- Ines Testoni is psychologist, psychotherapist and philosopher, pupil of Emanuele Severino, professor and director of the Master in Death Studiesedit
Background: The denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying. Literature shows that death education may allow them to become familiar with this topic without... more
Background: The denial of death in Western society deprives young people of the tools to derive meaning from experiences of death and dying. Literature shows that death education may allow them to become familiar with this topic without causing negative effects. This article describes the effects of a death education course with adolescents, wherein participants were given the opportunity to meet palliative doctors and palliative psychologists at school and in a hospice, where they were able to converse with the families of the dying. Methods: This study used mixed methods and included an evaluation of a death education intervention with longitudinal follow-up of outcomes. The course involved 87 secondary school students (experimental group) aged between 16 and 20 years. We also recruited a control group of 76 similarly-aged students to observe differences. The variables we examined were: alexithymia, representation of death, value attributed to life and spirituality. These were measured with the following instruments: the Toronto Alexithymia Scale-20, the Testoni Death Representation Scale, the Personal Meaning Profile and the Spiritual Orientation Inventory, respectively. To better understand how the students perceived the experience, we asked the experimental group to answer some open-ended questions. Their answers were analysed through thematic analysis.
This study was designed as an action research aimed to help students to elaborate their feelings of traumatic grief, due to a car accident and a suicide of two of their classmates, in an Italian high school. A death education project was... more
This study was designed as an action research aimed to help students to elaborate their feelings of traumatic grief, due to a car accident and a suicide of two of their classmates, in an Italian high school. A death education project was realized in order to prevent the Werther effect. The intervention was based on psychodramatic techniques and meditation with Tibetan bells to encourage reflection on the suffering of traumatic loss, the sense of life, and their future. A total of 89 students from four classes (46 in the experimental group: two classes, 43 in the control groups: two classes) participated in the study, among which 82 (45 in the experimental group, 37 in the control group) completed the pre-and post-test survey. The intervention consisted of eight 2-h meetings, during which the themes of death and loss were dealt with through theoretical discussions, dramatization, and meditation. Two other classes which participated in the assessment as a control group did not attend the activities. The following instruments were used: Death Attitude Profile-Revised, which measures individual attitudes toward death; Psychological Well-being Scale, which measures a person's psychological well-being; Resilience Scale for Adolescents, which measures the construct of resilience in adolescents; Self-Transcendence Scale, which measures self-transcendence; and Testoni Death Representation Scale, which measures the ontological representations of death. The results demonstrated that in the experimental group, there was a reduction in the fear of death and its avoidance, and that the students normalized the representation of death as something natural, thus improving their well-being. It is consequently possible to say that well-being is not simply the absence of suffering and worries, but rather, is rooted in the possibility of thinking of creative solutions to the trauma.
This study focuses on the dimensions of dignity, linking Chochinov's Dignity Therapy to Schwartz's Theory of Values. The use of family photo albums has enriched the application of dignity therapy. Seven terminal patients in home-based... more
This study focuses on the dimensions of dignity, linking Chochinov's Dignity Therapy to Schwartz's Theory of Values. The use of family photo albums has enriched the application of dignity therapy. Seven terminal patients in home-based palliative care participated in the therapeutic intervention. To measure the effects of the intervention, we administered the Edmonton Symptom Assessment Scale and the Patient Dignity Inventory, then, at the end of the meetings, collected the opinions of participants, available nurses, and relatives who attended the sessions. The resulting generativity documents were then analyzed through thematic analysis, which revealed three main themes linked to both fundamental values and the dimensions of dignity: The relationship between continuity of self and myriad values in the context of family relationships; personal dignity as characterized by the values of personal success, hope, and wisdom; and hope and generativity. The fourth theme reflected the participants' final judgements on the intervention, which were highly positive and greatly encouraged further use of photographs in similar therapeutic interventions. The assessment protocol highlighted a significant decrease in tiredness amongst the participants and a trend towards a significant decrease in drowsiness after the intervention.
This article considers a particular aspect of palliative psychology that is inherent to the needs in the area of attitudes concerning Advance Healthcare Directives (AHDs) among Italian physicians and nurses after the promulgation of Law... more
This article considers a particular aspect of palliative psychology that is inherent to the needs in the area of attitudes concerning Advance Healthcare Directives (AHDs) among Italian physicians and nurses after the promulgation of Law No. 219/2017 on AHDs and informed consent in 2018. The study utilized a mixed-method approach. The group of participants was composed of 102 healthcare professionals (63 females and 39 males). The quantitative part utilized the following scales: Attitudes toward Euthanasia, the Religious Orientation Scale, the Balanced Inventory of Desirable Responding, and the Testoni Death Representation Scale. The results were mostly in line with the current literature, especially concerning a positive correlation between religiosity and the participants' rejection of the idea of euthanasia. However, the qualitative results showed both positive and negative attitudes towards AHDs, with four main thematic areas: "Positive aspects of the new law and of AHDs", "Negative aspects of the new law and of AHDs", "Changes that occurred in the professional context and critical incidents", and "Attitudes towards euthanasia requests." It emerged that there is not any polarization between Catholics or religious people and secularists: Their positions are substantially similar with respect to all aspects, including with regard to euthanasia. The general result is that the law is not sufficiently understood, and so a quarter of the participants associate AHDs with euthanasia. Discussions on the opportunity for palliative psychologists to help health professionals to better manage these issues through death education courses are presented.
In Western society, the topic of death has been removed from everyday life and replaced with medical language. Such censorship does not reduce individuals' fear of death, but rather limits their ability to elaborate their experiences of... more
In Western society, the topic of death has been removed from everyday life and replaced with medical language. Such censorship does not reduce individuals' fear of death, but rather limits their ability to elaborate their experiences of death, thus generating negative effects. The objective of this follow-up qualitative study was to detect how and if death education can help to improve individuals' relationship with death and enhance care environments like hospices. Semi-structured interviews were conducted with palliative care professionals and teachers who had taken part in a death education initiative three years earlier. The results confirmed the initiative's positive effect on both palliative care professionals and teachers. The participants reported that the education initiative helped them to positively modify their perspective on death, end-of-life care, and their own relationship to life, as well as their perception of community attitudes towards the hospice, which seemed to become less discriminatory. This study confirmed that school education initiatives can usefully create continuity between hospices and local communities. This project provided an educational space wherein it was possible for participants to elaborate their experiences in relation to death and to re-evaluate and appreciate hospices.
The validation of the Italian version of Linehan, Goodstein, Nielsen, and Chiles (1983) Reasons For Living Inventory (RFL) is here presented. The sample in this study was made up of 532 participants (26-65 years old), from various Italian... more
The validation of the Italian version of Linehan, Goodstein, Nielsen, and Chiles (1983) Reasons For Living Inventory (RFL) is here presented. The sample in this study was made up of 532 participants (26-65 years old), from various Italian regions. Part of the sample also completed the Beck Depression Inventory (BDI) and the Beck Hopelessness Scale (BHS). The six-factor structure reported by Linehan et al. (1983) was reproduced using confirmatory factor analysis. The goodness-of-fit of the model was evaluated. In order to estimate convergent validity, correlations were calculated among the six factors of the RFL, and the BDI and BHS scales. The correlations with BDI and BHS support the convergent validity of the Italian version of the RFL Inventory.
Previous research has shown that nonattachment, or the ability to release from mental fixations, has many positive outcomes (Sahdra, Shaver, & Brown, 2010). Because creativity is one of the most im5 portant pro5social behaviors, we... more
Previous research has shown that nonattachment, or the ability to release from mental fixations, has many positive outcomes (Sahdra, Shaver, & Brown, 2010). Because creativity is one of the most im5 portant pro5social behaviors, we investigated the link between nonattachment and creativity. In addi5 tion, we investigated the moderating role of mood. We found that nonattachment was indeed positively related to creativity, but only when people were induced to feel authentic pride, that is, pride which re5 sults from attributing success to hard work. The link between nonattachment and creativity disappeared when people were merely induced to feel a positive or neutral mood.
