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PURPOSE: The present study examines the impact of traumatic childhood experiences in people with obesity seeking bariatric surgery. It considers the presence of eating disorders (ED) in the population with obesity and tests the role of attachment and family relationships as mediators of the relationship between traumatic events and ED. METHOD: 110 participants with severe obesity and 98 participants of a healthy weight (control group) filled out The Childhood Trauma Questionnaire (CTQ-SF), the Attachment Style Questionnaire (ASQ) and the Family Adaptability and Cohesion Evaluation Scale (FACES IV). RESULTS: Comparing the two groups on psychological variables, higher scores in the CTQ Emotional neglect and ASQ insecure attachment scales emerged in the control group than the group with obesity. Considering the presence/absence of an ED only in the group with obesity, and comparing these subgroups, higher scores in traumatic experiences emerged in the individuals with obesity and with ED than the individuals with obesity without ED. Moreover, participants with ED scored higher in ASQ insecure attachment and had lower levels of flexibility in family functioning than the group without ED. Finally, Logistic Regression models showed that insecure anxious attachment and dysfunctional familial relationships affected the relationship between traumatic childhood experiences and the presence of ED in the group with obesity. CONCLUSION: These findings suggest the importance focusing on psychosocial factors linked to obesity, specifically on attachment styles and familial relationships as emotion regulation strategies, since the impact of traumatic childhood events on psychopathology could be ameliorated by an individual's ability to rely on a significant attachment figure. LEVEL OF EVIDENCE: Level II, evidence obtained from well-designed controlled trials without randomization.
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Cirurgia Bariátrica , Transtornos da Alimentação e da Ingestão de Alimentos , Obesidade Mórbida , Testes Psicológicos , Autorrelato , Humanos , ObesidadeRESUMO
Rheumatoid arthritis (RA) is a chronic inflammatory disease, causing joint-swelling and pain. International literature highlights that patients with RA are more likely to report high levels of alexithymia, adverse childhood events (ACEs) and stress, but studies investigating the association between these dimensions are lacking. The general aim of the present study is to investigate the association between alexithymia, ACEs, and stress in RA patients and to highlight possible predictors of greater perceived stress. One hundred and thirty-seven female patients with RA (mean age = 50.74; SD = 10.01) participated in an online survey between April and May 2021. Participants completed a questionnaire for the collection of sociodemographic and clinical information, the 20-item Toronto Alexithymia Scale, the Adverse Childhood Events questionnaire and the 10-item Perceived Stress Scale. The correlational analysis highlighted several significant associations between the dimensions evaluated. Regression analyses showed that alexithymia, ACEs and the perceived health status have a predictive effect on the perceived stress of RA patients. More specifically, the role of difficulty in identifying feelings, and the physical and emotional neglect, has been highlighted. ACEs and high levels of alexithymia are common in RA clinical populations and seem to affect the wellbeing of these patients. The use of a biopsychosocial approach to RA treatment appears essential in achieving a better quality of life and illness control in this specific clinical population.
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Artrite Reumatoide , COVID-19 , Humanos , Criança , Feminino , Pessoa de Meia-Idade , Sintomas Afetivos/epidemiologia , Sintomas Afetivos/psicologia , Qualidade de Vida , Pandemias , COVID-19/epidemiologia , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/psicologia , Estresse Psicológico/epidemiologiaRESUMO
PURPOSE: This research aims to analyze the relationship between emotional regulation and the symbolic process in autobiographical narratives of a group of individuals diagnosed with restrictive anorexia nervosa (AN), compared to a non-clinical group. The study is framed within multiple code theory (MCT) (Bucci, 1997; 2021), which considers mind-body integration. The purposes of this study are to investigate whether participants of the AN group will show greater alexithymia and emotional dysregulation than the non-clinical group; and whether the specific linguistic and symbolic features, such as somato-sensory words, affect words, and difficulty in the symbolizing process will predict the AN group. METHODS: Twenty-nine female participants hospitalized with AN during an acute phase (mean age 19.8 ± 4.1) and 36 non-clinical female participants (mean age 21 ± 2.4) were selected through snow-ball sampling. The participants completed the Toronto Alexithymia Scale (TAS-20), the Profile of Mood of State (POMS), the Emotion Regulation Questionnaire (ERQ), and the Relationship Anecdotes Paradigm Interview (RAP). The RAP interview was audio-recorded and transcribed to apply the Referential Process (RP) Linguistic Measures. A T test for paired samples and a logistic binary regression was performed. RESULTS: AN presented a significantly higher emotional dysregulation through the ERQ, TAS20 and POMS measures. Specifically, AN showed higher ER expression/suppression strategies, fewer functional cognitive strategies, higher alexithymia, and higher mood dysregulation. Specific linguistic features such as sensory-somatic, word affect, and difficulty in RP symbolizing predict the AN group (R2 = 0.349; χ2 = 27,929; df = 3; p = .001). CONCLUSIONS: Emotional dysregulation is connected to AN symptoms and autobiographical narratives. The results can help a clinical assessment phase showing specific linguistic features in AN patients. LEVEL OF EVIDENCE: Level II, controlled trial without randomization.
