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Our exploratory qualitative study sought to examine the traumatic experiences lived, in the pre-migration, migration, and post-migration phases, by refugees and asylum seekers of African displaced people in Niger. Namely, in-depth semi-structured interviews were pursued on 50 participants (mean age 29 years), recruited through purposive convenience sampling via a local NGO in Niger. The analysis of the interviews revealed four main themes: the scenario in which refugees live, permeated by prolonged conflict, economic and political instability and the loss of loved ones; the everyday life marked by sexual violence, torture, family abuse, discrimination, imprisonment and deprivation situations; mental and physical health constantly at risk due to the challenges faced daily; and the search for safety and support, also as an underlying driver of the decision to migrate.The findings underscore the challenges of daily life marked by various forms of trauma such as sexual violence, torture, discrimination, and deprivation. Additionally, the study emphasizes the perpetual risks to both mental and physical health due to these adversities. Moreover, it illuminates how the pursuit of safety and support serves as a fundamental motivator for their migration decisions, shedding light on the complex and compelling factors driving their displacement.

Introduction: Parents vary in their gradual adaptation to the demands of caring for an autistic child. Their experiences can be positive, negative, or a combination of both, depending on the severity of the cases and various personal and social factors. Cross-cultural comparisons can aid in understanding how contextual factors, such as the availability of social and health services, and cultural factors, such as family relationships and the distribution of care burden, may influence the caregiving experience. However, there is a limited amount of cross-cultural research on this topic, which is almost exclusively quantitative. Aims and methods: From an ecocultural perspective, our interview-based study aimed to explore the experiences of Australian (15) and Italian (11) parents of autistic children living in their respective countries. Results: The analysis identified three main themes. Life through autism, autism through life: coexisting with an unexpected life partner, Parenting autistic children: reorganization of parents’ subjectivity and familiar dynamics, and The unseen side of disability: autism communities between inclusion and segregation. Discussion: Our comparative approach reveals both commonalities and differences between the two groups of participants. The similarities support features previously identified in the literature: the emotional and physical burden on parents and the positive impact on parental identity. The differences relate to the diagnostic process, interactions with health professionals, the impact of autism on family dynamics and parental perspectives, and the role assigned to siblings. Despite facing similar challenges, these differences reveal how Italian and Australian parents articulate different understandings linked to social and cultural differences.

Clinicamente vivi ma privi di consapevolezza di sé (West, 2014), i pazienti in stato vegetativo sono bloccati nella loro transizione tra la vita e la morte, cioè in un hotspot liminale. Essendo paradossalmente sia vivi sia morti, né vivi né morti (Kaufman, 2005), questi pazienti sollevano dilemmi ontologici, etici e legali (Nettleton et al., 2014) e sfidano le tradizionali categorie di significato e i convenzionali sistemi di pratiche forniti dalla medicina, dalla legge e dal senso comune. In questo modo, caregiver, legislatori e il pubblico in generale faticano a comprendere e gestire questi pazienti; e.g., concettualizzarli come vivi o decidere rispetto al fine-vita (Kitzinger & Kitzinger, 2013). Attingendo dalla teoria delle rappresentazioni sociali (Moscovici 1961/1976, 2008) e al quadro teorico della liminalità (Stenner et al., 2017), questa tesi ha indagato come lo stato vegetativo sia compreso e gestito - cioè de-paradossificato - da diversi gruppi e in diversi contesti. In primo luogo, analizzando la stampa che ha divulgato l'argomento, lo Studio 1 ha indagato la rilevanza del tema nel tempo (1990-2019) e in diversi paesi (e.g., in India, in Italia e in Regno Unito). Inoltre, questo studio ha anche mappato e confrontato il modo in cui lo stato vegetativo è stato diversamente rappresentato in questi paesi e nella comunicazione di diversi giornali (e.g.,, destra, sinistra, tabloid/religiosi). In secondo luogo, analizzando i dibattiti parlamentari italiani (2009-2017), lo Studio 2 ha indagato come lo stato vegetativo sia stato strategicamente rappresentato dalle coalizioni di destra e di sinistra per legittimare o delegittimare diverse proposte di legge sul fine vita. In terzo luogo, analizzando i racconti di familiari e professionisti, lo Studio 3 ha indagato le loro rappresentazioni dello stato vegetativo e come queste siano state funzionali a significare le loro pratiche di assistenza e a legittimare i loro diversi posizionamenti all'interno della cas, Persistently alive but unaware (West, 2014), vegetative state patients are enduringly stuck in their transition between life and death – i.e., in a liminal hotspot. Thus, being paradoxically both/neither alive and/nor dead (Kaufman, 2005), these patients raise ontological, ethical, and legal dilemmas (Nettleton et al., 2014) and defy familiar categories of meaning and practice provided by medicine, law, and common sense. In this way, caregivers, legislators, and the wider public struggle to understand and manage these patients; such as understanding them as alive or managing their end-of-life (Kitzinger & Kitzinger, 2013). Drawing on social representations (Moscovici 1961/1976, 2008) and the liminality framework (Stenner et al., 2017), this thesis investigated how the vegetative state has been made sense and dealt with – i.e., de-paradoxified – by different groups and within different contexts. First, by analysing the press disseminating the topic, Study 1 investigated the relevance of the topic over time (1990-2019) and across different public spheres (e.g., India, Italy, and the UK). Moreover, this study also mapped and compared how the vegetative state was differently framed across these public spheres and in the communication of different newspapers (e.g., right, left, tabloid/religious). Second, by analysing the Italian parliamentarian debates (2009-2017), Study 2 investigated how the vegetative state was strategically represented by the left and right-wing coalitions to legitimise or delegitimise different bills regulating end-of-life action. Third, by analysing the accounts of family relatives and professionals, Study 3 investigated how the vegetative state was differently represented to signify their care practices and to position themselves in the nursing home. In this way, it was possible to account for how the vegetative state – as a liminal hotspot – was de-paradoxified in a group-characteristic way, reaching specific purposes and performing various func

