Starting University at the Time of COVID-19: Psychoemotional Adjustment of a Group of Italian Students.

The transition from school to university typically occurs during emerging adulthood; this coming together of multiple challenging development tasks at the same time may be stressful for some students. The coronavirus disease 2019 (COVID-19) pandemic, and above all the health measures implemented to deal with it, may have been an additional factor contributing to the difficult adaptation of first-year students to academic life. This study evaluated the role played by emotional processing and differentiation of self for psychological well-being in a sample of 218 Italian students (78.4% women) who began their 1st year of college during the pandemic. The results showed that higher levels of differentiation of self, combined with fewer signs of unprocessed emotions, predicted lower psychological distress. The data support the importance of these variables as protective factors in promoting psychological well-being along with the transition to adulthood and adaptation to new life challenges. These findings draw attention to the relevance of support services aimed at university students and of emerging adults in general in considering and promoting the role of self-differentiation and the style of emotional processing for addressing well-being and mental health during the transition to adult life.

The Role of Family Support and Dyadic Adjustment on the Psychological Well-being of Transgender Individuals: An Exploratory Study.

Introduction: This study aimed to measure dyadic adjustment, social support, and psychological well-being. Methods: A research protocol composed of the Dyadic Adjustment Scale, the Outcome Questionnaire 45.2, and the Multidimensional Scale of Perceived Social Support was administered to a sample of 109 Italian transgender individuals. Results: Higher levels of global psychological distress, symptom severity, and interpersonal relationship distress were associated with lower levels of family support and dyadic adjustment. In addition, transgender women and younger transgender individuals reported higher levels of interpersonal relationship distress. Conclusions: The results indicate that the support and acceptance of one's partner and family of origin play a crucial role in promoting well-being. It represents an important protective factor with respect to negative psychological health outcomes. Policy Implications: The findings emphasize the need to develop specific clinical and social practices for transgender individuals and their families. Building family and partner-centered policies and programs is particularly important to enable transgender individuals to avoid paying the emotional and psychological costs associated with rejection and non-acceptance.

From pregnancy to 3 months after birth:the beginning of mother-infant relationship from a maternal perspective.

BACKGROUND: An early positive mother-child relationship is a central factor in the development of a psychologically balanced personality. The study aims to identify risk and protective factors for the development of a balanced maternal-infant postnatal attachment. We explored the association between maternal-infant attachment and prenatal and postnatal variables potentially implicated in the development of this early bond: maternal-foetal prenatal attachment, social support, memories of parental care, romantic attachment, dyadic adjustment, parity, breastfeeding, planning pregnancy, woman's and infant's age, and difficulty of delivery. METHODS: 123 pregnant women participated in the longitudinal study; they were assessed on the MAAS, PBI, ECR-R, MSPSS (t1: pregnancy), MPAS (t2: 3-months postnatally), DAS , and CES-D (t1, t2). RESULTS: Four significant predictors of maternal-infant postnatal attachment (MPAS) emerged: maternal-foetal prenatal attachment (ß = 0.379, p < .001), anxiety in the romantic relationships (ß=-0.237, p=0.019), prenatal and postnatal dyadic adjustment (t1, ß=-0.323, p=0.025 ;t2, ß=0.329, p=0.014) in the couple's relationship. These variables explained 20.2% of variance in mother-infant attachment (R2adjusted=0.202). DISCUSSION: The study highlights associations of maternal-infant postnatal attachment with prenatal and postnatal relational variables and with other variables related to the woman's reproductive and pregnancy history. Clinical attention to these factors could help protect the well-being of mother and child.

Couple Adjustment and Differentiation of Self in the United States, Italy, and Spain: A Cross-Cultural Study.

This study comprises a first attempt to explore a cross-cultural application of Bowen family systems theory and examines the relationship between differentiation of self and couple adjustment using measurement invariance. A sample of 2,141 individuals (n = 915 from the United States; n = 635 from Italy; n = 591 from Spain) completed measures of differentiation of self (DSI-R; Skowron & Schmitt, J Marital Fam Ther, 29, 2003, 209) and couple adjustment (DAS; Spanier, J Marriage Fam, 38, 1976, 15). Results showed evidence of partial measurement equivalence for the DSI-R across the three samples. Additionally, results from latent regression showed that less emotional cutoff predicted greater couple adjustment in the United States, Spain, and Italy, whereas greater emotional reactivity predicted poorer couple adjustment only in the more collectivistic cultures, Spain and Italy. Our findings are consistent with prior empirical studies, which suggest that emotional cutoff is a strong predictor of relationship adjustment. The use of measurement invariance provides a foundation for future studies to continue employing rigorous statistical methods when examining constructs across different cultures. The findings highlight culture-specific similarities and differences in differentiation that may benefit practitioners by informing psychotherapy with individuals, couples, or families from diverse populations.

