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Background Hydroxychloroquine (HCQ) use is associated with less disease activity, flares, damage and improved survival in Systemic Lupus Erythematosus (SLE). However, its effect on patient reported health outcomes (PROs) such as quality of life (QOL) is not known. Methods International data from Study on Outcomes of Lupus (SOUL) from 2,161 SLE patients were compared by HCQ use. Disease activity and damage were assessed using SELENA-SLEDAI and SLICC-ACR/SDI. QOL was evaluated using LupusPRO and Lupus Impact Tracker (LIT). Linear regression analyses were performed with LupusPRO summary scores health related HRQOL, non-health related NHRQOL and LIT as dependent and HCQ use as independent variable. Analyses were undertaken to test mediation of effects of HCQ use on QOL through disease activity. Results Mean age was 40.5 ± 12.8 years, 93% were women. Sixty-three (1363/2161) percent were on HCQ. On univariate analysis, HCQ use was associated with (a) better QOL (LupusPRO-HRQOL: β 6.19, 95% CI 4.15, 8.24, P ≤ 0.001, LupusPRO NHRQOL: β 5.83, 95% CI 4.02, 7.64, P ≤ 0.001) and less impact on daily life (LIT: β −9.37, 95% CI −12.24, −6.50, P ≤ 0.001). On multivariate and mediational analyses, the effects of HCQ on QOL were indirectly and completely mediated through disease activity. Conclusions HCQ use in SLE is associated with better patient reported health outcomes (LupusPRO-HRQOL and NHRQOL and impact on daily life), and the effects are mediated through disease activity. This information can facilitate patients and physician’s communication with decision-making regarding the use of HCQ for SLE management.

This study examined the social representations of SARS-CoV-2 virus in Italy. We used the technique of free word association involving 1572 adults living in Italy. An open coding procedure and content analysis lead to the identification of 13 key topics representing the categorisation of concepts that emerged from the elicited words. The most common categories were spread of the virus, negative feelings, life during quarantine, and health consequences of the virus. Multidimensional scaling of co-occurrences of categories revealed these categories were grouped into four thematic areas. In addition, we found that the frequency of the categories of words was associated with gender, age, well-being, and mental health symptoms. By revealing complex and differentiated social representations, results from the present study provide a comprehensive insight on Italian people’s perception of COVID-19 outbreak in the Spring of 2020. This early study of social representations forms a useful basis for later studies, in order to understand how collective understandings and framings of risk have evolved across the duration of the pandemic.

Objective Quality of life (QOL) and quality of care (QOC) in systemic lupus erythematosus (SLE) remains poor. Satisfaction with care (SC), a QOC surrogate, correlates with health behaviors and outcomes. This study aimed to determine correlates of SC in SLE. Methods A total of 1262 patients with SLE were recruited from various countries. Demographics, disease activity (modified Systemic Lupus Erythematosus Disease Activity Index for the Safety of Estrogens in Lupus Erythematosus: National Assessment trial [SELENA-SLEDAI]), and QOL (LupusPRO version 1.7) were collected. SC was collected using LupusPRO version 1.7. Regression analyses were conducted using demographic, disease (duration, disease activity, damage, and medications), geographic (eg, China vs United States), and QOL factors as independent predictors. Results The mean (SD) age was 41.7 (13.5) years; 93% of patients were women. On the univariate analysis, age, ethnicity, current steroid use, disease activity, and QOL (social support, coping) were associated with SC. On the multivariate analysis, Asian participants had worse SC, whereas African American and Hispanic patients had better SC. Greater disease activity, better coping, and social support remained independent correlates of better SC. Compared with US patients, patients from China and Canada had worse SC on the univariate analysis. In the multivariate models, Asian ethnicity remained independently associated with worse SC, even after we adjusted for geographic background (China). No associations between African American or Hispanic ethnicity and SC were retained when geographic location (Canada) was added to the multivariate model. Canadian patients had worse SC when compared with US patients. Higher disease activity, better social support, and coping remained associated with better SC. Conclusion Greater social support, coping, and, paradoxically, SLE disease activity are associated with better SC. Social support and coping are modifiable factors that should be addressed by the provider, especially in the Asian population. Therefore, evaluation of a patient's external and internal resources using a biopsychosocial model is recommended. Higher disease activity correlated with better SC, suggesting that the latter may not be a good surrogate for QOC or health outcomes.

