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.

La tesi si focalizza sui donatori di sangue.Obiettivo del lavoro è quindi la trattazione del fenomeno donazione di sangue al fine di cogliere, nella complessità plurale delle variabili che incidono su questo gesto, la rilevanza degli elementi personali, familiari ed organizzativi connessi all’azione donativa. L’impianto di ricerca è stato costruito procedendo in particolare da un’intuizione di Ferguson (2005): la donazione di sangue dev’essere studiata come un processo di stadi sequenziali. Questo approccio deriva dalla revisione del Transtheoretical Model di Prochaska e collaboratori (1982) sulla donazione di sangue (Ferguson, 1996; Ferguson e Chandler, 2005)e dal Volunteer Process Model di Omoto e Snyder (1995, 2000). L’azione donativa è quindi studiabile come un processo che, dall’avvicinamento iniziale, può portare alla nascita dell’Identità di Ruolo di donatore (Piliavin et al., 1999), alla ripetitività cadenzata del gesto e, quindi, alla fidelizzazione. Alla luce dell’obiettivo generale e della scelta di questi approcci, la popolazione di interesse del lavoro è ampia e varia: i primi studi si incentrano, infatti, su neodonatori; il terzo studio confronta neodonatori e donatori fidelizzati; il quarto studio, incentrato su donatori fidelizzati. La logica sequenziale “a scatole cinesi” con cui gli studi sono costruiti ha seguito anche l’altro elemento rilevante dell’obiettivo generale di questo lavoro: l’affondo sulle variabili personali, familiari ed organizzative connesse alla donazione di sangue.Il 1 studio, il cui obiettivo era Identificare tipologie specifiche di persone alla luce delle variabili della Scala Stadi di Cambiamento, mostra come coloro che si avvicinano a donare non possano essere considerati un gruppo omogeneo rispetto alla loro “prontezza” a donare. Evidente, allora, la necessità di costruire strategie di accoglienza differenziate.Il 2 studio, il cui obiettivo era Testare un modello Predittivo dell’Intenzione a Donare sangue con neodonatori, ha la peculiarità di contribuire a comprendere quali variabili intervengono nell’Intenzione a donare per i NEODONATORI.Il 3 studio conferma l’influenza della famiglia di impegnarsi in questo gesto, ed approfondisce le costellazioni motivazionali che avvicinano e che sostengono questo gesto nel tempo.Il 4 studio evidenzia, forse per la prima volta in modo chiaro, il ruolo delle variabili organizzative nell’influenzare non solo l’integrazione in associazione, ma anche la soddisfazione percepita per l’atto della donazione.La donazione di sangue, pur essendo un atto personalmente scelto, quindi, deriva da una costellazione di variabili personali, familiari ed organizzative complementari e mutualmente intersecantisi, che necessitano di essere approfondite e studiate nella loro globalità al fine di arrivare alla creazione di strategie di reclutamento e di fidelizzazione che portino alla soddisfazione totale del bisogno di scorte di sangue. / This work is focused on blood donors. This research’s purpose is the discussion of the blood donation’s phenomenon in order to grasp the complexity of plural variables affecting this gesture, the significance of personal, family and organizational action related gifts. The research starts by the revision of the Transtheoretical Model by Prochaska and colleagues (1982) on blood donation (Ferguson, 1996, Ferguson and Chandler, 2005) and the Volunteer Process Model by Omoto and Snyder (1995; 2000). The donation action has been studied as a process: by the approach, the birth of Role Identity of donor (Piliavin et al., 1999), the rhythmic repetition of the gesture, and therefore loyalty. Participants are wide and varied: the first studies focus, in fact, on neodonors; the third study compares neodonors and retained donors, the fourth study, is focused on Retained donors. The thesis is composed by four research studies. The first study’s aim is to identify genders of people on the basis of the variables of the Stages of Change Scale. It shows how the subjects who donate cannot be considered as a homogeneous group considering their "readiness" to donate. It is evident, then, the need of building strategies for different reception. The second study develops a model of the explanatory factors determining the predisposition to donate blood in neodonors will. The third study confirms the influence of the family to engage in this act, and explores the motivations that substained this act. The fourth study shows clearly, maybe for the first time, the role of organizational variables in influencing not only the integration in Avis, but also the perceived satisfaction for the act of donation. The blood donation, in spite of being a personal choice action, derives from a constellation of personal variables, complementary and mutually intersecting. this complex systems here studied in its entirety in order to create more proper recruitment and maintaining strategies that can lead to the total satisfaction of blood supply needs.

