'indice di attaccamento dei bambini in un campione di madri a rischio; articolo 3: Il parenting nei contesti di immigrazione; articolo 4: Valutazione preliminare dell'efficacia dell'intervento di supporto alla genitorialità a rischio in Trentino e un capitolo finale sulle conclusioni generali e sulle ricerche future.

Il presente lavoro ha lo scopo di studiare in dettaglio l’interazione genitore-bambino in famiglie con bambini con Disturbo dello Spettro Autistico (che verranno sintetizzati con l’acronimo ASD dalla definizione inglese “Autism Spectrum Disorder”). I disturbi dello spettro autistico sono disordini del neurosviluppo che alterando nei primi anni di vita la capacità di mettersi in relazione con gli altri, determinano gravi effetti cognitivi, affettivi e comportamentali. Le ricerche condotte negli ultimi decenni nell'ambito della psicologia dello sviluppo hanno evidenziato il ruolo centrale delle relazioni genitoriali nello sviluppo del bambino, sia in bambini con sviluppo tipico che con sviluppo atipico. Questo lavoro di tesi ha l’obiettivo di osservare alcuni aspetti peculiari dell’interazione genitore-bambino in bambini con disturbo dello spettro autistico, considerando come il deficit a livello del “cervello sociale” si ripercuote sullo strutturarsi e il mantenersi di questa relazione. Nel presente lavoro si collocano quattro studi. In particolar modo saranno analizzate nel primo studio le caratteristiche del gioco in diadi madre-bambino con ASD confrontandole con diadi madre-bambino in cui il bambino presenta la Sindrome di Down o lo sviluppo tipico al fine di evidenziare similitudini e differenze sia nelle abilità manifestate dalle madri sia per quelle espresse dai bambini. Nel secondo studio, verrà approfondito l’aspetto del gioco specificatamente in interazione madre-bambino e padre-bambino in famiglie con bambini con ASD, al fine di osservare se la capacità di gioco manifestate dal bambino si differenzino in base alla figura genitoriale con cui stanno interagendo e per evidenziare se madre e padre evidenziano delle caratteristiche peculiari in base al ruolo genitoriale rivestito. Il terzo studio, invece, si è concentrato sull’analisi dello scambio sincronico all’interno delle diadi madre-bambino con disturbo dello spettro autistico confrontandolo con interazioni con bambini con sviluppo tipico e sindrome di Down, con lo scopo di osservare più in dettaglio la struttura dello scambio diadico per evidenziare i contribuiti specifici di entrambi i membri della diade, mostrando come possano differire in base alla presenza o meno di una patologia. Infine nel quarto studio sarà osservata la disponibilità emotiva diadica all’interno di famiglie di bambini con disturbo dello spettro autistico, analizzando sia i comportamenti del bambino sia i comportanti delle due figure genitoriali.

Developmental Dyslexia (DD) is one of the most common neurodevelopmental disorders across cultures. Children affected by DD struggle to read fluently and/or correctly, despite normal intelligence, the absence of other psychological or neurological symptoms, and standard reading education. Not only does this condition affect academic achievement, but it is also associated with a number of other negative consequences across the lifespan, such as an enhanced risk of psychological distress and mental health problems. Despite considerable efforts to identify the underlying cause of dyslexia, agreement on a single interpretation has not yet been reached. DD is commonly described as a languagerelated disorder, with compromised phonological abilities being considered as the core deficit. Nonetheless, a growing body of evidence supports multifactorial models: reading is a complex cognitive process, involving not only phonological skills, but also auditory sensory processes, visual-spatial abilities, attention and memory. In this regard, various studies have documented a relationship between dyslexia and deficits in the Executive Functions (hereafter EFs), which can be defined as a cluster of general-purpose control mechanisms that modulate various cognitive sub-processes. However, the relationship between cognitive correlates and reading impairments is still a controversial issue. The present project aims to analyse the fundamental characteristics and the efficacy of different rehabilitation methods for Developmental Dyslexia. Although the neurocognitive causes of DD are still hotly debated, researchers agree that the main challenge is the remediation, that is, how to improve children’s reading fluency and accuracy. The most common approach has been to devise sophisticated remediation programs that train sub-skills of reading, especially phonological skills and auditory perception. Despite the promising results, the improvements in these sub-skills do not automatically transfer in better reading abilities in all subjects (especially regarding reading fluency), thus giving rise to the issue related to "non-responders" or "poor responders". Since the present data gives firm indications of the need to individualize intervention based on neuropsychological testing, the aim of this project is to investigate the efficacy of new types of treatment based on a multifactorial, probabilistic, model of the disorder. Consequently, this project consisted of two parts: specifically, in the first study, we