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Anorexia Nervosa , Regulação Emocional , Adolescente , Adulto , Feminino , Humanos , Adulto Jovem , Afeto , Sintomas Afetivos/psicologia , Anorexia Nervosa/psicologia , LinguísticaRESUMO
The association among alexithymia, somatic symptoms and clinical correlates has been scantly investigated in children. The present study examined alexithymic features and somatic symptomatology in schoolchildren with high and low levels of depression, testing the role of depressive symptoms in mediating the associations between alexithymia and somatic symptoms. Seven-hundred schoolchildren were involved in this study and divided into two subgroups (8-10 years and 11-14 years) in order to test differences according to the age. Participants completed the Children's Somatization Inventory-24 for the assessment of somatic symptoms, the Alexithymia Questionnaire for Children to evaluate alexithymic features and the Children's Depression Inventory-2 to investigate depressive symptoms. Results showed that children with high levels of depression reported both higher alexithymia and somatic symptoms levels. Despite a direct effect of alexithymia on somatic symptoms, the mediation analyses also highlighted an indirect effect of alexythimia on somatic symptoms through depressive symptoms. Findings suggested that a depressive symptomatology may clarify why schoolchildren with high alexithymia scores tend to report higher levels of health problems. Results also support the possibility that depressive symptoms may contribute to the development of somatic symptomatology among schoolchildren in the presence of high levels of alexithymia.
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Sintomas Afetivos/epidemiologia , Depressão/epidemiologia , Sintomas Inexplicáveis , Adolescente , Criança , Feminino , Humanos , Itália/epidemiologia , Masculino , Inquéritos e QuestionáriosRESUMO
Selective mutism (SM) is classified in DSM-5 as an anxiety disorder. The aim of the study was to investigate the psychological features of children with SM and their parental psychological profiles, compared to generalized anxiety disorder (GAD) children and their parents. The parents of 26 preschool children with SM and 32 with children with GAD filled out the child behavior check list for 1½-5 years (CBCL1½-5) and the symptom checklist-90-revised (SCL-90-R). Information about the children and their parents' histories was collected through clinical interviews. Children with SM scored higher than children with GAD on the CBCL1½-5 withdrawn scale and lower on the attention problems, aggressive behavior, and externalizing problems scales. Mothers of children with SM scored higher on the SCL-90-R obsessive-compulsive subscale and Global Severity Index than mothers of children with GAD, while fathers of children with SM scored higher on the SCL-90-R Phobic Anxiety subscale and on the Global Severity Index than fathers of children with GAD. Parents of children with SM displayed a greater presence of stressful life events than parents of children with GAD. Data appeared to confirm that SM and GAD share a common anxious core, though some differences in the children's psychological profiles and the parents' history and personality emerged. Future research should focus on the role of external factors, such as parent-child relationship, in the development of SM.
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Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Transtornos do Comportamento Infantil/psicologia , Mutismo/diagnóstico , Pais/psicologia , Criança , Filho de Pais com Deficiência/psicologia , Pré-Escolar , Transtorno da Conduta , Pai/psicologia , Feminino , Humanos , Masculino , Mães/psicologia , Mutismo/psicologia , Relações Pais-Filho , Transtornos da Personalidade/diagnóstico , Inventário de Personalidade , Transtornos Fóbicos/psicologiaRESUMO
The aim of the present study was to explore the dimensions of alexithymia and attachment styles in a group of disordered gamblers and to evaluate the relationship between alexithymia, attachment styles, and the severity of gambling disorder. Sixty disordered gamblers diagnosed according to the diagnostic and statistical manual-5 filled out the Kurzfragebogen zum Glücksspielverhalten, the 20-Item Toronto Alexithymia Scale, and the Experiences in Close Relationships-Revised. Approximately 70 % of the sample displayed 'intermediate' and 'severe' gambling severity levels on the Kurzfragebogen zum Glücksspielverhalten, and 77 % showed 'high' or 'borderline' levels of alexithymia on the Toronto Alexithymia Scale (mean = 56.40). Regarding attachment styles, 70 % of the sample displayed an 'insecure' attachment, with a particularly high prevalence of the 'fearful' style (26.66 %). A linear regression analysis revealed that only the anxiety dimension of the Experiences in Close Relationships questionnaire predicted the severity of gambling. Our data appear to confirm that gambling disorder is characterised by emotional and relational dysregulation, and that pathological gambling behaviours may serve as external regulators of internal undifferentiated emotional states.
