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Stomia e crescita post-traumatica: uno studio esplorativo mixed-method
Titolo Rivista: PSICOLOGIA DELLA SALUTE 
Autori/Curatori: Stefania Pozzi, Maria Elena Magrin, Marta Scrignaro 
Anno di pubblicazione:  2015 Fascicolo: Lingua: Italiano 
Numero pagine:  21 P. 24-44 Dimensione file:  145 KB
DOI:  10.3280/PDS2015-003002
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Il presente contributo indaga la presenza di crescita post-traumatica - PTG (Tedeschi e Calhoun, 2004) e il ruolo dei processi cognitivi di ruminazione intenzionale vs intrusiva (Cann et al., 2011) in un gruppo di persone stomizzate, mediante metodologia quali-quantitativa. Ai partecipanti (N = 39; 51% donne) è stata somministrata una batteria di questionari composta da posttraumatic growth inventory (Tedeschi e Calhoun, 1996), scala di intrusione della impact of event scale (Horowitz, 1979), scala di ruminazione intenzionale della event related rumination inventory (Cann et al., 2011), e una intervista semistrutturata sulla storia di vita legata alla stomia, ai cui trascritti sono stati applicati il sistema di codifica delle narrazioni autobiografiche (Pals e McAdams, 2004) e una analisi contenutistica esplorativa I risultati supportano l’idea che diventare stomizzato possa indurre un senso di crescita psicologica che abbraccia sia i domini descritti in letteratura (Tedeschi e Calhoun, 2006), sia un tema evento-specifico, "consapevolezza corporea". Inoltre la ruminazione intenzionale, ma non il pensiero intrusivo, correla con la PTG rilevato sia a livello quantitativo (r = .53; p <01) che qualitativo (r = .40; p <05), supportando il modello PTG come frutto di una ristrutturazione cognitiva dell’esperienza traumatica (Tedeschi e Calhoun, 2006). In un’ottica di intervento si delinea l’utilità di approfondire eventuali connessioni fra il rapporto mente-corpo e l’autoefficacia nella gestione della stomia, così come i meccanismi sottesi al passaggio da forme di ruminazione di tipo intrusivo a forme più consapevoli e costruttive, in grado di accogliere non solo i risvolti negativi ma anche quelli migliorativi dell’esperienza traumatica.


Keywords: Crescita post-traumatica, ruminazione intenzionale, ruminazione intrusiva, stomia, mixed-method

  1. McAdams D.P. (1999). Coding narrative accounts of autobiographical scenes for redemption sequences.
  2. Arnett J.J. (2000). Emerging Adulthood. A Theory of Development from the Late Teens Through the Twenties, American Psychologist, Vol. 55, 5: 469-480., DOI: 10.1037//0003-066X.55.5.46
  3. Baltes P.B. and Margret M. (1990). Successful aging: Perspectives from the behavioural sciences. New York: Cambridge University Press.
  4. Bauer J.J., McAdams D.P. and Pals J.L. (2008). Narrative identity and eudaimonic well-being. Journal of Happiness Studies, 9: 81-104., DOI: 10.1007/s10902-006-9021-
  5. Bekkers M.J.T.M., Van Knippenberg F.C.E., Van Den Borne H.W. and Van Berge-Henegouwen G.P. (1996). Prospective Evaluation of Psychosocial Adaptation to Stoma Surgery: the role of Self-Efficacy. Psychosomatic Medicine, 58: 183-191.
  6. Bower J.E., Kemeny M.E., Taylor S.E. and Fahey J.L. (1998). Cognitive processing, Discovery of meaning, CD4 decline, and AIDS related mortality among bereaved HIV-seropositive men. Journal of Consulting and Clinical Psychology, 66: 979-986., DOI: 10.1037//0022-006X.66.6.97
  7. Brewin C.R., Gregory J.D., Lipton M. and Burgess N. (2010). Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychological Review, 117 (1): 210-32: 0033-295X., DOI: 10.1037/a0018113
  8. Briganti L. (2003). “Diventare stomizzato: dalla riabilitazione alla prevenzione primaria” [Becoming ostomized: from rehabilitation to primary prevention]. Tesi di specializzazione in Psicologia della Salute, Alma Mater Studiorum Università di Bologna.