compared phonological-based treatment with computerized cognitive training of the executive functions (e.g., attention, working memory, planning, inhibition). The results of this study clearly pointed out an advantage both in terms of improvements in EFs and literacy skills for the group who undertook the Integrated training, i.e., the group that underwent 12 hours of Cognitive training prior to 12 hours of Phonological-based treatment. Next, the second study aimed to explore the efficacy of a video game Skies of Manawak purposefully designed to train several EFs. Indeed, it has been showed that the existing treatments are not sufficiently captivating and motivating and, thus, we developed a tool ex novo in order to obtain overall improvement and higher chances of transfer to untrained tasks. Our goal was to investigate whether playing this video game may enhance EFs following intervention, and whether these improvements transfer to important literacy skills in typically developing (Study 2 – Part A) and dyslexic children (Study 2 – Part B). All children underwent 12 hours of training, distributed over 6 weeks, either on Skies of Manawak or on a control computerized activity (Scratch). Assessments upon training completion indicated greater improvements in executive functioning and reading efficiency after Skies of Manawak than after the control training in both studies. Interestingly, the advantage in reading skills was maintained in a follow-up test 6 months later and seemed to generalize to academic performance (i.e., Italian marks). Overall findings highlighted promising effects of the training programs on children’s cognition, making way for future studies investigating the underlying brain mechanisms and the factors leading to treatment success.

Despite a large body of research has investigated child attachment during middle childhood, only a limited number of studies has focused on children with Autism Spectrum Disorder. Additionally. The few studies available on this topic have exclusively used self-reported measures to assess quality of attachment, overlooking the role of internal representations, which are considered to play a fundamental role since attachment is internalized. Therefore, no studies examined the way in which child attachment representations are associated with child diagnosis, parenting and caregiving environment in ASD. In the first study, we assessed attachment representations in children with ASD, Learning Disabilities (LD) and Typical development (TD). In particular, we investigated possible group differences on perceived attachment to parents, self-protective strategies and quality of attachment implicit representations using the Dynamic Maturational Model of Attachment and Adaptation (DMM). The Study 2 focused on the caregiving environment and its influence on child attachment implicit representations. To this aim, we assessed parenting stress and parental style in mothers and fathers of children with ASD and TD, examining whether parents of children with ASD differ from those of matched TD group. Secondly, we examined which caregiving environment dimensions contribute significantly in predicting at-risk attachment representations, assessing separately the contribution of maternal and paternal parenting stress and parental interactive social style. In the third study maternal and paternal attachment style were assessed to test the hypothesis of attachment continuity across generations. Firstly, we investigated whether parents of children of ASD reported higher level of attachment-related avoidance/anxiety compared to their TD counterpart. Next, the associations between attachment style of both mothers and fathers and quality of child attachment representations was tested, by examining the moderation effect of child ASD diagnosis. The Study 4 investigated the role of other potential child attachment predictors. Due higher co-occurrence of ASD and difficulties in identifying, describing and distinguishing one’s own feelings, the predictive effect of alexithymia on child explicit attachment representations was tested. Moreover, we also examined whether children with ASD reported higher level of alexithymia compared to controls. The Study 1 showed that children with ASD are able to develop secure and coherent attachment implicit representations, albeit with a lesser extent compared to typically developing children. They were able to engage the attachment interview, confirming the suitability of this method in this clinical sample. Importantly, children with ASD showed high-risk attachment implicit representations and greater presence of unresolved trauma and modifiers, despite no differences emerged on perceived attachment to parents. The lack of group difference on perceived attachment suggested that implicit and explicit attachment representations of children with ASD originate from different sources of information. It is plausible that low reflective functioning, impaired metacognition as well as altered psychobiological processes of children with ASD contributed to attachment maladaptive information processing. Secondly, we replicated the well-established finding of higher parenting distress in parents of children with ASD compared to controls also in fathers. Moreover, the Study 2 documented less didactic and limit/setting style in