Attachment representation in institutionalized children: a preliminary study using the child attachment interview.

UNLABELLED: The experience of being removed from one's home and the transition to a residential care system pose enormous challenges for a child. Substantial evidence has been found regarding severe developmental effects due to early exposition to extreme psychosocial and affective deprivation. The research on Bowlby's theoretical proposals has highlighted the link between insecure, disorganized and atypical attachment patterns and children both living in foster care facilities and adopted out of those institutions. The goal of this pilot study is to investigate the attachment representation in an Italian sample of children in middle childhood (9-13 years old) who have been removed from their homes. METHOD: Two compared groups of children participated in this study. The first group was composed of 24 Italian children who had been removed from their homes. The second group, considered as the control group, was composed of 35 Italian children who had never been in foster care placement. The quality of children's attachment to their primary caregivers was assessed by the Child Attachment Interview, an innovative semi-structured interview that seeks to bridge the measurement gap identified in middle childhood RESULTS: The children in foster care placement show a higher percentage of insecure and disorganized attachment representations and lower scores on the Child Reflective Functioning Scale. CONCLUSIONS: The clinical implications and enhancements to effective intervention for foster children's caretaking are discussed.

Affective interactions using virtual reality: the link between presence and emotions.

Many studies showed the ability of movies and imagery techniques to elicit emotions. Nevertheless, it is less clear how to manipulate the content of interactive media to induce specific emotional responses. In particular, this is true for the emerging medium virtual reality (VR), whose main feature is the ability to induce a feeling of "presence" in the computer-generated world experienced by the user. The main goal of this study was to analyze the possible use of VR as an affective medium. Within this general goal, the study also analyzed the relationship between presence and emotions. The results confirmed the efficacy of VR as affective medium: the interaction with "anxious" and "relaxing" virtual environments produced anxiety and relaxation. The data also showed a circular interaction between presence and emotions: on one side, the feeling of presence was greater in the "emotional" environments; on the other side, the emotional state was influenced by the level of presence. The significance of these results for the assessment of affective interaction is discussed.

Cellular phones for reducing battlefield stress: rationale and a preliminary research.

Battlefield stress is the consequence of man being exposed to the hostile environment of combat. Combat stress is specifically caused by man's feat of the dangers of combat, and is fueled and tempered by other variables such as morale, cohesion, fatigue, confidence, training and intensity of the combat. Treatment is often as simple as giving soldiers time to rest for a few hours or days, to get a shower and some sleep, to talk about the feelings they have in the presence of a counselor. Only in rare cases soldiers undergo more serious psychological treatment. One of the best strategies for dealing with stress is learning how to relax. However, relaxing is difficult to achieve in a battlefield. In this chapter we suggest the use of mobile multimedia technology--PDA/cellular phones--for the provision of advanced coping techniques suitable to the battlefield context. Specifically, we developed a protocol based on mobile narratives, to be experienced on mobile multimedia technology--3G cellular phones or PDAs--like the one now under development by the US Army within the "Soldier as a System--SaaS" and "Future Combat Systems--FCS" projects. Mobile narratives are audio-visual experiences, implemented on mobile devices, in which the narrative component is a critical aspect to induce a feeling of presence and engagement. Through the link between the feeling of presence and the emotional state, mobile narratives may be used to improve the mood state in their users. The rationale of the approach and a preliminary test of the proposed method are presented and discussed.

Managing exam stress using UMTS phones: the advantage of portable audio/video support.

Test-taking anxiety or stress is very common among university students. It can be very distressing and sometimes debilitating. Exam anxiety involves physical components and emotional components that may be taken into account for managing and reducing anxiety. An approach to control exam anxiety is to learn how to regulate emotions. To help students in managing exam stress we developed a specific protocol based on mobile narratives--multimedia narratives experienced on UMTS/3G phones. 30 female university students (M=23.48; sd=1.24) who were going to perform an exam within a week were included in the trial. They were randomly divided in five groups according to the type and mobility of the medium used: (1) audio only narrative (CD at home); (2) audio only narrative (portable MP3); (3) audio and video narrative (DVD at home); (4) audio and video narrative (UMTS based); (5) control group. Audio/video narratives induced a reduction in exam anxiety in more than 80% of the sample vs 50% of the MP3 sample and 0% of the CD sample. Further, all the users who experienced mobile narratives on UMTS phones were able to relax before the exam, against 50% of DVD users and 33% of audio-only users. The trial showed a better efficacy of mobile narratives experienced on UMTS phones in reducing the level of exam stress and in helping the student to relax. These results suggest that for the specific sample considered--Italian university students--the media used for providing an anti-stress protocol has a clear impact on its efficacy.

NeuroVR: an open source virtual reality platform for clinical psychology and behavioral neurosciences.