Este estudio constituye un primer intento de explorar la aplicabilidad intercultural de la teoría de sistemas familiares de Bowen y de analizar la relación entre la diferenciación del self y el ajuste de la pareja utilizando un análisis de invariancia. Una muestra de 2.141 personas (n = 915 de Estados Unidos; n = 635 de Italia; n = 591 de España), completaron medidas de diferenciación del self (DSI-R; Skowron & Schmitt, 2003) y de ajuste diádico (DAS; Spanier, 1976). Los resultados aportan pruebas de equivalencia parcial de las medidas del DSI-R entre las tres muestras. Además, los resultados de la regresión latente indicaron que un menor corte emocional predijo mayor ajuste de la pareja en Estados Unidos, España e Italia, mientras que una mayor reactividad emocional predijo un menor ajuste de la pareja solo en las culturas más colectivistas: España e Italia. Nuestros resultados concuerdan con estudios empíricos anteriores, que sugieren que el corte emocional es un fuerte predictor del ajuste relacional. El uso del análisis de invariancia ofrece una base para que futuros estudios sigan utilizando métodos estadísticos rigurosos cuando se examinan constructos entre culturas diferentes. Los resultados ponen de manifiesto diferencias y similitudes específicas en la diferenciación entre las culturas estudiadas, que pueden ayudar a los profesionales orientando la psicoterapia de personas, parejas o familias de poblaciones diversas.

Lesbian and Gay Individual Parenting Desires in Heteronormative Contexts.

The cultural, social and institutional barriers that LGBT (Lesbian, Gay, Bisexual, Transgender) individuals have to face play crucial roles in their desires and intentions to have children. However, unlike the many studies on the decision-making process in the transition to parenthood, few studies have analysed the origins of parenting desires and intentions among LGBT individuals. This study explores the desires and intentions to have children amongst a sample of childless lesbian and gay Italian individuals. A sample of 285 participants (127 women and 158 men) completed a research protocol composed of items evaluating the strength of their desire to have children, their intentions about having children and their general attitudes towards parenting. The findings revealed how, despite the persisting depth of heteronormativity in the country and the absence of legal protection for lesbian and gay parents, a large percentage of participants expressed the desire and intention to have a child. These parenting intentions would seem to be positively influenced mainly by the negative attitudes towards childlessness and by the value attributed to parenthood.

A Pilot Study of the Relationship Between Pregnancy and Autoimmune Disease: Exploring the Mother's Psychological Process.

Autoimmune disease mainly affects women in their reproductive years and has a significant impact on childbearing. Pregnancy can induce an improvement of the mother's symptomatology in some diseases such as rheumatoid arthritis while exacerbating or having no effect on other autoimmune diseases as multiple sclerosis (Borchers et al., 2010). This uncertainty can affect the process of psychological reorganization, which leads to the achievement of a maternal identity. The quality of the mother-fetus emotional bond is considered particularly relevant for the subsequent attachment relationship and the psychological development of the infant (Ammaniti et al., 2013). In the last trimester of pregnancy, 15 women with different autoimmune diseases were interviewed using the IRMAG-R (Ammaniti and Tambelli, 2010). They also completed a battery comprising: PAI (Della Vedova et al., 2008); MAAS (Busonera et al., 2016); DAS (Gentili et al., 2002); PBI (Scinto et al., 1999); MSPSS (Prezza and Principato, 2002); DERS, (Giromini et al., 2012); CES-D (Fava, 1983); HCR-TS (Bova et al., 2012). All interviews were audiotaped, transcribed verbatim, and analyzed by Atlas.ti. The results show that women with autoimmune disease were ambivalent toward pregnancy, had high levels of depression, had difficulties in recognizing physical and psychological changes, and had difficulties in imagining the child. These are considered risk factors that could negatively affect the postnatal mother-infant relationship. These results focus on the importance of early multidisciplinary interventions that can support expectant women when they show signs of relationship difficulties with their infants prior to his/her birth.

