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Suicide is a public health problem having important consequences also for people who survive to the suicide of a loved one – the suicide loss survivors. Since suicide bereavement can have a lasting and significant psychosocial impact on the bereaved individuals, psychosocial treatments are needed (postvention). Many countries have included postvention in their suicide prevention policies. This is a narrative review aiming to investigate the bereavement experience of suicide loss survivors, the associated symptoms, and to describe adequate treatments to properly reduce survivors’ grief and help them to adapt to the loss. Method. Literature review of peer reviewed literature (PubMed, PsycINFO), books about bereavement, suicide, postvention and postvention guidelines. Results. Suicide loss survivors may have an increased risk of developing psychiatric disorders such as post-traumatic stress disorder, depressive disorders, anxiety, and substance abuse; an increased risk of suicide; increased physical complaints; and an increased risk of developing Persistent Complex Bereavement. About postvention, two measures turn out to be very important. An immediate first on-the-spot intervention that includes: specific training for general practitioner and police; to direct survivors to support services; provide proactive and practical support; psychological autopsy. The second intervention is a long-term one and can be delivered in a variety of ways: the most effective therapy for survivors appears to be Complicated Grief Therapy, but in general the therapist must be adequately trained for individual psychotherapy with survivors. Other effective interventions include: writing projects; group psychotherapy; support groups. Conclusion. A public health approach to postvention can allow to tailor interventions to the needs of survivors, and to align postvention with suicide prevention programs.

Gestational Trophoblastic Disease (GTD) is a group of disorders that derive from the placenta and arise after a rare gestational event. They can be divided into pre-malignant forms (partial and complete hydatidiform mole) and malignant forms called Gestational Trophoblastic Neoplasia (GTN). Despite a favourable prognosis, the nature of this group of disorders can be a source of stress for patients who are affected by this disease. Methods. Thirty-one patients diagnosed with GTD completed a battery of self-administered questionnaires aimed at analysing the psychological adaptation of the patients to the disease. The variables analysed were the following: defense mechanisms, anxiety, depression and infertility-related stress. Results. Patients with GTN use mature defense mechanisms significantly more than patients with hydatidiform mole. Regression analyses highlight that, considering demographic and clinical variables, immature defense mechanisms are significantly related to state anxiety. Immature defence mechanisms also significantly predict infertility-related global stress. Conclusions. The results show the importance of taking into consideration defense mechanisms used by patients, as they are involved in the modulation of psychological adaptation to GTD.

In this contribution, we will present some findings from the “Emotional Thermometer [Termometro Emotivo]” project. The project aims at investigating the impact of COVID-19 pandemic outbreak on mental health in Italian adults. In this contribution, we present findings on short-term psychological consequences of the COVID-19 pandemic outbreak (Study 1) and real-time emotional and psychological responses (Study 2) to this exceptional situation. The first study includes a large sample of participants taken from the general population (N = 1548), who completed measures of psychological distress, emotion regulation strategies, perceived social support, and subjective perceptions of the situation. The second study includes a subsample of 823 participants who completed daily measures of emotional and psychological states for 21 days. Results from Study 1 suggest increased levels of psychological distress and post-traumatic responses to COVID-19 pandemic outbreak in participants. They also demonstrate the protective role of social support and coping strategies on individuals’ mental health. Furthermore, results from Study 2 show that participants experienced higher levels of daily negative psychological states during the COVID-19 pandemic outbreak, and inflexibility of negative emotional states. Overall, our findings stress the psychological cost of the COVID-19 pandemic outbreak in community people. As a consequence, our contribution aims at suggesting the need of paying clinical attention to potential pathological or maladaptive conditions related to the COVID-19 pandemic in community people.