  9. Brown H. and Randle J. (2005). Living with a stoma: a review of literature. Journal of Clinical Nursing, 14 (1): 74-81., DOI: 10.1111/j.1365-2702.2004.00945.
  10. Calhoun L.G. and Tedeschi R.G. (2006) Handbook of posttraumatic growth: Research and practice. New York: Lawrence Erlbaum Associates.
  11. Cann A., Calhoun L.G., Tedeschi R.G., Triplett K.N., Vishnevsky T. and Linsdrom C.M. (2011). Assessing posttraumatic cognitive process: the Event Related Rumination Inventory. Anxiety, Stress and Coping. 24 (2): 137-156., DOI: 10.1080/10615806.2010.52990
  12. Canova C., Giorato E., Roveron G., Turrini P. and Zanotti R. (2013). Validation of a stomaspecific quality of life questionnaire in a sample of patients with colostomy or ileostomy. Colorectal Disease, 15 (11): 692-8., DOI: 10.1111/codi.12324
  13. Carlson L.E., Labelle L.E., Gardland S.N., Hutchins M.L. and Birnie K. (2012). Interventi basati sulla mindfulness in oncologia [mindfulness based threatments in onchology]. In Didonna F., a cura di, Manuale clinico di mindfulness [clinical manual of mindfulness]. Milano: Franco Angeli.
  14. Giani U., Parrello S. and Osorio Guzman M. (2009). La narrazione della malattia come spazio per la ricerca del Sé. [Illness Narrative as a space for the search the Self]. In Giani U., a cura di, Narrative Based Medicine e Complessità [Narrative Based Medicine and Complexity]. Napoli: Scriptaweb.
  15. Hefferon K., Grealy M. and Mutrie N. (2009). Post-traumatic growth and life threatening physical illness: A systematic review of the qualitative literature. British Journal of Health Psychology, 14: 343-378., DOI: 10.1348/135910708X33293
  16. Helgeson V.S., Reynolds K.A. and Tomich P.L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74 (5): 797-816., DOI: 10.1037/0022-006X.74.5.79
  17. Horowitz M., Wilner N. and Alvarez W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41(3): 209-218.
  18. Janoff-Bulman R. (2006). Schema-Change Perspective on Posttraumatic Growth. In Calhoun L.G. and Tedeschi R.G., editors, Handbook of posttraumatic growth: Research and practice, 81-99. New York: Lawrence Erlbaum Associates.
  19. Joseph S. and Linley P.A. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of General Psychology, 9(3): 262-280., DOI: 10.1037/1089-2680.9.3.26
  20. Kalitzkus V. and Matthiessen PF. (2009). Narrative-Based Medicine: Potential, Pitfalls, and Practice. The Permanente Journal, 13 (1): 80-86.
  21. Lindstrom C.M., Cann A., Calhoun L.G. and Tedeschi R.G. (2013). The Relationship of Core Belief challenge, rumination, disclosure, and sociocultural elements to posttraumatic growth. Psychological Trauma: Theory, Research, Practice, and Policy. Vol. 5, 1: 50-55., DOI: 10.1037/a002203
  22. Magrin M.E., Scrignaro M. and Steca P. (2007). La sfida delle avversità: minaccia o transizioni di crescita? [The challenge of adversities: threat or growth transitions?] Psicologia della Salute, 1: 11-32.
  23. McAdams D.P. (1993). The stories we live by: Personal myths and the making of the self. New York: William Morrow and Company, Inc.
  24. McAdams D.P. and Adler J.M. (2010). Autobiographical Memory and the Construction of a Narrative Identity. In Maddux J.E., Tangney J.P., editors, Social psychological foundation of clinical psychology. New York: Guilford Press.