Made available in DSpace on 2017-06-01T18:08:32Z (GMT). No. of bitstreams: 1 suely santos.pdf: 1890183 bytes, checksum: f79780e2ec4600c84458378e632d21fd (MD5) Previous issue date: 2006-05-15 / The present research deals with the experience of being ex wife as a relevant subjective phenomenon, expressed in the actual reality of human being, although, yet, careless by appropriate comprehensive studies about its meaning in the contemporaneous world. The existential phenomenological methodology by the way of the narrative was chosen to conduct a Clinical Psychology research, taking into account that such mode of research may present a fertile theoretical and analytical path to guide toward the comprehensive sense of the experience of being ex wife for the contemporaneous women. A sociopsychodramatical workshop was taken as the clinical interventive modality to facilitate the narrative as expression. The subjects/narrators were six women that, after lived an interrupted conjugal relationship, presented various situations and expressions of the experience of being ex wife. The methodology reveals itself capable of promoting the conditions of the elaboration of experience, possibilited by the expressed care of listening/saying toward the experience of being ex wife, such as the considerative articulation of the opening it as the proper being-in-the world of the human being. In this way, this psychological clinical research emphasizes its interventive and interpretative character. The comprehension of the spoken and dramatical forms of the obtained narrative pointed to a possible felt meaning for the experience of being ex wife: to embody her own project for existing as a care of being-herself-with-others / Esta pesquisa enfoca como fenômeno subjetivo, expresso na realidade atual do ser humano, a experiência de ser ex- esposa, relevante mas ainda carente de estudos compreensivos pertinentes quanto à sua significação no mundo contemporâneo. A escolha em realizar uma pesquisa em Psicologia Clínica, recorrendo à metodologia fenomenológica existencial via a narrativa, aconteceu, por entender que esse modo de pesquisar pode apresentar-se como um caminho de grande fertilidade teórica e mordência analítica para a compreensão do sentido vivido pela mulher contemporânea na experiência de ser ex-esposa. A oficina sociopsicodramática foi a modalidade de intervenção/investigação clínica escolhida para a-colher a narrativa. As sujeitos/narradoras foram seis mulheres que, após uma relação conjugal interrompida, apresentavam variadas situações e expressões da experiência de ser ex-esposa. A própria metodologia revelou-se capaz de promover as condições de elaboração dessa experiência, à medida que possibilitou a presença do cuidar do escutar/dizer da experiência de ser ex-esposa na contemporaneidade, bem como a articulação considerativa com o desvelar do próprio ser-no-mundo do humano. Nesse sentido, destaca-se o caráter interventivo e interpretativo desta pesquisa clínica psicológica. A compreensão das formas falada e dramática de narrativa colhida apontou para um possível significado sentido para a experiência de ser ex-esposa: encarnar o seu projeto de existir como cuidado de ser-si-mesma-com-os-outros

Made available in DSpace on 2017-06-01T18:08:53Z (GMT). No. of bitstreams: 1 Inalda _Oliveira.pdf: 479560 bytes, checksum: 4a6a4f3cd347283e0f1c342171652cea (MD5) Previous issue date: 2000-02-22 / The purpose of the present research was to understand the nature of the feelings demonstrated by mothers who are experiencing the separation/individuation process of an adolescent son (daughter) as symbolized by the vestibular entrance exam and to analyze the possible effect of these feelings on the vocational choice of their children. The study had the collaboration of 8 mothers, ages between 39 to 43, which were going through the vestibular situation for the first time. Using semi-directive interviews the research analyzed the following dimensions: predominant feelings in face of the vestibular situation; the mother s perception of the son s (daughter s) differentiation process; their reaction to autonomy manifestations on the son s (daughter s) part; the meaning the mother attributes to the vestibular; a possible relation between the mother s career choice and the moment the adolescent faces and the mother s perception of possible changes in her life as a result of the vestibular situation. Each interview was first analyzed as an individual case study and afterward they were all compared to each other in relation to the above mentioned dimensions. It was observed that the high level of anxiety the mothers demonstrated in face of the situation represented a sum of feelings related to the difficulty of elaborating the separation/individuation process in their children. Mothers tended to: 1) perceive their sons (daughters) as dependent