Il termine distress indica un’esperienza spiacevole, di natura psicologica, sociale, spirituale c... more Il termine distress indica un’esperienza spiacevole, di natura psicologica, sociale, spirituale che riduce il coping efficace verso il cancro, i suoi sintomi fisici e il suo trattamento. Il distress di malattia sul paziente si riflette anche sul distress esperito dai caregiver. Essi vanno incontro a molteplici difficoltà che configurano la cosiddetta “Caregiver Stress Syndrome”: condizione debilitante che caratterizza persone che si prendono cura di pazienti con patologie croniche. Questo studio si propone di confrontare il distress emotivo del paziente oncologico e del caregiver elettivo. I pazienti (N=100) e i loro caregiver elettivi (N=100) afferivano alla V divisione di Medicina Interna della A.O.U. Vanvitelli. I criteri di inclusione erano: età:38-82 anni; diagnosi oncologica: 6 mesi-3 anni precedenti al reclutamento; sopravvivenza stimata: 6 mesi-1 anno; punteggio alla KPS: 50-60. I pazienti e i caregiver erano intervistati separatamente. Lo strumento utilizzato è stato il “Termometro del Distress”. Lo studio non ha evidenziato differenze significative (T= 1.468; p= 0.143) tra il distress dei pazienti (M=6.66, DS= 2.35) e dei caregiver (M=5.90, DS= 2.77), accoppiati uno a uno, i cui livelli sono risultati di grado medio. La rilevazione di pari livelli di distress nei pazienti e nei caregiver conferma l’ipotesi di letteratura che il paziente e i familiari rispondono al cancro come unico sistema emozionale. Gli interventi conseguenti sono mirati alla facilitazione dell’espressività emotiva e alla condivisione dei sentimenti di frustrazione, rabbia e dolore depressivo scatenati dalla malattia, nonché alla ristrutturazione cognitiva di tale esperienza.
Journal of biological regulators and homeostatic agents, 2018
To compare the results of psychometric tests in patients with BMS and controls, participants were... more To compare the results of psychometric tests in patients with BMS and controls, participants were tested for depression, anxiety, fatigue and distress. Patients with BMS had noticeably higher scores for depression, fatigue and distress, compared to controls. Depression and distress were significantly correlated with the burning symptom. Moreover, distress and burning symptoms proved to be interdependent. Depression seems to play a specific role in BMS. Burning symptoms affect quality of life of patients and they could be a predictor of distress.
Since 1997, the Bio-Psycho-Social Model, proposed by George Engel, attracted the interest of clin... more Since 1997, the Bio-Psycho-Social Model, proposed by George Engel, attracted the interest of clinical researchers as well epistemologists and was recognized as a turning point in the culture and praxis of medical diagnosis and treatments. According to Engel, biological, psychological as well as social events are mutually interconnected and reciprocally influenced; a paradigmatic shift in the approach to the mind-body problem. Lately, this model has received persuasive criticism that has caused a fading of its scientific reliability. This concise review focuses the core feature of Engel’s position as well as the scientific controversy that followed during these forty years.
The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members ... more The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members face the traumatic experience of living together all the time. This evidence evokes the hidden family’s frailty and operates as a litmus test of family life. The paper discusses some relational scenarios about this transient deprivation of the social context. Their cumulative effects are considered guiding the family to cope with the quarantine and it is argued that some changes of the family's daily life patterns, caused by the pandemic, will remain unchanged in the future.
Some considerations on the debate about cultural sensitivity in the practice of family system the... more Some considerations on the debate about cultural sensitivity in the practice of family system therapy are reported. Firstly, the different meanings of the concept are summarized. Then, the author formulates the hypothesis that most part of the related literature addresses this topic as the need of a cultural adaptation of the therapeutic processes to the ethnic minorities through a remodulation of the training programs, thus risking of disown the systemic nature of cultures. The Bateson contributions about culture is recalled supporting the idea that every single therapy with the family is always an “otherness” experience by which all the members of the therapeutic system are charged of a mutual legitimacy effort.