Collective action is typically studied in social protest contexts and predicted by different motivations (i.e., ingroup identification and efficacy beliefs, and outgroup-directed anger). Assuming that voting to some extent reflects a form of collective action, we tested whether these three different motivations predicted voting in Dutch, Israeli, and Italian national election contexts. Based on previous meta-analyses on voting and collective action, we hypothesized that identification with and efficacy beliefs regarding this party would motivate voting across the different elections (i.e., context-independent effects). As for anger, we predicted more context-dependent effects, depending on whether the anger is targeting the previous government or at the political system at large. Results were largely in line with predictions, showing the relatively context-independent motivational power of party identification and efficacy beliefs, and clearly context-dependent effects for anger. Specifically, we found little support for a similar motivational power of anger targeting previous government policies, but anger targeting politics in general demotivated Dutch and Israeli participants to vote (interpreted as an expression of political cynicism), while curiously motivating Italian participants to vote (interpreted as a desire for system change from “old” to “new” politics). We discuss these findings in the context of voting in national elections, and recommend further integration of the voting and social protest literatures.

Objective Systemic lupus erythematosus (SLE) predominantly affects women. Clinical phenotype and outcomes in SLE may vary by sex and are further complicated by unique concerns that are dependent upon sex-defined roles. We aimed to describe sex differences in disease-specific quality of life (QoL) assessment scores using the Lupus Patient-Reported Outcome (LupusPRO) tool in a large international study. Methods Cross-sectional data from 1,803 patients with SLE on demographics, self-identified sex status, LupusPRO, and disease activity were analyzed. The LupusPRO tool has 2 constructs: health-related QoL (HRQoL) and non-HRQoL. Disease activity and damage were evaluated using the Safety of Estrogens in Lupus Erythematosus National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, respectively. Nonparametric tests were used to compare QoL and disease activity by sex. Results A total of 122 men and 1,681 women with SLE participated. The mean age was similar by sex, but the damage scores were greater among men. Men fared worse on the non-HRQoL social support domain than women (P = 0.02). When comparing disease and QoL among men and women ages ≤45 years, men were found to have greater damage and worse social support than women. However, women fared significantly worse on lupus symptoms, cognition, and procreation domains with trends for worse functioning on physical health and pain-vitality domains. Conclusion In the largest study of a diverse group of SLE patients, utilizing a disease-specific QoL tool, sex differences in QoL were observed on both HRQoL and non-HRQoL constructs. Although men performed worse in the social support domain, women (especially those in the reproductive age group) fared worse in other domains. These observations may assist physicians in appropriately addressing QoL issues in a sex-focused manner.

Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which can affect any organ in the body, reducing patients' health-related quality of life (HR-QOL). Psychosocial research on SLE is quite recent and is mostly based on qualitative and cross-sectional evidence. Some studies suggest that a protective role is played by perceived self-efficacy in the management of the disease, while a detrimental role is played by problematic social interactions. Methods: In a longitudinal study, we tested the independent contribution of self-efficacy and problematic social support, in predicting patients' HR-QOL after 11 months. An online questionnaire was completed by 162 participants with SLE, the second questionnaire after 11 months. Results: Controlling for corticosteroids and hydroxychloroquine use, self-efficacy in the management of the disease at Time 1 showed a significant and positive effect on HR-QOL at Time 2, while problematic social support (denying/uninformed) showed a negative effect. Conclusions: HR-QOL of SLE patients is influenced by self-efficacy in the management of the disease and problematic support. Specific attention should be paid to the quality of patients' social relationships and their perceived efficacy in the management of the disease in focused interventions as in daily clinical practice.

