Presa di decisione in situazioni rischiose: effetto della rabbia

The current studies assessed the role of trait anger and anger expression styles on risk decision-making in adulthood, adolescence and childhood. In the first experiment 158 adults completed the STAXI-2 and an inventory consisting of a battery of hypothetical everyday decision-making scenarios. Participants were also asked to evaluate the perception of risk for each chosen option and some contextual characteristics, that are familiarity and salience for each scenario. The study provides evidence for a relationship between individual differences in the tendency to feel and express anger and risky decisions and for mediation effects of familiarity and salience appraisals. Moreover, results indicated that trait anger was predictive of risk perception and they provide evidence for a positive relationship between risk decision-making and risk perception. In the second study, we examined the relationship between specific components of anger (i.e., cognitive, affective and behavioural) and risk decision-making in adolescents. 101 subjects completed specific tasks, measuring risk decision-making, assessed using hypothetical choice scenarios, and anger, evaluated through the STAXI-CA and the MSAI-R. Results showed that adolescents higher on hostility, anger experience and destructive expression, make more risky decisions in everyday life situations. Moreover, regression analyses indicated that destructive expression of anger and hostility were predictive of adolescents’ risky decisions. In the third experiment, 104 children completed three tasks: the STAXI-CA, the MSAI-R and a task measuring risk decision-making in everyday situations. Subjects were also asked to evaluate the degree of danger, benefit, fun and fear perceived for each risky choice. Analyses indicated that: (a) risk decision-making was predicted by both trait anger and outward expression of anger; (b) destructive expression o anger was predictive of children’s risky decisions; (c) appraisal of danger fully mediated the relation between trait anger and risk; (d) perceptions of benefit, scare and fun partially mediated the relationship between trait anger and risk; and (e) appraisal of danger partially mediated the relationship between outward expression of anger and risk decision-making. The results provide evidence for a relationship between dispositional anger and risk decision-making during childhood, suggesting a possible explanation of the mechanisms below. In particular, risk decision-making can be viewed as the output of cognitive and emotive processes, linked to dispositional anger that leads children to be amused, optimistic and fearless in potentially risky situations. These findings substantiate the importance of incorporating cognitive and emotive factors in theories that seek to explain the relationship between personality traits and risk decision making across a broad range of age.

La caratterizzazione endofenotipica del rimuginio

Rumination, defined as the tendency to think about the negative affect evoked by stressful events, has been identified as potentially playing a role in the development of cardiovascular diseases. Specifically, recent studies suggest that ruminative thoughts might be mediators of the prolonged physiological effects of stress. The main goal of this research was to study the effect of rumination, evoked in the laboratory, during the subsequent 24 hours. As rumination has been associated with the activity of several physiological systems, including the cardiovascular, endocrine, and immune system, we also aimed at studying the process from a psychoneuroendocrine point of view. Levels of anxiety, depression, anger, hostility, and trait rumination were assessed by the use of validated questionnaires. Impedance cardiography-derived measures, skin conductance, respiration, and beat-to-beat blood pressure (BP) were monitored continuously in 60 subjects during baseline, the Anger Recall Inteview, a reading task and two recovery periods. Half of the sample was randomly assigned to a distracter condition after the Anger Recall Inteview. Cortisol, plasma concentrations of epinephrine, norepinephrine, and inflammatory biomarkers (CRP, sICAM-1) were also obtained at baseline and at the end of the session. Then, all subjects were asked to wear an ambulatory BP monitor for 24 hours. Results show that the distracter was effective in stopping rumination in the laboratory but did not have a long-lasting effect in the subsequent 24 hours. Rumination was associated with prolonged sympathetic activity, vagal withdrawal, cortisol secrection, pro-inflammatory reaction and mood impairment compared to the reading task. After controlling for age and body mass index, rumination also proved to be a strong predictor of daily moods, and ambulatory HR and BP. Personality traits did not have an effect in determining the frequency or duration of daily rumination. Findings suggest that perseverative cognition can prolong stress- related affective and physiological activation and might act directly on somatic disease via the cardiovascular, immune, endocrine, and neurovisceral systems.

La circolarita' delle idee nel pensiero medico bolognese: la Societa' Medica Chirurgica in Epoca Pontificia

La tesi di Dottorato, saldamente ancorata alle Medical Humanities, si è concentrata sul modo in cui la storia della letteratura italiana si intreccia con le altre discipline, per arrivare a configurare quell’ampio panorama di storia delle idee che aiuta a valutare l’evoluzione stessa delle credenze e dei pensieri dell’uomo nel corso del tempo. Essa ha contribuito a portare alla luce l’apporto dato dalla Società Medica Chirurgica di Bologna in Epoca Pontificia alla circolarità del pensiero medico, ricordando con forza che le varie correnti storico-mediche non sono appunto il semplice susseguirsi di teorie più o meno esatte. La tesi rende pienamente visibili non solo la struttura e le dinamiche della comunicazione scientifica, ma documenta attraverso la letteratura (anche quella scientifica) la presenza della medicina e delle sue pratiche all’interno della società, soffermandosi sui meccanismi, sui percorsi che legano i fenomeni tra loro; viene declinato anche il complesso e travagliato processo teso a ridefinire la figura del medico durante l’epoca del dominio pontificio nel suo declino, circondata da diffidenze e ostilità. Il fulcro della tesi è dato dalla dimostrazione inconfutabile che esiste ancora un ruolo per la cultura umanistica nella formazione del medico.

Psychosocial correlates of rehabilitation from stroke: a longitudinal study

The general aim of this dissertation was to uncover the association between psychosocial factors and rehabilitation outcome after stroke. METHOD. A sample of patients with stroke (n=40) and their caregivers (n=36) were assessed at admission to and six months after discharge from rehabilitation hospital, using the following instruments: Structured Clinical Interview for DSM-IV, structured interview based on Diagnostic Criteria for Psychosomatic Research, Symptom Questionnaire, Psychosocial Index, Psychological Well-Being Scales, and Family Assessment Device. 40 subjects from the general population underwent the same psychological assessment. In addition, patients' functional status was measured using the Functional Independence Measure. RESULTS. Stroke survivors reported lower education and higher alcohol consumption than controls. No significant differences emerged between the two groups in the prevalence of psychiatric diagnoses or psychosomatic syndromes, however patients reported significantly higher levels of anxiety, depression, somatic symptoms, and lower autonomy than controls. Caregivers reported significantly higher scores in anxiety, depression, and somatic symptoms compared to normative data, while no impairments emerged in psychological well-being and family functioning. At six-month follow-up, in patients a significant decrease in smoking habit and an increase in DSM diagnoses were reported. Both stroke survivors and caregivers showed significant reductions in anxiety, with patients displaying also a decrease in somatic symptoms, an increase in stress and a deterioration in quality of life. Significant deteriorations in several aspects of family functioning was perceived only by patients. An association between patients' functional recovery in the cognitive domain and family behavior control emerged. For caregivers, family functioning significantly predicted hostility and somatic symptoms were associated with family affective involvement. CONCLUSIONS. These data highlight the utility in the Italian setting of the adoption of a psychosocial assessment and a family-systems approach in stroke rehabilitation, in order to development interventions properly targeted to the characteristics of patients and their family members.