This article presents a qualitative analysis of published and unpublished texts, aimed to understand a new narrative phenomenon named "sick-lit." This is a genre of stories, written by professional novelists , rooted in disease,... more
This article presents a qualitative analysis of published and unpublished texts, aimed to understand a new narrative phenomenon named "sick-lit." This is a genre of stories, written by professional novelists , rooted in disease, self-harm, suicide, sufferance from violence, death, and dying. In the Internet it has been considered as a trivialization of serious issues and even potentially encouraging readers to harm themselves. Our hypothesis is that this negative judgment is based on the ontological representation of death and the objectification of the body depicted in these stories. In order to inquire into this possibility and to compare this anomalous form of story-telling with another kind of narration reflecting the wider common sensibility, a qualitative analysis was realized on six sick-lit novels (SLNs) and 21 unpublished tales written by amateur writers (AWTs). The results confirm the hypothesis: the SLNs represent death also as an absolute annihilation and the body is always reified through medical language , while the AWTs represent death only as a passage or reincarnation and the description of the deteriorated body is minimal. In recent years, psychological and social sciences have seen an upsurge of interest in death and dying, witnessed by the multiplying range of messages in popular media and by professional roles associated with the end of life. However, despite the huge number of messages inevitably exposing people to stimuli that, in a more or less fantastic and terrifying way, evoke death, there is still a lack of real experience with dying persons
This article presents the qualitative analysis of reports obtained through participant observations collected over a 4-year period in a series of suicide survivor self-help group meetings. It analysed how grievers' healing was managed by... more
This article presents the qualitative analysis of reports obtained through participant observations collected over a 4-year period in a series of suicide survivor self-help group meetings. It analysed how grievers' healing was managed by their own support. The longitudinal study was focused on self/other blame and forgiveness. Results show how self-blame was continuously present along all the period and how it increased when new participants entered the group. This finding indicates that self-blame characterizes especially the beginning of the participation, and that any new entrance rekindles the problem. However, no participant had ever definitively demonstrated self-forgiveness, while a general forgiveness appeared when self-blame stopped. It is also suggested how to facilitate the elaboration of self-blame and forgiveness.
The article presents the continuity between two Italian thinkers who have undergone a Catholic Inquisition process: the modern Giordano Bruno and the contemporary Emanuele Severino. The aim of this essay is not to make a comparison... more
The article presents the continuity between two Italian thinkers who have undergone a Catholic Inquisition process: the modern Giordano Bruno and the contemporary Emanuele Severino. The aim of this essay is not to make a comparison between the two philosophers but rather to study how the former passed the baton through history to Severino, in a way that was useful in refunding the relationships between Theology and Science. In particular, it describes how Severino completed what Bruno had only sketched. The ideas of eternity are discussed with respect to God, and they are related to the contraposition between Metaphysics and contemporary thought, from which the conflict between Theology and Science was derived in modernity, particularly after the immolation of Bruno. The article aims to address a number of aspects that unify many elements of Italian philosophy and the reasons why the Catholic Inquisition had to fight against it. The overall focus is on the originality of Severino and considers his philosophy as the basis of a possible "paradigm shift" for both Theology and Science. The theoretical treatise shows how Severino"s indication of eternity can solve many aspects of the clash between Theology and Science, substantially refunding both of them.
The censorship of death-related issues is widespread in contemporary Western culture because the boundary between death and life is substantially managed in medical areas. In the context of Italian educational initiatives, to remove this... more
The censorship of death-related issues is widespread in contemporary Western culture because the boundary between death and life is substantially managed in medical areas. In the context of Italian educational initiatives, to remove this limitation, 215 high school students in Southern Italy were educated on death through conventional and informal lessons. The students answered a questionnaire with open questions to survey their emotional and reflective experiences. Their answers were qualitatively, thematically analysed to explore how the representation of death can follow a death education course, and if this experience can be managed without harmful effects. The students' answers narrated how the course reduced their anxiety linked to these themes, on the one hand improving communication between peers by making it more authentic and empathic and, on the other, providing alternative perspectives on life. Indeed, the project offered an opportunity to discuss something strongly heartfelt but rarely faced, and the survey confirmed that the research objectives were fully achieved.
Background: This research is based on the perspective of dignity according to Chochinov; thus, the life imprisonment of detainees is assimilated to a severe disease. Methods: Ten male prisoners were interviewed trough Chochinov's Dignity... more
Background: This research is based on the perspective of dignity according to Chochinov; thus, the life imprisonment of detainees is assimilated to a severe disease. Methods: Ten male prisoners were interviewed trough Chochinov's Dignity Therapy, and the results were analysed using thematic analysis. Results: Two areas of thematic prevalence emerged, namely, value of freedom, self-consciousness and education and their failure in jail, and life sentence as annihilation of life meaning and of the values of generativity and family. Conclusions: Life imprisonment has been described in its negativity by several respondents as a punishment worse than the death penalty. It has been compared to death itself, to a terminal illness, to torture and to a pain that grows over the years, with the awareness that despite the passing of time, you will not have the opportunity to return to your loved one and to a free life. In fact, prisoners live out their condition within a space in which any value that gives meaning to life risks being destroyed.
The effects of boxing's extreme aggressive conditions in training and competitive activity in sportsmen's mental working capacity still remains under-explored. While the neurophysiological effects caused by micro traumas to the brain have... more
The effects of boxing's extreme aggressive conditions in training and competitive activity in sportsmen's mental working capacity still remains under-explored. While the neurophysiological effects caused by micro traumas to the brain have been extensively studied, less attention has been paid to the psychological consequences. This article reports on our study of the features of mental operations efficiency in Ukrainian boxers. The study involved athletes (n = 168, gender: men, average age: 25.5 ± 6.2 years), who were engaged in boxing and kickboxing in the Ukraine's eastern region. A 'Classification' method was used: a set of 70 cards with the images of various objects, plants, and living beings was given with instructions to arrange the items into groups in such a way that the objects in each concrete group possess common properties. Athletes were divided into groups, depending on the level of their sport qualification. Adopting the Vygotskian perspective, this study shows correlations between the productivity of boxers' thinking processes and the level of their sport skills: highly qualified sportsmen have many more well-marked thinking process defects than the sportsmen of the 2 nd and 3 rd categories. We observed a decrease in the generalization level, reduction in speed, deterioration of neurodynamic characteristics and criticality processes nearly in all participants. Exhaustibility and decrease in mental working capacity, impul-siveness of thinking, and its unproductive transformation were marked more often among the highly skilled boxers. A discussion on the cultural redefinition of this sport and on the necessary rehabilitative treatments is then presented.
This article presents the results of a qualitative study aiming to consider the relationship between ambiguous loss and anticipatory mourning amongst relatives of missing people in Italy. Eight people participated in the research,... more
This article presents the results of a qualitative study aiming to consider the relationship between ambiguous loss and anticipatory mourning amongst relatives of missing people in Italy. Eight people participated in the research, narrating their experiences of losing a beloved person (one found alive, three found dead, and four still missing). Findings suggest the presence of a particular form of ambiguous loss, characterised by traits typical of both prolonged and traumatic grief. These findings describe how families are faced with an emotional vortex related to a never-ending wait, and how the mourning is solved only when the missing person is found dead or alive. The discovery of a corpse is traumatic but it allows mourners to fully recognise their grief. When a person is found, it changes the relationship in a positive way. When neither of these events happen, mourners have two different kinds of reactions: they experience either a prolonged grief or a drive to solve their suffering by helping other people (post-traumatic growth). In this study, it is highlighted how a community can be useful or detrimental in this process, and the importance of psychological and social support to prevent significant clinical outcomes is stressed.
