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6° 6éme Congresso Congrès Européen Europeo de di Psicopatologia Psychopathologie dell’Infanzia de l’Enfance e et dell’Adolescenza de l’Adolescence Nuove Nouvelles normalità normalités Nuove Nouvelles patologie pathologies Nuove pratiche Nouvelles pratiques FRIDAY, May 6 WORKSHOPS Workshop 14 Dal prenatale alla diagnosi precoce QUALITY OF LIFE, ANXIOUS AND DEPRESSIVE SYMPTOMATOLOGY IN THE SECOND TRIMESTER OF PREGNANCY FOLLOWING ASSISTED REPRODUCTION Leonardo De Pascalis, Marcella Paterlini, Sara Reverberi, Fiorella Monti, Francesca Agostini, Giovanni Battista La Sala Dipartimento di Psicologia, Università di Bologna (Bologna - IT) could account for the lack of gender differences and of severe symptomatology regarding depression and anxiety; and it would seem that mood disorders in the couples, during this particular moment, is unaffected by ART. Quality of life instead offers a more varied picture: predictably, women show lower physical wellbeing, with their bodies having to bear the material burden of pregnancy and ART women show the lowest wellbeing of the sample, being still probably affected by the long medical journey through which they achieved their pregnancy and which might have still left them with a sense of physical inability and vulnerability; less predictably, from a mental point of view, the higher wellbeing in ART couples could be tied to the relief of having overcome the first trimester with the risks of pregnancy loss tied to it, but, if bordering on idealisation, could expose the couples to the risk of arriving unprepared to the moment of delivery and the first intense period of life with the child. 214 Bibliography Beaurepaire J, Jones M, Thiering P, Saunders D, Tennant C. Psychosocial adjustment to infertility and its treatment: Male and female responses at different stages of IVF/ET treatment. J Psychosom Res. 1994;38(3):229-40. Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Köhn FM, Schroeder-Printzen I et al. Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI. Andrologia. 1999;31(1):27-35. Cox JL, Chapman G, Murray D, Jones P. Validation of the Edinburgh postnatal depression scale (EPDS) in nonpostnatal women. J Affect Disord 1996;39:185-9 Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782-6. Drosdzol A, Skrzypulec V. Quality of life and sexual functioning of Polish infertile couples. Eur J Contracept Reprod Health Care 2008;13:271-81. Hjelmstedt A, Widström AM, Wramsby H, Matthiensen AS, Collins A. Personality factors and emotional responses to pregnancy among IVF couples in early pregnancy: a comparative study. Acta Obstet Gynecol Scand. 2003;82(2):152-61. Ragni G, Mosconi P, Baldini MP, Somigliana E, Vegetti W, Caliari I et al. Health-related quality of life and need for IVF in 1000 Italian infertile couples. Hum Reprod 2005;20:1286-91. Spielberg CD. Manual for the State-Trait Anxiety Inventory. Palo Alto, California: Consulting Psychologists Press, 1983. Ware JE Jr, Kosinski M. SF-36 physical and mental health summary scales: A manual for users of version 1, Second Edition. Lincol
6° 6éme Congresso Congrès Européen Europeo de di Psicopatologia Psychopathologie dell’Infanzia de l’Enfance e et dell’Adolescenza de l’Adolescence Nuove Nouvelles normalità normalités Nuove Nouvelles patologie pathologies Nuove pratiche Nouvelles pratiques FRIDAY, May 6 WORKSHOPS Workshop 14 Dal prenatale alla diagnosi precoce PSYCHOLOGICAL INTERVENTION DURING PRENATAL DIAGNOSIS D. Paggetti (1) , I. Lapi (2) , M. Iandolo (3) (1) Meyer Paediatric Hospital, Florence (Florence - IT), (2) Manager of the Infant and Adolescent Mental Health Unit, Local Health Authority, South-East Florence (Florence - IT); (3) Centro Studi Martha Harris, Florence (Florence - IT) The progresses in foetal medicine allowed new healthcare possibilities, making it possible for pregnant women to find out a lot of information about the soon-to-be-born baby. However, this new way of experiencing pregnancy has deep emotional consequences for the woman, such as potential narcissistic wounds which could undermine both the Self and the emotional investment of the foetus, feelings of mourning and death anguish. This could, in some cases, cause what Rothman (1986) called the tentative pregnancy, implying a kind of psychological and emotional distance from the foetus created by the mother. In fact, some studies show that some women wait for the results of the amniocentesis and the villocentesis before emotionally investing in their pregnancy (Besson, Golbius, 1979). The anxiety experienced by the woman in relation to the pregnancy and, later, in relation to the prenatal diagnosis leads the woman to create a psychological security distance from her baby. These experiences can interfere with the development of the mother-infant relationship. In a similar way, the healthcare professionals’ emotional experiences, the “countertransference” developed in response to the patient’s projections and their technical role are complex and difficult to manage from a psychological and relational point of view. The collaboration of the psychologists of the perinatal psychology path within the Prenatal Diagnosis Unit, part of the Perinatal Psychology Path started by Florence Local Health Authority, includes the following interventions: support in the organization of the informative sessions during prenatal diagnosis addressed to the couples; assessment of the women’s anxiety (both state and trait, through the STAI) among those taking part in the prena- 215 tal consultation, and, in cases of positive outcome, proposal of support psychological sessions; “binomial” physician-psychologist consulting sessions during specific phases of the prenatal consultation; inclusion of a psychological session in the intervention program of the unit, in cases of foetal pathology; team discussions of the cases from a relational and emotional perspective. In the full text of the communication we report the quantitative and qualitative data concerning the first semester of activity, along with a few brief clinical examples. The health consultation provided during prenatal diagnosis, which represents an undoubted clinical progress and a healthcare opportunity, arises anxiety and leads, starting from the very first weeks of pregnancy, to a strictly medical path, which sets a distance from the pregnancy experienced as a natural event, and leads to an over-controlled pregnancy, surrounded by technicians and experts. The emotional world, the experiences connected to giving birth to a new life, to expecting the baby, and to the new parental role, are “put in the corner”, defensively hidden behind the technical attitude of the professional team and behind the - sometimes cold and unresponsive, often full of doubts and anxiety- woman’s and couple’s emotional suspension (the tentative pregnancy, see also the work of Beeson, Golbius, 1979, Rothman, 1986, Righetti, 2010).The deep emotional consequences of the prenatal diagnosis revolve around potential narcissistic wounds, which could undermine both the Self and the emotional investment of the foetus (which, if damaged, turns from an idealized narcissistic element into a “perturbing” element, Freud, 1919), feelings of mourning and death anguish, which always accompany, both in a phantasmatic and
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Nouvelles normalités Nouvelles pathologies Nouvelles ... - Psynem

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