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Background: This study aimed to screen a wide range of emotional and behavioural variables emerging during the first COVID-19 pandemic-lockdown in a sample of parents and children, residents in the southern part of Italy, and explore which variables could predict children’s wellbeing. We hypothesised that difficulties in adapting routines to pandemic restrictions, parents’ emotional wellbeing, and attitude towards the pandemic could influence the children’s behavioural attitudes. Methods: 221 parents completed the survey and gave information about 246 children. Ad hoc questionnaires were created and then exploratory reduced in factors. Strengths and Difficulties Questionnaire (SDQ) for parents assessed positive and negative behavioural attitudes in children. Depression Anxiety Stress Scale (Italian DASS-21) scored depression, anxiety and stress in parents. Results: Children presented higher emotional distress (Mean difference (Mdiff)=0.6, 95% C.I. 0.2, 0.9, p=0.013) and better prosocial behaviour (Mdiff=0.5, 95% C.I. 0.1, 0.9, p=0.011) than the Italian normative sample. Parents were more depressed than expected in the general population (Mdiff=1.0, 95% C.I. 0.3, 1.6, p=0.005). Having developed a morbid attachment to an adult (B=0.37, 95% CI 0.05, 0.69, p=0.024), a higher parental depression (B=0.1, 95% CI 0.02, 0.18, p=0.014), and children’s suffering from nightmares (B=0.35, 95% CI 0.03, 0.67, p=0.032) explained the 31.9% of the total variance in children’s emotional distress. Children’s anxiety was related to parents’ fear of the pandemic effects (r=0.32, p=0.001) and avoiding communicative approach (r=0.24, p=0.011). Conclusion: The first lockdown determined emotional distress and regressive mechanisms in children in the contest of higher parental discomfort, fear of the infection and avoidant communication. Following parents’ indications, it could be helpful to provide families with informative and age-appropriate support., Mediterranean Journal of Clinical Psychology, Vol 9, No 2 (2021)

Background: The prevalence of Internet Gaming Disorder (IGD) in the Italian population of gamers is unknown. Several risk factors, including time spent playing (TSP), are proposed as an epiphenomenon of emotional dysregulation. Methods: The study estimated the prevalence of IGD in at-risk Italian online gamers, and the interplay between alexithymia and other risk factors. 5,979 responders were surveyed. IGDS-SF9 estimated pathological gaming. TAS-20 measured Difficult in Identifying (DIF) and Describing Feelings (DDF), and Externally Oriented Thinking (EOT). Results: 43% of participants had pathological IGD scores. Male gender (OR=1.2, 95% C.I.=1, 1.5, p=0.019), TSP (OR=7.6, 95% C.I.=5.5, 10.6, p0.001), DIF (OR=1.5, 95% C.I.=1.1, 2.1, p=0.003), boredom/loneliness feelings (OR=1.8, 95% C.I.=1.5, 2, p0.001), recent negative events (OR=1.1, 95% C.I.=1, 1.3, p=0.026), and a behavioral addiction (OR=2.1, 95% C.I.=1.2, 3.9, p=0.009) independently increased its risk. Conclusions: Almost one on two players joining online communities presented IGD. Some risk factors were crucial, including TSP, independently from emotional dysregulation., Mediterranean Journal of Clinical Psychology, Vol 8, No 3 (2020)

Some patients with dysphoria, explosive behaviour, or suicidal ideation, may receive a diagnosis of, and treatment for Bipolar Disorder (BD) and, not infrequently. The coexistence of these two diagnoses has been explained in different ways. Some authors include the BPD in the bipolar spectrum; others are sceptical about the existence of real comorbidity, suggesting a misdiagnosis. This study aimed to assess the personality of this group of poly-diagnosed patients (PolyD) and hypothesised they had a pathological borderline organisation. Via the administration of the Schedler Westen Assessment Procedure (SWAP-200), we compared PolyD patients with those suffering from BPD or BD only. We performed two different MANCOVAs to test PolyD, BPD and BD patients’ differences in PD-factors, Q-traits and age. The sample comprised 45 patients (Mean age=43.3, SD=15.7; Females 57.7%, N=26). BD patients (N=15) did not present any personality disorder, they had a higher functioning and Obsessive Q-traits, and a lower Histrionic PD-factor than both PolyD (N=20) and BPD (N=10) patients. Compared to PolyD patients, BD had inferior PD-Borderline, PD-Antisocial factor and Dependent-Masochistic Q-traits, but there were no other differences with BPD patients. PolyD did not differ from BPD patients in any of the PD-factors and Q-traits. Our results suggest that PolyD patients are different from BD patients and propose to consider the pathological borderline personality as a central core of their disease., Mediterranean Journal of Clinical Psychology, Vol 7, No 2 (2019)