Background: Ostracism is a negative experience that has been studied primarily in laboratory settings. This study extends current research by investigating ostracism in daily life, analyzing the transition from social death to social... more
Background: Ostracism is a negative experience that has been studied primarily in laboratory settings. This study extends current research by investigating ostracism in daily life, analyzing the transition from social death to social resurrection of Catholic partners who suffered ostracism both in the couple (with the consequent divorce) and in the religious community they belong to (ban from religious practices). Therefore, we introduce the notion of 'cumulative ostracism'. Method: Data are composed of the biographical narratives of n = 25 participants in a religious experience group in a period of 7 months. A narrative analysis was used within the framework of the temporal need-threat model. Results: Participants' narratives are consistent with the temporal need-threat model. The ostracism experience, both in the couple and in the religious group, is characterized by the sequence: immediate stage, coping stage and resignation stage. Moreover, the cumulative ostracism suffered by the participants presents an analogy with the cumulative trauma that occurs in intra-family abuse. Social resurrection occurs through the encounter with a new religious group that allows ostracized people to experience a Catholic religious affiliation again. Conclusions: Our findings reflect the existing theory and add to the existing laboratory research by capturing ostracism-unique dynamics in real life.
Citation details: Brown,P., RELISH Consortium, Zhou,Y. Large expert-curated database for benchmarking document similarity detection in biomedical literature search. Abstract Document recommendation systems for locating relevant literature... more
Citation details: Brown,P., RELISH Consortium, Zhou,Y. Large expert-curated database for benchmarking document similarity detection in biomedical literature search. Abstract Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.
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People often develop strong emotional connections with their dogs and consider them to be members of the family. The purpose of this study was to develop a novel validated tool, the Mourning Dog Questionnaire, to recognise and evaluate... more
People often develop strong emotional connections with their dogs and consider them to be members of the family. The purpose of this study was to develop a novel validated tool, the Mourning Dog Questionnaire, to recognise and evaluate the mourning process in people who have lost a dog. scores of the five questionnaires correlated with each other. The results from the Mourning Dog Questionnaire support the negative view of life after the death of a pet and people's tendency to humanise their pet, since dog owners perceived animals no differently from humans in terms of emotions, needs and legal rights. Findings arising from the use of the Mourning Dog Questionnaire will help the implementation of rationality-based strategies to improve the wellbeing, resilience and quality of life of people in the world experiencing the loss of a pet.
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In Italy, there are still very few studies on the psychological impact of losing a pet. The need to fill this gap springs from the fact that pet loss counseling services are increasingly being activated. The aim of this study is the... more
In Italy, there are still very few studies on the psychological impact of losing a pet. The need to fill this gap springs from the fact that pet loss counseling services are increasingly being activated. The aim of this study is the Italian adaptation of instruments for veterinary counseling services. The survey instruments adapted were: Pet Bereavement Questionnaire (PBQ) to describe the individual experience of pet-grief; Regret of Bereaved Family Members (RBFM) to assess the family regret; Shared Decision-Making Questionnaire (SDM-Q-9) for decision making in end of life; Consultation and Relational Empathy Measure (CARE) to assess the veterinarian relational empathy during clinical encounters. All the instruments obtained good internal reliability, and the results of the confirmative factor analysis of all the Italian versions were in accordance with the original ones. The correlational analysis among the variables evidenced the following aspects: the more the owner feels involved by the veterinarian in the decision making process the more the veterinarian is perceived by the owner as empathetic; when the veterinarian is perceived as empathic and the decision making is shared the owners' pet bereavement distress and regrets are reduced; negative dimensions of bereavement (grief, guilt, anger, intrusive thoughts and decisional regrets) are strictly linked to each other, therefore if one dimension increases or decreases the others do too. The path analysis suggests that developing a veterinary relationship-centered care practice may be beneficial for pet owners facing end-of-life issues and the death of their companion animals since it showed that shared-decision making strategies and empathic communication may reduce negative dimensions of bereavement that may complicate grief. Interestingly, adopting shared decision-making strategies may contribute to be perceived as more empathic. These aspects may be taken into consideration in end-of-life communication training in veterinary medicine.
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This paper focuses on the motives for vegetarian choices in contemporary Italian food culture, with specific reference to the role of the representations of death. The study adopts a qualitative research design aimed at an in-depth... more
This paper focuses on the motives for vegetarian choices in contemporary Italian food culture, with specific reference to the role of the representations of death. The study adopts a qualitative research design aimed at an in-depth exploration of the reasons for avoiding meat, following an ethnographic method. Twenty-two participants (55% women, 45% men) aged 19-74, all vegetarians or vegans, mainly from Northern and Central Italy, were involved. Data from the Interpretative Phenomenological Analysis were examined according to the qualitative thematic analysis: the results show the role of death in the construction of disgust towards meat, running parallel with an emphasis on spirituality, ethical treatment of animals and the environment as reasons for avoiding meat, in particular, the concern-generating disgust and its relationship with the representation of death as a contaminating essence. The basis of disgust lies in this connection, from which the idea that oral consumption of contaminants characterized by corruptive properties, passing through the flesh of dead animals to humans, derives. The role of anti-speciesism is considered as a latent perspective, which may influence the vegetarian and vegan choices.
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Unclear communication of inauspicious prognoses may disorientate both patients and their relatives, drastically jeopardizing the planning of palliative care. This paper considers the issue of truth-telling in the communicative problems of... more
Unclear communication of inauspicious prognoses may disorientate both patients and their relatives, drastically jeopardizing the planning of palliative care. This paper considers the issue of truth-telling in the communicative problems of nurses and students of nursing with terminally ill patients. The fundamental objective is the analysis of the difficulties related to the lack of truth-telling and how it might impact their professional and personal lives. A qualitative study was realized, involving 47 participants, both nurses (25) and nursing students (22), working in palliative care units or in associations of volunteers for the assistance of oncological patients. The exploration was focused on the way they relate to patients who are not aware of their real health conditions and their consequences. Particular attention was paid to their opinions concerning what could be done in order to manage such problematic situations in the near future.
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The studies on the relationship between religiosity and the management of trust in postmodern society are an emerging field of research. The psychological contribute of the attachment theory shows how early relationships with the parental... more
The studies on the relationship between religiosity and the management of trust in postmodern society are an emerging field of research. The psychological contribute of the attachment theory shows how early relationships with the parental figures determine the adult attachment styles and the related dispositions to trust and religiosity. Lack of trust is a critical aspect of the insecure attachment styles: the avoidant and the anxious. This study in focused on these two traits, considering their level of trust compared to religiosity and representations of death. The Interpersonal Trust Survey, The World Health Organization Quality Of Life-Spirituality, Religiousness and Personal Beliefs, the Testoni Death Representations Scale and the Experiences in Close Relationships-Revised were utilized. The results illustrated different expressions of trust in avoidant and anxious styles.
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This qualitative research explores the relationship between religiosity, suicide thoughts and drug abuse among 55 homeless people, interviewed with interpretative phenomenological analysis. Analyzing the thematic structure of the... more
This qualitative research explores the relationship between religiosity, suicide thoughts and drug abuse among 55 homeless people, interviewed with interpretative phenomenological analysis. Analyzing the thematic structure of the participants' narrations, important main themes appeared in order to avoid suicide, among which family, the certainty of finding a solution and the will to live. However, the suicide ideation inheres in about 30% of participants, almost all believers, addicted and/or alcoholics. Results suggest that religiosity and meaning of death neither prevent from substances abuse and alcoholism, nor is a protective factor against suicide ideation. Meanings of life are the most important reasons for living, and when they are definitively considered unworkable, alcohol and drug help to endure life in the street. A specific model is discussed.
