Stress management in mothers of children with Autism Spectrum Disorder : psychological characteristics, coping strategies and biological correlates

Un figlio con un Disturbo dello Spettro Autistico, caratterizzato da gravi difficoltà nelle relazioni, nei comportamenti e nella comunicazione, costringe tutto il sistema familiare a gestire un notevole stress dovuto alla gestione quotidiana di una patologia così complessa. Per questi motivi, i genitori necessitano di un sostegno il più possibile personalizzato rispetto alle caratteristiche del loro contesto familiare. Per fare questo sarebbe importante individuare quali siano i parametri correlati ai livelli di stress nei familiari di pazienti con autismo e che potrebbero avere un’influenza sul benessere familiare. Lo scopo di questo studio è quello di valutare quali caratteristiche di personalità, stili di coping e capacità di gestire le emozioni possano essere in relazione con la reattività individuale alle situazioni di stress, valutata attraverso alcuni correlati biologici, quali il livello di cortisolo (l’ormone dello stress) e la variabilità della frequenza cardiaca. L’ottica di ricerca applicata fa sì che gli obiettivi ultimi di questo lavoro siano anche quelli di diminuire l’accesso ai servizi per questi soggetti, considerando il fatto che progetti individualizzati di sostegno genitoriale costituiscono un fattore protettivo rispetto a conseguenze fisiche e psicologiche di disagio se implementati tenendo conto della variabilità individuale rispetto alle caratteristiche sopra citate.

Consequences of adolescent's evening preference on psychological functioning: a review

This review provides an overview of the role of circadian preference in psychological functioning of adolescents taking into account their shift to eveningness during this stage of life. After a brief explanation about morningness/eveningness and other terms related, an overview of the changes that occur on three of the most important areas in the adolescent‟s life is presented: school performance, personality styles, and health. Consequences of evening preference on school achievement are considered from the analysis of the relevance of sleep debt and time-of-day in cognition and mood aspects. In general, students who are able to choose activity times coinciding with their preferred times may have a greater opportunity to optimize their performance. The personality styles and health of morning and evening types are also important factors related to school and family adaptation. At last, some recommendations and conclusions in order to promote a healthy psychological functioning are described.

Development of a psychological assessment battery to measure client beliefs about the effectiveness of psychotherapy

The author attempted to develop a brief scale to measure clients' beliefs about the effectiveness of psychotherapy. The study is an early pilot study to determine if the scale can predict therapy outcomes. While the scale did differ significantly between clients who were active in therapy and those who were not, higher scores on the instrument were not indicative of greater involvement. Possibilities for future research to refine the instrument are discussed.

Psychological and Social Perspectives on Malingering and Symptom Exaggeration: Conceptualization and Interventions Using Acceptance and Commitment Therapy

Malingering and the production of false symptoms seen in such disorders as Factitious Disorder are an ongoing mystery to medical and mental health professionals. Historically, these presentations have been difficult to identify and treat. As might be expected, individuals with such symptomology rarely agree to participate in research, possibly because of a reluctance to admit to the feigning or exaggerating behaviors and a fear of reprisals. Many different etiologies have been proposed, including the assumption of roles in order to manage impressions, taking control of symptoms in order to gain attention or other rewards or avoid aversive events, and even the production of symptoms that is largely out of awareness such as is seen in conversion or somatoform presentations. By examining historical and present-day beliefs about etiology and treatment interventions, professionals can explore what new types of effective treatment might look like. The behaviorist philosophy that underlies Acceptance and Commitment Therapy proposes a perspective emphasizing effective working in context. This philosophy also suggests individuals sometimes engage in behavior in order to escape from or avoid aversive experiences. Utilizing case examples and fresh behavioral perspectives provides insight and ideas for conceptualization of these behaviors of interest. Using the above conceptualizations, an ACT based treatment of those who produce false symptoms is introduced.

The Perks of Playing Dress-Up: Psychological Impressions of Fashion and Feminism.