Introduzione. Nell’enorme mole di ricerche sui disturbi alimentari (DA) presente in letteratura è quanto mai evidente un’asimmetria di genere. La maggior parte degli studi, infatti, è stata finora condotta su campioni femminili, dando rilievo in modo fuorviante alla credenza che tali disturbi siano di esclusiva pertinenza delle donne. Scopo. La rassegna intende evidenziare come tale visione pregiudiziale sia ancora molto diffusa tra gli stessi pazienti maschi e tra i clinici, rappresentando un ostacolo per un corretto inquadramento diagnostico e per un’adeguata pianificazione del trattamento. Metodo. Gli studi inclusi nel lavoro sono stati individuati nella letteratura scientifica pubblicata fra gennaio 2007 e dicembre 2017 attraverso i principali database, abbinando le parole: “males”, “eating disorder”, “anorexia nervosa”, “bulimia nervosa”, “binge eating disorder”. Risultati. Dalla letteratura sono stati selezionati 54 studi nel rispetto dei criteri metodologici adottati. Discussione. Solo in anni più recenti l’attenzione dei ricercatori si è focalizzata anche sulla popolazione maschile: molteplici differenze tra i due generi emergono a livello di prevalenza, esordio, fenomenologia, diagnosi, comorbilità ed esiti dei DA. Anche la ricerca sui fattori di rischio ha evidenziato significative differenze tra maschi e femmine, soprattutto in relazione al diverso peso esercitato dalle variabili psicologiche coinvolte nell’eziologia dei DA. Conclusioni. A fronte di una scarsa conoscenza dei DA nella popolazione maschile, si ravvisa l’importanza di ampliarne la comprensione tenendo in conto la prospettiva di genere. In particolare, l’attenzione va rivolta ai periodi critici dello sviluppo come la pubertà e l’adolescenza, in cui l’individuazione precoce e la prevenzione di questi disturbi è di primaria importanza, all’interno di una cornice concettuale che consideri l’influenza reciproca tra vulnerabilità psicologica e fattori socioculturali.

Several studies confirm that obesity with comorbidity psychiatric disorders decreases the long-term success of surgical treatment. The prevalence of psychiatric disorders varies from 30% to 76% between the obese patients candidate for bariatric treatment (Hudson et al., 2007; Striegel-Moore et al., 2009). It goes without saying that it is essential to prearrange a correct assessment in patient with a severe obesity who are candidate for surgical treatment in order to ensure a long term successful treatment. The aim of the study is to outline some psychological factors that could promote and maintain conditions of severe obesity and to identify weak points in widely applied care pathway. This is a cross-sectional analysis of 39 consecutive treatment-seeking obese (body mass index > 35 kg/m2) patients (14 men, 25women) age 20-59 (age M= 39.3). All the study participants who filled in the DMI (Gleser & Ihilevic, 1969, 1986), a semi-projective test which aims to measure the relative intensity of usage of five major groups (TAO, PRO, PRN, TAS, REV) and in the TAS-20 (Bagby, Taylor, Parker, 1994) and in the TSIA (Taylor, Bagby, Caretti, & Schimmenti, 2014) to assess the alexithymia. 74% of the group (29 patients) got a symptomatic profile types. 79.3% of this is made up of REV and PRN/REV profiles. This defensive profile is related to a higher BMI, to an earlier onset obesity, to a poor effectiveness of medical treatments, to a high risk of post-surgical recurrence. At TAS-20, 36% of patients have a score > 51 (bordeline) and 19% a score >61 (alexithymic). At TSIA, 69.4% of patients are alexithymic. The results showed that mental functioning is mainly characterized by a tendency to deny the reality and overturn the representation of this and by alexithymic traits. This is a potential serious risk of bariatric treatment failure in these patients. Psychological treatment is necessary to reduce a higher risk of low adherence and drop out to treatment at the follow up.