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In Italy, the problem of asbestos pollution is increasing in severity. In fact, in recent years, the number of people affected by asbestos-related illnesses has been growing because of the fibre's slowly evolving effects and its... more
In Italy, the problem of asbestos pollution is increasing in severity. In fact, in recent years, the number of people affected by asbestos-related illnesses has been growing because of the fibre's slowly evolving effects and its progressive pollution in the environment adjacent to the places where it is processed. Even though the physical consequences of asbestos are now quite clear, few studies have examined the psychological consequences of this kind of disaster. Since it is difficult to perceive its pathogenicity in daily life, this study was conducted in the affected areas of northeastern Italy, using the qualitative research in psychology with 51 persons who experienced asbestos-related illnesses (19 sick persons and 37 relatives of sick persons). Their narratives described being rooted in a space contaminated by an invisible enemy. In particular, attention was paid to the consequent sol-astalgia, a kind of mourning arising from loss of place attachment. Results of the qualitative analysis revealed how the different phases of the Elisabeth Kubler-Ross DABDA (Denial Anger Bargaining Depression Acceptance) model of coping with death constitute such feelings, whereas the dual-process model of Stroebe and Schut emphasised how these people seem to be loss oriented because of their perceived lack of community restoration. A discussion of the relationships between attribution of responsibility, entirely external and mostly inscribed in the DABDA categories of ‛anger' and ‛acceptance', is presented, with further considerations about mourning and the need to improve specific psychological support in this field of environmental disaster.
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PhotoTherapy represents a recent psychotherapeutic intervention which, through the medium of photography, has the objective of helping a patient reach a higher self-knowledge and explore thoughts, desires, and intimate perceptions that... more
PhotoTherapy represents a recent psychotherapeutic intervention which, through the medium of photography, has the objective of helping a patient reach a higher self-knowledge and explore thoughts, desires, and intimate perceptions that would otherwise remain hidden. Because of this, it may help people overcome their cognitive and emotional boundaries and bring out their interiority, even when exploring some of the most distressing themes. The objective of the present research was to demonstrate that the elaboration and expression of inner desires, fears and needs of wellbeing among adolescents and young adults, who were either sick or had been cured of cancer, could be facilitated through the use of PhotoTherapy. Their responses were also compared with those of healthy young adults, in order to be able to explore the kind of impact such a pathology can have on those who are affected by it and highlight eventual differences in the kind of desires and needs expressed instead by those who never had a diagnosis of cancer. A qualitative research design was adopted. 45 people took part in the study, aged between 12 and 25 (mean age 19). The participants were divided into three groups: those currently being treated for cancer, those with a history of cancer and those who had no experience of cancer (third group). From the data analysis, different preferences and attitudes toward the presented pictures and themes emerged among the participants, depending on the specific group they belonged to. The article discusses these preferences and considers how PhotoTherapy can help treat psychological distress caused by cancer.
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Introduction: Drug addiction and alcoholism characterize the existential condition of most homeless people, while the risk of suicide runs in parallel. Objectives: Following the Provisional Model (PM), this study aimed to explore the... more
Introduction: Drug addiction and alcoholism characterize the existential condition of most homeless people, while the risk of suicide runs in parallel. Objectives: Following the Provisional Model (PM), this study aimed to explore the relationships between addiction, suicidal ideation, and religiosity among 13 homeless people, and the roles of bonding ties (within the group) and bridging ties (intergroup). Method: The study is rooted in the field of qualitative psychology research. A survey was conducted, analyzing the personal accounts of participants and applying the PM psychological interpretation integrated with theory from literature on drug addiction, religiosity, and suicidal ideation in the field of homelessness. Results: Outcomes show that suicidal ideation appears in the first phase of homelessness and is opposed by alcoholism and drug addiction. Religiosity does not help to counteract suicidal ideation or to create bonding relationships. Conversely, drugs and alcohol seem to be more useful for preventing suicide, but also do not help in bonding relationships. Conclusion: Our survey only partially confirmed the PM, because the main result was the importance of relationships between suicidal ideation and alcohol/drug abuse during the initial phase of becoming homeless, while the importance of bonding ties deriving from addiction behavior did not emerge.
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This study describes the psychological effects of an experience of death education (DE) used to explore a case of suicide in an Italian high school. DE activities included philosophical and religious perspectives of the relationships... more
This study describes the psychological effects of an experience of death education (DE) used to explore a case of suicide in an Italian high school. DE activities included philosophical and religious perspectives of the relationships between death and the meaning of life, a visit to a local hospice, and psychodrama activities, which culminated in the production of short movies. The intervention involved 268 high school students (138 in the experimental group). Pre-test and post-test measures assessed ontological representations of death, death anxiety, alexithymia, and meaning in life. Results confirmed that, in the experimental group, death anxiety was significantly reduced as much as the representation of death as annihilation and alexithymia, while a sense of spirituality and the meaning of life were more enhanced, compared to the No DE group. These improvements in the positive meaning of life and the reduction of anxiety confirmed that it is possible to manage trauma and grief at school with death education interventions that include religious discussion, psychodrama and movie making activities.
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The censorship of death and dying has removed the “memento mori” practices, and in order to reintroduce this practice, some “Before I die” projects have been increasingly implemented. Running in parallel, in the syllabi of social service... more
The censorship of death and dying has removed the “memento mori” practices, and in order to reintroduce this practice, some “Before I die” projects have been increasingly implemented. Running in parallel, in the syllabi of social service and psychology students, some experiences of death education has commenced. This study illustrates the results of a qualitative research conducted on the “Before I die I want to …” Polaroid® Project (BIDIWT), which is divided into two phases. The first phase entails an analysis of the wishes collected from the United States, Japan, India, and Italy. The second phase refers to the analysis of the captions of the BIDIWT realized from two groups of undergraduates, with regard to the effect of such experience on their religiosity, representation of death, and fear of death.
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Transgender identity can be defined as the self-awareness of a discrepancy between the assigned sex at birth and the personal gender identity of an individual. This study assumed the constructionist perspective, focused on the influence... more
Transgender identity can be defined as the self-awareness of a discrepancy between the assigned sex at birth and the personal gender identity of an individual. This study assumed the constructionist perspective, focused on the influence of culture on sex-typing and the representations of gender in child development. This research considers how parents of transgender children emotionally handled the transition. Being faced with a child's transgender identity may cause an emotional experience similar to mourning, in particular, ambiguous loss (Coolhart, Ritenour & Grodzinski 2018, McGuire et al. 2016, Norwood 2013). In this qualitative research, 97 associations dealing with Gay, Lesbian, Bisexual and Transgender (GLBT) issues were contacted to recruit participants from three different countries: Italy, Spain and U.S.A. The sample includes 18 parents of trangender people who completed an ad hoc questionnaire. A brief standard story was constructed about an experience of sexual transition, followed by some questions on the experience of parental mourning during the transgender transition of their children. The corpora were analysed in the three original languages, and the analysis was performed with Atlas.ti. From the qualitative analysis of the texts that describe parents' experience, three fundamental elements emerged. The first is inherent to the mourning orientation to loss and the fear of death; the second to the disenfranchisement of mourning and transgender identity between family and society; and the third illustrates the final restorative outcome of mourning.
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The study focuses on a specific problem in the area of child sexual abuse (CSA), which is still under-researched: the relationship between incest and adult female re-victimization treatment within the ambit of domestic violence in Italian... more
The study focuses on a specific problem in the area of child sexual abuse (CSA), which is still under-researched: the relationship between incest and adult female re-victimization treatment within the ambit of domestic violence in Italian centers. About 112 anti-violence centers were contacted, but only 13 participated and only 16 psychologists were interviewed to reconstruct the biographies of 32 victims. The study aimed to examine if and how the service centers recognized and dealt with the problem of re-victimization among survivors based on psychologists' narrations. Findings showed that the description of perpetrators revealed not only sexual abuse was perpetrated, but also psychological and physical abuse. About half of mothers did not come to their daughters' aid and those who cooperated with the abusers had mostly suffered from CSA at a time in their life. Only three mothers did help their daughters in contacting the anti-violence centers. However, most of the service centers were not concerned with the relationship between incest and domestic re-victimization, while those who considered the problem, dealt with it only on the practitioner-patient level. In addition, despite the psychologists used professional and empathetic language, they disclosed their high emotional involvement and a genuine bewilderment. A discussion on the need to standardize the psychotherapeutic support given to these re-victimized women was presented, with a critique to the un-discriminated de-pathologization approach adopted by almost all anti-violence centers. In particular, we wanted to underline the fact that, although, this approach is useful in treating victims who were not abused during infancy, it could be insufficient for women who suffered from incest.
