Le terapie espressive sono considerate tecniche di intervento particolarmente efficaci da impiegare con bambini vittime di catastrofi naturali. In particolare diversi arti-terapeuti affermano che per bambini vittime di traumi, il disegno rappresenta una modalità preferenziale per esprimere emozioni poiché consente di rappresentare la complessità di vissuti , percezioni, pensieri e memorie di natura traumatica, attribuendo loro una forma e, quindi un senso. Nonostante questo l’efficacia dell’impiego dello strumento non è stata scientificamente dimostrata. Questa tesi presenta due studi, uno studio pilota e uno studio principale, finalizzati ad esplorare l’utilizzo del “test de trois dessins: avant, pendant et avenir” come strumento diagnostico e tecnica terapeutica da impiegare con bambini vittime di terremoti di Abruzzo, Haiti e Cile. Lo studio pilota è basato sull’analisi qualitativa di case-studies,mentre lo studio principale utilizza strumenti quantitativi e qualitativi. I risultati mostrano l’efficacia dello strumento nel rilevare la presenta del trauma psichico e nel favorire processi di elaborazione del trauma. Ricerche future sono necessarie per attuare una validazione dello strumento come tecnica diagnostiche e strumento terapeutico con bambini vittime di traumi. / Expressive therapies are considered one of the most effective intervention modality with children who have experienced traumatic events such as natural catastrophes. Particularly, several art therapists affirm that for trauma affected children, drawing is a preferential mode for expressing emotions, as it gives them the possibility of conveying the complexity of traumatic feelings, perceptions, thoughts and memories, by giving them a shape and, therefore, a sense. Notwithstanding these assumptions, the efficacy of art therapies with children exposed to natural disasters, has not been research proved. This thesis presents two studies, a pilot study and the main study, aimed at exploring the use of the “test de trois dessins: avant, pendant et avenir”, as a diagnostic tool and a therapeutic technique, with children victims of the earthquake in Italy, Haiti and Chilli. The pilot study is based on non-statistical qualitative observation of case studies, while the principal one employ of both qualitative and quantitative methodology. The results show the efficacy of the test in both pointing out the presence and the extent of the psychological trauma, and in enhancing the process of elaborating trauma. Further researches need to be done in order to validate the use of the “test de trois dessins: avanat, pendant et avenir” as a diagnostic and therapeutic tool with trauma affected children.

Utilizzando il disegno single-case si indaga il processo terapeutico di una psicoterapia ad orientamento psicodinamico con sedute a cadenza settimanale della durata di un anno di un paziente con Depressione Anaclitica (secondo la definizione di Blatt, 2003); il processo ed i fattori che concorrono a determinarlo sono indagati nel conte-sto della valutazione della personalità del paziente. L’obiettivo consiste nel mostrare come sia possibile ottenere, utilizzando strumenti come la DMRS, la SWAP, la CALPAS, il CT-Q, il PRQ ed il CCRT, una valutazione che non si limiti solo al cambiamento sintomatico, in questo caso depressivo, ma fornisca un’idea più sfaccettata delle trasformazioni intrapsichiche ed interpersonali correlate al processo terapeutico, integrando la valutazione macroanalitica del cambiamento, ricavata dalle variazioni degli indici globali degli strumenti, alla valutazione microanalitica delle variabili. / The therapeutic process of a psychodynamic psychotherapy is evaluated through a single-case design. The patient, a 26-year-old man with Anaclitic Depression (as defined by Blatt, 2003) was followed on a weekly based therapy for one year. The factors that contribute to determine the therapeutic process are investigated in the context of the patient's personality assessment. The objective is to show how it is possible to obtain, using tools such as the DMRS, the SWAP, the CALPAS, the CT-Q, the PRQ and the CCRT, an assessment that is not limited only to the symptomatic change, in this case depressive, but provides a more multifaceted view of the intrapsychic and interpersonal transformations related to the therapeutic process, incorporating the macroanalytic evaluation of changement, derived from the global scores of the instruments, to the micro-analytic evaluation of the variables.