and immature; 2) identify with the adolescents in a symbiotic manner of relation and to deny possible changes in their own lives in view of the new situation; 3) interfere directly in their son s (daughter s) career choice; 4) perceive the vestibular situation as a victory or accomplishment mainly for themselves, instead of the adolescent s, which denoted how some mothers feel that they re valued by their children s performance. The research concluded that this resistance in face of the differentiation process interferes in a negative way in their children s career choices and contributes to difficult the elaboration of a personal life project by adolescents. It was empathized that such influence is mainly due to the moment when the vestibular takes place in Brazil, in which the adolescent is chronologically imature, fact that contributes to difficult the separation process / A presente pesquisa teve como objetivo compreender os sentimentos que as mães apresentam frente ao processo de separação/individuação do filho (a), simbolizado pela situação do vestibular, e analisar os possíveis efeitos que eles têm na escolha vocacional/ocupacional dos filhos(as). Participaram da pesquisa 8 mães, compreendidas na faixa etária de 39 a 43 anos, que estavam vivenciando, pela primeira vez, o vestibular de um filho. Através de entrevistas semi-dirigidas buscou-se analisar as seguintes dimensões: sentimentos predominantes frente à situação do vestibular, percepção do processo de diferenciação do filho (a), reações apresentadas frente às manifestações de autonomia do filho(a), significado que o vestibular assume para a mãe, possíveis relações entre a escolha profissional da mãe e o momento vivido pelo filho(a) e a percepção, por parte das mães, de possíveis mudanças em suas vidas a partir do vestibular do filho(a). Cada entrevista foi analisada como um estudo de caso independente e, em seguida, foi estabelecida uma comparação entre as respostas de todos os depoimentos nas dimensões pesquisadas. Observou- se que o elevado nível de ansiedade apresentado pelas depoentes frente à situação do vestibular constituía-se num somatório de sentimentos relacionados à dificuldade de elaborar o processo de separação/individuação do filho(a). As mães tenderam a: 1) perceber os filhos(as) como dependentes e imaturos; 2) a identificar-se com eles de forma simbiótica e a negar a possibilidade de mudanças em suas vidas diante da nova situação; 3) interferir diretamente na escolha profissional dos filhos(as); 4) atribuir ao vestibular o significado de vitória e realização principalmente delas mesmas, demonstrando que se sentem avaliadas em seu papel parental pelo desempenho dos filhos(as). Concluiu-se que tal resistência à diferenciação do jovem, influencia negativamente na possibilidade de escolha profissional e na elaboração de um projeto pessoal de vida por parte do adolescente. Foi salientado que tal influência ocorre principalmente pelo momento que o vestibular ocorre no Brasil, no qual o adolescente está cronologicamente imaturo, o que contribui para dificultar o processo de separação

Clinical and research practice in the context of Autism rapidly evolved in the last decades. Finer diagnostic procedures, evidence-based models of intervention and higher social inclusivity significantly improved the possibility for autistic children to participate in the fabric of social life. In terms of health best practices, gold-standard procedures still need to be improved, and bridging research and clinical practice still presents several challenges. From the clinical standpoint, the role of process variables, predictors, mechanisms, and timing of change still requires extensive investigation in order to explain response variability and design optimized interventions, tailored to individual needs and maximally effective. Observational techniques represent the elective research methods in child development, especially in clinical contexts, due to their non-invasiveness. However, they still suffer from limited objectivity and poor quantification. Further, their main disadvantage is that they are highly time-consuming and labor-intensive. The aim of this thesis was moving forward to promote translational research in clinical practice of Autism intervention with preschool children. At first, we tried to design and apply quantitative observational techniques to longitudinally study treatment response trajectories during developmental intervention. We tried to characterize different response profiles, and which baseline predictors were able to predict the response over time. Secondly, we investigated mechanisms of change. In particular, we focused on the role of the child-therapist interaction dynamics as a possible active mediator of the process of intervention, especially in the developmental framework that stresses the importance of interpersonal