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Sintomas Afetivos/psicologia , Comportamento Aditivo/psicologia , Jogo de Azar/psicologia , Apego ao Objeto , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto JovemRESUMO
The aim of this study was to investigate the effects of written emotional disclosure as an adjunct to physiotherapy. Forty outpatients with musculoskeletal pain were treated with Mézières physiotherapy for 10 sessions. Half of the subjects also wrote about difficult life experiences immediately after four of these sessions. Data analysis showed that although both the writing and non-writing groups displayed lower pain scores after physiotherapy, the difference was stronger in the writing group. Pain scores continued to decrease six months after physiotherapy in the writing group alone. The postural evaluation revealed a greater improvement in the writing group than in the non-writing group, while the TAS-20 and SCL-90 scores decreased in the writing group alone. These results indicate that written emotional disclosure is an effective adjunct to physiotherapy insofar as it promotes further health improvements at both the physical and psychological levels.
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Técnicas de Exercício e de Movimento/métodos , Dor Musculoesquelética/terapia , Narrativas Pessoais como Assunto , Redação , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrevelação , Resultado do TratamentoRESUMO
Exposure to traumatic events during childhood is common, and the consequences for physical and mental health can be severe. Adverse childhood experiences (ACEs) such as physical abuse, sexual abuse, emotional abuse, and neglect appear to contribute to the onset and severity of a variety of somatic inflictions, including obesity, diabetes, cancer, and heart disease. The aim of this scoping review was to try to gain insight into how this might occur. Given the evidence of indirect (i.e., through unhealthy behaviours such as excessive drinking or poor eating habits) and direct (i.e., through its impact on the endocrine, immune, and cardiovascular systems as well as on the brain) effects of attachment on health, we examined the possibility that insecure attachment might contribute to the development of somatic symptoms in adult survivors of childhood trauma. Eleven studies met our inclusion criteria. Findings from this review suggest that insecure and disorganized attachment orientations are related to DNA damage, metabolic syndrome and obesity, physical pain, functional neurological disorder, and somatization in adults exposed to childhood trauma. We discuss the implications of this for the conceptualization and treatment of trauma and stress disorders.
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This study aims to explore the perspectives of Italian psychologists who work in assisted reproductive treatment (ART) centres regarding their roles within multidisciplinary teams. Twenty-eight psychologists were interviewed, recorded and their transcribed text was analysed using emotional text mining. The analysis revealed four clusters representing the psychologists' cultural symbolizations of their works: 'Clinical Practice with the patient', 'Placing Psychology within the Treatment', 'Psychologist's Loneliness' and; 'Collusion with Medicine'. The symbolic representations emerging clearly highlighted a lack of integration of psychology within the medical field. Psychologists expressed emotional and practical difficulties in trying to integrate their role, including a desire to provide psychological assistance, feelings of loneliness and concerns about jeopardizing their professional opportunities, which are intertwined with the medical field. Present findings underscore the importance of integrating psychology within ART centres and multidisciplinary teams and of establishing operational guidelines for psychologists. These steps are crucial for reaching integration of psychologists within the medical setting.
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Infertility and related treatments can negatively affect a couple's wellbeing. The aim of this study was to evaluate couples starting assisted reproductive treatment, differences in alexithymia and quality of life levels between partners, and the association of these psychological dimensions within the couple's members. Data was collected in two fertility centres in Rome; 47 couples completed the Fertility Quality of Life (FertiQoL), the 20-item Toronto Alexithymia Scale (TAS-20), and a socio-demographic questionnaire. Data analysis showed a worsened quality of life in women compared with their partners, as well as higher externally oriented thinking in men compared with their spouses. Associations between alexithymia and quality of life levels between women and men emerged. According to the regression analysis, a better quality of life in women was predicted by a greater partner's capabilities in identifying and describing emotion as well as by a better partner's quality of life, whereas for men, a better quality of life was predicted by their spouse's higher levels of quality of life. This study highlights the protective role that couples can play in the perception of the negative impact that infertility can have on their partner's quality of life. Further investigations are needed for the development of specific therapeutic interventions for the promotion of the couples' wellbeing.