Il presente lavoro di tesi affronta il tema della prevenzione del tumore alla mammella nell’ambito del contesto italiano. Con un primo studio ci si pone l’obiettivo di indagare le conoscenze, le rappresentazioni, le emozioni ed i comportamenti che donne del nord e del sud d’Italia hanno riguardo il concetto di prevenzione del tumore alla mammella. Nello specifico si vuole indagare se la cultura e il luogo di provenienza delle donne hanno un’influenza sulle loro rappresentazioni riguardo l’argomento di interesse. Questo obiettivo è stato perseguito con l’utilizzo di focus group condotti in Lombardia e in Campania. I risultati a questo studio hanno messo in luce notevoli differenze tra i due gruppi, in particolare rispetto alle conoscenze e alle pratiche preventive messe in atto. Con un secondo studio si vuole indagare un ampio campione (N= 2070) di donne lombarde che partecipano allo screening mammografico (programma preventivo offerto dal SSN). All’interno di tale campione si voglio individuare profili psicologici caratterizzanti le donne e i predittori dell’ansia pre-screening, una variabile frequente tra i soggetti che si sottopongono a mammografia preventiva. I risultati a questo studio evidenziano la presenza di tre profili psicologici (cluster) all’interno dei quali si suddivide il campione. Questi profili differenziano le donne e le motivazioni che le conducono a prendere parte al programma di screening. Sempre grazie alle analisi effettuate per soddisfare gli obiettivi del secondo studio è stato possibile determinare che bassa stabilità emotiva, bassa qualità di vita e basso ottimismo hanno influenza nell’incrementare i livelli di ansia in donne in attesa di sottoporsi a screening mammografico. / The present dissertation deals with the topic of breast cancer prevention in the Italian context. The first study of the research aimed to explore the knowledge, the representations, the emotions and the behaviors that northern and southern women have about breast cancer prevention. We want to investigate if cultural and contextual factors influence representations that women have about the topic of interest. We satisfied the objective of the first study conducting focus group in a northern and in a southern region of Italy. The outcome of this study highlighted differences between the two groups especially concerning women knowledge and their behaviors in regard to breast cancer prevention. The second study aimed to investigate a sample (N=2075) of Italian northern women that choose to take part in the national breast cancer screening. The specific objectives of this study were the identification of psychological profiles that characterize this sample and pre-screening anxiety predictors, a common variable among women waiting to have a mammogram. The results at this study highlighted three clusters that differentiated women and the reason why they decide to take part in the prevention program. Analysis performed for the second study identified low emotional stability, low quality of life and low optimism as pre-screening anxiety predictors.

La transizione alla genitorialità è da sempre considerato un periodo di criticità per la coppia, questo processo ha inizio già nella fase della gravidanza, in cui il rapporto a due comincia a modificarsi in direzione triangolare, rompendo l’originaria struttura diadica. E’ tuttavia importante che il processo di riorganizzazione della relazione, necessario all’acquisizione del ruolo genitoriale, salvaguardi gli aspetti coniugali, oltre ad includere quelli genitoriali: molte coppie, faticano ad alimentare o dimenticano lo spazio della coniugalità. In termini più generali, per quanto i partner possano essere consapevoli della necessità di far fronte ai cambiamenti, spesso risultano impreparati e, a volte, poco adattabili. In tal senso il periodo perinatale può essere vissuto come un evento potenzialmente molto stressante. Tale progetto si pone l’obiettivo di studiare i possibili percorsi della transizione alla genitorialità focalizzandosi sul benessere/malessere psicologico dei partner in relazione alla loro percezione della qualità della relazione di coppia. I risultati evidenziano differenti traiettorie di benessere/malessere psicologico nel periodo perinatale e una relazione tra la condizione psicologica dei partner e la loro percezione della qualità della relazione di coppia. / In the psychological literature the transition to parenthood has been always considered a critical period for the couples. This process should begin during the pregnancy, the period during which the couple’s relationship should develops from the original dyadic structure to a new triangular structure. It must be underlyned the importance of the process of “renovation” of the relationship. This process includes the acquisition of the parental role and protects relavant marital and parental aspects such as the feeding of the marital relationship. Despite couples’ awerness of the importance to cope with the changes that the transition entails, often result unprepared. In this sense the perinatal period can be seen as a potentially stressfull event. This dissertation aims to study the possible paths of transition to parenthood focusing on partener’s psychological well-being and distress in relation to their perception of the quality of the couple’s relationship. The results show different trajectories of psychological well-being and distress in the perinatal period and a relation between the couples’ psychological condition and their perception of the quality of couple’s relationship.

