Spontaneous and induced labor: association with maternal well-being three months after childbirth.

A woman's first childbirth represents a moment of elevated maternal emotional vulnerability. Indeed, there is a prevalence of anxiety and depression symptomatology in primiparas during the postpartum period that negatively influences the well-being of the woman, of her newborn, and of the quality of their attachment bond. Much attention has been paid to the possible risk factors involved in the onset of mood disturbance in the postpartum. However, knowledge is still limited regarding the role played by the specific clinical aspects linked to labor. Therefore, the aim of the present study was to explore whether spontaneous or elective induction labor is linked to the level of postnatal depression and anxiety three months after birth. One hundred and sixty-one women (Mage = 31.63; SD = 4.88) were recruited, using the following inclusion criteria: native Italian women; age > 18 years; physically and psychologically healthy nulliparous with singleton no-risk pregnancy; no previous abortion or interruption of pregnancy; no previous psychopathological diagnoses. Exclusion criteria: twin pregnancy, fetal pathologies, and planned elective cesarean. Data was collected at two different times: T1 (day of childbirth) clinical data of labor (spontaneous or induced) from hospital records; T2 (three months after birth) level of mother's depression and anxiety. In order to explore if the level of depression and anxiety three months after childbirth differ in women according to the type of labor, spontaneous or induced, two univariate analyses of variance (ANOVA) were conducted. Results showed that women who had a spontaneous labor reported lower levels of anxiety and depression than women who had an induced labor. Our results highlight the significant implications that the mode of labor has on the emotional well-being of mothers, underlining the need to support women throughout all their transition to motherhood, including the childbirth experience.

Gambling Behaviors in Adolescent Male and Female Regular and Non-Regular Gamblers: A Study of Central Italian Adolescents.

Gambling is a widespread and popular phenomenon among adolescents. However, little is known specifically about adolescent gambling behaviors in Italy. The aim of the present study was to explore the prevalence and frequency of gambling behaviors, the types of bets most frequently chosen, the amount of money spent on gambling, and the more frequent problem gambling behaviors, taking into account the type of gambler (regular and non-regular), gender, and age. For this propose, 1255 adolescents (59.1% males) aged 13 to 19 years (M = 16.06; SD = 1.47), were recruited for the study. Results of a series of chi-squared tests show that 70.8% of adolescents had gambled at least once in the previous year, with more than 68% of minors declaring that they had gambled. Among those who claimed to have gambled, 24% were regular gamblers who spent more money, had more gambling-related problems, and chose games more at risk for developing gambling addiction, compared to non-regular gamblers. Regarding gender, results show that males gambled more, more frequently, spent more, and presented more gambling-related problems than females. About age, adolescents of age gambled more on some games that involved going to places to bet than minors but no differences between minors and of-age adolescents emerged on the amount of money spent and in being a regular gambler or not. However, gender and age differences emerged only in the non-regular group, whereas in the regular-gambling group, males and females and minor and of-age adolescents did not differ on any aspect analyzed.

The relationship between romantic and prenatal maternal attachment: The moderating role of social support.

The aim of this study was to examine the relationships between three types of maternal attachment bonds: anxious romantic, avoidant romantic and prenatal. The moderating role of perceived social support is also analysed. Ninety-one pregnant women in or near their thirtieth week of gestation (M = 29.59; SD = 4.57) were recruited, all of whom completed a series of questionnaires to assess the quality of their romantic and prenatal attachment bonds and their levels of perceived social support. The results reveal that both anxious and avoidant romantic attachments were significantly associated with low levels of maternal prenatal attachment. Moreover, the level of social support perceived during pregnancy moderated the relationship between anxious and prenatal attachments but had no effect on avoidant romantic and prenatal attachments. Our discussion of these findings considers the emotional and behavioural characteristics of various forms of insecure romantic attachments. Overall, the data highlight the relevance of the quality of intimate close relationships on maternity experiences and women's caregiving abilities.

Sensation Seeking and Gambling Behavior in Adolescence: Can Externalizing Problems Moderate This Relationship?

Gambling is a widespread phenomenon during adolescence. Among different risk factors involved in the onset of adolescent gambling behaviors, one factor that is studied is the sensation seeking personality trait. However, the literature is heterogeneous and a direct relationship between sensation seeking and gaming behaviors has not always been highlighted. This suggests that the relationship can be influenced by other factors. In particular, we explored the moderating role of externalizing problems in this relationship. A total of 363 adolescents (232 males and 131 females) aged 14 to 20 (M = 16.35, SD = 1.36) completed a battery of questionnaires aimed to assess their gambling behaviors, as well as the levels of externalizing problems and sensation seeking. The results showed that sensation seeking was associated with gambling severity, but this relationship was significant when externalizing problems were high and medium. On the contrary, when externalizing problems were low, the relationship between sensation seeking and gambling severity was not significant. Overall, sensation seeking in adolescence can favor the implementation of risk behaviors, such as gambling, but only in association with the presence of externalizing problems. Limitations, strengths, and social and clinical implications of the present study are discussed.