Le favole, è noto, ricoprono un ruolo fondamentale nel percorso di sviluppo e maturazione psicologica del bambino. Esse riescono, come le leggende, i racconti, i sogni e i miti, con linguaggio se mplice e immediato, attraverso la metafora, a presentare in modo comprensibile e accessibile alla portata della psiche infantile, situazioni di conflitto, suggerendo soluzioni più o meno magiche. Nella loro struttura a trama leggera e aperta, sono un dispositivo che, di per sé, incrocia e condensa principalmente tre dimensioni: comunicativa, narrativa e simbolica.

Il Defense Mechanisms Inventory (DMI) (Gleser e Ihilevich, 1969; Gleser e Ihilevich, 1986) è un questionario semiproiettivo per la valutazione degli stili difensivi. Creato alla fine degli anni sessanta da Gleser e Ihilevich, si è diffuso nella pratica clinica e nella ricerca, godendo di buona considerazione nella letteratura scientifica (Davidson e McGregor, 1998). Soltanto la forma per adulti è stata validata in Italia, ma esistono sia la forma per adolescenti sia quella per anziani. La forma per adolescenti prevede una versione breve risultata piuttosto affidabile sia nella clinica sia nelal ricerca (Recklitis et al. 1995).

Da un orientamento psicoanalitico, l’operare clinico consiste nel ricercare il senso del sintomo, riconnettendo legami perduti all’interno della vita del soggetto, allargando lo spazio di pensiero, per incrementare la padronanza della vita psichica e il piacere relativo al funzionamento della mente. Si tratta di reimmettere il sintomo – di per sé fisso, denso, immutabile, ignorante nel continuum vitale della persona, pensandolo come una forma di comunicazione con potenzialità trasformative, una sorta di falla temporale che consente al passato, presente e futuro di prendere contatto tra di loro in entrambe le direzioni.

Lo scenario contemporaneo della salute è molto cambiato negli ultimi anni: se è vero che abbiamo una speranza di vita più lunga, questa non sempre corrisponde ad un reale miglioramento della qualità di vita dei pazienti (Lazzari, 2013). Oggi ci troviamo di fronte alla necessità di rispondere sempre più ai bisogni di salute di persone affette per lo più da malattie croniche e di rispondere alle esigenze economiche relative alla necessità di riduzione della spesa sanitaria attraverso programmi di prevenzione.

Aim. Sexuality in disabled people is faced with difficulty and inadequateness, if not with complete refusal, the result being that young disabled people are often relegated to a destiny of solitude and abandon. This is even more true when the disability includes mental retardation. Methods. Twenty-five youngsters between the age of 13 and 25 years - 14 males (56%) and 11 females (44%) were recruited together with their mothers for this study. All attend the Family Association for Down people in Palermo. The youngsters with Down's syndrome were invited to carry out a drawing activity and then to describe what they had drawn. The mothers, on the other hand, replied to a semi-structured interview, the contents of which were organised into three areas: 1) the reaction of parents when the doctors communicate the birth of a child with Down's syndrome; 2) parents and the sexuality of a child with Down's syndrome; 3) the expectations of parents with regard to the future of their child with Down's syndrome. Results. The free designs and their description demonstrated a clear emergence of themes that regard sexuality in 6 protocols out of 25. In 9 cases out of 25 the reference to sexuality is hidden behind allusive designs and descriptions. Six protocols testify, even if indirectly referable to the theme of sexuality, the emergence of an autonomy conflict, typical of adolescents, which demonstrates the beginning of the transitory process towards adulthood. Only in four situations was a sexuality reference not interpretable in the productions of the children. The qualitative analysis of the interviews carried out with the mothers evidences how the theme of the sexuality of the disabled child is lived in a conflictual way by the parents. Conclusion. The results obtained lead to affirm that the "question regarding sexuality" is more problematic from the parents' point of view rather than from that child's. In this prospective, in order to advantage the parents, it is necessary to plan psychological and clinical interventions regarding an education to sexuality.

The moments that follow the diagnosis of celiac disease and the early stages of the gluten-free diet are extremely difficult and complex for parents and child, because they face an important change punctuated by self-denial and deprivation. The main objective of this research is to assess the impact of celiac disease on quality of life in subjects in developmental age, taking into account the perceptions of parents about the child's illness, with the aim to highlight the effect of disease on the child and the entire family.The study included both parents of 45 children aged between 2 and 10 years, with established celiac disease. To evaluate the effect of celiac disease on the lifestyle of affected children and their families has been used, after having adapted to the Italian context, the Impact Scale of Childhood Diseases of Hoare and Russell (1995). This study shows that celiac disease is a condition that has a significant impact on both the child and his family.The results obtained by administration of Impact Scale of Childhood Diseases to parents showed that subjects in developmental age with celiac disease could have difficulty on emotional level that affect child development and the whole family context. Acceptance of the illness by the child depends mainly by how much and how this has been accepted by parents.