The presence of young people as engaged active citizens in the political scenario seems to be declining in recent years all over Europe. However, whereas many young people are disinterested in politics and political participation, others are active political actors involved in new patterns of engagement and actions of participation. What are the factors leading some youth to be politically active and others not? There are multiple explanations for this phenomenon, and it is crucial for the future of citizens’ democratic participation to understand the position that young people might take between apathy and participation. The present chapter aims to contribute to this focusing on the psychosocial factors and processes that facilitate and hinder youth’s political and civic engagement with particular attention to the new forms of participation and engagement, including digital ones, that youngsters adopt to have their voice heard at national and European levels.

Research suggests that sense of community in the school is a promising construct in terms of its ability to promote students’ well-being. However, mechanisms behind and the potential benefits of school sense of community have not been studied in detail. This cross-sectional study tested a model which examined the role of sense of community in the school, social skills, exposure to aggression, and victimization in shaping students’ well-being. The sample consisted of 1076 students from 22 public middle schools and 724 students from 22 public high schools located in the Italian Region of Liguria. Using a Bayesian estimation for a structural equation model, results showed that sense of community in the school directly predicted students’ social skills, exposure to aggression, and well-being and, indirectly (through social skills and exposure to aggression), victimization. In addition, we found that social skills were related to victimization. Finally, results showed that victimization was predicted by exposure to aggression and predicted well-being. The current study suggests that sense of community in the school and social skills are key variables for interventions that aim to prevent aggressive behaviors at school and to increase students’ well-being.

School sense of community has been associated with lower levels of students' aggressive behaviors. The main aim of the study was to examine whether the magnitude of the influence of school sense of community on students' aggressive behavior is similar or different across schools with different levels of aggressive behaviors. Participants were 1,800 Italian students attending 44 middle and high schools. Using multilevel modeling (a random intercepts and slopes model), we found that the magnitude of the negative relationship between sense of community in the school and students' aggressive behaviors was stronger in schools with high levels of aggressive behavior. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Patient engagement is recognized as a crucial component of high-quality healthcare services. Among rheumatic diseases, systemic lupus erythematosus (SLE) appears particularly challenging for the engagement of patients in their own care. According to the patient health engagement (PHE) model, patient engagement is a dynamic phenomenon that proceeds through four experiential positions (blackout, arousal, adhesion and eudaimonic project). The aim of the present study was to describe the engagement process from the point of view and the experiences of SLE patients. Ten in-depth interviews and four focus groups were conducted with an international sample of SLE patients from different European countries. Transcripts were analysed through thematic content analysis. Findings showed that a fully engaged patient results from reframing emotional, cognitive and behavioural dimensions. The advances along the process depends on how the patient succeeds in each position. In conclusion, PHE represents an appropriate model by which to understand the engagement process of SLE patients. In order to meet patients' needs, healthcare providers and patient support groups should consider the specific position of SLE patients, providing adequate and tailored support.

Background and aims Patient engagement is recognised as a crucial component of high-quality healthcare services. Among rheumatic diseases, Systemic Lupus Erythematosus (SLE) appears particularly challenging for the engagement of patients in their own care. According to the Patient Health Engagement (PHE) model, patient engagement is a dynamic phenomenon that proceeds through four experiential positions (blackout, arousal, adhesion, and eudaimonic project). The aim of the present study was to describe the engagement process through the experiences of SLE patients. Methods Ten in-depth interviews and four fous group were conducted with an international sample of SLE patients from different European countries. Interviews focused on several aspect of patients‘ life with SLE and their relationship with the healthcare system. Transcripts were analysed through thematic content analysis. Results The mean age of the participants to the study was 40.6 years (±10.0). The average years since diagnosis were 15.5 (SD=8.6) with great variability in terms of disease manifestations. Findings showed that a fully engaged patient results from reframing emotional, cognitive, and behavioural dimensions. The advances along the process depends on how the patient succeeds in each position. Conclusions PHE represents a appropriate model to understand the engagement process of SLE patients. In order to meet patients needs, healthcare providers should consider the specific position of SLE patients, providing adequate and tailored support.