Our present study sought to qualitative explore the perceptions of experts on the meaning of children agency in a context characterized by ongoing colonial violence and structural racism. Namely, we explored culture and context-specific features of agency, experts’ perceptions about a decolonized definition, and gaps with the mainstream definition of the construct in Western contexts. The study involved 14 participants (N = 8 women), aged between 32 and 70 years with a mean age of 45 years (SD = 9.72) who came from the Gaza Strip, the West Bank (Ramallah, Bethlehem, Hebron and Jenin) and territories currently part of the State of Israel (Jerusalem and Jaffa). They are all mental health professionals in universities, research centres, hospitals and social welfare services. Secondly, the analysis resulted in a map of five themes representing a culturally oriented Palestinian children’s agency model. A threatening context, alleviating factors, healthy agency, aggravating factors, harmful agency. The Palestinian conceptualization of child agency lies in the multifaceted nature of the construct itself re-declined in a context characterized by multiple levels of complexity- cultural, political, social, economic. Our findings might contribute to creating indicators of Palestinian children’s agentic behaviours and a better operationalization of the construct itself.

Our present study sought to qualitative explore the perceptions of experts on the meaning of children agency in a context characterized by ongoing colonial violence and structural racism. Namely, we explored culture and context-specific features of agency, experts’ perceptions about a decolonized definition, and gaps with the mainstream definition of the construct in Western contexts. The study involved 14 participants (N = 8 women), aged between 32 and 70 years with a mean age of 45 years (SD = 9.72) who came from the Gaza Strip, the West Bank (Ramallah, Bethlehem, Hebron and Jenin) and territories currently part of the State of Israel (Jerusalem and Jaffa). They are all mental health professionals in universities, research centres, hospitals and social welfare services. Secondly, the analysis resulted in a map of five themes representing a culturally oriented Palestinian children’s agency model. A threatening context, alleviating factors, healthy agency, aggravating factors, harmful agency. The Palestinian conceptualization of child agency lies in the multifaceted nature of the construct itself re-declined in a context characterized by multiple levels of complexity- cultural, political, social, economic. Our findings might contribute to creating indicators of Palestinian children’s agentic behaviours and a better operationalization of the construct itself.

Background & aims: Several symptoms impair the quality of life (QoL) of patients with primary biliary cholangitis (PBC). They are reported to vary significantly in different countries. Aim of our study was to explore whether there is a geographical clustering that accounts for symptoms in PBC. Methods: Data was analysed from four cohorts of PBC patients from the UK, Spain, Japan and Italy using the PBC-27 scale. Results: Overall, 569 patients from four cohorts were identified, including 515 females (90.5%) with a mean age of 61 years. The analysis provided evidence for strict factorial invariance of the scale, a robust indicator of its validity for cross-cultural research. The mean of the fatigue domain of British patients was significantly greater than that of the Japanese (p ​< ​0.05), Italian (p ​< ​0.05), and Spanish patients (p ​< ​0.001). The mean of the cognitive domain after 54 years of age, was significantly greater in the British patients than in the Japanese (p ​< ​0.05) and Spanish patients (p ​< ​0.01). However, after 69 years of age, there were not significant differences between countries. The mean of the emotion domain after 54 years of age, was greater in the British that in the Spanish (p ​< ​0.01) and Italian patients (p ​< ​0.01). Conclusions: Differences in the four countries concerning fatigue, cognitive and emotional dysfunction were found. The association of latitude and symptoms might provide new insights into the role of sun exposure, genetics and/or cultural component into disease phenotype in PBC.