aspects. We also aimed at understanding whether certain time-windows during the intervention were particularly predictive of the response, as well as which specific interaction aspects played a role. Finally, to promote the translational application of observational methods and to improve objective quantification, we proposed and validated an Artificial Intelligence (AI) system to automate data annotation in unconstrained clinical contexts, remaining completely non-invasive and dealing with the specific noisy data that characterize them, for the analysis of the child-therapist acoustic interaction. This effort represents a base building block enabling to employ downstream computational techniques greatly reducing the need for human annotation that usually prevents the application of observational research to large amounts of data . We discuss our findings stressing the importance of assuming a developmental framework in Autism, the key role of the interpersonal experience also in the clinical context, the importance of focusing on trajectories of change and the important need to promote the acquisition of large amounts of quantitative data from the clinical contexts exploiting AI-based systems to assist clinicians, improving objectivity, enabling treatment monitoring, and producing precious data-driven knowledge on treatment efficacy.

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.

[pt] O presente estudo parte da insistente indagação sobre os motivos da falência das redes públicas brasileiras de atenção à saúde. Apesar de instituído na Constituição da República de 1988 como um sistema público de saúde que se pretende de cobertura integral e acesso universal, o Sistema Único de Saúde (SUS), na prática, não avançou neste sentido. Pelo contrário, são enormes as desigualdades em saúde no Brasil. O objetivo deste estudo é demonstrar que uma das principais chaves para a superação desta adversidade se encontra na forma como as ações e serviços públicos de saúde no Brasil são financiadas. Afirma-se que o atual modelo de financiamento do SUS apresenta ineficiências e promove iniquidade. No primeiro capítulo são apresentados os aspectos do direito à saúde sob a ótica global, buscando traçar um panorama dos conceitos e tendências desta área do conhecimento. O segundo capítulo discute o conflito entre a infinitude das demandas de saúde e a escassez de recursos para supri-las, procurando destacar a importância do equilíbrio entre as dimensões da equidade e da eficiência durante o exercício da tarefa de alocação de recursos sanitários. O terceiro e o quarto capítulos tratam propriamente do financiamento do SUS. O terceiro capítulo se ocupa com o padrão dos gastos públicos, tornando evidente que os governos brasileiros historicamente se imiscuem da responsabilidade de promover o financiamento adequado das ações e serviços públicos de saúde. O quarto e último capítulo aborda um outro aspecto problemático do financiamento do SUS, qual seja, a ausência de um pacto interfederativo que promova a colaboração mútua entre os entes federativos, situação que prejudica a harmonia do sistema. / [en] This research explores the persistent question regarding the reasons for the failure of the Brazilian Public Health System. Although the Brazilian Constitution of 1988 envisioned its Unified Health System (Sistema Único de Saúde) to become an universal system intended to guarantee full access and coverage for all, in practice this concept has never materialized. On the contrary, there are enormous inequalities on the delivery of health in Brazil. This research aims to demonstrate that methods of financing are one of the key elements to overcome such arduous situation. It is asserted that the current health financing model in Brazil is inefficient and ultimately promotes inequality. The first chapter reflects on aspects related to right to health from a global perspective, mapping the key concepts and tendencies of Global Health. The second chapter deliberates on the conflict between the infinite demand for health and the scarcity of resources to fulfill such demand, them, highlighting therefore the great importance of achieving a balance between equity and efficiency when conducting the task of allocating health resources. The third and the fourth chapters are addressed to the financing of the Brazilian s Unified Health System. The third chapter considers the Brazilian pattern of public health spending, in order to demonstrate that, historically, Brazilian governments evaded their responsibility of providing adequate health financing. The fourth and last chapter examines another problematic aspect of the public health financing in Brazil, which is the lack of cooperation between the federal units, the absence of such inter-federal covenant is believed to be detrimental to the health system as it impacts on its harmony and unity.