The 2012–13 Italian national campaign against HIV/AIDS was based on a video primarily targeted to women, youth, migrants, and gay men. Its conceptual basis was to encourage preventive behaviors by promoting people’s perceived similarity and identification with the video characters and communicating the message that AIDS is everyone’s concern. The aim of this study was to investigate how people belonging to the target groups reacted to the video and, more specifically, their comprehension of the message, their perceived similarity and identification with the characters, and the perceived efficacy of the video. Fourteen focus groups were conducted with 130 participants. Transcripts were analyzed through qualitative content analysis. Results showed that the core message was adequately understood. Participants perceived themselves as partially similar to the video characters but they did not strongly identify with them. Most participants did not consider the video as effective. Peculiarities of the four target groups are discussed.

The aim of the study was to investigate the effects of sport activity on health-related quality of life (HRQoL) of solid organ transplant recipients participating in sports competitions. A group of 168 sportive transplanted patients (STP), a group of 97 nonsportive transplanted patients (NSTP), and a group of 152 sportive healthy controls (SHC) were compared on the eight scales of the SF-36 questionnaire. STP and NSTP reported significantly lower scores than SHC on the physical functioning scale. STP did not differ from SHC in the Role-Physical, General Health, and Vitality scales, while NSTP reported significantly lower scores. STP obtained higher scores than NSTP and SHC on Mental Health. Among STP, the effect of quantity of sport activity was significant on General Health and Role Emotional, with more sport activity associated with higher HRQoL. Organ failure and post-transplant therapies may have negative consequences on HRQoL. Sports activities and participation in sports competitions can reduce this impact, improving general and psychological functioning of solid organ transplant recipients.

The aim of this cross-national study was to assess the relationships among sense of community (SoC) vis-a-vis the residential community (i.e., one's home town), identity formation processes, and feelings of loneliness toward parents and peers. The sample included 431 Italian adolescents (59.4% females) and 221 Belgian (Flemish) adolescents (54.3% females) aged 14–23 years. Results indicate that the more adolescents developed firm and sustained commitments, the more they developed positive feelings toward the residential community. SoC toward the home town is lower among youth in less advanced identity statuses. Parent- and peer-related loneliness differentially predicted Italian and Belgian adolescents’ SoC. Results have significant theoretical and methodological implications for the study of SoC, identity, and loneliness.

This research assesses the coverage and impact of “United Against AIDS,” the 2012–2013 Italian National HIV/AIDS prevention campaign to promote safer sex behavior and voluntary HIV counseling and testing. The campaign used gain-framed messages and aimed at creating a superordinate identity. We conducted two studies. The first study employed a quasi-experimental design involving three groups of participants: general population (n=858), men who have sex with men (MSM; n=109), and migrants (n=211). In the second study, we carried out a time-series design to analyze the archival data of the Italian National AIDS Help-Line. Exposure to the campaign was reported by 78.3%, 67.5%, and 57.8% of the general population, MSM, and migrant respondents, respectively. The probability of having unprotected sexual intercourse with multiple partners decreased significantly in the subsample of the general populations that was exposed to the campaign (compared to the nonexposed participants), but the same effect was not found among MSM and migrant participants. The probability of having unprotected sexual intercourse with someone of unknown HIV status decreased after the campaign in the exposed MSM subsample (compared to the nonexposed participants), but the same effect was not found among the general population and migrant participants. In addition, the probability of undertaking HIV testing increased significantly in the exposed participants belonging to the general population but not among MSM and migrant participants. Time-series analysis revealed that the number of calls at the Italian National AIDS Help-Line significantly increased during the campaign. This research provides evidence that the effect of the campaign was complex and varied across participants.