Background & aims: Several symptoms impair the quality of life (QoL) of patients with primary biliary cholangitis (PBC). They are reported to vary significantly in different countries. Aim of our study was to explore whether there is a geographical clustering that accounts for symptoms in PBC. Methods: Data was analysed from four cohorts of PBC patients from the UK, Spain, Japan and Italy using the PBC-27 scale. Results: Overall, 569 patients from four cohorts were identified, including 515 females (90.5%) with a mean age of 61 years. The analysis provided evidence for strict factorial invariance of the scale, a robust indicator of its validity for cross-cultural research. The mean of the fatigue domain of British patients was significantly greater than that of the Japanese (p ​< ​0.05), Italian (p ​< ​0.05), and Spanish patients (p ​< ​0.001). The mean of the cognitive domain after 54 years of age, was significantly greater in the British patients than in the Japanese (p ​< ​0.05) and Spanish patients (p ​< ​0.01). However, after 69 years of age, there were not significant differences between countries. The mean of the emotion domain after 54 years of age, was greater in the British that in the Spanish (p ​< ​0.01) and Italian patients (p ​< ​0.01). Conclusions: Differences in the four countries concerning fatigue, cognitive and emotional dysfunction were found. The association of latitude and symptoms might provide new insights into the role of sun exposure, genetics and/or cultural component into disease phenotype in PBC.

Experiences of social exclusion, including ostracism and rejection, can last anywhere from a few seconds to many years. Most research focused on short-term social exclusion, whereas virtually no empirical work has investigated the experiences of long-term social exclusion. Williams theorized that prolonged experiences of social exclusion (i.e., ostracism) would cause individuals to pass from the reflexive and reflective stages to the resignation stage characterized by the inability to recover threatened psychological needs and feelings of alienation, unworthiness, helplessness, and depression. Across two studies, we explored this prediction—and, in light of pain overlap theories, considered the possibility that chronic exclusion and chronic pain induce common psychological responses. Study 1 consisted of a quasi-experimental study involving five groups of participants: (1) those with chronic experiences of social exclusion (n = 82), (2) those with chronic physical pain (n = 82), (3) those with chronic hypertension (n = 69), (4) those with chronic kidney disease (n = 60), and (5) a group of healthy people (n = 83). Participants filled out a questionnaire including measures of need threat, negative emotions, and the four key outcomes linked to the resignation stage (i.e., alienation, unworthiness, helplessness, and depression). Although our data showed little evidence to support the psychological overlap between chronic exclusion and chronic physical pain, the results suggested that chronic experiences of social exclusion were associated with higher levels of negative emotions and resignation stage outcomes compared to participants in all the other groups. Furthermore, we found that threatened psychological needs mediated the effect of social exclusion on the resignation stage outcomes. Study 2 tested, but found no support for, the possibility that acute experiences of social exclusion could increase the resignation stage outcomes. Overall, our research indicates that

A text analysis of dreams and waking-life narratives let us detect typical dream contents. The sample is composed of 1,000 subjects, from early adolescents to young adults, including males and females. For each subject, we collected a dream and a waking-life episode according to "the most recent dream" (Hartmann, Elkin, & Garg, 1991) and "a recent episode" methodology (Maggiolini, Cagnin, Crippa, Persico, & Rizzi, 2010). Through a word analysis, we were able to identify the typical narratives of dreams and episodes. We identified 5 clusters of dreams: dreams of (a) fear and escape, (b) school, (c) competition and sport, (d) attack, and (e) falling and spatial disorientation. Instead, regarding episodes, T-LAB identified 5 clusters: episodes of (a) fun with friends, (b) competition and success, (c) significant emotions, (d) family relationships, and (e) accidents and diseases. This research shows a way of empirically finding typical dreams, without starting from an arbitrary list. Typical dreams are not only a description of similar contents in different dreams, but those contents that are typical of dreams compared with waking narratives.