Different data indicate that psychological and/or emotional disorders may play an important role in the natural history of heart diseases. Although the major evidence is that related to depression, epidemiological data would indicate that anxiety and panic disorders are highly represented in cardiac patient, thus influencing mortality and morbidity. The diagnosis of panic disorder in patients with chest pain is crucial to a correct therapeutic approach, as well as to reduce the risks and costs of inappropriate treatments. Anxiety and panic may accelerate different direct and indirect processes involved in the pathogenesis of cardiovascular diseases: lifestyle risk factors, arterial hypertension, myocardial perfusion, autonomic nervous system or hypothalamus-pituitary-adrenal axis, platelet activation, and inflammation processes. Panic disorder seems to correlate particularly with sudden death: this suggests that it may be considered one of the main inducers of life-threatening arrhythmias, rather than to be linked to the development and progression of coronary atherosclerosis. Beyond hard outcomes, panic disorders produce negative effects on both global adjustment and life quality that may impair the course of the cardiac diseases. Interestingly, specific antipanic and anxiolytic agents seem to be particularly effective upon life quality. In any case, adequate controlled clinical trials are necessary in order to confirm the possibility of cardiovascular risk reduction by means of anxiety and panic disorder treatment.

BACKGROUND: Bigorexia or muscle dysmorphia (MD) is a subtype of body dysmorphic disorder, and it is characterized by an excessive dissatisfaction with body size and muscularity. Orthorexia nervosa (ON) is an obsessive focus on healthy eating and emotional distress related to food choices that are perceived as unhealthy. MD and ON are considered two emerging psychiatric disorders. METHODS: The aim of this study was to evaluate the prevalence of traits of ON and MD between amateurs and professional athletes who practice bodybuilding. The secondary endpoint of the study is to identify the anabolic steroid abuse among the athletes. To this end we have administered a dichotomic questionnaire to 60 young men: 30 amateur bodybuilders (ABBs) and 30 professional bodybuilders (PBBs). RESULTS: Scores compatible with a full-blown MD disorder have been found in 100% of subjects of PBB group and in 83% of ABB group. Afull-blown ON has been detected in 87% of BBPs and 40% of BBAs and a risk for ON in 10% of BBPs and in 37% of BBAs. CONCLUSIONS: This study shows a high co-occurrence of MD and ON among the bodybuilders suggesting a link between eating disorders and body dysmorphic disorders.

This study contributes to the knowledge on the effects of the COVID-19 pandemic by examining a moderated mediation model in which the impact of job loss over quality of life (QoL) is mediated by hopelessness and moderated by trait emotional intelligence (trait EI). Data were collected from a large nationally representative Italian sample of adult workers (N = 1610), who completed a series of anonymous online questionnaires. Total, direct and indirect effects were estimated through bootstrapped mediated moderation analyses providing 95% bias corrected bootstrap confidence intervals. After controlling for the effects of gender and age range, job loss was found to be negatively associated with QoL, and hopelessness partially mediated such relationship. These relationships were in turn moderated by trait EI. Our study suggests that trait EI levels act as protective factor for a good QoL, mitigating the impact of both job loss and hopelessness over QoL levels during the COVID-19 pandemic. Identifying psychological protective and/or risk factors for a better QoL is crucial for the development of interventions aimed at reducing the emotional impact of the pandemic and of its negative real-life consequences.

