Social Environment and Attitudes toward COVID-19 Anti-Contagious Measures: An Explorative Study from Italy.

Social and cultural aspects (i.e., political decision making, discourses in the public sphere, and people's mindsets) played a crucial role in the ways people responded to the COVID-19 pandemic. Framed with the Semiotic-Cultural Psychological Theory (SCPT), the present work aims to explore how individual ways of making sense of their social environment affected individuals' perception of government measures aimed at managing the pandemic and the adherence to such measures. An online survey was administered from January to April 2021 to the Italian population. Retrieved questionnaires (N = 378) were analyzed through a Multiple Correspondence Analysis (MCA) to detect the factorial dimensions underpinning (dis)similarities in the respondents' ways of interpreting their social environment. Extracted factors were interpreted as markers of Latent Dimensions of Sense (LDSs) organizing respondents' worldviews. Finally, three regression models tested the role of LDSs in supporting the individual satisfaction with the measures adopted to contain the social contagion defined at national level, individual adherence to the containment measures and the perception of the population's adherence to them. Results highlight that all the three measures are associated with a negative view of the social environment characterized by a lack of confidence in public institutions (health system, government), public roles and other people. Findings are discussed on the one hand to shed light on the role of deep-rooted cultural views in defining personal evaluations of government measures and adherence capacity. On the other hand, we suggest that taking into account people's meaning-making can guide public health officials and policy makers to comprehend what favors or hinders adaptive responses to emergencies or social crises.

How socio-institutional contexts and cultural worldviews relate to COVID-19 acceptance rates: A representative study in Italy.

RATIONALE: Despite its importance to counter the COVID-19 pandemic, vaccination has raised hesitation in large segments of the population. This hesitation makes it important to understand the mechanisms underlying vaccine acceptance. To this end, the study adopts the Semiotic Cultural Psychology Theory, holding that social behaviors - and therefore, vaccination acceptance - depend on the cultural meanings in terms of which people interpret the social world. OBJECTIVE: The study aims at estimating the impact a) of the way people interpret the socio-institutional context of the pandemic and b) of the underlying cultural worldviews on vaccine acceptance. More particularly, the study tested the three following hypotheses. a) The meanings grounding the interpretation of the socio-institutional framework - that is, trust in institutions and political values - are an antecedent of vaccination acceptance. b) The impact of these meanings is moderated by the cultural worldviews (operationalized as symbolic universes). And c), the magnitude of the symbolic universes' moderator effect depends on the uncertainty to which the respondent is exposed. The exposure to uncertainty was estimated in terms of socioeconomic status - the lower the status, the high the exposure to uncertainty. METHODS: An Italian representative sample (N = 3020) completed a questionnaire, measuring vaccination acceptance, the meanings attributed to the socio-institutional context - that is, political values and trust in institutions - and symbolic universes. RESULTS: The findings were consistent with the hypotheses. a) Structural equation modelling proved that vaccine acceptance was predicted by trust in institutions. b) Multigroup analysis revealed that symbolic universes moderated the correlation between trust in institutions and vaccine acceptance. And c), the moderation effect of symbolic universes proved to occur only in the segment of lower socio-economic status (i.e., the group exposed to higher uncertainty). CONCLUSIONS: Vaccination acceptance is not only a medical issue; it is also dependent upon the rationalization of the socio-institutional context. Implications for the promotion of vaccination acceptance are discussed.

Parental Experiences of Coming Out: From "Un-doing Family Bonds" to "Family Generativity".

The coming out (CO) is a family process that involves the LGB+ person and all family members. The present study aimed to analyze the CO process from parents' perspective and examine if and how the emotional states of mothers and fathers changed in the years following the disclosure. The study involved 25 Italian parents (16 mothers, 9 fathers; Mage = 67, SD = 7.8) of 17 gay men and 8 lesbian women. Data were collected using a semi-structured interview designed to explore parents' reactions to their child's CO and the evolution of their CO experiences over the medium to long term (M = 13.9; SD = 8.3). Interviews were analyzed using emotional text analysis, representing a mixed methodology for tracing the emotional dimensions that organize linguistic productions. The factorial analysis generated four thematic clusters: (1) the un-doing of family bonds; (2) perceived gender typicality in childhood; (3) the freedom to be oneself and transgression; and (4) family generativity. Parents experience CO as challenging, especially in the initial phase. However, some parents develop CO narratives characterized by openness, pride, and generativity. The findings have implications for practice.