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The literature on burnout syndrome among Penitentiary Police Officers (PPOs) is still rather scarce, and there are no analyses on the protective factors that can prevent these workers from the dangerous effect of burnout, with respect to... more
The literature on burnout syndrome among Penitentiary Police Officers (PPOs) is still rather scarce, and there are no analyses on the protective factors that can prevent these workers from the dangerous effect of burnout, with respect to the weakening of the reasons for living and de-humanization. This study aimed to examine the relationships between burnout, protective factors against weakening of the reasons for living and not desiring to die and the role of de-humanisation, utilising the Maslach Burnout Inventory (MBI); the Reasons for Living Inventory (RFL); the Testoni Death Representation Scale (TDRS); and the Human Traits Attribution Scale (HTAS), involving 86 PPOs in a North Italy prison. Results showed the presence of a high level of burnout in the group of participants. In addition, dehumanization of prisoners, which is considered a factor that could help in managing other health professional stress situations, does not reduce the level of burnout.
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Context: In the last decade, a wide literature has highlighted the importance of religiosity as support of severe illnesses, especially the oncological ones, and in the end of life. In the field of the liver transplant, there is a lack of... more
Context: In the last decade, a wide literature has highlighted the importance of religiosity as support of severe illnesses, especially the oncological ones, and in the end of life. In the field of the liver transplant, there is a lack of similar research. This article aims to bridge this gap and presents an exploratory study on the relationships between fear of death, courage and religiosity among patients who wait for liver transplant.
Method: Sixty-two participants awaiting a liver transplant were interviewed with regard to their quality of life, religiosity, ontological representations and fear of death, courage and fear of intervention and donor-related thoughts. The following instruments were utilized: a specific interview; the Short Form Health Survey (SF-36); the Testoni Death Representation Scale (TDRS); and the Courage Measure. Results: Patients reporting higher levels of fear for intervention showed less courage and were more likely to avoid the surgery. They also tended to be non-believers, to have a lower quality of life and to represent death as an absolute annihilation. Conclusions: Less death was represented as a passage, the stronger the avoidance behaviour and the fear of transplant were. Since it is possible to develop a positive thought about death, the study underlined how spiritual support could be useful to manage fear of transplantation.
Method: Sixty-two participants awaiting a liver transplant were interviewed with regard to their quality of life, religiosity, ontological representations and fear of death, courage and fear of intervention and donor-related thoughts. The following instruments were utilized: a specific interview; the Short Form Health Survey (SF-36); the Testoni Death Representation Scale (TDRS); and the Courage Measure. Results: Patients reporting higher levels of fear for intervention showed less courage and were more likely to avoid the surgery. They also tended to be non-believers, to have a lower quality of life and to represent death as an absolute annihilation. Conclusions: Less death was represented as a passage, the stronger the avoidance behaviour and the fear of transplant were. Since it is possible to develop a positive thought about death, the study underlined how spiritual support could be useful to manage fear of transplantation.
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Research has widely demonstrated that religiosity is related to psychological well-being even in situations of severe illness. To assess religious beliefs, explicit measures have generally been used. In this study, we measured the belief... more
Research has widely demonstrated that religiosity is related to psychological well-being even in situations of severe illness. To assess religious beliefs, explicit measures have generally been used. In this study, we measured the belief that God is reality as opposed to myth or abstraction by using an implicit technique (the Single Category Implicit Association Test). The study was carried out in Italy, where a large majority of the population is Catholic, and the prevailing image of God is that of a compassionate and supportive father. Participants were cancer patients identifying themselves as believers. As expected, the automatic belief that God is reality (vs. abstraction) was related to beneficial outcomes: lower reported psychophysical anxiety symptoms and a weaker use of avoidance strategies to cope with stress. Thus, also, automatic religious beliefs may affect feelings and behaviors.
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This study investigates the psychological effects of participation in Death Education (DeEd) by middle school children in two towns in northeast Italy in which suicides occur to a greater extent than in the rest of the region. The aims of... more
This study investigates the psychological effects of participation in Death Education (DeEd) by middle school children in two towns in northeast Italy in which suicides occur to a greater extent than in the rest of the region. The aims of the project "Beyond the Wall" were inherent to the prevention of suicide, address existential issues and enhance the meaning of life through positive intentions for the future and reflection on mortality. It involved eight classes (150 students in four classes in the experimental group; 81 in four classes in the control group) engaging with films, workgroup activities, photovoice and psychodrama. The constructs of resilience, emotional competency and psychological well-being were monitored with the Resilience Scale for Adolescents, the Hopelessness Scale for Children, the Alexithymia Questionnaire for Children and the Stirling Children's Well-being Scale. The DeEd intervention was found to be significantly related to some of the variables investigated, improving the students' ability to recognise emotions and communicate them verbally while maintaining stable initial characteristics, such as psychological well-being and positive expectations for the future.
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Introduction: The passage from adolescence to young adulthood introduces many challenges and chances aimed at promoting independence, financial self-sufficiency, assumption of responsibilities and separation from parents. Literature shows... more
Introduction: The passage from adolescence to young adulthood introduces many challenges and chances aimed at promoting independence, financial self-sufficiency, assumption of responsibilities and separation from parents. Literature shows that in the continuum between these two phases of life, many factors intervene, producing significant differentiations.
Methods: This study considered three dimensions – well-being, measured through the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM); spontaneity, measured through the Spontaneity Assessment Inventory-Revised (SAI-R); and self-efficacy, measured through the General Self-Efficacy scale (GSE). The study involved two groups of Italian participants: 495 adolescents, aged between 13 and 19 years, selected at a high school; and 368 young adults, aged between 18 and 30 years, recruited by snowball sampling.
Results: Results of confirmatory factor analysis for each instrument in each group indicate the validity of the three instruments for both age groups. No significant differences were found between adolescents and young adults on total or subtotal scores of the CORE-OM, except for the risk factor. Conversely, the mean scores obtained with SAI-R and GSE were very different between adolescents and young adults.
Conclusions: The results of path analysis show a significant mediation of spontaneity in the link between self-efficacy and all specific psychological distress domains for adolescents. Instead, there is a significant mediation of spontaneity between selfefficacy and all specific psychological distress domains except the risk domain for young adults.
Methods: This study considered three dimensions – well-being, measured through the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM); spontaneity, measured through the Spontaneity Assessment Inventory-Revised (SAI-R); and self-efficacy, measured through the General Self-Efficacy scale (GSE). The study involved two groups of Italian participants: 495 adolescents, aged between 13 and 19 years, selected at a high school; and 368 young adults, aged between 18 and 30 years, recruited by snowball sampling.
Results: Results of confirmatory factor analysis for each instrument in each group indicate the validity of the three instruments for both age groups. No significant differences were found between adolescents and young adults on total or subtotal scores of the CORE-OM, except for the risk factor. Conversely, the mean scores obtained with SAI-R and GSE were very different between adolescents and young adults.
Conclusions: The results of path analysis show a significant mediation of spontaneity in the link between self-efficacy and all specific psychological distress domains for adolescents. Instead, there is a significant mediation of spontaneity between selfefficacy and all specific psychological distress domains except the risk domain for young adults.
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Background: This study considers the specific context of the end of life, in particular the agony phase, and the experience of sharing the body observation competence with the relatives of dying patients, in order to consider the effect... more
Background: This study considers the specific context of the end of life, in particular the agony phase, and the experience of sharing the body observation competence with the relatives of dying patients, in order to consider the effect of such psychological intervention.