Understanding what constitutes typical adult processing of infant cues and the potential individual variations associated with it is an important early step in comprehending how caregiving practices arise. By adopting a multi-method approach, the present work aimed to enrich the knowledge on adults’ cognitive and electrophysiological responses to infant cues, by focusing on the role of the adults’ sex, the perceived quality of early care from caregivers, and the actual involvement in childcare. Four studies were presented to cover different perspectives on adults’ responses to infant cues, from cognition to electrophysiology and parental behaviors. Methodologies encompassed cognitive experimental tasks, EEG, standardized observations, and self-reported measures. Samples included non-parents, different-sex parents, and same-sex parents. Overall, the present work responded to the recent interest in understanding adults’ responses to infant cues going beyond a heteronormative perspective. Our findings reinforced the argument that differences between males and females, if present in the response to infant stimuli, might not always be biologically determined, but reinforced by societal norms. In addition, we supported the relevance of accounting for both past and current experiences of care when investigating the adults’ cognitive and electrophysiological responses to infant cues. Eventually, we started to gain some knowledge on the neurophysiological correlates of sensitive caregiving in different family contexts. On the whole, considering the complexity of plural family models, we hopefully contributed to socializing the idea that there are different ways of conceiving and understanding parenting nowadays.

Nella presente ricerca, che unisce metodologie di tipo sia qualitativo che quantitativo, vengono approfonditi alcuni fattori di rischio potenziale per i “minori stranieri non accompagnati”, in riferimento alle variabili di accentuato svantaggio che caratterizzano il percorso migratorio e i processi di integrazione di questi adolescenti. / In Italy the number of foreign adolescents who experienced the event of unaccompanied migration is constantly and continuously increasing.The research goal was to assess how the early unaccompanied experience of migration, characterized by difficult conditions such as the absence of parents and/or family mandate, influenced the Self representations in autobiographical narrations, depression levels, coping strategies and ethnic identity. And the broad normative-institutional context in which several social-justice workers play a role in the process of protection and custody as well.

Mother child relationship is the first and the most important social relationship as it has implications on psychological and neural development of the individual. Here we investigated mother child relationship focusing on different aspects and using a combination of behavioural and neuroimaging techniques. In the first study we addressed the association between brain connectivity and interpersonal competences which are at the basis of every social interaction including the ones involved in mother-child relationship. Several studies suggests that higher White Matter (WM) integrity - an index of increased brain connectivity - , is associated with better cognition and behavioural performance. To test the hypothesis that higher WM integrity is associated with higher interpersonal competence we used Diffusion Tensor Imaging (DTI), a neuroimaging technique which allows to study in vivo the anatomy of boundless of axons conveying information in the brain. Then we correlated this information with a self-reported measure of interpersonal competences: the Adolescent Interpersonal Competence Questionnaire (AICQ). Results indicate that Interpersonal competence is associate with higher WM integrity in several major tracts of the right hemisphere, in specific the uncinate fasciculus, the cingulum, the forceps minor, the infero-fronto occipital fasciculus, the inferior longitudinal fasciculus, and the superior longitudinal fasciculus. These results provide the first direct analysis of the neuroanatomical basis of interpersonal competencies and young adult self-reported skills in social contexts. In the second work we used the same paradigm to test one of the main assumption of the attachment theory which states that social skills highly depends on the quality of attachment relationship. Results show higher integrity in four white matter association fibers in the left hemisphere: Uncinate Fasciculus, Cingulum, Superior Longitudinal Fasciculus and Inferior Fronto Occipital Fasciculus. This result supports the idea that the quality of the attachment relationship influences the emotional and social life of the individual from childhood to adulthood. Furthermore, the research represents an explorative approach to the study of mother-child relationship in healthy population, demonstrating the feasibility of using neuroimaging tools coupled with clinical investigations. Together those studies show that efficient structural connectivity is linked with secure attachment, improved social cognition and cognitive ability. Similarities and differences emerged in these studies will be discussed at the end of