Safety at high altitude: the importance of emotional dysregulation on pilots' risk attitudes during flight.

Introduction: Aviation psychology is very interested in understanding how personological and psychological variables influence flight performances. Indeed, risk attitudes have been considered as a risk factor for aviation accidents. In this context, emotions and coping style are key variables which could influence concentration by affecting cognition and attention. In addition, the specific training backgrounds seemed to be associated with differences in in-flight accident rates. The aim of the present study was to investigate the association between age, sex, flight experience, emotional dysregulation, coping styles, flight licenses, and pilots' risk attitudes. Methods: Eighty pilots completed an online survey composed of ad hoc questionnaire for sociodemographic and work-related information's and self-report questionnaires that assessed emotional dysregulation, coping styles, and risk attitudes. Results: Results showed that older age and emotional dysregulation were associated with higher risk attitudes in pilots. Moreover, emotional dysregulation seemed to promote worse self-confidence. Ultralight pilots appeared to be more risk-oriented and less self-confident than civil pilots, while more flight experience appeared to favorite greater self-confidence. Discussion: In conclusion, the study suggests the importance of promoting interventions based on sharing pilots' difficulties and emotions and promoting safe attitudes with special attention to ultralight pilots, age, and sex differences.

Affective Saturation Index: A Lexical Measure of Affect.

Affect plays a major role in the individual's daily life, driving the sensemaking of experience, psychopathological conditions, social representations of phenomena, and ways of coping with others. The characteristics of affect have been traditionally investigated through physiological, self-report, and behavioral measures. The present article proposes a text-based measure to detect affect intensity: the Affective Saturation Index (ASI). The ASI rationale and the conceptualization of affect are overviewed, and an initial validation study on the ASI's convergent and concurrent validity is presented. Forty individuals completed a non-clinical semi-structured interview. For each interview transcript, the ASI was esteemed and compared to the individual's physiological index of propensity to affective arousal (measured by heart rate variability (HRV)); transcript semantic complexity (measured through the Semantic Entropy Index (SEI)); and lexical syntactic complexity (measured through the Flesch-Vacca Index (FVI)). ANOVAs and bi-variate correlations estimated the size of the relationships between indexes and sample characteristics (age, gender), then a set of multiple linear regressions tested the ASI's association with HRV, the SEI, and the FVI. Results support the ASI construct and criteria validity. The ASI proved able to detect affective saturation in interview transcripts (SEI and FVI, adjusted R2 = 0.428 and adjusted R2 = 0.241, respectively) and the way the text's affective saturation reflected the intensity of the individual's affective state (HRV, adjusted R2 = 0.428). In conclusion, although the specificity of the sample (psychology students) limits the findings' generalizability, the ASI provides the chance to use written texts to measure affect in accordance with a dynamic approach, independent of the spatio-temporal setting in which they were produced. In doing so, the ASI provides a way to empower the empirical analysis of fields such as psychotherapy and social group dynamics.

Narratives of Dreams and Waking Thoughts: Emotional Processing in Relation to the COVID-19 Pandemic.

The Coronavirus-19 (COVID-19) pandemic posed a significant challenge to the physical, mental, and emotional well-being of each individual. It also brought the importance of daily emotional management for survival to the forefront of every human being. Our study aims to explore whether emotional processes perform different functions during waking thoughts and night dreams during the first lockdown in Italy. Utilizing Multiple Code Theory (MCT), our goal is to verify whether waking thoughts facilitate a functional disconnection in order to manage the trauma caused by COVID-19. Two online forms were distributed to random participants in the general population, presenting a total of 49 reports of night dreams (23 males; mean age 33.45 ds. 10.12; word mean 238.54 ds. 146.8) and 48 reports of waking thoughts (25 males; mean age 34.54 ds. 12.8; word mean M. 91 words ds. 23). The Referential Process linguistic measures and Affect Salience Index were utilized. It was found that Affect Salience is present in both dreams and in waking thoughts; however, Referential Activity was higher in dreams and Reflection and Affect words were higher in waking thoughts. Two different processes of emotional elaboration emerged. The results highlight the use of greater symbolization processes during dreams and a higher emotional distance in waking thoughts. These results confirm that during the nocturnal processes, there is greater contact with the processing of trauma, while during the diurnal processes, defensive strategies were activated to cope with and manage life via a moment of the defensive disruption of daily activities.

Making sense of the COVID-19 pandemic: A qualitative longitudinal study investigating the first and second wave in Italy.