Methods: The research was conducted in two phases: during the pre-exitus period (days or hours before the death of the patient) six relatives received some information .on the phenomenology of agony; during the post-exitus, they participated in semi-structured interviews, which were audio-recorded and transcribed with the purpose of extracting relevant aspects of their experience with their terminally-ill relative. The interpretative Phenomenological Analysis (IPA) was used to cluster the emerged experiences by thematic analysis, which was performed using the Atlas.ti 7 software.
Results: The relatives’ verbatim representation is clustered in three areas of thematic prevalence: context and choice of the hospice, phenomenology of agony and psychological support. The first area shows how essential the choice of the hospice was for the patient. Even if the hospice is perceived as a place of death, it allows to manage the pain and simultaneously relieves the caregiver’s burden. The second area describes the process of perception of body changes during agony. Finally, the third area outlines how giving elements to recognise the progression of the dying body and suggestions on the functional behaviour around the agonising patient may fill the cultural lack of practical experience regarding dying.
Conclusions: The results require further investigation, starting from the positive feedback on the efficacy of a specific support model called “human protocol”.
Methods: The research was conducted in two phases: during the pre-exitus period (days or hours before the death of the patient) six relatives received some information .on the phenomenology of agony; during the post-exitus, they participated in semi-structured interviews, which were audio-recorded and transcribed with the purpose of extracting relevant aspects of their experience with their terminally-ill relative. The interpretative Phenomenological Analysis (IPA) was used to cluster the emerged experiences by thematic analysis, which was performed using the Atlas.ti 7 software.
Results: The relatives’ verbatim representation is clustered in three areas of thematic prevalence: context and choice of the hospice, phenomenology of agony and psychological support. The first area shows how essential the choice of the hospice was for the patient. Even if the hospice is perceived as a place of death, it allows to manage the pain and simultaneously relieves the caregiver’s burden. The second area describes the process of perception of body changes during agony. Finally, the third area outlines how giving elements to recognise the progression of the dying body and suggestions on the functional behaviour around the agonising patient may fill the cultural lack of practical experience regarding dying.
Conclusions: The results require further investigation, starting from the positive feedback on the efficacy of a specific support model called “human protocol”.
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Spiritual approaches in healthcare settings proved effective in reducing the negative outcomes of dehumanization processes impacting health professionals and patients. Although previous literature focused on explicit measures of... more
Spiritual approaches in healthcare settings proved effective in reducing the negative outcomes of dehumanization processes impacting health professionals and patients. Although previous literature focused on explicit measures of spirituality, the present research explored the role of implicit components of spirituality and their effects on the humanization of patients in two healthcare contexts. Professionals from hospices and nursing homes completed an implicit task to assess whether the diverse representation of death as physical or spiritual led to perceive patients with more uniquely human traits. Results showed that only for hospice participants, implicit and explicit spirituality predicts more humanness attribution to patients. This article discusses palliative care models and death education as a resource for reducing dehumanization.
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This paper discusses how psychodrama methods and techniques can empower abused women and stimulate changes in their victim role. Through an in-depth exploration, we sought to gain an insider's perspective of the experiences of change and... more
This paper discusses how psychodrama methods and techniques can empower abused women and stimulate changes in their victim role. Through an in-depth exploration, we sought to gain an insider's perspective of the experiences of change and perceived outcomes for abused women, which could contribute to optimizing gender violence intervention. Theoretically, the study is grounded in the female co-responsibility and trans-generational transmission of women's victim role from mother to daughter. A mixed methods experimental design employing an explanatory sequential approach to data collection was implemented. A total sample of 33 abused women (15 in the experimental group, and 18 in the control group) was involved in studying the impact of a psychodrama intervention combined with an ecological intervention. Spontaneity and wellbeing, considered in this study as dimensions of empowerment, were measured. Phenomenological interviews were conducted with 7 women 3 months after the psychodrama intervention ended, and with 6 women 5 years later. Data was analyzed using the Interpretative Phenomenological Analysis method. The matrix of themes that emerged reflects four overarching themes: the victim, the group experience, the process of change, and the corollary of change. Benefits perceived by the women include trust, hope, increased self-esteem, empowering, and courage to make decisions and changes. Findings describe three paths of change for women who participated in an empowering-oriented psychodrama intervention program: the Proactive-Resilient type, the Active-Resistant type, and the Repetitive-Non-Resilient type. Role-reconstruction and the interruption of trans-generational victim pattern were clear for the proactive type and possible for the active type, while the repetitive type showed minor changes but remained stuck in the victim pattern. As no claims to generalizability can be made, further research is needed to verify the proposed typology on larger samples. Psychodrama, as an action method, can empower abused women and has the potential to stimulate action in women's lives and initiate adaptive coping strategies leading to resilience. The study ends with several suggestions for assisted resilience specialists.
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Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety... more
Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.
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Riassunto. Il problema del suicidio nell'anziano assume dimensioni ragguardevoli e si inscrive ormai nelle politiche dell'OMS inerenti alla promozione della salute, nell'ambito della prevenzione. Centrando l'indagine sulla... more
Riassunto. Il problema del suicidio nell'anziano assume dimensioni ragguardevoli e si inscrive ormai nelle politiche dell'OMS inerenti alla promozione della salute, nell'ambito della prevenzione. Centrando l'indagine sulla variabile psicosociale relativa al contesto di ...
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According to the Terror Management Theory (TMT; Greenberg, Pyszczynski, & Solomon, 1986), the psychological conflict resulting from humans' having a desire to live, but realizing that death is inevitable , gives rise to potentially... more
According to the Terror Management Theory (TMT; Greenberg, Pyszczynski, & Solomon, 1986), the psychological conflict resulting from humans' having a desire to live, but realizing that death is inevitable , gives rise to potentially debilitating existential terror that is managed by embracing cultural belief systems and adhering to the standards of value associated with them. The present article considers one psychosocial effect of this dissonance: the contemporary discord between Western and Middle-Eastern cultures. The role of religion and secularism in contemporary intercultural hostilities, which characterizes the contemporary global crisis, is investigated, starting from a consideration of the role of ontological representations of death in the construction of cultural worldviews that provide a sense of meaning and value and afford opportunities to obtain literal and symbolic immortality.
Introduction: Nutrition primarily affects human health and lifespan. The current developments in the nutritional/dietetics sciences and technology are part of an extensive strategy aimed at promoting the wellbeing and at ensuring a longer... more
Introduction: Nutrition primarily affects human health and lifespan. The current developments in the nutritional/dietetics sciences and technology are part of an extensive strategy aimed at promoting the wellbeing and at ensuring a longer lifespan. Materials and Methods: This article discusses a specific issue that may be included in this category, examined for its possible negative consequences. In fact, we highlight the results of a qualitative pilot study aimed at considering the irrational management of the relationship between the extension of human life and the lack of economic resources. Results: The issue is discussed through an analysis of the information posted on the Internet following the warning by the International Monetary Fund in April 2012. The article analyzes some of the characteristics of the texts published after the International Monetary Fund alarm and reports on the textual qualitative outcome of this observation. Conclusions: Our study lasted 6 months, and included the analysis of English, Italian, and Portuguese language sites. We discuss some of the psychological characteristics of the texts, and we reflect on the irrational traits of our current culture that censors any representation of death.
This study analyzes the "sick-lit" narrative phenomenon, a story writing genre rooted in self-harm and suicide, which seems to be gaining remarkable popularity amongst adolescents. This success is a symptom of young people's need to... more
This study analyzes the "sick-lit" narrative phenomenon, a story writing genre rooted in self-harm and suicide, which seems to be gaining remarkable popularity amongst adolescents. This success is a symptom of young people's need to address the issue of death. The qualitative research was composed of two parts: the first explored the ambivalent representation of sick-lit on the internet, where two opposing factions argue about its educative usefulness vs. its potentially dangerous copycat effect. The second part investigated six novels and their representations of self-harm, death, sufferance and suicide. The analysis confuted the idea that sick-lit may be a positive instrument for making adolescents aware of mortality and showed the need to transform the Werther risk effect into the Papageno possibility by exploring the content of these books with adolescents in death education courses.