Differentiation of Self and Dyadic Adjustment in Couple Relationships: A Dyadic Analysis Using the Actor-Partner Interdependence Model.

Bowen's multigenerational theory provides an account of how the internalization of experiences within the family of origin promotes development of the ability to maintain a distinct self whilst also making intimate connections with others. Differentiated people can maintain their I-position in intimate relationships. They can remain calm in conflictual relationships, resolve relational problems effectively, and reach compromises. Fusion with others, emotional cut-off, and emotional reactivity instead are common reactions to relational stress in undifferentiated people. Emotional reactivity is the tendency to react to stressors with irrational and intense emotional arousal. Fusion with others is an excessive emotional involvement in significant relationships, whilst emotional cut-off is the tendency to manage relationship anxiety through physical and emotional distance. This study is based on Bowen's theory, starting from the assumption that dyadic adjustment can be affected both by a member's differentiation of self (actor effect) and by his or her partner's differentiation of self (partner effect). We used the Actor-Partner Interdependence Model to study the relationship between differentiation of self and dyadic adjustment in a convenience sample of 137 heterosexual Italian couples (nonindependent, dyadic data). The couples completed the Differentiation of Self Inventory and the Dyadic Adjustment Scale. Men's dyadic adjustment depended only on their personal I-position, whereas women's dyadic adjustment was affected by their personal I-position and emotional cut-off as well as by their partner's I-position and emotional cut-off. The empirical and clinical implications of the results are discussed.

La teoría multigeneracional de Bowen (1978) ofrece una explicación de cómo la internalización de experiencias dentro de la familia de origen promueve el desarrollo de la capacidad para mantener un yo diferenciado y a su vez conectarse de forma íntima con otras personas. Las personas diferenciadas pueden mantener su posición del yo en las relaciones amorosas. Pueden mantener la calma en relaciones conflictivas, resolver problemas relacionales eficazmente y llegar a acuerdos. En cambio, la fusión con los demás, el distanciamiento emocional y la sensibilidad emocional son reacciones comuntes al estrés relacional en las personas indiferenciadas. La sensibilidad emocional es la tendencia a reaccionar a factores desencadentes de estrés con excitación emocional irracional e intensa. La fusión con los demás es una implicación emocional excesiva en las relaciones significativas, mientras que el distanciamiento emocional es la tendencia a controlar la ansiedad relacional mediante la distancia física y emocional. Este estudio se basa en la teoría de Bowen, comenzando desde la suposición de que la adaptación diádica puede verse afectada tanto por la diferenciación del yo de un integrante de la pareja (efecto actor) como por la diferenciación del yo de su pareja (efecto pareja). Utilizamos el modelo de interdependicia actor-pareja (Cook & Kenny, 2005) para estudiar la relación entre la diferenciación del yo y la adaptación diádica en una muestra de conveniencia de 137 parejas italianas heterosexuales (datos diádicos, no independientes). Las parejas contestaron la "Encuesta sobre la diferenciación del yo" (Differentiation of Self Inventory, Skowron & Schmitt, 2003) y la "Escala de adaptación diádica" (Dyadic Adjustment Scale, Spanier, 1976). La adaptación diádica de los hombres dependió solo de su posición personal del yo, mientras que la adaptación diádica de las mujeres estuvo afectada por su posición personal del yo y el distanciamiento emocional así como por la posición del yo y el distanciamiento emocional de su pareja. Se debaten las consecuencias empíricas y clínicas de los resultados.

Psychometric properties of the Postpartum Bonding Questionnaire and correlates of mother-infant bonding impairment in Italian new mothers.