The COVID-19 pandemic further highlighted the crucial role of people's compliance for the success of measures designed to protect public health. Within the frame of Semiotic Cultural Psycho-social Theory, we discuss how the analysis of people's ways of making sense of the crisis scenario can help to identify the resources or constraints underlying the ways the citizens evaluate and comply with the anti-covid measures. This study aimed to examine how Italian adults interpreted what was happening in the first wave of the pandemic and how the interpretation varied in the period up to the beginning of the second wave. Diaries were collected for six months, from 11 April to 3 November 2020. Participants were periodically asked to talk about their life 'in the last few weeks'. A total number of 606 diaries were collected. The Automated Method for Content Analysis (ACASM) procedure was applied to the texts to detect the factorial dimensions - interpreted as the markers of latent dimensions of meanings- underpinning (dis)similarities in the respondents' discourses. ANOVA were applied to examine the dissimilarities in the association between factorial dimensions and production time. Findings show that significant transitions occurred over time in the main dimensions of meaning identified. Whereas the first phase was characterized by a focus on one's own daily life and the attempt to make sense of the changes occurring in the personal sphere, in the following phases the socio-economic impact of the crisis was brought to the fore, along with the hope to returning to the "normality" of the pre-rupture scenario. We argued that, despite the differences, a low sense of the interweaving between the personal and public sphere emerged in the accounts of the pandemic crisis throughout the sixth months considered; a split that, we speculate, can explain the "free for all" movement that occurred at the end of the first wave and the beginning of the second wave.

The Meaning of Living in the Time of COVID-19. A Large Sample Narrative Inquiry.

The spread of the COVID-19 pandemic has been a sudden, disruptive event that has strained international and local response capacity and distressed local populations. Different studies have focused on potential psychological distress resulting from the rupture of consolidated habits and routines related to the lockdown measures. Nevertheless, the subjective experience of individuals and the variations in the way of interpreting the lockdown measures remain substantially unexplored. Within the frame of Semiotic Cultural Psychosocial Theory, the study pursued two main goals: first, to explore the symbolic universes (SUs) through which Italian people represented the pandemic crisis and its meaning in their life; and second, to examine how the interpretation of the crisis varies over societal segments with different sociodemographic characteristics and specific life challenges. An online survey was available during the Italian lockdown. Respondents were asked to write a passage about the meaning of living in the time of COVID-19. A total of 1,393 questionnaires (mean = 35.47; standard deviation = 14.92; women: 64.8%; North Italy: 33%; Center Italy: 27%; South Italy: 40%) were collected. The Automated Method for Content Analysis procedure was applied to the collected texts to detect the factorial dimensions underpinning (dis)similarities in the respondents' discourses. Such factors were interpreted as the markers of latent dimensions of meanings defining the SUs active in the sample. A set of χ2 analysis allowed exploring the association between SUs and respondents' characteristics. Four SUs were identified, labeled "Reconsider social priorities," "Reconsider personal priorities," "Live with emergency," and "Surviving a war," characterized by the pertinentization of two extremely basic issues: what the pandemic consists of (health emergency versus turning point) and its extent and impact (daily life vs. world scenario). Significant associations were found between SUs and all the respondents' characteristics considered (sex, age, job status, job situation during lockdown, and place of living). The findings will be discussed in light of the role of the media and institutional scenario and psychosocial conditions in mediating the representation of the pandemic and in favoring or constraining the availability of symbolic resources underpinning people's capability to address the crisis.

A Phase Transition of the Unconscious: Automated Text Analysis of Dreams in Psychoanalytic Psychotherapy.

AIM: Psychotherapy could be interpreted as a self-organizing process which reveals discontinuous pattern transitions (so-called phase transitions). Whereas this was shown in the conscious process of awake patients by different measures and at different time scales, dreams came very seldom into the focus of investigation. The present work tests the hypothesis that, by dreaming, the patient gets progressively more access to affective-laden (i.e., emotionally charged) unconscious dimensions. Furthermore, the study investigates if, over the course of psychotherapy, a discontinuous phase transition occurs in the patient's capacity to get in contact with those unconscious dimensions. METHODS AND PROCEDURES: A series of 95 dream narratives reported during a psychoanalytic psychotherapy of a female patient (published as the "dreams of Amalie X") was used for analysis. An automated text analysis procedure based on multiple correspondence analysis was applied to the textual corpus of the dreams, highlighting a 10-factor structure. The factors, interpreted as affective-laden unconscious meaning dimensions, were adopted to define a 10-dimensional phase space, in which the ability of a dream to be associated with one or more local factors representing complex affective-laden meanings is measured by the Euclidean distance (ED) from the origin of this hyperspace. The obtained ED time series has been fitted by an autoregressive integrated moving average (ARIMA) model and by non linear methods like dynamic complexity, recurrence plot, and time frequency distribution. Change point analysis was applied to these non linear methods. RESULTS: The results show an increased frequency and intensity of dreams to get access to affective-laden meanings. Non linear methods identified a phase transition-like jump of the ED dynamics onto a higher complexity level of the dreaming process, suggesting a non linear process in the patient's capacity to get in contact with unconscious dimensions. CONCLUSION: The study corroborates the hypothesis that, by dreaming, the patient gets progressively more access to affective-laden meaning intended as unconscious dimensions. The trajectory of this process has been reproduced by an ARIMA model, and beyond this, non linear methods of time series analysis allowed the identification of a phase transition in the unconscious process of the psychoanalytic therapy under investigation.