La capacità di esprimere adeguatamente le emozioni attraverso l’uso di strategie adattive di regolazione delle emozioni è cruciale per il sano sviluppo dei bambini. Secondo la teoria dell'attaccamento di Bowlby, la reattività e la regolazione emotiva dei bambini sono correlate ai loro stili di attaccamento. Il presente studio mira ad indagare se l'interazione tra la classificazione di attaccamento e l’espressione emotiva può predire i cambiamenti nella reattività fisiologica dei bambini durante un compito stressante. In un primo momento (T1), le rappresentazioni di attaccamento di N = 59 bambini in età scolare sono state misurate utilizzando la Child Attachment Interview. In un secondo momento (T2), i bambini hanno sostenuto un’impegnativa procedura di laboratorio standardizzata in cui dovevano cercare di risolvere una serie di puzzles risolvibili e irrisolvibili. I livelli di conduttanza cutanea (SCL), l'aritmia sinusale respiratoria (RSA) ed i livelli di cortisolo sono stati registrati come indici fisiologici durante l’intero compito. Le espressioni emotive facciali dei bambini (tristezza e vergogna) sono state codificate durante il quarto puzzle irrisolvibile. I risultati hanno evidenziato che l'espressione dell'emozione modera la relazione tra l'attaccamento evitante e le risposte fisiologiche: in alcuni compiti sono stati mostrati una RSA più bassa e dei SCL più alti; inoltre, l'interazione tra attaccamento ed espressione emotiva di ritiro era associata ad un aumento quasi significativo dei livelli di cortisolo durante l’intera esecuzione dei puzzles. I risultati rivelano che la presenza di attaccamento evitante modulata dall'espressione emotiva di ritiro induce uno stress fisiologico più elevato nei bambini. Comprendere i fattori che influenzano la reattività allo stress nei bambini è essenziale nello sviluppo di interventi che promuovano un adattamento funzionale in risposta al disagio.

Nel presente lavoro di tesi sono riportati i risultati di un innovativo progetto di ricerca longitudinale nell'ambito della psicobiologia. I recenti progressi nel campo dell'epigenetica sono stati applicati allo studio delle conseguenze di esperienze avverse precoci sullo sviluppo socio-emozionale in bambini nati fortemente pretermine. La nascita pretermine costituisce un fattore di rischio per lo sviluppo socio-emozionale, in parte per l'esposizione ad eventi stressanti (es.: dolore neonatale) durante l'ospedalizzazione in terapia intensiva neonatale (TIN). L'epigenetica si riferisce a processi biochimici altamente sensibili alle esperienze ambientali e che alterano la funzione di trascrizione di specifici geni, senza modificare la struttura della sequenza di DNA. Il candidato ha sviluppato un razionale clinicamente rilevante per la ricerca epigenetica comportamentale della prematurità. Inoltre il progetto di ricerca ha dimostrato che il livello di esposizione a procedure dolorose si associa a esiti avversi sul piano temperamentale e della risposta allo stress a tre mesi e che tale associazione è mediata da alterazioni epigenetiche a livello del gene che codifica per il trasportatore della serotonina. Le implicazioni teoriche, cliniche ed etiche di questi risultati sono trattate nella sezione conclusiva. Il progetto di epigenetica comportamentale della prematurità fornisce una nuova prospettiva teorica ed empirica sul tema dell’interazione tra genetica ed ambiente. / In the present work, the candidate reports the results of an innovative longitudinal research project in the field of psychobiology. The recent epigenetic progresses have been applied to the study of the consequences of early adverse event exposures on the socio-emotional development of very preterm infants. Preterm birth is a major concern for socio-emotional development, partly due to the exposure to adverse stressful stimulations (i.e., skin-breaking procedures) during the Neonatal Intensive Care Unit (NICU) stay. Epigenetics refers to biochemical processes which are sensitive to environmental cues and which alter the transcriptional activity of specific genes without changing the DNA structure. The candidate has developed a clinically relevant rationale for preterm behavioral epigenetics (PBE). The research project has demonstrated that the early exposure to high levels of skin-breaking procedures during NICU stay associate with non-optimal temperamental profile and stress regulation at 3 months of age. This association was mediated by epigenetic modifications (DNA methylation) of the stress-related gene encoding for serotonin transporter. The theoretical, clinical and ethical implications of these findings are discussed further in the final section of the thesis. The PBE project provides a new framework for the issue of the interconnections between nature and nurture.