Dealing with female breast cancer (BC) strongly modulates the patient’s self-concept, hence affec... more Dealing with female breast cancer (BC) strongly modulates the patient’s self-concept, hence affecting her interpersonal network, notably with the partner. In this review, we assume that the patient-partner couple reacts as a unique dyadic system when facing the experience of BC, thus influencing the disease’s adjustment and coping processes. From this point of view, BC adjustment and coping studies focused on the patient-partner couple are relevant to better understand the psychosocial dimension of this disease and plan useful dyadic support programs. The paper reviews the studies on a dyadic approach to the adjustment as well as the coping consequences of BC. The dyadic features of adjustment and coping processes over the course of illness are highlighted. The association with some specific relationship patterns as well as with the communication styles is investigated to emphasize the crucial role of conjoint psychological dynamics that define the BC dyad struggle with the illness....
Bioetica pratica e cause di esclusione sociale, 2012
1. Il processo di de-istituzionalizzazione, iniziato nei Paesi dell’Europa Occidentale negli anni... more 1. Il processo di de-istituzionalizzazione, iniziato nei Paesi dell’Europa Occidentale negli anni cinquanta, ha portato, tra gli anni ‘60 e ’90, a radicali cambiamenti nelle politiche psichiatriche e nella pratica clinica con il tramite della psichiatria di comunità. Nonostante la chiusura delle strutture manicomiali, la drastica riduzione dei posti letto nelle istituzione psichiatriche e la collocazione dei servizi psichiatrici all’interno della comunità, marginalizzazione, esclusione social..
Cognitive involvement in beta-thalassaemia is strikingly controversial and poorly studied in adul... more Cognitive involvement in beta-thalassaemia is strikingly controversial and poorly studied in adulthood. This multicentre prospective study investigated 74 adult neurologically-asymptomatic beta-thalassaemia patients (mean-age 34Á5 AE 10Á3 years; 53 transfusion-dependent [TDT], 21 nontransfusion dependent [NTDT]) and 45 healthy volunteers (mean-age 33Á9 AE 10Á7 years). Participants underwent testing with Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV), Brief Psychiatric Rating Scale (BPRS) and multiparametric brain 3T-magnetic resonance imaging (MRI) for parenchymal, vascular and iron content evaluation. Patients had lower Full-Scale Intelligence Quotient (FSIQ) than controls (75Á5 AE 17Á9 vs. 97Á4 AE 18Á1, P < 0Á0001) even after correction for education level. Compared to TDT, NTDT showed a trend of higher FSIQ (P = 0Á08) but a similar cognitive profile at WAIS-subtests. FSIQ correlated with total and indirect bilirubin (P < 0Á0001 and P = 0Á002, respectively); no correlation was found with splenectomy, intracranial MRI/magnetic resonance-angiography findings, brain tissue iron content or other disease-related clinical/ laboratory/treatment data. FSIQ did not correlate with BPRS scores, although the latter were higher among patients (28Á74 AE 3Á1 vs. 27Á29 AE 4Á8, P = 0Á01) mainly because of increased depression and anxiety levels. Occupation rate was higher among controls (84Á4% vs. 64Á9%, P = 0Á004) and correlated with higher FSIQ (P = 0Á001) and education level (P = 0Á001). In conclusion, Italian adult beta-thalassaemia patients seem to present a characteristic cognitive profile impairment and an increased rate of psychological disorders with possible profound long-term socioeconomic consequences.
Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence a... more Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence affecting her interpersonal network, notably with the partner. In this review, we assume that the patient-partner couple reacts as a unique dyadic system when facing the experience of BC, thus influencing the disease's adjustment and coping processes. From this point of view, BC adjustment and coping studies focused on the patient-partner couple are relevant to better understand the psychosocial dimension of this disease and plan useful dyadic support programs. The paper reviews the studies on a dyadic approach to the adjustment as well as the coping consequences of BC. The dyadic features of adjustment and coping processes over the course of illness are highlighted. The association with some specific relationship patterns as well as with the communication styles is investigated to emphasize the crucial role of conjoint psychological dynamics that define the BC dyad struggle with the ...
Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence affec... more Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence affecting her interpersonal network, notably with the partner. In this review, we assume that the patient-partner couple reacts as a unique dyadic system when facing the experience of BC, thus influencing the disease's adjustment and coping processes. From this point of view, BC adjustment and coping studies focused on the patient-partner couple are relevant to better understand the psychosocial dimension of this disease and plan useful dyadic support programs. The paper reviews the studies on a dyadic approach to the adjustment as well as the coping consequences of BC. The dyadic features of adjustment and coping processes over the course of illness are highlighted. The association with some specific relationship patterns as well as with the communication styles is investigated to emphasize the crucial role of conjoint psychological dynamics that define the BC dyad struggle with the illness. Finally, the literature findings on these topics are discussed together with the couple post-traumatic growth phenomena. RIASSUNTO Fare esperienza del cancro al seno femminile (BC) modula fortemente l'idea di sé della paziente, influenzando la sua rete interpersonale, in particolare con il partner. Il presupposto di questa rassegna di concetti, è che la coppia paziente-partner risponde come un sistema diadico unico di fronte all'esperienza del BC, influenzando così i processi di adattamento e coping alla malattia. In questo quadro di riferimento, gli studi di adattamento e coping al BC focalizzati sulla coppia paziente-partner sono rilevanti per comprendere meglio la dimensione psicosociale di questa malattia. Il testo passa in rassegna gli studi riguardanti un approccio diadico ai processi di adattamento e coping nel BC. La revisione di letteratura evidenzia le caratteristiche diadiche dei processi di adattamento e di coping nel corso della malattia. L'associazione con alcuni modelli specifici di relazione e con gli stili di comunicazione è studiata al fine di sottolineare il ruolo cruciale dei programmi di supporto psicologico congiunto per supportare il paziente e il suo partner. Infine, i risultati della letteratura su questi argomenti sono discussi insieme con i fenomeni di crescita post-traumatica della coppia.
The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members ... more The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members face the traumatic experience of living together all the time. This evidence evokes the hidden family's frailty and operates as a litmus test of family life. The paper discusses some relational scenarios about this transient deprivation of the social context. Their cumulative effects are considered guiding the family to cope with the quarantine and it is argued that some changes of the family's daily life patterns, caused by the pandemic, will remain unchanged in the future.
Il termine distress indica un’esperienza spiacevole, di natura psicologica, sociale, spirituale c... more Il termine distress indica un’esperienza spiacevole, di natura psicologica, sociale, spirituale che riduce il coping efficace verso il cancro, i suoi sintomi fisici e il suo trattamento. Il distress di malattia sul paziente si riflette anche sul distress esperito dai caregiver. Essi vanno incontro a molteplici difficoltà che configurano la cosiddetta “Caregiver Stress Syndrome”: condizione debilitante che caratterizza persone che si prendono cura di pazienti con patologie croniche. Questo studio si propone di confrontare il distress emotivo del paziente oncologico e del caregiver elettivo. I pazienti (N=100) e i loro caregiver elettivi (N=100) afferivano alla V divisione di Medicina Interna della A.O.U. Vanvitelli. I criteri di inclusione erano: età:38-82 anni; diagnosi oncologica: 6 mesi-3 anni precedenti al reclutamento; sopravvivenza stimata: 6 mesi-1 anno; punteggio alla KPS: 50-60. I pazienti e i caregiver erano intervistati separatamente. Lo strumento utilizzato è stato il “Termometro del Distress”. Lo studio non ha evidenziato differenze significative (T= 1.468; p= 0.143) tra il distress dei pazienti (M=6.66, DS= 2.35) e dei caregiver (M=5.90, DS= 2.77), accoppiati uno a uno, i cui livelli sono risultati di grado medio. La rilevazione di pari livelli di distress nei pazienti e nei caregiver conferma l’ipotesi di letteratura che il paziente e i familiari rispondono al cancro come unico sistema emozionale. Gli interventi conseguenti sono mirati alla facilitazione dell’espressività emotiva e alla condivisione dei sentimenti di frustrazione, rabbia e dolore depressivo scatenati dalla malattia, nonché alla ristrutturazione cognitiva di tale esperienza.