Defense Mechanisms, Gender, and Adaptiveness in Emerging Personality Disorders in Adolescent Outpatients.

The present study focused on demographic and personality differences in the use of 30 defense mechanisms in adolescents with personality psychopathology and explored the hierarchical organization of personality traits based on the adaptiveness of defensive functioning. A total of 102 self-referred adolescent outpatients were interviewed and assessed on defense mechanisms and personality traits using the Defense Mechanisms Rating Scales and the Shedler-Westen Assessment Procedure 200 for Adolescents, respectively. Age and gender differences were found throughout the hierarchy. Pearson's correlations revealed a hierarchical organization of emerging personality disorders (PDs) in adolescence. More adaptive defenses were clearly associated with healthier personality style, whereas more pathological personality styles such as those with borderline traits were characterized by more rigid and maladaptive defenses. Dissociation was also associated with maladaptive personality types. Identifying the defenses associated with emerging personality disorders may inform the unconscious function of defense mechanisms in specific PDs. The systematic assessment of defense mechanisms might also help therapists to monitor changes during treatment.

The Role of Defense Mechanisms in Emerging Personality Disorders in Clinical Adolescents.

Background: Defensive functioning is related to overall mental functioning and personality traits in adults but only few studies investigated the role of defenses in adolescence. The present study analyzed the use of defense mechanisms in clinical adolescents to test how defensive functioning is related to age, gender, and personality traits.Design: 102 self-referred outpatients were interviewed using the Clinical Diagnostic Interview (CDI). Defense mechanisms and personality profile were assessed using the Defense Mechanisms Rating Scale (DMRS) and the Shedler-Westen Assessment Procedure-200 for Adolescence (SWAP-200-A) respectively.Findings: Multivariate analysis of variance showed significant age and gender differences in clinical adolescents; while younger teenagers used more immature defenses, older adolescents scored significantly higher in high-neurotic and mature defenses. Girls showed higher use of minor image distortion and neurotic defenses, whereas boys recurred more frequently to obsessional level defenses. Neither age nor gender differences were found for narcissistic defense level. Significant correlations between personality disorders and specific defenses were found for all personalities with sufficient base rate, with the exception of paranoid, schizotypal, and schizoid personalities.Conclusions: In line with previous studies we confirmed the hypothesis of an ontogenetic line of development of defense mechanisms. In addition, the present study found that age and gender differences in adolescence are related to the use of specific defenses that contribute to the development of the personality and various psychological capacities. Several clinical implications are linked to the systematic investigation of defense mechanisms in youth, although further studies are required to confirm these findings.

Training in psychotherapy: a call for embodied and psychophysiological approaches.

Psychotherapy research studies are increasingly focused on the clinical process, which has allowed for the definition of general models about clinical functioning and the role of the therapist. Embodiment-based research has shown that interpersonal processes, such as synchrony and attunement, are critical for the development of crucial therapist skills and that these mechanisms are mediated by physiological processes. Although the connection between these embodied processes and clinical practice is currently a topic of investigation in psychotherapy research, its implications for clinical training are potentially broad, but they remain unexplored. The present contribution proposes the idea of embodied trainings for psychotherapy trainees, which could support their acquisition of clinical skills through implicit, embodied, and affective learning. We present detailed potential mechanisms, study designs, and psychological variables that could be used to develop such an in vivo training and suggest some possible applications, ranging from biofeedback sessions to experimental settings and roleplaying. Additional research in this field can help bridge the gap between psychotherapy research and psychotherapy training, by overcoming some of the limitations of post-session and external evaluations, by enriching psychotherapy training programs, and by facilitating the implicit and automatic attunement of the attitudes of the students who will become tomorrow's therapists.