In the past decade, the use of virtual reality for clinical and research applications has become more widespread. However, the diffusion of this approach is still limited by three main issues: poor usability, lack of technical expertise among clinical professionals, and high costs. To address these challenges, we introduce NeuroVR (http://www.neurovr.org--http://www.neurotiv.org), a cost-free virtual reality platform based on open-source software, that allows non-expert users to adapt the content of a pre-designed virtual environment to meet the specific needs of the clinical or experimental setting. Using the NeuroVR Editor, the user can choose the appropriate psychological stimuli/stressors from a database of objects (both 2D and 3D) and videos, and easily place them into the virtual environment. The edited scene can then be visualized in the NeuroVR Player using either immersive or non-immersive displays. Currently, the NeuroVR library includes different virtual scenes (apartment, office, square, supermarket, park, classroom, etc.), covering two of the most studied clinical applications of VR: specific phobias and eating disorders. The NeuroVR Editor is based on Blender (http://www.blender.org), the open source, cross-platform suite of tools for 3D creation, and is available as a completely free resource. An interesting feature of the NeuroVR Editor is the possibility to add new objects to the database. This feature allows the therapist to enhance the patient's feeling of familiarity and intimacy with the virtual scene, i.e., by using photos or movies of objects/people that are part of the patient's daily life, thereby improving the efficacy of the exposure. The NeuroVR platform runs on standard personal computers with Microsoft Windows; the only requirement for the hardware is related to the graphics card, which must support OpenGL.

Stress management using UMTS cellular phones: a controlled trial.

One of the best strategies for dealing with stress is learning how to relax. However, relaxing is difficult to achieve in typical real world situations. For this study, we developed a specific protocol based on mobile narratives - multimedia narratives experienced on UMTS/3G phones - to help workers in reducing commuting stress. In a controlled trial 33 commuters were randomly divided between three conditions: Mobile narratives (MN); New age music and videos (NA); no treatment (CT). In two consecutive days the MN and NA samples experienced during their commute trip 2 x 2 6-minute multimedia experiences on a Motorola A925 3G phone provided by the "TRE" Italian UMTS carrier: the MN sample experienced a mobile narrative based on the exploration of a desert beach; the NA sample experienced a commercial new age video with similar visual contents. The trials showed the efficacy of mobile narratives in reducing the level of stress experienced during a commute trip. No effects were found in the other groups. These results suggest that 3G mobile handsets may be used as relaxation tool if backed by a specific therapeutic protocol and meaningful narratives.

Perceptions and patterns of use of generic drugs among Italian family pediatricians: first round results of a web survey.

Prescription of generic medicines represents an efficacious healthcare cost containment strategy. In some European countries and in the US, generic medicines are largely prescribed. In Italy, generic drugs prescription rate is lower. General Practitioners and Family Pediatricians may be less confident in prescribing generic equivalents instead of "branded" medicines. There are currently no data about Italian Family Pediatricians' perceptions and patterns of use of generic drugs. This is a first nationwide web survey conducted with the aim to evaluate generic medicines knowledge and prescribing habits of Italian Family Pediatricians. 303 Family Pediatricians completed the online questionnaire. 37.2% and 32.6% of them declared to have a sufficient or fairly good knowledge of generic medicines, respectively, and the majority of them believed that efficacy of generic medicines was sufficient (33.6%) or good (45.2%). Nevertheless, Italian Family Pediatricians are still prone to prescribe trade medicines more frequently, since only 13.5% of them declared that more than a half of their patients were treated with generic medicines. Major issues related with generic medicines prescriptions by Italian Family Pediatricians seem to be represented by diffuse scepticism about reliability of bioequivalence tests and safety of switchability from branded to generic equivalents. More information about generic drugs and more research in the field of pediatric pharmacology are needed for increasing generic medicines prescription rate among Italian Family Pediatricians.

Can relaxation training reduce emotional eating in women with obesity? An exploratory study with 3 months of follow-up.

Stress and negative emotions have been shown to be critical factors in inducing overeating as a form of maladaptive coping in some patients with obesity. We evaluated the efficacy of a 3-week relaxation protocol enhanced by virtual reality and portable mp3 players in reducing emotional eating in a sample of 60 female inpatients with obesity who report emotional eating, using a three-arm exploratory randomized controlled trial with 3 months of follow-up. The intervention included 12 individual relaxation training sessions provided traditionally (imagination condition) or supported by virtual reality (virtual reality condition). Control participants received only standard hospital-based care. Weight, behavior and psychological data were collected and analyzed. Relaxation training was effective in reducing emotional eating episodes, depressive and anxiety symptoms, and in improving perceived self-efficacy for eating control at 3-month follow-up after discharge. The virtual reality condition proved better than the imagination condition in the reduction of emotional eating. Weight decreased in subjects in all three conditions without significant differences between them, probably due to the common treatment all inpatients received. We conclude that relaxation training supported by new technologies could be a useful tool for reducing emotional eating episodes and thereby reducing weight and obesity.