Background: Circuits is a computerized cognitive remediation program for individuals with schizophrenia. this study aimed to evaluate the feasibility of the italian version of circuits. MethODs: Feasibility was measured through ad-hoc questionnaires in a non-clinical sample (N.=30; target-score 70%; study 1); in patients with schizophrenia (N.=5; target-score 60%; study 2) and cr therapists (N.=3; target-score 60%; study 2). study 3 was a pilot study investigating: 1) enrolment, compliance, and retention rates; 2) satisfaction; 3) potential post-treatment and follow-up improvements in patients with schizophrenia (N.=20). these results were used to estimate sample size and feasibility for a future trial. resULts: all non-clinical participants rated high feasibility of circuits (83.3-100% scores). all patients (60-100% high-scores) and cr therapists (66-100% high-scores) evaluated circuits feasible. high rates of retention in treatment (74.5%) and satisfaction (85-100%) in patients were showed. Post-treatment assessment revealed an improvement in all cognitive measures. a sample size of 32 was calculated for each arm of the trial, at the desired power of 80%, to recruit for 18 months. cONcLUsiONs: results showed the feasibility of the italian version of circuits, they will inform a controlled future trial and implementation study of this therapy approach in the italian mental health system.

La transizione alla genitorialità è uno degli eventi critici del ciclo vitale della famiglia maggiormente indagati in ambito clinico e psicosociale; rappresenta un fondamentale rito di passaggio all’età adulta, caratterizzato dalla scelta più o meno consapevole di avere un bambino (Molgora, Saita e Fenaroli, 2010). Generalmente, la letteratura in ambito clinico così come gli studi psicoanalitici sui primi anni di vita e quelli sull’attaccamento (Bowlby, 1972; 1980; Ainsworth, 2006; Main, 2008) hanno rivolto maggiormente l’attenzione alla donna, approfondendo le dinamiche della relazione madre-bambino e trascurando la figura del padre. Oggi però, risulterebbe inappropriato affrontare queste tematiche prescindendo dall’importanza che la figura paterna riveste in termini di ruolo e di funzione all’interno della triade familiare. [...]

The relationship between social anxiety and cannabis use among adolescents and young adults is a highly debated topic. In this cross-sectional study, we tested whether cannabis use expectancies mediated the association between social anxiety and cannabis use severity in a sample of 343 young adults (74.3% male) who used cannabis. They completed self-report measures for the screening of problematic cannabis use (Cannabis Use Problems Identification Test) and social anxiety symptoms (Social Interaction Anxiety Scale and Social Phobia Scale). A multiple mediation analysis was used to test whether marijuana effect expectancies mediate social anxiety effect on problematic cannabis use. Social anxiety was negatively associated with cannabis use severity in this sample, and we found evidence that cannabis use expectancies fully mediated this relationship. Specifically, global negative effect expectancies influence the relationships between social anxiety and problematic cannabis use. These findings may inform current prevention strategies and clinical intervention for young adults who use cannabis.

Background Self-image is the subjective perception about one's own self, body, mental functioning, social attitudes, and adjustment in different aspects of life. Research has linked negative self-image with a number of problem behaviors and psychiatric symptoms in adolescence; however, studies of the relationship between self-image and anxiety disorders are still scarce. Method This study involved a community sample of 1305 high-school students (51.4% female) who ranged in age from 14 to 19 years old. They completed self-report measures of self-image and social anxiety disorder (SAD). Results A quarter of the students reported high levels of social anxiety. Statistical analyses showed significant differences between these students and the other students in all the self-image subscales. Several dimensions of impaired self-image (emotional tone, social attitudes, vocational and educational goals, family relationships, external mastery, and psychological health) were associated with high levels of social anxiety, with some gender differences underpinning these relationships. Conclusions Clinicians treating SAD in youth may wish to consider that a negative self-image may play a critical role in the onset and retention of social anxiety symptoms.

As a theoretical extension of other previous studies, this work represents an improvement of the notions about the relationship between adolescence and Mafia. The research has been aiming at exploring teenagers’ universe within specific social contexts where the presence of criminal organizations is significant, focusing the attention on the modalities through which evolutionary tasks are coped with in contexts with high Mafia density and often characterized by a perception of social space that makes personal, financial, and political development problematic. The research has involved 93 teenagers who live in southern regions where the presence of Mafia organizations (Camorra, ‘Ndrangheta, and Cosa Nostra) is significant. Six focus groups have been carried out, recorded, and transcribed. Verbalizations were analyzed through appropriate qualitative templates, which allowed detecting of three thematic macro-areas: representations of Mafia, emotions connected to it, and planning skills. The qualitative analysis of transcriptions points out that the presence of Mafia organizations, the contiguity between legal and illegal symbolic–cultural codes, the commonality of belonging matrices, and sharing the same symbolic and social spaces are all elements that violently enter these teenagers’ identification and release paths, deeply influencing them.