Objective: The premature birth of their infant can constitute a sudden interruption of the transition to motherhood that requires a reorganisation of the process. The present study aimed to analyse the experience of the transition to motherhood of preterm infants’ mothers, framing it within Stern’s transition to motherhood theory. Method: A semi-structured interview was administered to 30 mothers during the recovery of the infant in the Neonatal Intensive Care Unit. The interview explored the experience of mothers related to pregnancy, the infant’s birth and recovery. Results: Thematic Analyses evidenced four interrelated themes: disconnection from the child, perception of maternal inadequacy, loss of parental role and temporal suspension. The themes showed that the mothers’ experience of preterm birth not only concerns the traumatic delivery, but is also embedded in the entire process of becoming a mother within an institutional context. Conclusions: Results were connected to Stern’s theory. Findings revealed difficulties for preterm mothers that could affect the development of the maternal constellation and thus their transition to motherhood. These difficulties may influence the construction of maternal identity, mother’s representation of their child and the bond with their child.

Mutual aid groups have become a common form of help in the mental health field. Although self-help groups are associated with a range of health and social benefits, they remain poorly understood in terms of the dynamics of their interactions. Adopting an ethnographic-discursive approach, we conducted a 6-month observation of the meetings of a self-help group of parents with children diagnosed with attention deficit/hyperactivity disorder (ADHD) to analyze the discursive dynamics of the interactions that characterized the group. Using a set of discursive strategies and practices, the parents promoted a homogeneity of viewpoints and experiences within the group and constructed a shared and consensual narrative to endorse a specific understanding of ADHD. The production of both homogeneity within the group and a shared narrative served to absolve parents of guilt, helped parents to signify their experience within a blaming social context, and preserved their identities as good parents.

Teachers' perceptions of attention deficit hyperactivity disorder (ADHD) can influence the diagnostic rates of the disorder and the management of children in schools. This study investigated the knowledge and perceptions of ADHD in a sample of 589 Italian primary school teachers using a self-report questionnaire that included the ADHD perceptions questionnaire (Norvilitis & Fang, 2005) and the ADHD knowledge scale (Jerome, Gordon, & Hustler, 1994). The results showed that Italian teachers had a moderate level of knowledge, that their perceptions of ADHD were ambivalent, that their teaching experience was not positively correlated with their perceptions and knowledge of ADHD, and that receiving specialized information about ADHD had a limited influence on their perceptions. These findings suggest that perceptions are more than a matter of knowledge and should be addressed with regard to deep cultural values and representations. The educational and psychological implications of these results are discussed; particular attention is given to the importance of understanding the social context of ADHD and taking into consideration the teachers' perceptions of ADHD in the organization of training. Future research should address the role of children's gender in influencing perceptions of ADHD as well as the perceptions of parents and siblings

Research suggested that ostracism increases susceptibility to indirect forms of social influence (e.g., conformity). Yet, no study to date explored whether the effects of ostracism extend to the most direct form of social influence, obedience. We investigated whether ostracized individuals will be more likely to obey a direct command to do something effortful in uncomfortable conditions. Participants (N = 62) were randomly assigned to be included or ostracized in Cyberball, or assigned to a control condition. They were then approached by the experimenter and commanded to go outside when temperatures were below 30F and take 39 unique and creative photographs in the cold of winter. Ostracized participants were more likely to obey the experimenter’s command to be creative when taking photographs. No differences in obedience emerged between the inclusion and the control condition. We provided evidence completing the social influence “trifecta”: ostracism increases susceptibility to conformity, compliance, and now, obedience

The paper discusses the development of Italian Critical psychology, as a current that enjoys full recognition within the psychological discipline, although it critiques the hegemonic currents making up the mainstream. We reconstruct its roots in the historical, political and cultural developments of the Country: the influence of German-language philosophy and science in the Italian culture; the socialist tradition of the nascent Italian social psychology of the 19th century; the protest movements of the late ’60s in Italian psychiatric hospitals as well as in the universities; the “paradoxical” situation due to the fact that Gramsci’s Marxism promoted openness to psychology as the science of subjectivity; but ‘official’ Italian Marxism failed to recognize the potential emancipatory relevance of psychology. In this context, the publication in 1974 of the Italian translation of Holzkamp’s Critical Psychology appealed to Italian left-wing psychologists as the answers they had been waiting for regarding the external relevance of psychology and its relationship with Marxism, articulated in a complete systemic model of psychology. The relationships with the Cultural Historical School are also explained. Critical Psychology still enjoyed an active presence in Italy during the 1980s and we suggest that it still continues to exert a significant – although not manifest– influence on the areas of Italian psychology outside of the hegemonic mainstream. This influence - concerning in particular the emancipatory aims and use psychology to address concrete social problems – is visible in the development of the European Social Psychology, which has grown up in opposition to mainstream North American Social Cognition, in Rhetoric and discursive psychology and in the Italian critical community psychology informed by Lewin’s action research