The Role of Vulnerable and Grandiose Narcissism in Psychological Perpetrated Abuse Within Couple Relationships: The Mediating Role of Romantic Jealousy.

The aim of this study was to analyze the direct and indirect relationships between the two phenotypes of narcissism, vulnerable and grandiose, and the tendency to perpetrate psychological abuse, exploring the mediating role of romantic jealousy. Our sample included 473 participants (213 males), aged 18-30 years (M = 22.74; SD = 2.81), involved in a stable romantic relationship. A structural equation modeling was conducted to test our model and a multigroup analysis was performed to test gender differences. Results show that the two forms of narcissism are both linked to psychological perpetrated abuse, but in different ways. Vulnerable narcissism was linked to psychological abuse only indirectly, through the role of romantic jealousy. On the contrary, grandiose narcissism was positively and directly associated with psychological abuse within the romantic relationship. Moreover, the model was invariant across genders. Limitations, strengths, and theoretical and clinical implications are discussed.

A Revised Short Form of the Extended Class Play Among Italian Early Adolescents.

Among the measures assessing peer reputation, the Extended Class Play (ECP) is now used extensively in North American settings. Little information is available in other cultural contexts. Furthermore, practical considerations suggest developing a shorter form of the ECP to be used in socio-educational environments. This study examined the ECP dimensions of peer assessment in Italy as well as developed a shorter form of the measure. We revised the ECP using factor analyses according to an explorative-confirmatory approach. The original 37-item ECP was shortened to a 22-item version and, subsequently, the properties of the revised measure were evaluated. We performed two studies comprising, respectively, 643 (55% male; 97% Italian; Mage = 12.20, SD = 0.60) and 652 (58% male; 94% Italian; Mage = 12.26, SD = 0.66) seventh-grade young adolescents living in southern and central Italy. Results revealed a clear and consistent seven-factor structure and acceptable levels of reliability and validity. Factors included constructs such as Shyness-Withdrawal, Prosociality-Leadership, Aggression, Popularity-Sociability, Victimization, Rejection-Exclusion, and Boastfulness. Correlations between the dimensions of the 22-item ECP and teacher ratings of young adolescents' behaviors further confirmed the validity of the solution. Findings suggest the importance of culturally revised measures of social reputation and indicate that the short form of the ECP has considerable promise to be considered a valuable measure to assess the multidimensional aspects of peer relationships.

Day Surgery Management of Early Breast Cancer: Feasibility and Psychological Outcomes.

BACKGROUND/AIM: Breast cancer treatment represents a substantial amount of health-care costs and has a negative impact on womens' psychological health. Day-Surgery managment (DS) is a favorable alternative to a classic inpatient setting. In our prospective study we evaluated DS-treatment feasibility in terms of patient satisfaction, same-day-discharge rate, surgical-reintervention rate, psychological impact and costs. PATIENTS AND METHODS: We operated on 131 early breast cancer patients in DS. Surgical outcomes were evaluated. In 64 DS-treated breast cancer patients, psychological outcomes were analyzed using validated psychometric questionnaires and comparison was made with a corresponding group of women treated as inpatients. RESULTS: The same-day-discharge rate was 95.4%. No patient required readmission. The surgical-reintervention rate was 6.2%. DS-treatment significantly reduced anxiety (p=0.05) and depression (p=0.01) and afforded cost savings of 49%. CONCLUSION: DS-treatment of early breast cancer was feasible, with low reintervention rate, reduced anxiety and depression, high patients' satisfaction and substantial financial savings.

Maternal depressive symptomatology during pregnancy is a risk factor affecting newborn's health: a longitudinal study.