Questo studio, in continuità teorica con altri che lo precedono, rappresenta un amplia-mento delle conoscenze sulla relazione tra adolescenza e mafia. La ricerca si è proposta come obiettivo l’esplorazione dell’universo adolescenziale all’interno di specifici contesti sociali in cui la presenza di organizzazioni criminali è pregnante, focalizzando l’attenzione sulle modalità at-traverso cui vengono affrontati i compiti evolutivi all’interno di contesti caratterizzati da alta densità mafiosa e spesso contraddistinti da una percezione dello spazio sociale che rende pro-blematico lo sviluppo personale, economico e politico. La ricerca ha coinvolto 93 adolescenti che vivono in regioni meridionali in cui la presenza delle mafie (Camorra, ‘Ndrangheta e Cosa Nostra) è capillare. Sono stati realizzati sei focus-group, audioregistrati e in seguito trascritti; le verbalizzazioni sono state analizzate attraverso apposite griglie qualitative che hanno consenti-to di individuare tre macro-aree tematiche: rappresentazioni del fenomeno mafioso, emozioni ad esso connessi e progettualità. L’analisi qualitativa dei trascritti evidenzia che la presenza delle Mafie, la contiguità fra codici simbolico-culturali legali ed illegali, la comunanza delle matrici di appartenenza, la condivisione del medesimo spazio simbolico e sociale, sono tutti elementi che entrano violentemente dentro i percorsi di individuazione e svincolo di questi adolescenti, in-fluenzandoli profondamente. As a theoretical extension of other previous studies, this work represents an improve-ment of the notions about the relationship between adolescence and Mafia. The research has been aiming at exploring teenagers’ universe within specific social contexts where the presence of criminal organizations is significant, focusing the attention on the modalities through which evolutionary tasks are coped with in contexts with high Mafia density and often characterized by a perception of social space which makes personal, financial and political development problematic. The research has involved 93 teenagers who live in southern regions where the presence of Mafia organizations (Camorra, ‘Ndrangheta and Cosa Nostra) is widespread. Six focus groups have been carried out, audio recorded and then transcribed. Verbalizations have been analyzed through appropriate qualitative grids which allowed detecting three thematic macro-areas: representations of the phenomenon of Mafia, emotions connected to it and plan-ning skills. The qualitative analysis of transcriptions points out that the presence of Mafia or-ganizations, the contiguity between legal and illegal symbolic-cultural codes, the commonality of belonging matrices, sharing the same symbolic and social spaces are all elements which vio-lently enter these teenagers’ identification and release paths, deeply influencing them.

Alexithymia is a theoretical construct concerning the ability to contact our feelings and the ability to describe them in words. It is very useful in clinical experience and also in empirical research for its operationalization and applicability possibility. After more than 40 years from its original definition, with clinical observation of patients defined “psychosomatics” according a classic definition, alexithymia has become one of the most investigated disease in the last decades. This paper aims to explore etiopathogenetic hypotheses and contemporaneous prospective within which it is possible to understand the relevance of the construct both in clinical experience and in empirical research. Furthermore, the paper examines alexithymia assessment methods to provide a complete and updated description of tools now available for clinical research. We also wish to underline the fundamental limit in a detailed study on alexithymia: the absence of psychometric tools to assess the disease in developmental age. This limit is related to the difficulty of building research tools able to understand the developmental movement in emotional processing capacity during childhood. However, there are recent preliminary studies on children/teens and preteens which pave the way for research in this direction.

Sturge-Weber-Krabe syndrome (SWS), also known as encephalotrigeminalangiomatosis and named the forthfacomatosis, recall the names of the authors who first describedit in its basic clinical, radiological andanatomopathological aspects. We report here 14 cases of Sturge-Weber disease. In 6 of these, despite what had been previously described in literature, an extension of the angioma has been noted in other parts of the body. The study of these subjects stresses not only the need for a pharmacological/neuropsychomotor intervention, but alsothe need of a psychotherapeutic approach, for the emotional and affective implications thatcould derive from this syndrome. The reported cases are similar to those presented in literature for their main features. In particular, two elements are interesting: i) the exceptional diffusion of the red nevousto the whole hemicorpo; and ii) the evaluation of the way the patients live the disease, which has not beenpreviously considered in literature. We can conclude that SWS is a multisystem disorder that requires the neurologist to be aware of the possible endocrine, psychiatric, ophthalmological, and other medical issues that can arise and impact on the neurological status of the patients. and neuropsychomotor therapies, but also a psychotherapeutic support to patients. It should be noted that the literature does not take psychotherapeutic support into consideration.