Background and Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Previous studies showed that perceived social support has an important role in enhancing patient's quality of life (QOL). However, the precise mechanisms through which social support exerts such an effect are not completely understood. The aim of this paper is to test two alternative models explaining the relationship between social support (positive and problematic) and two dimensions of QOL: Health-Related (HR-QOL) and Non-Health-Related (NHR-QOL). Design: Model A (mediation) hypothesized that positive support would reduce stress while problematic support would increase stress), and that this in turn would reduce QOL. Model B (moderation) hypothesized that the effect of support on QOL would be moderated by the experience of stress in that more stressed individuals would show stronger effects. Methods: Three hundred and forty-four Italian patients with SLE completed an online questionnaire. Results: Stress partially mediated the relationship between support and QOL dimensions (either HR-QOL and NHR-QOL) thus supporting Model B. As hypothesized, positive support reduced stress, while problematic support increased stress. Conclusions: These findings help to explain the complex relationship between social support, stress and QOL in patients with SLE.

The role of conflict in parent–adolescent relationships is a topic of considerable theoretical debate and empirical investigation; however, limited attention has been devoted to the strategies used by family members to deal with disagreements and their outcomes and how they differ from early to late adolescence. This study explored conflict styles and outcomes in a sample of 302 families with adolescent children (total N = 906), of two age groups (13‐year‐olds and 15‐year‐olds). One hundred sixty‐four adolescents (45.7%) are female. Participants completed the ‘when we disagree’ scales. Results from both adolescents and parents confirmed the intensification of conflict from early to middle adolescence, in terms of conflict style (higher aggression, lower compromise) and outcome (lower intimacy). Age trends differ according to gender; in particular, there is evidence of a more difficult position of older girls, and of the worsening of mother–adolescent relationship from early to middle adolescence.

The aim of this study was to evaluate the psychometric properties of the parent version of “When We Disagree” scales (WWD), measuring the style of conflict (aggression and compromise) within parent–adolescent relationship. Differences according to adolescent gender and age, and according to perspective (description of self and description of the adolescent) were assessed. Concurrent validity was established by correlations with family communication and parenting self-efficacy. Participants include 302 mother–father dyads with adolescent children (13 and 15 years old; total n = 604). Results confirmed the usefulness of the WWD in assessing conflict styles as perceived by parents. Correlations with family communication and parenting self-efficacy were in the expected direction. There was evidence of a more conflicting relationship between female adolescents and mothers. Adolescents are described by parents as less compromising and more aggressive than self.

Aim of the study was to assess the relationship between social participation and Sense of Community in a sample of University students and the impact of such variables on Social well being. A further aim was to assess the generality of the relationships between these constructs across different countries, and specifically, the USA, Italy and Iran. The sample includes 200 Italian, 125 American and 214 Iranian University students, male and female. Results show higher levels of social participation, Sense of Community and Social well being among American students. Sense of Community is positively correlated with social participation in all three samples; however, only among Italian students social participation positively predicts Social well being. Implications of results will be discussed.

The aim of this research was to assess which criteria laypeople use to evaluate the importance of treatments the Italian National Health Service (NHS) should or should not guarantee and the relationship with their degree of importance. A convenience sample of 100 individuals (22–65 years old) were asked to evaluate 52 treatments partly included and partly not included in the Essential Assistance Levels. Results showed that laypeople employ a wide range of criteria, only part of which corresponds to those traditionally investigated in the psychosocial literature. Two main dimensions emerge as organizing principles underlying their judgments, referring to NHS function (prevention vs. treatment) and to the opportunity to focus on the specific health needs of particular categories of citizens (selectivity). Advances in medical research have increased the number and types of effective forms of treatment for conditions that were once considered untreatable, significantly improving patients’ quality of life. The greater knowledge of the progresses of medicine, the awareness of the possible treatments, and the widespread optimistic belief that actual diagnostic-therapeutical possibilities of medicine are almost unlimited resulted in a growing health demand from the general population. However, several treatments are still inaccessible for a large number of people, owing to their cost, lack of accessibility, or complexity. All health systems in Western industrialized countries are facing the need to guarantee

Several studies demonstrated the importance of psychosocial factors, like social support, for understanding the experience of people with Systemic Lupus Erythematosus (SLE). Less information is available on "problematic support"; that is, instances of support that are perceived as non-supportive, even though the provider's actions may be well intended. Aim of this qualitative study was to explore the experiences of problematic support from SLE patients' perspective. Nine women with SLE were interviewed and transcripts were analyzed through qualitative content analysis. Three main types of problematic social support were indentified. Oppressive support describes social support offers characterized by excessive worries and unwanted advices. Support denying the illness is characterized by a neglect of the disease or of its consequences. Support based on divergent illness representations is perceived as not punctual and not in line with patients' actual clinical condition. This study confirms the complexity of providing useful support to SLE patients and suggest that also people living close to patients should represent a target of interventions. Copyright © Taylor & Francis Group, LLC.