Il narcisismo è un costrutto studiato da tempo nella letteratura teorica ed empirica all’interno di differenti campi di conoscenza quali la psicologia clinica, la psicologia sociale e di personalità, e la psichiatria (Pincus & Lukowitsky, 2010). Nonostante la sua importanza, esso è stato un costrutto di difficile definizione per lungo tempo (Cain, Pincus & Ansell, 2008). Uno dei principali ostacoli nell’elaborazione di una definizione di narcisismo patologico che potesse essere univoca ed esaustiva è imputabile alle divergenze tra modelli fenotipici e modelli tassonomici, ed in particolare alle differenze tra concettualizzazione clinica e psichiatrica. Il Disturbo Narcisistico di Personalità (NPD), infatti, cattura solo parzialmente le espressioni fenotipiche della patologia narcisistica, descrivendo esclusivamente le espressioni comportamentali della grandiosità narcisistica. A differenza del modello tassonomico, invece, le evidenze empiriche hanno suggerito da tempo l’esistenza di due principali manifestazioni fenotipiche di narcisismo patologico: la forma grandiosa e quella vulnerabile (Cain et al., 2008; Ronningstam, 2005). Nonostante ciò, il predominio dell’approccio tassonomico allo studio del narcisismo ha fortemente influenzato la ricerca, tanto che ricercatori e i clinici non hanno potuto disporre per molto tempo di validi strumenti che valutassero l’intero spettro della patologia narcisistica. Inoltre, vi è da sottolineare che i principali strumenti di valutazione del narcisismo hanno mostrato inadeguate proprietà psicometriche, limitando la validità delle misurazioni fornite e il loro utilizzo. A partire da tali considerazioni, di recente è stato elaborato un nuovo strumento: il Pathological Narcissism Inventory (PNI; Pincus et al., 2009). Il PNI è uno strumento autosomministrato che valuta il narcisismo patologico in senso multidimensionale, cogliendo manifestazioni overt e covert di grandiosità e vulnerabilità narcisistica. Esso, inoltre, ha mostrato buone proprietà psicometriche in diversi studi (Pincus et al., 2009; Wright et al., 2010; You et al., 2013). Data l’assenza di strumenti autosomministrati che siano in grado di fornire una misura esaustiva di narcisismo patologico in Italia, la presente tesi è volta ad esaminare approfonditamente il PNI attraverso due studi. In particolare, lo studio presentato nel Capitolo 3 ha indagato le proprietà psicometriche del PNI in due campioni non clinici (studenti e partecipanti tratti dalla popolazione generale) e un campione di pazienti ambulatoriali di un servizio ospedaliero di psicologia clinica. E’ stata studiata la struttura fattoriale del questionario e la sua validità concorrente con altre misure come autostima, dimensioni relative alla struttura di personalità, ed empatia. I risultati hanno replicato la struttura originaria del PNI, il quale ha mostrato buone proprietà psicometriche nei due campioni non clinici. In accordo con la letteratura sul narcisismo, inoltre, il PNI ha mostrato pattern specifici di associazioni con le misure esterne considerate sia nei partecipanti non clinici sia nel campione di pazienti ambulatoriali. L’obiettivo del secondo studio (Capitolo 4) era quello di indagare la possibilità di ottenere una versione breve del PNI, per facilitarne la somministrazione. A tal fine, sono state condotte analisi fattoriali (esplorative e confermative) e di invarianza della misurazione multi-gruppo all’interno dei due campioni non clinici. I risultati hanno suggerito una versione del PNI a 28 item con buone proprietà psicometriche. In conclusione, i due studi condotti suggeriscono che il PNI sia uno strumento autosomministrato che consente di ottenere una valida misurazione di narcisismo patologico. Le implicazioni cliniche e di ricerca degli studi condotti, sia a breve sia a lungo termine, sono state discusse all’interno della tesi.

The cancer genetic counseling (CGC) identifies genetic mutations for hereditary neoplastic diseases, but little is known on its psychological effects on subjects. Methods. The present study involved women who underwent genetic counseling for breast or ovarian cancer: 19 unaffected, 43 current patients, and 28 past patients. The aim of the study was to examine the relation between coping strategies and the quality of life during genetic counseling before testing, considering the effects of psychopathological symptoms and the health status. Results. Results showed that the use of avoidance strategies led to a decrease in quality of life, and that this relationship was entirely mediated by the intensity of psychopathological symptoms, while the health status did not show any effect on it. Conclusions. The study, which is the first in Italy, suggests the importance of assessing coping strategies in subjects who undergo the CGO to identify individuals who are at risk of decrease of psychological well-being. Indeed, psychological counselling improving coping strategies could preserve the psychological well-being of individuals.