Research on the psychological impact of women's fashion has focused on fashion's negative influence over how women think and feel about themselves. Several studies have examined the relationship between fashion and women's self-appraisals (Martin & Gentry, 1997; Pinhas, Toner, Ali, Garfinkel, & Stuckless, 1999; Tiggemann, Polivy, & Hargreaves, 2009), although few investigations have explored the range of viewpoints that arise when women interact with their own personal style or with other forms of fashion media. This paper presents a narrative review of what has been written about fashion in clinical research. I briefly discuss why this is an important topic and why fashion has psychological meaning. Cognitive behavioral therapy (CBT) is considered in the exploration of fashion's impact on conjuring unproductive and productive schemas (Beck, 1976; Wright, Basco, & Thase, 2006). This discussion includes a presentation of interviews with female consultants, hypothetical examples, my own accounts, and feminist perspectives. While emphasizing the potential biases of women's interactions with fashion, I discuss matters of gender performance and reflections on clinical work. The purpose of this article is to present a pro-social defense of fashion. I do this by acquiring personal chronicles, applying those findings to the current body of research, and adding to the continued investigation of why women's fashion is still important in a postfeminist world.

A Framework for Addressing Psychological Inflexibility Among Act Therapists-In-Training.

Novice therapists training in Acceptance and Commitment Therapy (ACT) may encounter challenges in therapy in which their own personal history functions as a barrier to flexible modes of therapeutic engagement with the therapist. From the ACT perspective, counter-therapeutic interpersonal responses may be examined relative to six behavioral sub-processes. It is suggested that the most vulnerable moments for the therapist will involve those in which certain contextual features of therapy pull historical awareness of a painful personal past into relation with the psychological present. This paper hypothesizes that utilizing approaches based in ACT will assist therapists in overcoming these challenges and will illustrate how to approach case formulation and intervention with therapists in training from a functional contextualistic perspective. To begin, the philosophical and theoretical underpinnings of ACT will be outlined in sufficient depth to intellectually ground the model and its therapeutic project. This conceptual foundation will then be brought to applied focus using hypothetical case material, followed by ACT interventions designed to increase clinical flexibility in the given therapeutic scenario. Future research that systematically examines the effectiveness of such methods among therapists is encouraged.

Weight-Based Emotional Abuse: Self Psychological Implications for Treatment

The aim of this paper is to provide evidence that overweight individuals are at increased risk for emotional abuse compared to their normal weight counterparts. Studies examining weight-based discrimination and bullying demonstrate examples of emotional abuse aimed at overweight individuals. The psychological difficulties associated with emotional abuse, such as symptoms of anxiety, depression and social difficulties, are reviewed. It is hypothesized that similar psychological difficulties are experienced when obese persons experience weight based emotional abuse. A self psychological conceptualization is applied to understand the effect emotional abuse has on one's sense of self. A treatment proposal, which aims to utilize self-object transferences to strengthen the self, is offered. Future research for the application of self psychology in a group therapy format is discussed.

Clinical Implications for Working with Gay Men A Self Psychological Treatment Approach.