Chapter 3 in particular regarding left and right hemisphere specialization. In the second part of the thesis we switched the focus on parenting behaviour. Evidence from the literature suggest an association between Axonal Integrity measured with FA and functional connectivity measured with TMS in two region involved in preparing ad executing actions: premotor and motor cortex. Moreover neuroimaging reveals that infant cries activate parts of the premotor cortical system. In line with this evidence we linked parenting and brain functional connectivity conducting a study on motor cortex excitability in response of infant cries. We used event-related transcranial magnetic stimulation (TMS) to investigated the presence and the time course of modulation of motor cortex excitability in young adults who listened to infant cries. TMS was delivered from 0 to 250 ms from sound onset in six steps of 50 ms in 10 females and 10 males. Motor Evoked Potentials (MEPs) were recorded from the biceps brachii (BB) and interosseus dorsalis primus (ID1) muscles. Results indicate an excitatory modulation of MEPs at 100 ms from the onset of the infant cry specific to females and to the ID1 muscle. This modulation is considered as automatic response to natural cry as it was not present in response of control sounds and the effect is found at 100-ms latency which make this modulation not compatible with a voluntary reaction to the stimulus but suggests an automatic, bottom-up audiomotor association. These results indicate that the brains of adult females appear to be tuned to respond to infant cries with automatic motor excitation. This effect may reflect the greater and longstanding burden on females in caregiving infants. The second part of the thesis continue with a study addressing the natural condition in which baby cries arise when the parent is not attending for infant stimulation. In this study we investigated how infant crying, compared to control sounds, captures adults’ attentive resources. Participants were all nulliparous women and men, we investigated the effects of different sounds on cerebral activation of the default mode network (DMN) while listeners engaged in two different kind of tasks: one designed to activate the DMN ( self-referential decision task) and one designed to deactivate the DMN (syllabic counting tasks). We found a strong deactivation of DMN in woman during baby cry which suggest a shift of attention from self-referential thinking toward the baby cry stimuli. In men we found instead a weaker deactivation of DMN during woman cry while their attention was directed toward an external task and simultaneously a sudden woman crying arise. Gender differences found in our studies and in the literature will be discussed. In the third part of the thesis we investigated the ability to discriminate synchrony and asynchrony during interaction between mother and child with typical or atypical development. We tested two kind of population: in the first study we compared parents of children with Autism Spectrum Disorder (ASD) to parents of children with Typical Development (TD). In the second study we used the Autistic Quotient questionnaire to divide the sample in two groups according with their autistic traits. The relevance of this task is due to the extreme importance to promptly individuate cues of abnormal social behavior in those cases in which the child might shows deficit in the social development. We hypothesized that individual related with a child with ASD or an individual with high autistic traits, might show similar social difficulties as the individual with ASD finding more challenging to detect cue of appropriate or unappropriated social behavior. To test this hypothesis we asked parents of children with ASD and parents of children with TD to judge video of interactions between mothers and child with ASD and mothers and child with TD. Each video were 20s long and depicted either a synchrony or asynchrony interaction, as categorized by an expert clinician. Contrary to our initial hypothesis results indicate that parents of children with ASD are as accurate as parents of children with TD in discriminating synchrony and asynchrony interaction with ASD, however they are less accurate than parents of children with TD in judging interaction with TD. In the second study by testing individual with higher autistic traits (HAQ group) versus lower autistic traits (LAQ group) we confirmed this trend. Using the same paradigm we found that both groups were less accurate during asynchrony interaction. However HAQ was more accurate in judging synchrony interaction with ASD while LAQ was more accurate in judging synchrony interaction with TD. This result indicate a facilitation effects in understanding interaction which include people that share similar characteristic with the observer disconfirming the hypothesis that people with higher autistic traits would have more difficulties in understanding social interactions and pointing the attention on other factors which might contribute during this process. A discussion on the need of further investigation using neuroimaging techniques to understand similarities and differences on neural processing of social interactions is provided at the end of Chapter 4.