(da Definition) The concept refers to quality of life (QoL) of individuals engaged in emergency work, either professionally (e.g., health-care workers, fire fighters) or as volunteers. Dimensions of QoL that have been proposed in the literature include PSTD, compassion fatigue, burnout, and compassion satisfaction. Recent perspectives advocate the adoption of a multidimensional approach including both negative and positive outcomes (Stamm, 2005).

The maintenance of an adequate of quality of life (QoL) represents a critical issue in the management of patients in haemodialysis and is also used to assess the effectiveness of health care programmes. The Consumer Direction Theory of Empowerment (CDTE) implies that greater patient direction in policy formulation and services delivery, together with an increased community integration, endorses a process which leads to a better QOL. The aim of the study was to test a contextualized version of CDTE in an ambulatory for patients in haemodialysis. Sixty-nine patients completed a questionnaire measuring the following variables: Patient direction, family integration, self-efficacy in managing the disease, mental and physical health. The results showed that patient direction and family integration have an indirect effect on QoL, through self-efficacy in managing the disease. The hypotheses were thus confirmed, providing support for the potential of CDTE in the context of health services for haemodialysis patients. Implications for the implementation of health programmes aimed at improving QoL of patients in haemodialysis are discussed, including interventions focused on psychological and contextual factors.

The role of structural characteristics of the residential context in influencing adolescents’ Sense of community (SoC) has received limited consideration in the literature. Aim of this study was to assess SoC in male and female adolescents living in two Italian provinces characterized by different positions on indicators of quality of life. The moderating role of adolescent gender and age group on SoC was also considered. The sample includes 1,182 adolescents: 46.2 % male and 53.8 % female. Age ranged from 16 to 22 years (M = 17.5; SD = 1.23). Findings indicate that levels of Sense of community differ between the two provinces and are higher among adolescents living in the more “advantaged” context (Rimini) based on quality of life objective indicators. Males score higher than females except in the more “advantaged” context, whereas girls experience greater opportunities for influence. SoC tends to decrease with age, as the context becomes increasingly insufficient for satisfying adolescents’ needs. Findings indicate that the context significantly affects adolescents’ SoC and that such effect is partly moderated by gender and age.

Objective. Considering the importance of sport activity for enhancing quality of life, the aim of this study was to investigate the effects of regular sport activity on quality of life of kidney transplant recipients. Methods. Health-related quality of life (HRQoL) was assessed with the use of the SF-36 questionnaire on a group of 118 active kidney transplant patients (AKTPs) practicing different sports at low to moderate intensity (5 4 h/wk). Scores were compared with those of 79 sedentary kidney transplant patients (SKTPs) and with 120 active healthy control subjects (AHCs). Results. AKTPs reported higher scores than SKTPs in the SF-36 scales of Physical Functioning (P < .05), Role Limitations due to Physical Problems (P < .05), General Health (P < .01), Vitality (P < .05), Social Functioning (P < .05), Role Limitations due to Emotional Problems (P < .05), and Mental Health (P < .01). AKTPs obtained higher scores than AHCs on the Mental Health (P < .01) and Social Functioning scales (P < .01) and similar scores (P > .05) on all the other scales. The effect of quantity of sport activity was significant on the General Health (P < .01; h2 ¼ 0.05), and Role Physical scales (P ¼ .04; h2 ¼ 0.03), with higher sport activity associated with higher HRQoL. The effect of sex was significant for Bodily Pain (P ¼ .05; h2 ¼ 0.02), Vitality (P ¼ .08; h2 ¼ 0.06), Social Functioning (P ¼ .08; h2 ¼ 0.05), and Mental Health (P ¼ .05; h2 ¼ 0.02), with male participants scoring higher than female participants. Conclusions. This study indicates that regular sport activity significantly improves different dimensions of HRQoL among kidney transplant recipients. The benefits of sport activity go beyond its impact on physical health to involve psychologic and social components of quality of life. Spontaneous and low to moderate sport activity may play an important role after kidney transplantation that has been largely underestimated in the literature.