Attention Deficit/Hyperactivity Disorder (ADHD), characterized by inattention and hyperactivity/impulsivity (APA, 2000), is currently the most common and debated childhood psychiatric diagnosis. ADHD has mobilized great social attention in the last decade and has primed a profound scientific and public controversy during the last years. Considering the circulation of competing perspectives, this research aims to analyze the discursive construction of ADHD by the key adults who interact with the child. The study involves relevant social actors who are engaged in the diagnostic/treatment processes of ADHD - mental health professionals, primary school teachers, and parents - that also belong to powerful social institutions for children’s education and socialization: the medical field, school and family. The theoretical framework integrates discourse analysis (Foucault, 1969; Parker, 2005) and positioning theory (Harré & Van Lagenhove, 1999). The general aim concerning the discursive construction of ADHD was articulated in two sub-aims. The first was to map the participants’ positioning repertoire, in terms of reflexive positioning, used to position oneself, and interactive positioning, used to position others. The second subaim was to analyze the discursive dynamics characterizing the interactions among the members of a self-help group of parents. The analysis allowed identifying three relevant discursive patterns. First, the discourse of risk, which transversally crosses the narratives of the participants and is related to the positioning of the child diagnosed with ADHD as both “at-risk” for himself and “risky” for others. Second, the blame embedded in the mutual positioning of the key adults surrounding ADHD children. The mutual blame is not merely related to the debate regarding the validity of the ADHD diagnosis. Rather, it is centered on questions of compliance, recognition of authority, and morality. Third, the self-legitimation towards which the narrative prod

The paper discusses the development of Italian Critical psychology, as a current that enjoys full recognition within the psychological discipline, although it critiques the hegemonic currents making up the mainstream. We reconstruct its roots in the historical, political and cultural developments of the Country: the influence of German-language philosophy and science in the Italian culture; the socialist tradition of the nascent Italian social psychology of the 19th century; the protest movements of the late ’60s in Italian psychiatric hospitals as well as in the universities; the “paradoxical” situation due to the fact that Gramsci’s Marxism promoted openness to psychology as the science of subjectivity; but ‘official’ Italian Marxism failed to recognize the potential emancipatory relevance of psychology. In this context, the publication in 1974 of the Italian translation of Holzkamp’s Critical Psychology appealed to Italian left-wing psychologists as the answers they had been waiting for regarding the external relevance of psychology and its relationship with Marxism, articulated in a complete systemic model of psychology. The relationships with the Cultural Historical School are also explained. Critical Psychology still enjoyed an active presence in Italy during the 1980s and we suggest that it still continues to exert a significant – although not manifest– influence on the areas of Italian psychology outside of the hegemonic mainstream. This influence - concerning in particular the emancipatory aims and use psychology to address concrete social problems – is visible in the development of the European Social Psychology, which has grown up in opposition to mainstream North American Social Cognition, in Rhetoric and discursive psychology and in the Italian critical community psychology informed by Lewin’s action research

The research explores the trainees’ perceptions of their internship as an instrument for the construction of their professional identity, by means of 56 qualitative interviews with psychology trainees graduated from two Italian universities. The analysis showed 3 interconnected themes: 1) the intern’search for identity, emerging in the interaction between the interns’ expectations and the concrete activities done in the organizational context; 2) the coping strategies activated by the interns to overcome the problems faced during the internship. Moreover, 3) the tutor, perceived as a socialization agent during internship program, as an expert guide within the organization and a model for the construction of professional identity. Results show some critical elements to be investigated in future research.

The research analyses media discourse on migration in Italy, regarded as a means of reproducing and maintaining a racist interpretation of inter-group relations. The theoretical framework is the Critical Discourse Analysis approach. Quantitative and qualitative analyses were performed on data consisting of headlines and articles from the Italian newspaper Corriere della Sera, published between 1992 and 2009. Overall, it emerged that discourse is built according to themes and discursive strategies already identified by similar research based on European media, indicating how this system of representations defines a common sense of cultural belonging and a shared construction of ethnic relations. The rather long time span considered in the study allowed us to focus on how the discourse on migration in Italy might have evolved over time, but also to identify any elements that may have remained unchanged.