Background: Depression symptomatology in pregnant women is a condition that represents an important risk factor for the health of both women and children. Objectives: The aim of this study was to investigate the influence of women's depression symptomatology on the clinical aspects of their delivery, both directly and indirectly, through mothers' prenatal attachment to their unborn children. Moreover, we analysed whether these aspects affect the well-being of the newborn, assessed through the Apgar score. Methods: A longitudinal design was carried out on a total of 203 pregnant women. At weeks 31-32 of gestation, women filled out the Beck Depression Inventory and the Prenatal Attachment Inventory. The day of childbirth, hospital healthcare staff registered the clinical data of childbirth. Results: A woman's depressive symptomatology negatively affects prenatal attachment to her unborn child and positively affects the clinical aspects of the delivery, both directly and mediated by the quality of prenatal attachment. Moreover, the Apgar score was negatively influenced by the clinical aspects of the delivery and, indirectly, by the depressive symptomatology. Conclusion: Depressive symptomatology during pregnancy has negative outcomes, affecting the delivery experience of women, the first emotional bond with the child, and the well-being of the newborn.

The effect of maternal depression and anxiety on labour and the well-being of the newborn.

Maternal symptomatology during pregnancy represents a significant risk factor for women and children. The main focus of this paper is to jointly investigate the role of maternal depression and anxiety during pregnancy on the well-being of the newborn, through their influences on the clinical aspects of labour. A longitudinal study was conducted on 167 pregnant women (Mage=32.07, SD = 4.50) recruited in the third trimester of gestation. The data was collected at two different times: the socio-demographical data and prenatal anxiety and depression were assessed at T1 (31-32 week of gestation); the clinical data on childbirth (duration of labour, administration of oxytocin and epidural analgesia) and the Apgar index of the newborn were registered at T2 (the day of childbirth). A structural equation modeling was performed using the MPLUS statistical programme. The results showed that a maternal psychopathological symptomatology during pregnancy constitutes a significant risk factor for the well-being of the newborn. In particular, both prenatal anxiety and depression negatively affect the clinical aspects of the labour experience and, indirectly, the Apgar index. The limitations, strengths, and theoretical and clinical implications are discussed. Impact statement What is already known on this subject? Depression and anxiety during pregnancy can negatively affect the well-being of women, the experience of labour and delivery, and birth outcomes. All of these aspects are documented in literature, however, they are usually analysed independently. What do the results of this study add? This is the first study that analyses all of the above psychological and clinical variables together, testing a theoretical model where prenatal anxiety and depression influence the newborn's Apgar index, through the clinical aspects of labour. The outcomes highlight the role that depressive and anxiety symptoms during pregnancy and the labour experience play on the newborn's wellbeing. What are the implications of these findings for clinical practice and/or further research? Overall, our data confirms the importance of putting a new light on maternal psychological symptoms during pregnancy and birth experience, considering them as complex human processes in which psychological and physical aspects are highly interconnected, influencing maternal and newborn well-being. Our results highlight how important it is that, when approaching the delivery experience, healthcare professionals pay attention not only to the physical condition of pregnant women and newborns, but also to the psychological condition of women, given the impact this can have on delivery and, therefore, on the baby's wellbeing.

A study on the Italian validation of the family questionnaire.

Expressed Emotion (EE) refers to the emotional behavior and patterns of communication of relatives toward patients, and it is a strong predictor of illness outcome across a variety of psychiatric disorders. The aims of the present study were to provide a contribution for the Italian validation of the Family Questionnaire (FQ), developed by Wiedemann et al. (2002). The FQ is a self-report questionnaire to assess the EE construct. Specifically, the present study aims to examine the psychometric properties (factorial structure, internal consistency and concurrent validity) of the Italian version of the FQ and to explore the differences between mothers' and fathers' emotional responses to patients with eating disorders. The sample was composed of 199 carers of patients with eating disorders (80 males and 119 females, M age = 49.63, SD = 6.24). Confirmatory Factor Analyses verified the original two-factor structure. The internal consistency coefficients of the two FQ dimensions were satisfactory. Further, the present study provided support for the concurrent validity of FQ, also within the Italian context.

How Different Guilt Feelings Can Affect Social Competence Development in Childhood.

The authors examined how the two different dimensions of guilt feelings, needed for reparation and fear of punishment, could influence social conduct, such as prosocial and aggressive behaviors, and how they are linked to popularity in childhood. The authors hypothesized a theoretical model that they tested, fitting it with empirical data obtained from a sample of 242 Italian children 9-11 years old. Both dimensions of guilt predict prosocial and aggressive behaviors. Specifically, the feeling of guilt linked to the need for reparation tends to negatively predict aggressive behaviors, and positively predict prosocial behaviors. The feeling of guilt linked to the fear of punishment, on the contrary, tends to positively affect aggressive and negatively affect prosocial conducts in children. These results highlight that the different feelings of guilt can represent a relevant risk or protective factor for the development of social competence in childhood. Limitations, strengths, and further development of the present study are discussed.

Women who had positive relationships with their own mothers reported good attachments to their first child before and after birth.