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The incidence of type 1 diabetes (T1D) has increased by about 3% per year over the last two decades. Continuous Insulin Subcutaneous Therapy (CSII) is widely used in the pediatric population with diabetes; however, it requires more preparation by the treating team and a careful selection of its potential users. Prescriptive provisions vary from region to region, and the perspective of health workers in this regard remains an unexplored area. The aim of this research project is to explore the representations of a group of diabetologists and psychologists working in pediatric diabetology throughout the country, regarding their roles, functions, and activities as part of a multidisciplinary team; it also aims to investigate their views on the potential benefits of CSII and the types of individuals who apply for the use of this technology. A socio-anagraphic data sheet was administered, and two homogeneous focus groups were conducted, one for each profession, which were then audio recorded. The transcripts produced were analyzed using the Emotional Text Mining (ETM) methodology. Each of the two corpora generated three clusters and two factors. For diabetologists, a focus on patient care emerged at different levels, involving collaboration with other health professionals and engagement with the community, often incorporating technology in medical interventions. Similarly, psychologists' representations highlighted interdisciplinary networking with a stronger emphasis on the psychological processes involved in managing the disease, from acceptance to the elaboration and integration of diabetes into the family narrative. Understanding the representations of health professionals working in pediatric diabetes with new technologies can contribute to the consolidation of a network of professionals through targeted work on possible critical issues that may arise.
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Ehlers-Danlos syndromes are a heterogeneous group of Heritable Connective Tissue Disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Among the different types, the hypermobile Ehlers-Danlos syndrome is the most frequent and includes generalized joint hypermobility as the major diagnostic criterion. Joint hypermobility in hypermobile Ehlers-Danlos syndrome is often associated with pain that does not always allow the use of effective pain-reducing treatments. Patients with hEDS constantly describe their pain in detail. Eighty-nine patients with hEDS diagnoses were recruited and evaluated. They were asked to describe their pain in writing. The texts were examined through Linguistic Inquiry and Word Count. Correlational analyses were conducted between pain perception and language. A comparison of high/low pain perception and the quality of metaphors was carried out. The results showed that language quality varies depending on how much pain is perceived. The greater the pain is perceived, the lesser the positive effects and the greater the negative effects and dehumanizing metaphors are being used. Moreover, a greater pain seems to be related to a verbal experience of greater isolation and less self-care. In conclusion, the use of metaphors is a useful tool for examining illness experience and may help clinicians in the rehabilitation program.
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BACKGROUND: COVID-19 pandemic added additional burden upon healthcare systems and anesthesiology and intensive care physicians (AI) who possessed crucial expertise for dealing with the pandemic. Aim of the study was to uncover specific burnout patterns among Italian AI, exploring the hypothesis that burnout has a multicluster structure. Differences in social and professional characteristics between burnout patterns were explored. METHODS: One thousand and nine AI (658 women) members of the Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) working during COVID-19 pandemic participated. Sociodemographic, working information and burnout levels evaluated through Maslach Burnout Inventory (MBI) were collected. RESULTS: According to the MBI cutoff, 39.7% and 25.8% of participants scored high in emotional exhaustion and depersonalization respectively, and 44.2% scored low in personal accomplishment. Cluster analysis highlighted four burnout profiles: resilience, detachment, burnout, and emotional reserve. The results showed that AI in the Resilience and Emotional Reserve groups were significantly older and more experienced than those in the Detachment and Burnout groups. Additionally, more of the individuals in the Resilience group were working in intensive care units and departments dedicated to COVID-19 patients. The Detachment group was comprised of more AI working in operating units, while the Burnout group contained a higher number of AI working in COVID-19 departments. CONCLUSIONS: These findings highlight different burnout patterns in Italian AI: older age, more professional experience, and work in intensive care units and departments dedicated to COVID-19 seemed to be protective factors during the pandemic. This appears a first step to promote focused interventions.