  25. McAdams D.P., Reynolds J., Lewis M., Patten A.H. and Bowman P.J. (2001). When bad things turn good and good things turn bad: Sequences of redemption and contamination in life narrative and their relation to psychosocial adaptation in midlife adults and in students. Personality & Social Psychology Bulletin, 27: 474-485., DOI: 10.1177/014616720127400
  26. Morris A.B., Shakespeare-Finch J. and Scott J.L. (2012). Posttraumatic growth after cancer: the importance of health-related benefits and newfound compassion for others. Supportive care in Cancer, 20 (4): 749-756., DOI: 10.1007/s00520-011-1143-
  27. Nicholas D.B., Swan S.R., Gerstle T.J., Allan T. and Griffiths A.M. (2008). Struggles, strengths, and strategies: an ethnographic study exploring the experience of adolescents living with an ostomy. Health and Quality of Life Outcomes, 6: 114., DOI: 10.1186/1477-7525-6-11
  28. Milam J. (2006) Posttraumatic Growth and HIV Disease Progression. Journal of Consulting and Clinical Psychology, 74 (5): 817-827., DOI: 10.1037/0022-006X.74.5.81
  29. Mols F., Vingerhoets A.J.J.M., Coebergh J.W. and van Poll-Franse L.V (2005). Quality of life among long-term breast cancer survivors: a systematic review. European Journal of Cancer, 41: 2613-2619., DOI: 10.1016/j.ejca.2005.05.01
  30. Osorio Guzman M. and Parrello S. (2012). Malattia e bisogno di relazioni significative: studio per l’ampliamento dell’IPQ-R in un gruppo di operatori sanitari della regione Campania [Illness and need for meaningful relationships: study for the expansion of the IPQ-R in a group of Campania health care operators]. Psicologia della Salute, 3: 75-92., DOI: 10.3280/PDS2012-00300
  31. Pals J.L. and Mcadams D.P. (2004). The transformed self: A narrative understanding of posttraumatic growth. Psychological Inquiry, 15: 65-69.
  32. Park C.L. (2010). Making Sense of the Meaning Literature: An Integrative Review of Meaning Making and Its Effects on Adjustment to Stressful Life Events. Psychological Bulletin, 136 (2): 257-301., DOI: 10.1037/a001830
  33. Pennebaker J.W. and Keough K.A (1999). Revealing, organizing, and reorganizing the self in response to stress and emotion. In Ashmore R., Jussim L., editors, Self and social identity, Vol. 2. New York: Oxford University Press, 101-121.
  34. Pietrantonio F., De Gennaro L., Di Paolo M.C. and Solano L. (2003). The impact of event scale. Validation of an Italian version. Journal of Psychosomatic Research, 55: 389-393., DOI: 10.1016/S0022-3999(02)00638-
  35. Pittman J., Rawl S.M., Schmidt C.M., Grant M., Ko C. Y., Wenderl C. and Krouse R.S. (2008) Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy. J Wound Ostomy Continence Nurs, 35 (5): 493-503., DOI: 10.1097/01.WON.0000335961.68113.c
  36. Prati G. and Pietrantoni L. (2006). Crescita post-traumatica: un’opportunità dopo il trauma? [Posttraumatic Growth: opportunity after trauma?] Psicoterapia Cognitiva e Comportamentale, 12 (2): 133-144.