AIM: Bowlby's attachment intergenerational transmission theory suggests that a woman's attachment to her parents, particularly her mother, plays an important role in her future parenting. We studied whether there was any association between pregnant women's attachment to their baby before and after birth and their relationships with their mothers. METHODS: A longitudinal study was carried out in 2015 on 201 first-time mothers recruited in the maternity ward of the level two Misericordia e Dolce Hospital in Prato, Italy. At 32 weeks of pregnancy, the women filled in the Parental Bonding Instrument and the Prenatal Attachment Inventory and their spontaneous attachment behaviour towards their newborn infants were observed in the nursery during the first two days after childbirth. RESULTS: Having a good relationship with their own mothers was a positive predictor for the women's prenatal attachment to their baby and caregiving and attachment behaviour to their newborn infants. In addition, the mothers' prenatal attachment positively predicted their behavioural attachment pattern after birth. CONCLUSION: We found that women who had positive relationships with their own mothers also had positive attachments to their unborn babies and in the period immediately after birth. Our findings supported Bowlby's attachment intergenerational transmission theory.

Psychopathological features in a sample of substance-abusing individuals with criminal history: Towards a definition of a personality prototype of an 'Addict with Criminal Conduct'.

BACKGROUND: The relationship between substance use disorders and criminal activity is strong, and one that is not easily resolved in the criminal justice system. A better understanding of personality traits among substance misusers who commit offences could support better treatment efforts. AIMS: The aim of this study is to explore associations between the psychopathology of people addicted to substances who have also committed crimes. METHODS: We recruited 263 substance-dependent individuals (80% male, 20% female) from a cohort of people attending regional community services in Italy. They all completed an extensive evaluation of their current mental health and personality traits. Their official criminal records were obtained, and the psychopathology of those who had a criminal record compared with those who did not. RESULTS: The criminal group was more likely to perceive the external world as hostile and to consider others as responsible for their own problems and difficulties; in addition, substance-dependent individuals with criminal records showed more personality traits within the psychopathy range and fewer in the dependent personality range than the substance abusers who had never committed crimes. CONCLUSIONS: These findings allow us to hypothesise that substance abusers who also have criminal convictions may have a specific personality profile. If further research were to confirm this, then it could have important implications for identifying people for particular treatment pathways and developing more effective treatments. Copyright © 2016 John Wiley & Sons, Ltd.

Maternal social support, quality of birth experience, and post-partum depression in primiparous women.

BACKGROUND: Social relationships provide individuals with a general sense of self-worth, psychological wellbeing, as well as allowing them access to resources during stressful periods and transitions in life. Pregnancy is a time of significant life change for every woman. The aim of this study was to verify the influence of social support perceived by mothers during pregnancy on the quality of their birth experience and post-partum depression. METHOD: A longitudinal study at three different times was carried out on 179 nulliparous pregnant women. Women completed a Maternal Social Support Questionnaire during the third trimester of their pregnancy. Then, on the first day after childbirth, clinical birth indices were collected. Finally, a month after childbirth, the Edinburgh Postnatal Depression Scale was administered. RESULTS: Post-partum depression was influenced negatively by maternal perceived social support and positively by negative clinical birth indices. In addition to these direct effects, analyses revealed a significant effect of maternal perceived social support on post-partum depression, mediated by the clinical indices considered. CONCLUSIONS: Social support perceived by mothers during pregnancy plays a significant role as a protection factor against post-partum depression, both directly and indirectly, reducing the negative clinical aspects of the birth experience.

Impulsivity, alexithymia and dissociation among pathological gamblers in different therapeutic settings: A multisample comparison study.

Since many psychopathological traits seem to be related to Gambling Disorder (GD), impulsivity, alexithymia and dissociation could play a central role in gambling behaviors, particularly in pathological gambling. We test this hypothesis in four distinct samples of gamblers, three undergoing different types of treatments and a control group. The study sample consists of 204 subjects (males 87.3%, mean age=47.75 years, SD=12.08) divided into four groups: (1) 59 subjects belonging to an Outpatients Treatment Program in the National Health System (NHS); (2) 60 subjects of an Outpatients Self-Help Group Program; (3) 35 subjects belonging to a Residential Treatment Program (Inpatients Program); and (4) 50 subjects without gambling problems (Control Group). Results show a positive relationship between gambling behaviors, impulsivity and alexithymia, and a negligible link between gambling behaviors and dissociation. Findings also display the presence of higher levels of all these features in pathological gamblers with higher scores on the SOGS, and particularly, in participants attending a Residential Treatment Program (Inpatients Program). This study confirms the hypothesis of the presence of higher levels of impulsivity, alexithymia and dissociation in pathological gamblers with a greater severity and seems to indicate a significant importance of impulsivity and alexithymia in predicting gambling behaviors.