La presente ricerca, con un approccio qualitativo-ermeneutico, esplora il fenomeno del conflitto armato colombiano, con un focus specifico sul processo di reintegrazione sociale e sull’esperienza soggettiva come ex sequestrati e come ex guerriglieri. La ricerca consente un’esplorazione in profondità, integrando la dimensione politico-sociale con quella clinica, lasciando alla luce tre vertici d’analisi; Studio 1: le rappresentazioni sociali intorno alle figure di vittime e di carnefice e alle dinamiche relazionali del conflitto armato colombiano; 
 Studio 2: l’approccio, i metodi e le tecniche di lavoro degli operatori che si occupano di reintegrazione sociale di ex sequestrati (nella Fondazione País Libre) e di ex guerriglieri (nell’Agenzia Colombiana per la Reintegrazione, “ACR”); 
 Studio 3: le matrici familiari e i suoi principali risorse relazionali che hanno supportato i soggetti durante la loro esperienza come sequestrati e come guerriglieri e una volta rientrano in società. Sono analizzati i tre assi delle matrici familiari (le origini, i rapporti di coppia e il passaggio generazionale –Cigoli & Tamanza, 2009- e le risorse che possono alimentare la resilienza familiare (Walsh, 2005) Gli studi cercano di superare la dicotomia vittima/carnefice, che organizza l’opinione pubblica colombiana e le rappresentazioni sociali delle figure di ex-sequestrati (le vittime) ed ex-guerriglieri (i carnefici). I risultati degli studi effettuati possono fornire strumenti utili per orientare l’intervento clinico e favorire il processo di reintegrazione sociale. Si presentano a sua volta nuovi approcci che includono il lavoro decisivo delle comunità e delle famiglie, che si presentano come attori partecipativi e non passivi e vittimizzati come generalmente sono trattati. / The current research (with a qualitative-hermeneutic approach) explores the phenomenon of Colombian armed conflict. It is specifically focus on social reintegration process and the subjective experience of ex combatants and ex abducted people. The study of the phenomenon in its clinical and sociopolitical complexity, articulates three vertices of analysis: Study 1: Social representations, around the current armed conflict and its involved figures. Study 2: The principal models of intervention offered by two organizations that work directly with ex abducted people (País Libre Foundation) and with demobilized people from illegal groups (Colombian Agency for Reintegration, “ACR”). Study 3: Family patterns, and its principal relational resources tan have supported subjects during their experience as abducted or combatants and once their return to society. The three axes of family patterns were explored (the origins, the couple relationship and the generational passage –Cigoli & Tamanza-) and the resources that can support family resilience (Walsh, 2005). Results break traditional polarization on the lectures around Colombian armed conflict. The present research transcends the individual study of involved participants and of implications of traumatic facts, to explore inside their relationships and resources. New approaches are presented to orientate interventions in clinical psychology that could be helpful to social reintegration process. It is also presented a new approach that includes the decisive role of families and communities as active actors instead of passive and victimized as they have been generally treated.