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Esgotamento Profissional , COVID-19 , Humanos , Feminino , Anestesiologistas/psicologia , Pandemias , Inquéritos e Questionários , COVID-19/epidemiologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Itália/epidemiologiaRESUMO
BACKGROUND: the diagnosis of infertility and its related treatment can be traumatic, leading to profound psychological distress and a variety of psychopathological symptoms. The primary objective of this study is to contrast the linguistic features of narratives from women undergoing Assisted Reproductive Treatment with those of women not undergoing any fertility treatment. This study examines the speech of both groups of individuals as an indicator of their capacity to cope with current and past distressing experiences. METHOD: 44 women (mean age 36.05; SD = 4.66) enrolled in a fertility medical center in Rome, and 43 control women (mean age 36.07; SD = 3.47) completed a socio-demographic questionnaire and a semi-structured interview designed to collect their memories of a neutral, a positive, and a negative event. This interview also aimed to investigate: (a) (for women with fertility difficulties) how they realized they and their partner had fertility problems and a description of an event when they talked about these difficulties with their partner; and (b) (for control group participants) the most difficult moment of their pregnancy and an event when they talked about it with their partner. The interviews were audio recorded and transcribed, and the text was analyzed using the referential process (RP) linguistic measures software. RESULTS: Mann-Whitney non-parametric U tests for the independent samples showed several significant differences regarding the linguistic measures applied to the narratives of neutral, positive, negative, and difficult experiences in the form of a linguistic style, with more intellectualization and defenses in all the narratives associated with the women with fertility problems compared to the women in the control group. CONCLUSIONS: the traumatic and painful experience of infertility and ART seems to characterize the whole mode of narrating life experiences. Present findings sustain the importance of helping women to elaborate on their experience and to understand and recognize the difficult feelings that are activated in relation to the difficulties of having a child.
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The Junior Temperament and Character Inventory (JTCI) has been developed for the assessment of the personality in individuals 6 to 14 years old according to the psychobiological model of Cloninger. The aim of the present study was to evaluate the psychometric properties of an Italian version of JTCI. The sample included 459 subjects ranging in age from 6 to 15.9 years. Starting from the original parent version, an Italian version of JTCI was developed and administered to parents recruited in primary schools of Lazio and Campania. Using statistically appropriate methods for the analysis of dichotomous variables (binary coded), we analyzed the factor structure, the internal consistency, and the test-retest reliability. The architecture of the JTCI was consistent with the original hypothesis of the Cloninger model. Parent reports of each of the JTCI dimensions had good internal consistency and test-retest reliability over 3 months. Regarding the analysis of risk personality traits, significant correlations were found between several JTCI factors and Strengths and Difficulties Questionnaire scales. The JTCI is useful in research and in clinical practice to evaluate the role of temperament and character dimensions in psychopathology.
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Caráter , Temperamento , Adolescente , Criança , Feminino , Humanos , Itália , Masculino , Inventário de Personalidade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
The physiotherapist represents a resource for the psychophysical well-being of an individual. Specific characteristics of the physiotherapist-patient relationship can influence the outcome of rehabilitation. This study aimed to explore physiotherapists' representations on how they perceive their relationship with their patients, in order to highlight helpful elements in promoting the outcome of the intervention. In this study, 50 physiotherapists (27 females and 23 males; mean age = 42 years; sd = 12.2) participated in an individual interview, conducted remotely via videocall. Socio-demographic and occupational data were collected. The interviews were recorded and transcribed. Texts were analyzed using emotional text mining (ETM). Participants organized their work by means of three categories: (1) work with the patient, in which the physiotherapists described two complementary elements of the therapy, which are the observable-technical aspects of their work and the internal predispositions; (2) the healing process, highlighting the aims of their intervention, including the physical pathology and the relationship with the patients; (3) physiotherapist as a psychologist, describing the attempt to understand patients' emotional experience to gradually transition to the practical intervention. Understanding the emotional and relational processes that form the basis of physiotherapist practice can contribute to the development of interventions in which the body and the mind can be integrated, resulting in a real person-centered point of view.
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Alexithymia is connected to adolescents' psychopathology, but the current methods of assessment present limitations. The Toronto Structured Interview for Alexithymia (TSIA) was developed to overcome the limits of the main used self-rating scale in adults, but no studies investigated its feasibility with adolescents. This study involved 95 community adolescents aged 12-19 years. Adolescents were assessed with the TSIA, the 20-item Toronto Alexithymia Scale (TAS-20), the Verbal Comprehension Index of the WISC-IV for verbal skills, and the Child Behavior Checklist and Youth Self Report for emotional-behavioral symptoms. The aims were to investigate the TSIA internal consistency, concurrent validity with the TAS-20, discriminant validity with participants' verbal skills, and relationships with emotional-behavioral symptoms. TSIA showed good internal consistency, concurrent validity with the TAS-20 (except for factor DDF), and independence by participants' verbal skills, but few relationships with emotional-behavioral symptoms. In conclusion, TSIA showed some good psychometric proprieties but little convergence with research findings obtained with the TAS-20, suggesting the need for further research to check the feasibility of using the TSIA with adolescents. Meanwhile, a precautionary multi-method assessment of alexithymia is recommended.