Development of a new measure for assessing insight: Psychometric properties of the insight orientation scale (IOS).

INTRODUCTION: Given the centrality of insight in promoting change, the relevance of measures for assessing this construct has become increasingly clear. This paper describes a new self-report measure for assessing some of the characteristics of insight, the insight orientation scale (IOS). AIMS: In study 1, we evaluated the factor structure and the reliability of the scale. In study 2, we analyzed the concurrent and discriminant validity of the scale in patients with different clinical diagnoses. METHODS: In study 1 participants were 600 individuals (41.1% male, 58.9% female) with a mean age of 33.95 years (SD = 13.04). In study 2 participants were 136 individuals divided into the following groups: 1) schizophrenia spectrum and other psychotic disorders (n = 26); 2) substance-related disorders (n = 55); 3) depressive disorders (n = 27); and 4) personality disorders (n = 28). INSTRUMENTS: Instruments are the insight orientation scale (IOS) and the Beck cognitive insight scale. RESULTS: The goodness-of-fit indices showed a satisfactory fit of a one factor model. We found also a good internal consistency (α = .77). CONCLUSIONS: These findings support the dimensionality of the IOS and suggest that it may be useful as an assessment tool for use in guiding psychotherapy.

Empathy and autobiographical memory: are they linked?

Autobiographical memory and empathy have been linked with social interaction variables as well as gender in independent bodies of literature. However a scarcity of research exists on the direct link between autobiographical memory and empathy. Exploring this link, in particular for memory of friendships and empathy, was the authors' main aim. A total of 107 Italian undergraduates participated. A memory fluency task was used to assess accessibility of memories spanning their entire life (preschool through university) and an empathy scale (Italian version of the Interpersonal Reactivity Index) was employed to measure the participants' level and dimensions of empathy. For men, empathy scores were related to how many memories they could recall. Specifically, men with higher scores on the fantasy and empathic concern scales and those with lower scores on the personal distress scales recalled more memories of friends. However, affective quality of their memories was unrelated to empathy. In contrast, for women there was no relationship between number of memories and empathy, but the emotional tone of their memories was related to empathy: those with higher scores on the personal distress scale had proportionately fewer affectively positive memories. Results are discussed in terms of gender differences in both empathy and parental socialization patterns.

Medical error and systems of signaling: conceptual and linguistic definition.

In recent years the issue of patient safety has been the subject of detailed investigations, particularly as a result of the increasing attention from the patients and the public on the problem of medical error. The purpose of this work is firstly to define the classification of medical errors, which are distinguished between two perspectives: those that are personal, and those that are caused by the system. Furthermore we will briefly review some of the main methods used by healthcare organizations to identify and analyze errors. During this discussion it has been determined that, in order to constitute a practical, coordinated and shared action to counteract the error, it is necessary to promote an analysis that considers all elements (human, technological and organizational) that contribute to the occurrence of a critical event. Therefore, it is essential to create a culture of constructive confrontation that encourages an open and non-punitive debate about the causes that led to error. In conclusion we have thus underlined that in health it is essential to affirm a system discussion that considers the error as a learning source, and as a result of the interaction between the individual and the organization. In this way, one should encourage a non-guilt bearing discussion on evident errors and on those which are not immediately identifiable, in order to create the conditions that recognize and corrects the error even before it produces negative consequences.

Parental influences on memories of parents and friends.

The authors evaluated the role parent-child relationship quality has on two types of memories, those of parents and those of friends. Participants were 198 Italian university students who recalled memories during 4 separate timed memory-fluency tasks about their preschool, elementary school, middle school, high school and university years. Half were instructed to recall memories involving parents and the remainder memories involving friends. Moreover, parent-child relationships were assessed by the Network of Relationships Inventory (NRI; W. Furman & D. Buhrmester, 1985) and Adolescents' Report of Parental Monitoring (D. M. Capaldi & G. R. Patterson, 1989). Results showed that men with positive parent-son relationships had more memories of parents and more affectively positive memories of friends, supporting a consistency model positing similarity between parent-child relationships and memories of friends. Women with positive parental relationship quality had more affectively positive memories of parents but for friends, positive relationship quality only predicted positive memories when young. At older ages, especially middle school-aged children, negative parent-daughter relationships predicted more positive memories of friends, supporting a compensatory model. The gender of parent also mattered, with fathers having a more influential role on affect for memories of friends.