Attention deficit/hyperactivity disorder is currently the most debated childhood psychiatric diagnosis. Given the circulation of competing perspectives about the ‘real’ causes of children’s behaviour and the ‘best’ way to treat them, we aim to analyse the interactions of the central social actors’ discourses about attention deficit/hyperactivity disorder children within the Italian context. Adopting a multi-method approach, we focus on the polyphonic chorus of voices surrounding the child, studying the discourses of mental health professionals, teachers and parents. These actors are representative of three contexts that are deeply engaged with attention deficit/hyperactivity disorder: medical institutions, schools and families. Our theoretical and methodological approach integrates positioning theory, the Bakhtinian notion of dialogical thinking and discourse analysis to study stakeholders’ reflexive and interactive positioning in terms of the attribution of rights, duties, responsibilities and power issues. The results show that mutual blame is a constitutive element of relational dynamics among the key adults surrounding attention deficit/hyperactivity disorder children. We argue that these conflicting relationships are not merely related to the debate regarding the validity of the attention deficit/hyperactivity disorder diagnosis. Rather, the mutual blame centres on questions of compliance, recognition of authority and morality. Through the blame game, adults negotiate their own and others’ subjectivity in ways that simultaneously (re)produce power relationships and resistance efforts.

Attention deficit hyperactivity disorder (ADHD) is the most common diagnosis given to children. In recent decades, there has been an increase in the diagnosis of ADHD and in methylphenidate use. This research analyses the discursive construction of ADHD in the Italian context, focusing on the positioning of the child. The study addresses the discourses of the key adults who interact with the child, analysing professional, scholarly and parental discourses. Regarding the theoretical and methodological framework, this study integrates a discourse analysis approach with positioning theory. The discourse and psychological framing of ‘risk’ pervades the structuring of participants’ narratives, which position the child as at-risk, and risky, in body and mind. The three groups of participants in this study articulated the notion of risk in different, but overlapping, ways. For mental health professionals, children are likely to develop serious psychiatric conditions; for teachers, children mainly represent a potential threat and danger to other children and the school’s social order; for parents, the child is susceptible to becoming an ‘out-of-society’ individual in the future. The notion of risk operates as a regulatory device, leading from warning (picturing a possible future) to action (preventing this future), and implies the moral obligation to intervene and govern children in the name of risk

OBJECTIVE: This study explores the underlying values and beliefs that guide women's reasoning on prenatal genetic test (PGT) uptake, as framed by their own words, during a group discussion, in a Catholic country such as Italy. METHODS: Women's reasoning was explored by means of five focus group consisting of seven pregnant women and 13 new mothers. RESULTS: The focus group material content was analysed using the Nudist software. The discourse around PGT was rooted into four frames of reference: The usefulness dimension was used to express the positions in favour of PGT, whereas morality, risk and trust were used to express negative evaluations on such a technology. Participants advocated for themselves the choice of being tested, besides giving some credit to the partner's opinion. Moreover, participants reported little knowledge on PGT. CONCLUSION: The research shed some light on the frames of reference used by participants to build their positions on PGT uptake, confirming the public's ability to translate scientific accounts into personally meaningful information. A more complete understanding of the reasons for decisions to test would help counsellors to better communicate with women and couples, and to better assist them to make a better informed testing decision. © 2012 John Wiley & Sons, Ltd.

Pain overlap theories (Eisenberger & Lieberman, 2004; MacDonald & Leary, 2005) suggest that the detection of social threats has mapped onto the pre-existing neurological circuitry used to signal physical pain. Supporting this assumption, several studies have found that social pain activates brain regions known for their role in processing the unpleasantness of physical pain (e.g., Eisenberger, Lieberman & Williams, 2003). In this dissertation, considering the amount of physiological evidence for common brain responses to social and physical pain, I examine whether and how social and physical pain overlap in their psychological antecedents and consequences. I first consider fear of pain as a common antecedent. In the medical literature on physical pain, the fear of pain—compared with other potential variables—emerges as one of the most relevant predictors of the perception of pain. Study 1a assesses whether fear of social and physical pain reflect unitary psychological dimensions related to, but still distinct from, each other. Study 1b investigates whether both fear of social and physical pain are associated with measures conceptually related to one of them. The findings show that fears of social and physical pain are two related—yet distinct—psychological dimensions. Likewise, I show that dimensions traditionally associated with fear of one type of pain have some degree of overlap with fear of the other type of pain. Then, to test a common antecedents hypothesis, Study 1c replicates previous findings, showing that the fear of physical pain can enhance the perception of physical pain. Likewise, I examine whether fear of social pain can enhance the perception of social pain. Study 1d shows that individuals with higher fear of social pain perceive social threats as more painful. Aside from supporting the common antecedents hypothesis, the present results also suggest a specificity effect in that each fear is able to predict its associated type of pain. Indeed, it emer