Specific training for conducting psychotherapy with gay men is limited for psychologists, particularly when using a Self Psychology theoretical orientation (Robertson, 1996). In fact, psychologists often are faced with conflicting and contradictory points of view that mirror society's condemnation of homosexuality (Robertson, 1996). This paper is written from a self-psychological perspective to address the lack of a constructive body of literature that explains the unique treatment needs which impact gay men. Estimates of the prevalence of male homosexuality have generated considerable debate. A common assumption is that there are homosexual and non-homosexual men. However, scientists have long been aware that sexual responsiveness to others of the same sex, like most human traits, is continuously distributed in the population (Michaels, 1996). Still the presumption exists that such traits are stable within each man over time (Michaels, 1996). Conflating same-sex sexual experiences with a categorization of the man as homosexual is problematic, in that defining sexuality solely on the basis of experience excludes people who fantasize about sex with others of the same sex but never have sexual contact. Thus, most modern conceptions of sexual orientation consider personal identification, sexual behavior, and sexual fantasy (McWhirter, Sanders & Reinisch, 1990). Gay men's mental health can only be understood in the context of homosexuality throughout history, since religious and moral objections to sexual attraction between men have existed for centuries. Men who desired other men were regarded as sinful and depraved if not ill or abnormal, and same sex contacts were not distinguished from lewd behaviors (Weeks, 1989). Although most people, regardless of sexual orientation, have experienced some feelings of personal rejection, rarely do heterosexuals become targets for disapproval based on the nature of their attractions and behaviors relative to the same and to the other sex. For lesbians, bisexuals, and gay men, however, homosexuality becomes the focus of aspects of themselves that make them feel hated and hateful (Isay, 1989). While gay men and lesbians are often considered together because of the same-sex nature of their relationships and the similar issues that they may experience in their treatment within society, there are many issues where they might be best studied separately. Issues involving with health, parenthood, sexuality and perceived roles and status in society, for example, are often related more to gender than to any shared concept of a 'gay and lesbian community'. Many issues surrounding lesbians and lesbian culture will have more to do with women's issues, and some issues involving with gay men will have more to do with the gay male subculture and with masculinity. The author of this paper has limited experience in working with lesbian and bisexual individuals, and although it is likely that some of the concepts articulated in this paper could translate to working with lesbian and bisexual individuals, further research is indicated to examine the beneficence of utilizing a Self Psychological orientation in psychotherapy with lesbian women and bisexual individuals. This paper presents an overview of the literature including historical treatments of homosexuality, the history of Self Psychology, key principles in Self Psychology, research on Self Psychology, identity development models for gay men, and Self Psychological perspectives on identity development related to gay men. The literature review is followed by a section on treatment implications for psychologists seeking to treat gay men, including case vignettes based on work from my own practice. I have preserved the anonymity of clients by changing demographics, and rearranging and combining presenting issues and historical backgrounds among the case examples.

Recovery from Pediatric Brain Injury: A Preliminary Comparison of Longitudinal Data on Psychological Symptomology and Mental Health Treatment

Objective: To document the course of psychological symptomology, mental health treatment, and unmet psychological needs using caregiver reports in the first 18 months following pediatric brain injury (BI). Method: Participants included 28 children (aged 1-18 years) who were hospitalized at a children's hospital's rehabilitation unit. Caregiver reports of children's psychological symptoms, receipt of mental health treatment, and unmet psychological needs were assessed at one month, six months, 12 months, and 18 months post-BI. Results: Caregivers reported a general increase in psychological symptoms and receipt of mental health treatment over the 18 months following BI; however, there was a substantial gap between the high rate of reported symptoms and low rate of reported treatment. Across all four follow-up time points there were substantial unmet psychological needs (at least 60% of sample). Conclusions: Findings suggest that there are substantial unmet psychological needs among children during the first 18 months after BI. Barriers to mental health treatment for this population need to be addressed.

Gay Couples Who Adopt Children Who Have Been Abused: Ideas and Interventions From a Self Psychological Perspective to Facilitate the Adoption Process

here are currently hundreds of thousands of children in the US foster care system who are all in need of a stable and predictable home with parents on whom they can depend. Recently, there has been an increased interest in adoption from gay couples who want to start a family. Because the majority of children in the foster care system have some sort of abuse or neglect history, a large number of them present with difficulties such as oppositional behavior, mood dysregulation, and other kinds of mental health problems. This paper addresses the unique situation of gay couples who adopt children who have been abused. Kohut's self psychology theory is utilized to help identify strengths and potential problems that could arise from this type of situation. Particular attention is given to the three selfobject needs that are central in self psychology: mirroring, idealization, and twinship. Additionally, ideas for interventions are posed for potential adoptive parents and mental health professionals to use to help the adoption process progress more smoothly and to hopefully lead to long-term, healthy placements.