RiassuntoA partire dal loro lavoro di psicoterapeute e attraverso alcuni frammenti clinici che si riferiscono ad un gruppo di adolescenti svoltosi in un quartiere a rischio di Palermo, le Autrici analizzano la dimensione mafiosa non restringendola al solo comportamento criminale; piuttosto declinandola lungo alcuni significanti: non identità e gruppo mafioso che colonizza e sottomette lo psichismo del singolo; fantasmi familiari potenti e spietati che impediscono il costituirsi di sé originali e autonomi; personalità impastate di indifferenza emotiva e vendicatività. Significanti che rendono conto delle vaste aree di desertificazione e pietrificazione – resistenza al cambiamento – avvertita dagli psicoterapeuti che prendono in carico giovani di famiglie mafiose. Parole chiave: mafia, psicoterapia, gruppo, vendetta, identità, resistenza, cambiamentoKidnapped by revenge: “being locked out of the object”Abstract Starting from their work as psychotherapists and by means of some clinical fragments which refer to a group of teenagers of a neighbourhood at risk in Palermo, the Authoresses analyze the Mafia dimension not limiting it to a criminal behaviour only. They rather decline it along some signifiers: non identity and mafia group which colonizes and subjugates the indi-vidual’s psychism. Powerful and merciless family ghosts who prevent from building original and autonomous selves. Personalities kneaded with emotional indifference and vindictiveness. Signifiers which account for the large desertification and petrification areas – resistance to change – that psychotherapists, who deal with young people belonging to Mafia families, are able to feel. Key word: mafia, psychotherapy, group, revenge, identity, resistance, change

Obiettivi. Scopo del presente studio è esplorare il funzionamento psichico dei soggetti con disturbo bipolare I e II attraverso l’analisi e il confronto degli stili di pensiero e dei pattern difensivi. Metodi. Nel corso di un intero anno solare (2009-2010), presso la clinica Psichiatrica del Policlinico Universitario di Palermo sono stati reclutati 29 pazienti con disturbo bipolare I e II. È stato somministrato il seguente protocollo: Wechsler Adult Intelligent Scale-R (WAIS-R) per valutare il funzionamento cognitivo generale; Defense Mechanisms Inventory (DMI) per misurare i pattern difensivi. Sono stati quindi ana- lizzati e confrontati i risultati ai due reattivi. Risultati. I soggetti con diagnosi di disturbo bipolare utilizzano modalità cognitive e strategie difensive del tutto peculiari, differenti rispetto alla popolazione normativa. La diagnosi incide sul livello e sul tipo di funzionamento cognitivo nonché sui pattern difensivi. I bipolari I presentano compromissioni cognitive più serie ed estese e un profilo difensivo più rigido dei bipolari II. In generale, i pazienti bipolari manifestano una personalità immatura centrata su funzionamenti arcaici che si riscontrano in tutte le sfere della loro personalità: emozioni, affetti, cognizione, forza dell’Io, adattamento alla realtà. Discussione. Il profilo cognitivo e difensivo del tutto specifico ottenuto conduce a importanti riflessioni sul contributo che le strategie psicologiche possono dare al trattamento “su misura” per questi pazienti. Aim. The aim of this research is to explore the psychical functioning in bipolar I or bipolar II disorder people through the analysis and comparison of their thought styles and defense patterns. Methods. 29 bipolar I and bipolar II peo- ple afferent to Palermo University Policlinical Psychiatric Hospital Department were selected during the whole 2009-2010 year. The following tests were administred: Wechsler Adult Intelligent Scale-R (WAIS-R) in order to measure the general cognitive function; Defense Mechanisms Inventory (DMI) in order to measure defense patterns. Afterwards, the results of the two tests were analysed and compared. Outcome. Bipolar disorder people use cognitive mechanisms and defense strategies that are very different from standard population. Bipolar I subjects show both wider and more serious cognitive deterioration and stricter defense mechanisms than bipolar II subjects. Generally bipolar patients show an immature personality based on ar- chaic mechanisms that can be found in all the spheres of their personality: emotions, cognition, Ego-strength, adaptability to reality. Discussion. The peculiar achieved cognitive and defense profile leads to important considerations about how psychological strategies can contribute to use “bespoke” treatments for these patients.