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INTRODUCTION: Infertility has an impact on the psychophysical health of individuals and couples, and its treatment through an assisted reproductive technology (ART) is a very exacting experience. The aim of this study was to explore the characteristics of psychological counselling services in Italian ART centres through a specially designed questionnaire administered to the physicians in charge of the centres. METHODS: The questionnaire online was sent to 306 ART authorized centres. It consisted of 26 questions. A total of 15 were single-selection questions, 5 were multiple-choice and the remaining 6 were open-ended. RESULTS: 113 (37%) ART centres responded to the questionnaire. All the ART centres offered psychological counselling, but only in 47% of them the psychologist is a permanent staff member. In 69% of the centres, 10 to 20% of couples use the psychological counselling service. DISCUSSION: Although the Italian Guidelines under Law 40/2004 stress the need to provide couples with psychological support and counselling and the literature highlights the efficacy of such interventions, the results of our study show that psychological counselling services are not yet fully operational in Italian ART centres or integrated into their day-to-day medical practice. CONCLUSION: In conclusion, the results show that psychological services in Italian ART centres are not yet fully operational and integrated in the ART procedure. All of this highlights the importance of further investigations with the aim to shared information to use to establish common protocols for psychological interventions in ART centres.
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Infertilidade , Aconselhamento , Humanos , Infertilidade/psicologia , Infertilidade/terapia , Itália , Técnicas de Reprodução Assistida , Inquéritos e QuestionáriosRESUMO
Infertility may have a very strong emotional impact on individuals, requiring adequate support, but few studies on patients' demands toward psychological support have been conducted. This study aims to explore the emotions related to the infertility and to the Assisted Reproductive Technology (ART) procedure for which patients consider useful a psychological support. A total of 324 women completed a sociodemographic and clinical questionnaire and an open-ended questionnaire on emotional needs for psychological support. The written texts were explored by the Linguistic Inquiry and Word Count (LIWC) programme and linguistic characteristics were related to sociodemographic and anamnestic variables. Specific linguistic features were connected to several individual characteristics. More specifically, differences in linguistic processes emerged comparing women with an age over or under 40 years, women undergoing their first attempts versus more attempts, women undergoing ART with or without gamete donation, and women undergoing ART for male or unknown causes, as well as those undergoing ART for female or both partners' problems. These differences seem to confirm that older age, more attempts, gamete donation, and ART for unknown or male causes are risk factors that may worsen women's psychological well-being. This study contributes to increase the knowledge about the emotional needs of patients undergoing an ART procedure to develop specific psychological intervention programs.
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The coronavirus pandemic is a unique collective event which has affected the physical and psychological health of all individuals. Restrictions imposed by governments to counteract this situation have represented risk factors for developing psychopathological symptoms. This study aims to explore the relationship between psychological symptoms and the referential process (RP). Forty-eight healthy participants (25 males, mean age = 39.3; SD = 16.6) completed a demographic questionnaire and the Symptom Checklist-90-Revised (SCL-90-R) through an online platform and wrote about their experience 3 weeks after the imposition of the lockdown. Different linguistic measures of the RP were applied to the narratives. The logical functions expressed through written narratives (The Italian Reflection Dictionary score, IREF) showed significant positive correlations with the SCL-90-R General Score Index (GSI) and different SCL-90-R subscales (depression, anxiety, obsessive-compulsiveness, interpersonal sensitivity, hostility, and paranoid ideation). On the contrary, the reorganization and reflection function related to emotional events (The Italian Weighted Reflection and Reorganization List score, IWRRL) showed significant negative correlations with the SCL-90-R's GSI and different subscales (obsessive-compulsiveness, depression, anxiety). The results highlight the relationship between psychological symptoms and complex defense mechanisms based on the intellectualization of negative emotions and a positive strategy of reorganization based on emotional elaboration. These results suggest the importance of supporting collective elaborations of citizens in the context of the pandemic.