OBJECTIVE: impaired maternal bonding is a risk factor for problems with infant well-being and development. The investigation of perinatal variables related to disorders of the mother-infant relationship as well as the administration of reliable and valid screening tools to new mothers in the postpartum can help identify early signs of a disturbed mother-child relationship. The Postpartum Bonding Questionnaire (PBQ) has been shown to be a valid screening instrument, but its dimensional structure is still controversial. An analysis of the literature demonstrated the need for research into the perinatal correlates of the quality of mother-newborn bonding as measured by the PBQ, and for information about the reliability and validity of the Italian version of the questionnaire. AIM: to (a) carry out preliminary analysis of the psychometric properties of an Italian version of the PBQ and (b) explore how mother-infant disturbances are related to relevant perinatal psychological variables. DESIGN: the research design consisted of a prenatal and a postnatal phase. SETTING: prenatal education classes delivered in public and private institutions. PARTICIPANTS: 123 pregnant Italian women were recruited from prenatal education classes. MEASUREMENTS: in the prenatal period participants completed a questionnaire measuring maternal-fetal attachment; at the postnatal assessment (3 months postpartum) participants completed the Italian PBQ together with measures of mother-infant attachment, the couple's adjustment and maternal psychological well-being. Exploratory factor analysis was used to investigate the factor structure of the PBQ. Internal consistencies were evaluated using Cronbach's alpha. Nomological validity was assessed via Pearson correlations. FINDINGS: a three-factor model provided the most meaningful representation of the PBQ data, with one factor reflecting annoyance and anger towards the infant, another reflecting detachment and rejection and the third reflecting anxiety about infant care. Internal consistencies were good. Impaired mother-infant bonding was negatively correlated with prenatal and postnatal mother-infant attachment and couple adjustment, as well as being positively correlated with maternal depressive symptoms. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the Italian PBQ is a reliable, valid screening instrument and can be used for research, including transcultural comparisons in perinatal psychiatry. It can also be used clinically to detect signs of a disordered mother-child relationship. Knowledge of the variables generally associated with mother-infant bonding problems combined with data from postpartum administration of the PBQ could be used in midwifery to develop preventive programmes based on the specific needs of new mothers.

Prenatal Attachment Inventory: expanding the reliability and validity evidence using a sample of Italian women.

BACKGROUND: The Prenatal Attachment Inventory (PAI) is a widely used questionnaire to measure prenatal attachment. However, its internal structure is controversial. None of the previous studies have investigated the dimensions of the Italian version of the scale using both an exploratory and a confirmatory approach. There is also a need to explore extensively the external validity of the Italian PAI. OBJECTIVE: We designed a study aimed at shedding further light on the dimensionality of the questionnaire and expanding the evidence of its reliability and validity. METHOD: Five-hundred and thirty-five Italian expectant mothers participated in the prenatal phase; a subsample of 100 women participated in the postnatal phase of the study. The PAI was administered together with other scales measuring maternal-fetal attachment, psychological wellbeing and relational variables. RESULTS: The hypothesised relationships with external criteria were substantiated overall. The five dimensions described in the Italian study by Barone, Lionetti, and Dellagiulia also emerged from our factor analyses, with the exception of two items. Internal consistency was adequate for the total scale and for four of the five subscales. CONCLUSION: As the Fantasy subscale showed poor internal consistency, we advise against its use as an independent measure. However, when used as a global score, the PAI is a reliable and valid measure of prenatal attachment in Italian women. Thus, it can be used for research purposes. The use of the PAI could also be very helpful in clinical settings, in order to identify expectant mothers who have difficulty in establishing an affective bond with their unborn infants. To this end, further research should study the characteristics of the PAI on high-risk groups and clinical samples in order to obtain clinical cut-offs.

Psychometric properties of a 20-item version of the Maternal-Fetal Attachment Scale in a sample of Italian expectant women.

OBJECTIVE: the Maternal-Fetal Attachment Scale (MFAS), a 24-item self-report questionnaire to measure the antenatal maternal feeling towards the unborn baby, was introduced by Mecca Cranley in 1981. Despite the widespread use of the questionnaire in clinical and research contexts, issues exist about its psychometric properties. An analysis of the literature showed the need for studies aimed at reviewing the MFAS by eliminating some items and modifying and "modernising" others. This study started from these suggestions and aimed to investigate the psychometric properties of a modified 20-item Italian version of the scale. DESIGN: the original MFAS was back translated and then administered to a pilot sample of 20 pregnant women in order to identify items hard to understand, inappropriate or ambiguous. On the basis of qualitative information derived from this pilot phase, we developed a 20-item Italian version of the MFAS that was later administered to a large sample of pregnant women. SETTING: antenatal education classes carried out in public and private structures of Italian central and insular regions. PARTICIPANTS: a sample of 482 women in middle and late pregnancy, attending antenatal education classes between February 2013 and October 2014. MEASUREMENTS: the modified MFAS was administered together with other scales measuring maternal-fetal attachment, psychological well-being, relational variables. Internal consistencies were evaluated using Cronbach׳s alpha. Nomological validity was assessed via Pearson correlations. Exploratory and confirmatory factor analyses were used to test the factor structure. FINDINGS: the hypothesised relationships with external criteria were partially substantiated. Exploratory factor analyses suggested a three-dimensional structure. Confirmatory factor analyses provided general support for an oblique three-factor model. Internal consistency was adequate for the total scale and for two of the three subscales. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: the 20-item Italian version of the MFAS is a reliable measure of maternal attachment to the fetus in Italian women. Cranley׳s five dimensions were not confirmed; instead, three factors emerged that could be renamed ׳Future parental roletaking׳, ׳Present interaction with the baby׳ and ׳Giving of self and responsibility to the unborn child׳. As maternal-fetal attachment is considered a predictor of the quality of the postnatal mother-child relationship, the MFAS could be a helpful tool in pre- and perinatal research and midwifery care to develop prevention programs based on women specific needs. Moreover, the availability of this questionnaire can assist in expanding research and in facilitating trans cultural comparison in issues related to pregnancy.