PURPOSE: This study was done to evaluate the psychological state and anxiety of patients undergoing computed tomography coronary angiography (CTCA), and assess their acceptance and satisfaction compared to invasive conventional coronary angiography (CCA). MATERIALS AND METHODS: A total of 442 consecutive patients (282 male; mean age 57.7 ± 9.5 years) who underwent CTCA for suspected or known coronary artery disease were evaluated with the Endler Multimodality Anxiety Scales (EMAS) before and after the scan, and a questionnaire administered after the scan. Among the 442 patients, 181 had a history of CCA. Two radiologists assessed the image quality of CTCA. RESULTS: Anxiety was more intense prior to the scan (EMAS score 51.7 vs. 46.7, p < 0.01) and in patients with a history of CCA (EMAS score 55.5 vs. 49.1, p < 0.01). Women presented more intense anxiety (EMAS score 59.5 vs. 47.3, p < 0.01), higher mean heart rate (63.5 ± 7.6 vs. 60.7 ± 7.3 beats per minute, p < 0.01) and a lower image quality than men (p < 0.0001). CTCA proved to be more acceptable than CCA because of accurate preparation, lower concern prior to the examination, negligible pain, higher comfort, and greater overall satisfaction (p < 0.0001). CONCLUSIONS: Computed tomography coronary angiography is a patient-friendly imaging method because of the minimal perceived discomfort. Anxiety may affect CTCA image quality in women.

Previous studies of auditory hallucinations in schizophrenia found that the hallucinations were reduced by the application of transcranial magnetic stimulation (rTMS). Here we describe a case of traumatic brain injury associated with continuous music hallucinations. An MRI scan showed a structural lesion of the right temporal pole and a PET scan indicated a hyperactive area of the posterior right temporal lobe. We hypothesized that rTMS applied to the right temporal area would reduce this activity and the corresponding hallucinations. The patient's music hallucinations were significantly reduced by rTMS treatment. A PET scan following treatment also indicated that rTMS treatment reduced brain activity in the right temporal lobe. This case provides initial evidence that rTMS may be a successful treatment of syndromes associated with hyperactive brain areas.

Introduzione. La sessualità nella persona con disabilità viene affrontata con difficoltà e con inadeguatezza se non con franco rifiuto, con il risultato che le giovani persone disabili vengono, spesso, relegate ad un destino di solitudine e abbandono. E ciò si realizza ancora di più quando la condizione di disabilità comporta ritardo mentale. Metodi. Sono stati reclutati 25 ragazzi di età compresa tra 13 e 25 anni - 14 maschi (56%) e 11 femmine (44%) – insieme alle loro madri. Tutti frequentano l’Associazione Famiglie Persone Down di Palermo. Le giovani persone con sindrome di Down sono state invitate a svolgere una attività di disegno libero, quindi, a descrivere ciò che avevano disegnato. Le madri, invece, hanno risposto ad una intervista semistrutturata i cui contenuti sono stati organizzati intorno a tre aree: - reazioni dei genitori di fronte alla comunicazione da parte dei medici della nascita del figlio Down; i genitori e la sessualità dei figli Down; le aspettative dei genitori rispetto al futuro dei propri figli Down. Risultati. I disegni liberi e la loro descrizione hanno dimostrato il chiaro emergere di temi che riguardano la sessualità in 6 protocolli su 25. In 9 casi su 25 il riferimento alla sessualità si nasconde dietro disegni e descrizioni allusive. 6 protocolli testimoniano, sebbene non direttamente riferibili al tema della sessualità, l’emergere del conflitto di autonomia, tipico dell’adolescenza, a dimostrazione dell’iniziato processo di transito verso l’età adulta. Soltanto in 4 situazioni il riferimento alla sessualità non è interpretabile nelle produzioni dei ragazzi. L’analisi qualitativa delle interviste alle madri, ha evidenziato come il tema della sessualità nel figlio con disabilità sia vissuto dal genitore in maniera conflittuale. Conclusioni. I risultati ottenuti ci spingono ad affermare che la “questione sessuale” si pone in termini problematici dal punto di vista del genitore più che dal punto di vista del ragazzo. Ed in questa prospettiva, a vantaggio dei genitori, occorre pianificare gli interventi psicologico-clinici di educazione alla sessualità.