Ogni modifica o aggiunta va evidenziata e circondata da due &&, così: &&modifica&&, altrimenti verrà ignorata Angoscia di morte, scotomizzazione e congiura del silenzio Lo scrittore Henry James (1909), fratello dello psicologo William, in... more
Ogni modifica o aggiunta va evidenziata e circondata da due &&, così: &&modifica&&, altrimenti verrà ignorata Angoscia di morte, scotomizzazione e congiura del silenzio Lo scrittore Henry James (1909), fratello dello psicologo William, in Le ali della colomba usa l'espressione "congiura del silenzio" (conspiracy of silence) per indicare la modalità con cui viene scotomizzata nella vita quotidiana "la grande macchia della mortalità" (the great smudge of mortality). Questa espressione è stata successivamente adottata in riferimento a dinamiche rela-zionali volte a negare l'evidenza. Si tratta di una vera e propria rimozione, an-zi, potremmo parlare in modo più forte-volendo utilizzare il linguaggio la-caniano-di "forclusione" della malattia, della morte e del lutto. Il termine la-caniano riprende il concetto di Verwerfung ("rigetto", "preclusione"), consi-derato da Freud (1894) già in Neuropsicosi da difesa a proposito dell'esclu-sione dall'Io di una rappresentazione insopportabile e insieme affettivamente rilevante. La forclusione della mortalità si manifesta appunto attraverso la congiura del silenzio, entro cui s'incardinano i processi "psicotici" di rifiuto della realtà che caratterizzano tutt'oggi la comunicazione in ambito sanitario e anche familiare (Testoni, Lazzarotto Simioni & Di Lucia Sposito, 2013). La ricca Milly Theale, colei che nel capolavoro di James introduce questo tipo di congiura, è gravemente malata e il destino deciso per lei dallo scrittore è la morte. Oggi forse la stessa storia sarebbe stata diversa perché molte pato-logie gravi, grazie alle biotecnologie, possono essere con probabilità crescente guarite o cronicizzate. I loro livelli di mortalità stanno riducendosi sempre di * Direzione del Master in "Death studies & the end of life", Dipartimento di Filosofia, So-ciologia, Pedagogia e Psicologia Applicata (FISPPA), Università di Padova, Piazza Capitania-to 3, 35139 Padova, E-Mail <ines.testoni@unipd.it>. Ringrazio gli otto referees anonimi che hanno contribuito a migliorare alcune parti del testo.
Riassunto. Nel mondo occidentale agli animali domestici viene riconosciuto un ruolo sempre più significativo in quanto è accertato che essi guadagnano nella vita delle persone un posto affettivo importante. Nonostante ciò, la società... more
Riassunto. Nel mondo occidentale agli animali domestici viene riconosciuto un ruolo sempre più significativo in quanto è accertato che essi guadagnano nella vita delle persone un posto affettivo importante. Nonostante ciò, la società contemporanea è ancora incapace di riconoscere la sofferenza che deriva dalla morte di questi compagni. L'articolo illustra il fenomeno, descri-vendo i più importanti studi sul pet-loss, e prende in considerazione alcune ipotesi inerenti alle forme di rappresentazione ontologica della morte che possono intervenire per spiegare questo tipo di delegittimazione. [Parole chiave: Relazione uomo-animale; Lutto per la perdita di un animale da compagnia; Rappresentazione ontologiche della morte; Stereotipi; Antispecismo] Introduzione Il rapporto uomo-animale sta guadagnando un sempre maggiore interesse, a tal punto da diventare un tema trattato da un numero crescente di riviste scientifiche e divulgative. Poiché si tratta di un argomento che appartiene all'intera storia dell'umanità, necessariamente, oggi, ogni riflessione su di es-so non può che risultare complessa e nello stesso tempo parziale. Di fatto la moltiplicazione degli studi in proposito è dettata dall'esigenza di ridefinire gli assunti di base che statuiscono la natura di questa relazione, in quanto lo svi-luppo tecnologico e scientifico si sostituisce quasi totalmente all'uso strumen-tale degli animali nel rispondere ai bisogni dell'uomo. Se è vero che dal punto di vista macro-sistemico gli allevamenti intensivi e gli stermini di molte spe-cie, dovuti ai processi produttivi industriali e all'urbanizzazione, stanno cau-sando danni irrimediabili all'ecosistema terrestre, a livello micro-sistemico il rapporto con alcuni tipi di animali sta progressivamente evolvendo, e tale tra-sformazione sta producendo su larga scale effetti psicologici importanti nella Cite this article: Testoni, I., & De Cataldo, L. (2017). Un lutto speciale. Delegittimazioni culturali e rappresentazioni della morte nella perdita di un animale domestico [A special kind of grief. Cultural delegitimizations and representations of death in the case pet loss]. Psicoterapia e scienze umane, 51(3), 413-428.
Studies that have examined pet loss hypothesize that attachment , representations of death, and the belief in an afterlife for animals may influence owners' bereavement and depressive outcomes. The following instruments were administered... more
Studies that have examined pet loss hypothesize that attachment , representations of death, and the belief in an afterlife for animals may influence owners' bereavement and depressive outcomes. The following instruments were administered to 159 Italian participants recruited through snowball sampling: the Lexington Attachment to Pets Scale (LAPS), the Pet Bereavement Questionnaire (PBQ), the Testoni Death Representation Scale (TDRS), and Beck's Depression Inventory II (BDI-II). Questions concerning pet euthanasia-related issues and the relationship between owners and veterinarians were also submitted to the participants. A path model was conducted, showing that the representation of death and the attachment to a pet had a direct effect on pet grief, which in turn had a direct effect on depression. The results show a positive correlation between the LAPS and PBQ factors, particularly with the PBQ factor Grief. The LAPS factors positively correlated with the TDRS representation of Death as a Passage and negatively correlated with the TDRS representation of Death as Annihilation. The LAPS People Substituting factor positively correlated with the total score and the Cognitive-Affective factor of the BDI-II. The PBQ factors positively correlated with the BDI-II, whereas only the TDRS Death as Annihilation factor positively correlated with the BDI-II. Belief in a transcendent dimension was associated with higher scores on the PBQ Guilt factor and the TDRS factors of Death as a Passage and Death as Change, whereas these beliefs were associated with lower scores on the TDRS factor Death as Annihilation. The results indicated that the sensitivity of the veterinarian and a veterinarian who helps owners make conscious and informed decisions for their pet and choose the right time to perform euthanasia are important variables in the management of pet loss. However, these factors are not sufficient and psychological support should be improved to help owners better cope with grief.
The huge problems related to chronic, ultimately fatal diseases involve disability, pain, suffering and the perception of one's doom; this calls for reappraising the conventional concepts of health and disease, life and death,... more
The huge problems related to chronic, ultimately fatal diseases involve disability, pain, suffering and the perception of one's doom; this calls for reappraising the conventional concepts of health and disease, life and death, encompassing spirituality and the mystery of death beyond any limited perspective. The management of suffering and pain to enhance resilience plays a central role in palliative care (PC) and is the core of the patient-centered approach, focused on the "to care" instead of the "to cure" of the illness-centered medicine. In this article, the perspectives supporting these instances are analyzed, focusing on hypnosis, to be considered as a powerful technique able to improve patient's control over mind and body (including relaxation, fairness, analgesia, improved stability of physical parameters and wellbeing).
Objective: This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression. Method: The... more
Objective: This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression. Method: The first phase involved 219 healthy participants, while the second encompassed 30 cancer patients. Each participant completed the Personal Meaning Profile (PMP), the Testoni Death Representation Scale (TDRS), the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). The primary analyses comprised (1) correlation analyses between the overall scores of each of the instruments and (2) path analysis to assess the indirect effect of the PMP on DT score through anxiety and depression as determined by the HADS. Results: The path analysis showed that the PMP was inversely correlated with depression and anxiety, which, in turn, mediated the effect on distress. Inverse correlations were found between several dimensions of the PMP, the DT, and the HADS-Anxiety and HADS-Depression subscales, in both healthy participants and cancer patients. Religious orientation (faith in God) was related to a stronger sense of meaning in life and the ontological representation of death as a passage, rather than annihilation. Significance of Results: Our findings support the hypothesis that participants who represent death as a passage and have a strong perception of the meaning of life tend to report lower levels of distress, anxiety, and depression. We recommend that perceived meaning of life and representation of death be more specifically examined in the cancer and palliative care settings.