Journal of biological regulators and homeostatic agents, 2018
To compare the results of psychometric tests in patients with BMS and controls, participants were... more To compare the results of psychometric tests in patients with BMS and controls, participants were tested for depression, anxiety, fatigue and distress. Patients with BMS had noticeably higher scores for depression, fatigue and distress, compared to controls. Depression and distress were significantly correlated with the burning symptom. Moreover, distress and burning symptoms proved to be interdependent. Depression seems to play a specific role in BMS. Burning symptoms affect quality of life of patients and they could be a predictor of distress.
Since 1997, the Bio-Psycho-Social Model, proposed by George Engel, attracted the interest of clin... more Since 1997, the Bio-Psycho-Social Model, proposed by George Engel, attracted the interest of clinical researchers as well epistemologists and was recognized as a turning point in the culture and praxis of medical diagnosis and treatments. According to Engel, biological, psychological as well as social events are mutually interconnected and reciprocally influenced; a paradigmatic shift in the approach to the mind-body problem. Lately, this model has received persuasive criticism that has caused a fading of its scientific reliability. This concise review focuses the core feature of Engel’s position as well as the scientific controversy that followed during these forty years.
The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members ... more The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members face the traumatic experience of living together all the time. This evidence evokes the hidden family’s frailty and operates as a litmus test of family life. The paper discusses some relational scenarios about this transient deprivation of the social context. Their cumulative effects are considered guiding the family to cope with the quarantine and it is argued that some changes of the family's daily life patterns, caused by the pandemic, will remain unchanged in the future.
Some considerations on the debate about cultural sensitivity in the practice of family system the... more Some considerations on the debate about cultural sensitivity in the practice of family system therapy are reported. Firstly, the different meanings of the concept are summarized. Then, the author formulates the hypothesis that most part of the related literature addresses this topic as the need of a cultural adaptation of the therapeutic processes to the ethnic minorities through a remodulation of the training programs, thus risking of disown the systemic nature of cultures. The Bateson contributions about culture is recalled supporting the idea that every single therapy with the family is always an “otherness” experience by which all the members of the therapeutic system are charged of a mutual legitimacy effort.
Dealing with female breast cancer (BC) strongly modulates the patient’s self-concept, hence affec... more Dealing with female breast cancer (BC) strongly modulates the patient’s self-concept, hence affecting her interpersonal network, notably with the partner. In this review, we assume that the patient-partner couple reacts as a unique dyadic system when facing the experience of BC, thus influencing the disease’s adjustment and coping processes. From this point of view, BC adjustment and coping studies focused on the patient-partner couple are relevant to better understand the psychosocial dimension of this disease and plan useful dyadic support programs. The paper reviews the studies on a dyadic approach to the adjustment as well as the coping consequences of BC. The dyadic features of adjustment and coping processes over the course of illness are highlighted. The association with some specific relationship patterns as well as with the communication styles is investigated to emphasize the crucial role of conjoint psychological dynamics that define the BC dyad struggle with the illness....
Bioetica pratica e cause di esclusione sociale, 2012
1. Il processo di de-istituzionalizzazione, iniziato nei Paesi dell’Europa Occidentale negli anni... more 1. Il processo di de-istituzionalizzazione, iniziato nei Paesi dell’Europa Occidentale negli anni cinquanta, ha portato, tra gli anni ‘60 e ’90, a radicali cambiamenti nelle politiche psichiatriche e nella pratica clinica con il tramite della psichiatria di comunità. Nonostante la chiusura delle strutture manicomiali, la drastica riduzione dei posti letto nelle istituzione psichiatriche e la collocazione dei servizi psichiatrici all’interno della comunità, marginalizzazione, esclusione social..