Key factors in psychotherapy training: an analysis of trainers', trainees' and psychotherapists' points of view.

The literature on clinical training lacks identifications of the factors that are most relevant in training programs; accordingly, the main aim of this work is to fill this research gap by assessing which factors that trainers, trainees and psychotherapists consider most relevant in psychotherapy training programs. A secondary aim is to identify whether these factors differ among trainers, trainees and psychotherapists. An ad hoc questionnaire was created and administered at 24 psychotherapy schools from 14 institutions; the sample included 641 trainees, 172 trainers and 218 psychotherapists of various theoretical orientations. The questionnaire included 63 items and used a 5-point Likert scale. An exploratory factor analysis was completed to identify the latent structure. The reliability of the dimensions was then checked. Finally, an analysis of variance and a multivariate analysis of variance were completed to achieve the study's aims. Four factors emerged from the study's results: trainers' relational characteristics, supervision, transmission of clinical know-how, and theoretical background and technical support. All these factors displayed acceptable reliability and internal consistency. Moreover, their relative rankings varied based on the participants' roles and theoretical backgrounds. This study's results indicate that the new instrument's psychometric qualities are acceptable. It thus could be used to develop a new approach to psychotherapy training, as this study's results regarding trainees' needs underline the differences between trainees' perceptions of those needs, as compared to trainers' and psychotherapists' perceptions.

A systematic review of psychotherapy research topics (2000-2016): a computer-assisted approach.

The present work aims to empirically map what has been investigated and which issues (i.e. topics) characterize the debates of psychotherapy research, using a computer-assisted, bottom-up method of content analysis. The abstract of papers (N=13,499), published between 2000-2016 and retrieved from a sample of 10 journals selected as representing the field of psychotherapy research, were subjected to a method of automated content analysis. Five different research topics were identified (clinical relationship, clinical efficacy, clinical practice and research, psychopathology, and neuroscientific approaches to mental disorders) and each abstract was labeled according to the retrieved research topic. Two different Chi-square analyses investigated the distributions of research topics over time and among the selected journals. Results concerning the distribution over time highlighted an increase in the clinical relationship and clinical efficacy topics and a decrease in the others. An examination of the distribution among journals showed that psychopathology and neuroscientific approaches to mental disorders were associated with psychiatric journals, while the others were associated with non-psychiatric journals. The findings are discussed in light of the theoretical, methodological, and practical implications offering pointers for a critical understanding of the current psychotherapy research domain.

Beyond Verbal Behavior: An Empirical Analysis of Speech Rates in Psychotherapy Sessions.

Objective: The present work aims to detect the role of the rate of speech as a mechanism able to give information on patient's intrapsychic activity and the intersubjective quality of the patient-therapist relationship. Method: Thirty clinical sessions among five patients were sampled and divided into idea units (N = 1276) according to the referential activity method. Each idea unit was rated according to referential activity method and in terms of speech rate (syllables per second) for both patient and therapist. A mixed-effects model was applied in order to detect the relationship between the speech rate of both the patient and the therapist and the features of the patient's verbal production in terms of referential activity scales. A Pearson correlation was applied to evaluate the synchrony between the speech rate of the patient and the therapist. Results: Results highlight that speech rate varies according patient's ability to get in touch with specific aspects detected through referential activity method: patient and the therapist speech rate get synchronized during the course of the sessions; and the therapist's speech rate partially attunes to the patient's ability to get in touch with inner aspects detected through RA method. Conclusion: The work identified speech rate as a feature that may help in the development of the clinical process in light of its ability to convey information about a patient's internal states and a therapist's attunement ability. These results support the intersubjective perspective on the clinical process.

An automated method of content analysis for psychotherapy research: A further validation.

OBJECTIVE: The aim of the study is to validate the ability of ACASM (Automated Co-occurrence Analysis for Semantic Mapping) to provide a representation of the content of the therapeutic exchange that is useful for clinical analysis. METHOD: We compared the clinical case analyses of a good outcome psychodynamic therapy performed by a group of clinicians (n = 5) based on the verbatim transcripts (transcript-based analysis) with the clinical case analyses performed by another group of clinicians (n = 5) based on the ACASM representation of the same sessions (ACASM-based analysis). Comparison concerned two levels: the descriptive level and the interpretative level of the clinical case analysis. RESULTS: Findings showed that, inconsistently with our hypothesis, ACASM-based descriptions of the case obtained worse evaluations than transcript-based descriptions of the case (on all 3 criteria adopted). On the contrary, consistently with our hypothesis, ACASM is undistinguishable from the verbatim transcripts as regards the case interpretation (on 2 out of 3 criteria adopted). CONCLUSIONS: ACASM provides a description of the case that, though different from the one provided by the transcripts, enables clinicians to elaborate clinical interpretations of the case which approximate those produced by clinicians working directly on verbatim transcripts.