Loss and its associated grief are important elements of many adverse life events. The focus of this study is centred on a particular form of mourning: the affliction derived from the social identity loss caused by the disaffiliation with... more
Loss and its associated grief are important elements of many adverse life events. The focus of this study is centred on a particular form of mourning: the affliction derived from the social identity loss caused by the disaffiliation with a religious sect. In postmodern society, this phenomenon needs to be better evaluated because it may be causing severe distress in an increasing number of people. The literature describes the stress caused by switching from one religious group to another, but less analysis has been done on the potential deleterious effects of the loss of social identity because of the breaking down of relationships with people within the original group. Following the grounded theory approach, 14 former Jehovah's Witnesses were interviewed with interpretative phenomenological analysis. Three main profiles emerged-born into the faith, converts to the faith, and inactive members-with different difficulties deriving from the loss of social identity and the relational network. The inquiry was focused on the effects of the identification versus individuation processes and also addressed the role of death anxiety. Results confirmed on the one hand a high level of distress that often caused death anxiety, alcoholism, panic attacks, and depression, as described in the literature. On the other hand, the importance of the individuation process emerged, following theologian Paul Tillich's concept of "courage of self-affirmation" and Bernard Lonergan's "self-appropriation ," whose development occurs in three phases: de-identification and loss, grieving and crisis, and the work of grief and complete self-affirmation or self-appropriation. The usefulness of communicating these specific themes to a broad audience by enhancing community education through widespread spiritual counseling is also addressed.
Death is the most threatening experience to human life because it is inevitable and causes irreversible loss. The article describes the results of a qualitative study undertaken with 25 Italian psychodramatists. Respecting the... more
Death is the most threatening experience to human life because it is inevitable and causes irreversible loss. The article describes the results of a qualitative study undertaken with 25 Italian psychodramatists. Respecting the Consolidated Criteria for Reporting Qualitive Research (COREQ) checklist, the research was aimed at bringing out their strategies and techniques used to manage loss and grief when real or symbolic death appeared in patients' narratives. The results showed that participants overwhelmingly believed that psychodrama offers excellent instruments to treat both forms of grief, despite few differences between the forms having been recognized. The participants considered the main strategies to be the therapeutic action of the group and the surplus-reality to put on a scene of death and the dead, while the main techniques are the role reversal involving the representation of the lost person or situation with the auxiliary ego, the empty chair, the double, and the genodrama. Finally, a striking factor from the qualitative analysis was that it diagnosed a lack of competence related to an explanation of real grief and its complex constellation. Suggestions useful for the improvement of psychodrama in the treatment of all types of loss are presented. Particular attention is paid to the continuing bonds. Death is considered to be the most threatening experience to human life. Terror Management Theory shows how any individual is constantly threatened by fear of death and by the traumas that dying produces (Solomon, Testoni, & Bianco, 2017; Testoni, 2016). It is true especially when it causes irreversible loss, because of the disruption of the bonds with beloved persons. The experience of loss results in anguish and grief for the reasons that it reactivates the early experiences of separation by the attachment figures. As John Bowlby (1980) indicated, attachment is a deep and enduring CONTACT Ines Testoni
Spirituality and religiosity are important aspects of an individual's psychology, but little is known about this dimension in people suffering from Asperger syndrome, and research on its relationship with work experience is rare. The main... more
Spirituality and religiosity are important aspects of an individual's psychology, but little is known about this dimension in people suffering from Asperger syndrome, and research on its relationship with work experience is rare. The main objective of this qualitative study is to report how 12 people suffering from Asperger syndrome perceived their current or past jobs, focusing on the role of spirituality and religiosity, fear of death, and relationships with colleagues. Although a larger percentage of participants are of the opinion that death means absolute annihilation, only a few have faith in a transcendental dimension. However, the highest number of questions was recorded for concerns derived from relational difficulties with colleagues, while concerns regarding spirituality and religiosity were substantially negligible.
End of life and palliative care are viewed in chaplaincy as an important time when spiritual support is considered highly beneficial. Dignity therapy is an important care strategy in this field. This article lends support to the Chochinov... more
End of life and palliative care are viewed in chaplaincy as an important time when spiritual support is considered highly beneficial. Dignity therapy is an important care strategy in this field. This article lends support to the Chochinov protocol using Schwartz's matrix of values. Five dignity therapy Bgenerativity documents^prepared for terminally ill patients using interpretative phenomenological analysis were analyzed using qualitative thematic analysis. The results showed the role of values in the construction of wisdom and confirmed the importance of family relationships. The value of sacrifice, which is supported by various religious traditions, emerged as a perceived factor, indicating personal wisdom. The most significant result is the discovery of sacrifice as a positive value. Since hedonism, another of the values of Schwartz's matrix, is quite common in contemporary culture, it is important that those applying dignity therapy pay sufficient attention to the value of sacrifice, understanding that it could be recognized as a characteristic component of wisdom by those who are terminally ill. The implications, not only for end of life counseling but also for other fields and disciplines focusing on spiritual care, in particular for pastoral psychology, are significant.
This paper presents the results of a six-month psychodrama intervention for the prison-based treatment of people with substance dependence, held in an attenuated custody institution in Northern Italy (Istituto a Custodia Attenuata per il... more
This paper presents the results of a six-month psychodrama intervention for the prison-based treatment of people with substance dependence, held in an attenuated custody institution in Northern Italy (Istituto a Custodia Attenuata per il Trattamento delle Tossicodipendenze-ICATT). Seven patients participated in the psychodrama intervention (21 weekly sessions) and were monitored through an idiographic change process using a mixed methods design. The longitudinal quantitative assessment employed the Clinical Outcomes in Routine Evaluation − Outcome Measure (CORE-OM), the Revised Spontaneity Assessment Inventory (SAI-R), the General Self-Efficacy Scale (GSE), and the Toronto Alexithymia Scale (TAS-20). The qualitative assessment was based on the Client Change Interview Schedule (CCS) and the Helpful Aspects of Therapy Form (HAT). The quantitative and qualitative results supported the effectiveness of psychodrama as a treatment method for this group of patients, showing a decrease in psychological distress; a related decrease in depressive, anxious, physical, and/or traumatic symptoms; and a relative increase in the patients' general emotional and social functioning.
c Prison of Padua "Due Palazzi" Padua (PD), Italy ARTICLE INFO Keywords femicide intimate fatal violence masculinity arts-based therapy photo-based therapy psychodrama prison ABSTRACT Gender-based violence is deeply rooted in hegemonic... more
c Prison of Padua "Due Palazzi" Padua (PD), Italy ARTICLE INFO Keywords femicide intimate fatal violence masculinity arts-based therapy photo-based therapy psychodrama prison ABSTRACT Gender-based violence is deeply rooted in hegemonic masculinity and patriarchy, the source of both hostile and benevolent sexism. This study is an assessment of a gender-sensitive intervention realized through photo-based therapy and psychodrama, conducted in 9 sessions with 9 male prisoners detained in northeastern Italy who are convicted of assaulting or murdering women. The research adopted a qualitative method design in analysing the interview texts, carried out with the Client Change Interview and the Helpful Aspects of Therapy, and the transcribed reports from all 9 sessions. The findings revealed that the intervention transformed the participants' hostility into benevolent sexism and that they had replaced their concepts of machismo and honor with a new representation of the ideal man as a "maternal father." This shift was a result of a consciousness-raising process that recognizes the value of emotions and the need for empathic relationships.