Introduction. Studies regarding health care professionals' representations of pain indicate that doctors and nurses tend to concentrate on the organic origin of pain, and to view pain as subordinate to diagnosis and treatment of the disease; they also tend to underestimate the psychological and psychosocial components of pain, which means that they generally view the patient's subjective experience as secondary. This leads to an underestimation of pain. Objective. The objective of this study was to analyze the representations of pain held by doctors, head nurses, and nurses in two Italian hospitals, focusing on how these representations are shaped according to the local culture in which they are constructed and negotiated. Methods. Our study is based on a socio-constructionist approach, drawing on semi-structured, in-depth interviews with 26 health care professionals. Results. The results show similarities and differences in how health care professionals construct their representations of pain. Three main issues emerged. First, the contents of these representations are strictly related to participants' job position and professional training; second, the representation of pain is significantly influenced by the values and meanings associated with the different professions; and third, there are two conflicting representations of pain, focusing on the objectivity vs the subjectivity of pain, respectively. Conclusions. To promote significant change regarding pain management within hospital organizations, it is essential to construct shared representations of the problem and its implications, particularly as regards relations with the patient. This change should take place at the educational as well as the socio-organizational level, and it should take into account ideas and proposals from the subjects involved. Wiley Periodicals, Inc.

The ability to detect facial expressions of pain is crucial in eliciting prosocial behaviors towards the individual experiencing pain. Previous studies have shown that the sufferers' gender can affect the observers' explicit judgment of the pain face, thus suggesting its possible influence on pain decoding. The present study investigates whether the sufferer's gender affects the observer's reflexive or implicit detection of facial expression of pain. More specifically, we used implicit measures to test whether observers detect pained expression more quickly or accurately on male or female faces. In three experimental studies, we devised a set of stimuli using computer-generated faces. In Experiment 1, prototypical female and male avatars with different facial expressions (pain, anger, disgust, and neutral) were displayed, while subjects' (N=34) accuracy and speed at identifying the expressions were recorded. In Experiment 2, participants (N=56) watched videos of the avatars displaying dynamic expressions and had to quickly and accurately identify each expression. In Experiment 3, participants (N=38) were shown an androgynous avatar face showing different expressions and were asked to identify the face as either female or male. Overall, we found that the target's gender affected the observer's reflexive decoding of the facial expression of pain. Specifically, the results showed that participants, regardless of their gender, were slower and less accurate in recognizing pain expressions (but not other expressions) on female faces. Furthermore, androgynous faces displaying pained expressions were more likely to be categorized as male than female. Several potential explanations are discussed.

This study investigates the illness experience of women who are affected by primary biliary cirrhosis (PBC), a rare chronic liver disease which mostly affects women. Despite the fact that PBC is medically recognised, it shares many characteristics with other chronic and controversial conditions which may lead to delegitimation of the patient's experience of illness, impacting on the construction of the patient's self-identity. Twenty three women took part in semi-structured interviews. Data were analysed using interpretative phenomenological analysis and the analysis identified three themes that are interrelated and characterised by a dynamic of normalisation. The first theme, the delegitimation of women's experience, implies denial of patients' sick-role, trivialisation of fatigue and lack of consideration of patients' needs. The second theme, PBC as a challenge to women's social identity refers to how patients face delegitimation and manage the illness's consequences for relationships and social roles. The third theme, the need for biographical continuity, focuses on how patients construct their ill identities as a consequence of both the delegitimation and the challenges posed by PBC. Results are discussed in a gender perspective, highlighting how delegitimation and identity construction processes are influenced by women's social roles and conditions. © 2011 Taylor and Francis Group, LLC.

This study investigates the sense of community and interethnic relations in two different metropolitan areas that vary in ethnic heterogeneity. The study was conducted in Milan, Italy using a sample of 318 participants living in different city districts that vary in ethnic heterogeneity (low vs. high). The participants completed a questionnaire that assessed their psychological sense of community, blatant and subtle prejudice, host community acculturation strategies, and some measures of contact (quality, quantity, and type). The results indicate that high ethnic heterogeneity is related to a lower sense of community, higher blatant prejudice, and exclusionism. Residents living in lower ethnic heterogeneity neighborhoods reported closer contact opportunities and lower levels of prejudice. © 2011 Wiley Periodicals, Inc.