HIV prevention with "at risk" adolescents: how to "reach" and "involve" young people in extra-school contexts? - The paper discusses the issue of the difficulty to reach and involve the targets of preventive interventions, by taking as example a HIV prevention intervention aimed at out-ofschool adolescents and young people. Keywords: prevention, HIV, adolescents, action research, evaluation

Conflicts between parents and adolescents were explored from the viewpoint of 13- and 15-year-old children (N = 397). There was support for Steinberg's (1989) distancing hypothesis: older children reported more aggression, more frustration and lower intimacy outcomes. There was also support for the hypothesis that the more complex position of adolescent girls (valuing both closeness and autonomy) would result in higher levels of frustration, whereas boys would be more clearly confrontational-producing relatively more escalation. Overall, mothers were experienced as more compromising and as fostering greater intimacy in comparison to fathers. There were differences between family types: those mothers living with a partner were reported as more aggressive than mothers from non-divorcing families, and adolescents living with mother alone reported more frustration and escalation outcomes. In respect of fathers, non-residential fathers and daughters experienced less aggression, lower escalation outcomes and sustained higher levels of compromise in comparison to fathers in non-divorcing families. Boys without their father resident reported the lowest levels of compromise with both mothers and fathers-consistent with others' research suggesting that boys' accommodation to parental separation is more problematic. Finally, effects of parental age were explored.

Internet forums represent a useful but understudied resource to understand psychosocial aspects of living with systemic lupus erythematosus. This study was aimed to describe the demand/supply of social support through the Internet in relation with the description of personal illness experiences. All the posts (118) from an Italian forum for systemic lupus erythematosus patients were collected and analyzed combining qualitative content analysis with statistical textual analysis. The results showed different purposes for posts: starting new relationships, seeking information, receiving emotional support, and giving a contribution. Lexical analysis identified three ways of describing patients’ experiences. Discussion focuses on the relationship between the requested/offered support and systemic lupus erythematosus experiences.

Research on the consequences of motor vehicle accidents centres mainly on the assessment and treatment of post-traumatic psychological–behavioural reactions of the people involved. Few studies have explored the experience of surviving a serious accident and its impact on different dimensions of individuals' lives. This qualitative study aims at investigating adaptation strategies and quality of life of 20 severely injured accident survivors who spent several months in an intensive care unit of a hospital, and who still suffer permanent injuries of varying extent. Participants completed individual in-depth interviews which were subsequently analysed according to the grounded theory method. The findings indicate that the adaptation process follows a sequence of temporal phases (‘past–present’, ‘present’, ‘future’ and ‘being’), characterized by different emotional and behavioural reactions, perceived needs, and by the adoption of specific coping strategies. The duration of the adaptation process is influenced by the severity of the injury suffered, participants' age at the time of the trauma, the occurrence of coma and the availability of social support in participants' life environment.

In the last decades, with the improvement of life expectancies for systemic lupus erythematosus (SLE) patients, the relationship between social support and health in this population has received a considerable amount of attention in behavioural medicine and health psychology. This paper is the first to review research studies which specifically investigated perceived social support in relation to SLE patients’ health outcomes (quality of life, disease activity and damage). Starting with a descriptive approach to social support perceived by patients with SLE, the research evidence on the impact of social support on health is presented. These studies demonstrate that the consideration of social support is critical in predicting disease activity, damage and quality of life (both physical and psychological components) although the precise ways in which social support contributes to health are not yet completely understood. Discussing the results, the authors offer some suggestions which could guide further research in this field. Finally, clinical and non-clinical implications of the findings are discussed.