  37. Prati G. and Pietrantoni L. (2013). Italian Adaptation and Confirmatory Factor Analysis of the Full and the Short Form of the Posttraumatic Growth Inventory. Journal of Loss and Trauma, 19: 12-22., DOI: 10.1080/15325024.2012.73420
  38. Pressman S.D. and Cohen S. (2005). Does positive affect influence health? Psychological Bulletin, 131: 925-71., DOI: 10.1037/0033-2909.131.6.92
  39. Prieto L., Thorsen H. and Juul K. (2005). Development and validation of a quality of life questionnaire for patients with colostomy or ileostomy. Health and Quality of Life Outcomes. 3: 62., DOI: 10.1186/1477-7525-3-6
  40. Raimondo S., De Pandis F.M., Di Matteo M., Carlomusto E. and D’Aguanno S. (2012). Tai ji quan per malati di Parkinson. Studio clinico [Tai ji quan for Parkinson patients. Clinica study]. In Bottacioli F., a cura di, Stress e Vita. La scienza dello stress e la scienza della salute alla luce della psiconeuroendocrinoimmunologia [stress science and health science in the light of the psychoneuroendocrinoimmunology]. Milano: Tecniche Nuove.
  41. Ricci Bitti E. and Gremigni P. a cura di (2013), Psicologia della salute. Modelli teorici e contesti applicativi [Health psychology: theoretical models and applied contexts]. Roma: Carocci ed.
  42. Sawyer A., Ayers S. and Field A.P. (2010). Posttraumatic growth and adjustment among individuals with cancer and HIV/AIDS: A meta-analysis. Clinical Psychology Review, 30: 436-447., DOI: 10.1016/j.cpr.2010.02.00
  43. Scrignaro M., Barni S., Bonetti M.L. and Magrin M.E. (2011). Studying Predictors of Posttraumatic Growth in Cancer Patients. In Brdar I., editor, The Human Pursuit of Well-Being: a cultural approach. New York: Springer, 83-91.
  44. Siegel D. (2012). The developing mind. Second Edition. New York: Guilford Press (trad. it.: La mente relazionale. Neurobiologia dell’esperienza interpersonale. Seconda edizione. Milano: Raffaello Cortina Editore, 2013).
  45. Stanton A.L., Bower J.E. and Low C.A. (2006). Posttraumatic Growth after Cancer. In Calhoun L.G. and Tedeschi R.G., editors, Handbook of posttraumatic growth: Research and practice (138-175). New York: Lawrence Erlbaum Associates.
  46. Stanton A.L., Revenson T.A. and Tennen H. (2007). Health Psychology: psychological adjustment to chronic disease. Annual Review of Psychology, 58: 565-92., DOI: 10.1146/annurev.psych.58.110405.08561
  47. Stockton H., Hunt N., Joseph S. (2011). Cognitive Processing, Rumination, and Posttraumatic Growth. Journal of Traumatic Stress, 24 (1): 85-92., DOI: 10.1002/jts.2060
  48. Taku K., Calhoun L.G., Cann A. and Tedeschi R.G. (2008). The role of rumination in the coexistence of distress and posttraumatic growth among bereaved Japanese university students. Death Studies, 32 (5): 428-444., DOI: 10.1080/0748118080197474
  49. Taku K., Cann A., Tedeschi R.G. and Calhoun L.G. (2009). Intrusive versus deliberate rumination in posttraumatic growth across US and Japanese samples. Anxiety Stress Coping, 22 (2):129-36., DOI: 10.1080/1061580080231784
  50. Tedeschi R.G. and Calhoun L.G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9: 455-471., DOI: 10.1002/jts.249009030
  51. Tedeschi R.G. and Calhoun L. (2004). Posttraumatic Growth: Conceptual Foundations and Empirical Evidence. Psychological Inquiry, 15 (1): 1-18., DOI: 10.1207/s15327965pli1501_0
  52. Walter M. and Bates G. (2012). Posttraumatic Growth and Recovery from Post Traumatic Stress Disorder, Essential Notes in Psychiatry, Dr. Victor Olisah (Ed.), ISBN: 978-953-51-0574-9, InTech., DOI: 10.5772/38296

Stefania Pozzi, Maria Elena Magrin, Marta Scrignaro, in "PSICOLOGIA DELLA SALUTE" 3/2015, pp. 24-44, DOI:10.3280/PDS2015-003002

   

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