Cognitive involvement in beta-thalassaemia is strikingly controversial and poorly studied in adul... more Cognitive involvement in beta-thalassaemia is strikingly controversial and poorly studied in adulthood. This multicentre prospective study investigated 74 adult neurologically-asymptomatic beta-thalassaemia patients (mean-age 34Á5 AE 10Á3 years; 53 transfusion-dependent [TDT], 21 nontransfusion dependent [NTDT]) and 45 healthy volunteers (mean-age 33Á9 AE 10Á7 years). Participants underwent testing with Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV), Brief Psychiatric Rating Scale (BPRS) and multiparametric brain 3T-magnetic resonance imaging (MRI) for parenchymal, vascular and iron content evaluation. Patients had lower Full-Scale Intelligence Quotient (FSIQ) than controls (75Á5 AE 17Á9 vs. 97Á4 AE 18Á1, P < 0Á0001) even after correction for education level. Compared to TDT, NTDT showed a trend of higher FSIQ (P = 0Á08) but a similar cognitive profile at WAIS-subtests. FSIQ correlated with total and indirect bilirubin (P < 0Á0001 and P = 0Á002, respectively); no correlation was found with splenectomy, intracranial MRI/magnetic resonance-angiography findings, brain tissue iron content or other disease-related clinical/ laboratory/treatment data. FSIQ did not correlate with BPRS scores, although the latter were higher among patients (28Á74 AE 3Á1 vs. 27Á29 AE 4Á8, P = 0Á01) mainly because of increased depression and anxiety levels. Occupation rate was higher among controls (84Á4% vs. 64Á9%, P = 0Á004) and correlated with higher FSIQ (P = 0Á001) and education level (P = 0Á001). In conclusion, Italian adult beta-thalassaemia patients seem to present a characteristic cognitive profile impairment and an increased rate of psychological disorders with possible profound long-term socioeconomic consequences.
Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence a... more Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence affecting her interpersonal network, notably with the partner. In this review, we assume that the patient-partner couple reacts as a unique dyadic system when facing the experience of BC, thus influencing the disease's adjustment and coping processes. From this point of view, BC adjustment and coping studies focused on the patient-partner couple are relevant to better understand the psychosocial dimension of this disease and plan useful dyadic support programs. The paper reviews the studies on a dyadic approach to the adjustment as well as the coping consequences of BC. The dyadic features of adjustment and coping processes over the course of illness are highlighted. The association with some specific relationship patterns as well as with the communication styles is investigated to emphasize the crucial role of conjoint psychological dynamics that define the BC dyad struggle with the ...
Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence affec... more Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence affecting her interpersonal network, notably with the partner. In this review, we assume that the patient-partner couple reacts as a unique dyadic system when facing the experience of BC, thus influencing the disease's adjustment and coping processes. From this point of view, BC adjustment and coping studies focused on the patient-partner couple are relevant to better understand the psychosocial dimension of this disease and plan useful dyadic support programs. The paper reviews the studies on a dyadic approach to the adjustment as well as the coping consequences of BC. The dyadic features of adjustment and coping processes over the course of illness are highlighted. The association with some specific relationship patterns as well as with the communication styles is investigated to emphasize the crucial role of conjoint psychological dynamics that define the BC dyad struggle with the illness. Finally, the literature findings on these topics are discussed together with the couple post-traumatic growth phenomena. RIASSUNTO Fare esperienza del cancro al seno femminile (BC) modula fortemente l'idea di sé della paziente, influenzando la sua rete interpersonale, in particolare con il partner. Il presupposto di questa rassegna di concetti, è che la coppia paziente-partner risponde come un sistema diadico unico di fronte all'esperienza del BC, influenzando così i processi di adattamento e coping alla malattia. In questo quadro di riferimento, gli studi di adattamento e coping al BC focalizzati sulla coppia paziente-partner sono rilevanti per comprendere meglio la dimensione psicosociale di questa malattia. Il testo passa in rassegna gli studi riguardanti un approccio diadico ai processi di adattamento e coping nel BC. La revisione di letteratura evidenzia le caratteristiche diadiche dei processi di adattamento e di coping nel corso della malattia. L'associazione con alcuni modelli specifici di relazione e con gli stili di comunicazione è studiata al fine di sottolineare il ruolo cruciale dei programmi di supporto psicologico congiunto per supportare il paziente e il suo partner. Infine, i risultati della letteratura su questi argomenti sono discussi insieme con i fenomeni di crescita post-traumatica della coppia.
The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members ... more The COVID-19 pandemic imposes lockdown policies all over the world. Hence, family system members face the traumatic experience of living together all the time. This evidence evokes the hidden family's frailty and operates as a litmus test of family life. The paper discusses some relational scenarios about this transient deprivation of the social context. Their cumulative effects are considered guiding the family to cope with the quarantine and it is argued that some changes of the family's daily life patterns, caused by the pandemic, will remain unchanged in the future.
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Papers by Paolo Gritti