parents of children with ASD. In accordance to a bidirectional perspective, these parenting behaviors were interpreted as parental functional responses to adapt to child unusual social-communication. Interestingly, data revealed a significant effect of maternal parenting stress and social exchange style on child attachment implicit representations. Thus, the study supports the coexistence of both child-driven and parent-driven effects in the context of parent-child relationship in ASD. Similarly, the Study 3 documented that children with ASD who have an insecurely attached primary caregiver showed at-risk attachment implicit representations. In other words, the continuity of attachment security across generations revealed a clear effect in ASD, suggesting that these children may be more susceptible to this mechanism compared to controls. In addition, parents of children with ASD reported higher attachment-related avoidance in comparison to their TD counterpart. This difference could be associated to the significant couple adjustment associated to the impact of rear a child with ASD. In addition, the Study 4 showed that alexithymia, but not ASD predicts perceived attachment to parents highlighting the different nature of attachment explicit and implicit representation. Moreover, our results confirmed higher co-occurrence of alexithymia and ASD also in school-age, extending literature on adulthood. Our findings pointed out that children with ASD (without intellectual disability) showed higher rates of at-risk self-protective strategies (attachment pattern). These results may be related to several factors associated with ASD symptoms, such as the more frequent disruptions of interpersonal exchanges with the caregiver across development, the difficulties in social information processing and reflective functioning. The higher exposure to adverse childhood experience (e.g. bullying), may explained the higher occurrence of unresolved trauma in these children. Up to date, to the best of our knowledge, these are the first studies on group differences and parental predictors of attachment implicit representations in school-age children with ASD. Therefore, these studies brought initial data to ASD literature on attachment representations, suggesting that these children are at increased risk of developing maladaptive information processing. Limitations of the studies and clinical implications are discussed.

L’obiettivo generale del progetto di ricerca è valutare la percezione della qualità dei servizi offerti in due RSA del Nord Italia e proporre interventi di miglioramento. Nel primo capitolo della tesi sono stati descritti i principali modelli teorici della qualità dei servizi. La letteratura riconosce la mancanza di scale validate che esplorano la percezione della qualità dei servizi nelle RSA Italiane. Per questo motivo, è stato realizzato uno studio di validazione e adattamento della versione italiana della scala SERVQUAL. Nel secondo capitolo della tesi è stato presentato uno studio qualitativo retrospettivo. Partendo dagli eventi critici che si sono verificati nella RSA, sono stati analizzati i principali episodi positivi e negativi ricordati dai famigliari degli anziani. I risultati sono stati utilizzati per ipotizzare nuovi percorsi di intervento e per fornire strategie organizzative per migliorare la gestione degli eventi problematici. La letteratura riconosce l’importanza del coinvolgimento dei famigliari per il benessere degli anziani. Per questo motivo, in questo progetto di ricerca sono state delineate le basi concettuali per l’applicazione di un modello collaborativo di assessment all’interno delle RSA. Nello specifico, il terzo capitolo della tesi ha esplorato l'efficacia dell’Assessment Terapeutico attraverso una meta-analisi multilivello e nell'ultimo capitolo della tesi è stata applicata una componente del modello di Assessment Collaborativo e Terapeutico nelle RSA. / The general aim of the present research project was to broaden the knowledge and understanding of the ways in which elderly’s family members perceive the quality of service and propose interventions to improve services. To lay the ground for discussion about the quality of services offered by nursing homes, Chapter 1 provides a historical overview of the models of the quality of services. Given the lack of validated measures of the quality of services in Italian nursing homes, I presented data regarding the validation and adaptation of the Italian version of the SERVQUAL Scale. Chapter 2 introduced a retrospective qualitative study. Starting from critical events that occurred in nursing homes, I analyzed family members’ observations of the incidents. The results were used to generate new paths for interventions to improve the family members’ evaluation of services and to provide organizational strategies to improve the management of problematic events. Given the effect of family involvement on elder people’s well-being, I presented the conceptual underpinnings and the applicability of a collaborative model of assessment in nursing homes. Chapter 3 explored the effectiveness of the Therapeutic Assessment model through a multilevel meta-analytic study. From these results, a component of the Collaborative and Therapeutic Assessment model was applied in nursing homes, as described in the last chapter.