Context. Research on decision making suggests that a wide range of spontaneous processes may influence medical judgment. Objectives. We considered an easily accessible strategy, anchoring and insufficient adjustment, which might contribute to the healthcare professionals’ miscalibration of patients’ pain. Methods. A sample (N = 423) of physicians, nurses, medical students and nursing students participated in a computerized task that showed sixteen vignettes featuring fictitious patients reporting headache. In the experimental condition, participants were asked to evaluate the severity of patient’s pain before and after knowing the patient’s rating. In the control condition, participants were shown all information about the patient at the same time and were required to make judgments in a single stage. Results. When participants could express an initial impression before knowing the patient’s rating, they fully anchored to their initial impressions in almost half of the responses. Moreover, even among those who revised the initial impression, the extent of the revision was often insufficient. Greater anchoring was associated with patients’ ratings which were higher than the participants’ initial impression. Finally, we provided evidence that anchoring increased pain miscalibration. We discuss our findings in terms of their contribution to the understanding of the cognitive processes involved in pain assessment. Conclusion. When estimating patients' pain intensity, observers are driven by anchoring, a rule of thumb that might have pernicious consequences in terms of unwarranted overreliance on initial impressions and insufficient revision in light of relevant disconfirming evidence. Taking into account this heuristic might foster accurate pain assessment and treatment.

This article presents two experiments aiming to investigate the adoption of a graduated measure to describe credibility attribution by observers who evaluate patients' pain accounts. A total of 160 medical students were required to express a credibility judgment on the pain intensity level of hypothetical patients. We used 16 vignettes based on a factorial mixed-design. Within-participants factors were the reported pain, the presence of a physical sign, the patient's facial expression and the patient's gender, and between-groups factors were the patient's age and the geographical distribution of the patient's name. Results confirm the well-established tendency not to believe patients' self-reports and provide information regarding the evaluators' uncertainty. The findings suggest that a graduated measure is useful for assessing the degree of uncertainty of the observers and subtle effects of different factors upon the judgment of patient's pain.

This article presents two experiments aiming to investigate the adoption of a graduated measure to describe credibility attribution by observers who evaluate patients' pain accounts. A total of 160 medical students were required to express a credibility judgment on the pain intensity level of hypothetical patients. We used 16 vignettes based on a factorial mixed-design. Within-participants factors were the reported pain, the presence of a physical sign, the patient's facial expression and the patient's gender, and between-groups factors were the patient's age and the geographical distribution of the patient's name. Results confirm the well-established tendency not to believe patients' self-reports and provide information regarding the evaluators' uncertainty. The findings suggest that a graduated measure is useful for assessing the degree of uncertainty of the observers and subtle effects of different factors upon the judgment of patient's pain.

Research on impression formation suggests that information acquired early might have a much greater impact on the credibility attribution made by a judger than subsequent evidence. This is relevant in the medical context, where subjective experiences, as pain, requires the observers to evaluate the credibility of the patients to assess pain severity and decide treatment options. We aimed at investigating the credibility attribution process in the observer-patient relationship by considering the role of the judgers’ first impressions. We thus determined whether or not initial judgments were revised after knowing the patient’s self-report of pain. A sample (N = 423) of physicians, nurses, medical students and nursing students participated to a computerized task which showed 16 vignettes featuring fictitious patients. In the experimental condition participants were asked to evaluate the patient’s pain severity and hypothesize prescriptions before and after knowing the patient’s rating, which was systematically varied as a function of the first participants’ estimates, whereas in the control condition participants were shown all the information about the patient at the same time and required to make judgments in a unique stage. The results showed that in 46% of the responses participants didn’t revise their initial pain ratings and they confirmed their first prescriptions in 63% of cases. Also, we found that physicians were less miscalibrated, but more affected by the initial impressions than the other groups. Overall, these findings show how the initial impressions can serve as an “anchor” for the observers in the credibility attribution process.

In the field of gender psychology, the theoretically innovative approach proposed by feminist psychologists rejected biologist reductionism and essentialism and developed a critical analysis concerning the mainstream cognitive approach and the malestream. The article examines some of the problems that were posed. These problems concern, from an epistemological point of view, the realism/antirealism controversy and the linguistic turn and, from a methodological point of view, the comparison between quantitative and qualitative methodologies. The analysis highlights the relevance of some issues - concerning the researcher subjectivity, the role of the context, the influence of power in the relationship between the researcher and the participants - for psychosocial research.