Parenting after preterm birth: link between infant medical risk and premature parenthood. A pilot study.

BACKGROUND: The aim of the present study was to examine the relationship between parental emotion regulation, infant medical risks and representation of child's behavior at 3 months corrected age. METHODS: The sample includes 28 couples (parents) and 32 preterm infants (4 set of twins) (AG average: 29 weeks), low birth weight (average weight: 1180.62 g), hospitalized for about two months. At the 3rd month of corrected age of the child all couples were interviewed using the "Clinical Interview for Parents of High Risk Infants" (CLIP), which explores the emotional aspects associated with preterm birth. The interviews were recorded, transcribed and analysed using ATLAS.TI. After the interview, only 14 mothers and 14 fathers completed the Behavior Rating Scale (SVC-80; Laicardi, 1998), which explores the observational-representative styles of each parent with respect to the child's behavior in the context of everyday life. We identified three Couples Groups indicating qualitative differences in the emotional functioning of the subjects mainly in the temporal dimension: 1) 12 "future-oriented"; 2) 12 "suspended in the present"; 3) 4 "oriented to the past". RESULTS: The results show that the infant's medical status has a impact on ability of parents to process the experience of preterm birth: increasing the infant's medical risks increases the difficulty of parents ability to process the experience. CONCLUSIONS: The CLIP can be a useful screening tool to identify difficulties of parents, to structure interventions focused on the elaboration of the traumatic experience of birth and on improving the quality of parent-infant relationship.

Investigating validity and reliability evidence for the Maternal Antenatal Attachment Scale in a sample of Italian women.

This study focused on the development of the emotional tie of the expectant mother towards her unborn child and aimed to achieve structural and external validity evidence for an Italian version of the Maternal Antenatal Attachment Scale (MAAS; Br J Med Psychol 66: 167-183, 1993). The MAAS was translated into Italian and was administered to a sample of 482 Italian expectant women (age 20-43 years), together with other questionnaires measuring maternal-fetal attachment, psychological well-being, and relational variables. The hypothesised relationships with external concurrent and predictive criteria were substantiated. Internal consistencies were adequate for the total scale and for one of the two subscales. Confirmatory factor analyses provided general support for an oblique two-factor model, with minor model misfit. Therefore, an exploratory factor analysis with oblimin rotation was performed. The findings suggested that some items may represent extraneous constructs. Implications for future research regarding the functioning of the instrument are addressed.

[The gender gap in Italian medicine]. / Il gender gap nella medicina italiana.

BACKGROUND: This study is collocated in the debate about the gender gap in Medicine giving voice to female physicians who have damaged the "glass ceiling". OBJECTIVES: Our research offers a contribute to the exploration about the motivations of persistence of gender gap in Medicine despite current changes. METHODS: This study is based on 21 biographical interviews to female physicians who are managers in Italian hospitals. The themes emerged by data analysis concerned the participants 'discrimination experiences in their hierarchical advancement, the evidences of a persistence of horizontal segregation in some medical specializations, the difficult to find a work-life balance and the effects of this difficult on the female physicians' health. RESULTS: Our research confirmed a persistence of gender gap in the medical world, which disadvantages women in their career choices and in their hierarchical advancement and which appears in the form of invisible barriers impregnated of stereotypes and prejudices that are taken for granted by many men and women, especially those who have the power; these barriers make the female doctors 'health more vulnerable to the event of work-related stress. CONCLUSIONS: By the dates emerged the necessity of cultural and institutional interventions, actions for deconstruction of gender stereotypes, and the necessity of intervention for a more flexible and functioning work organization that satisfies the female physicians' needs.