Dynamic mapping of the structures of content in clinical settings (DMSC). A new coding system for analysing the patient's narratives.

OBJECTIVES: The paper presents a method of content analysis framed within a semiotic and contextual model of the psychotherapy process as a situated dynamics of sensemaking: the Dynamic Mapping of the Structures of Content in Clinical Settings (DMSC). DESIGN: DMSC is a system of content analysis focused on a generalized level of meaning, concerning basic aspects of the patient's narrative (e.g., if the narrative concerns herself or other than herself). METHOD: The paper presents the result of the application of DMSC to an intensive single-case analysis (Katja). The method has been applied by judges to the transcripts of sessions and is aimed at identifying patterns of combinations (defined: Patterns of content) of the categories characterizing the patient's narratives (pattern analysis approach) as well as at mapping the transition among these patterns (sequential analysis approach). RESULTS: These results provide evidence of its construct validity. In accordance with the theoretical model grounding the method, we have found that: (a) DMSC provides a meaningful representation of the patient's narratives in terms of Patterns of content; (b) the probability of transition among the Patterns of content have proved to be significantly associated with the clinical quality of the sessions. CONCLUSION: The DMSC has to be considered an attempt paving the way for further investigations aimed at developing a deeper understanding of the role played by the dynamics of sensemaking in the psychotherapy process.

Automated method of content analysis: a device for psychotherapy process research.

The work presents a computer-aided method of content analysis applicable to verbatim transcripts of psychotherapy: the Automated Co-occurrence Analysis for Semantic Mapping (ACASM). ACASM is able to perform a context-sensitive strategy of analysis aimed at mapping the meanings of the text through a trans-theoretical procedure. The paper is devoted to the presentation of the method and testing its validity. To the latter end we have compared ACASM and independent blind human coders on two tasks of content analysis: (a) estimating the semantic similarity between two utterances; (b) the semantic classification of a set of utterances. Results highlight that: (a) ACASM's estimates of semantic similarity are consistent with the corresponding estimates provided by coders; (b) coders' agreement and coder-ACASM agreement on the task of semantic classification have the same magnitude. Results lead to the conclusion that the content analysis produced by ACASM is indistinguishable from that performed by human coders.

The building of models as pathway to understand the therapeutic process.

The present work highlights the necessity to re-think the paradigmatic, methodological and theoretical assumptions which for a long time have regulated the practices of research in the field of the study of therapeutic processes. Following this suggestion, and commenting on Ribeiro and Gonçalves (2011), and Faccio, Centomo and Mininni (2011), I highlight the need to reframe the therapeutic change research in terms of a modelling approach. According to such perspective models arise through focusing on the general rule of the functioning of a change process within the local domain of a particular therapeutic encounter, making it possible both to manage it in line with the specific local aims, and to promote the deepening and the develop of scientific knowledge. This is a step towards a new research perspective able to promote the integration of empirical research and clinical practice.

Analyzing psychotherapy process as intersubjective sensemaking: an approach based on discourse analysis and neural networks.

The authors propose a method for analyzing the psychotherapy process: discourse flow analysis (DFA). DFA is a technique representing the verbal interaction between therapist and patient as a discourse network, aimed at measuring the therapist-patient discourse ability to generate new meanings through time. DFA assumes that the main function of psychotherapy is to produce semiotic novelty. DFA is applied to the verbatim transcript of the psychotherapy. It defines the main meanings active within the therapeutic discourse by means of the combined use of text analysis and statistical techniques. Subsequently, it represents the dynamic interconnections among these meanings in terms of a "discursive network." The dynamic and structural indexes of the discursive network have been shown to provide a valid representation of the patient-therapist communicative flow as well as an estimation of its clinical quality. Finally, a neural network is designed specifically to identify patterns of functioning of the discursive network and to verify the clinical validity of these patterns in terms of their association with specific phases of the psychotherapy process. An application of the DFA to a case of psychotherapy is provided to illustrate the method and the kinds of results it produces.