A PLAY-based approach for adolescent patients: The Importance of Panksepp’s Primary Emotional System of PLAY in Engagement with Adolescent Psychiatric Patients

Author/s Guido Trabucchi, Simona Pelaccia, Mario Biagiarelli, Rachele Mariani, Elena Petrovska, Cinzia Sarlatto, Maurizio Pompili
Publishing Year 2023 Issue 2023/3
Language English Pages 21 P. 64-84 File size 315 KB
DOI 10.3280/PDS2023-003004
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Professionals working with adolescents invest enormous resources and energies to find a tailored approach to improve patients’ compliance and promote their access to care. As a re-sult, Panksepp’s Primary Emotive Systems (PES) can be useful instruments to develop tai-lored treatment plans specific for this age. We aimed to find a PES specific for adolescence, correlated to psychopathological fea-tures, in order to guide mental health professionals in approaching and treating adolescent psy-chiatric patients. This is a cross-sectional study. We recruited 156 patients seeking help during their first evaluation and divided the sample into two different age groups: 114 were 14-19 years old (ADO) and 42 were 20-65 years old (ADULT). They performed a psychopatholog-ical evaluation. We found strong associations between PLAY PES and psychopathological features in the ADO group (not in the ADULT group). Then we sub-divided the ADO and the ADULT group in HIGH-PLAY(HP) and LOW-PLAY(LP) and performed a One-Way ANOVA. In the ADO group, we found significant differences between HP and LP group psychopathological features, but the same was not found in the ADULT group. PLAY is an emotive system that is highly correlated with psychopathological features in our sample of adolescents seeking help. This correlation was not found in ADULT patients. For these results, we suggested PLAY can be a useful instrument to treat help-seeking adoles-cents with mental health issues.

Keywords: adolescent psychiatry, affective neurosciences, primary emotive systems, psy-chopathology, therapeutic engagement.

  1. Achenbach T., Ivanova M., Rescorla L., Turner L. and Althoff R. (2016). Internalizing/ externalizing problems: review and recommendations for clinical and research applications. J Am Acad Child Adolesc Psychiatry, 55: 647-656.
  2. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington D.C. (tr. it.: DSM-IV-TR. Manuale diagnostico e statistico dei disturbi mentali, Text Revision. Masson, Milano, 2004).
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC:: American Psychiatric Association.
  4. American Psychological Association (2002). Developing Adolescents: A Reference for Professionals. Washington DC: American Psychological Association. Available at: https://www.apa.org/pi/families/resources/develop.pdf [Accessed 02 Jun. 2019].
  5. Arnett J.J. (1999). Adolescent storm and stress, reconsidered. American Psychologist, 54: 317-326. DOI: 10.1037/0003-066X.54.5.31
  6. Bonduelle S., Vanderfaeillie J., Denijs K., Lampo A. and Imeraj L. (2020). Factors influencing adherence to therapeutic recommendations made after diagnostic reassessment of medically unexplained symptoms in children and adolescents. Clin Child Psychol Psychiatry, 25(1): 62-77.  DOI: 10.1177/1359104519827995
  7. Cohen J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.
  8. Conti L. (1999). Repertorio delle scale di valutazione in Psichiatria [The Inventory of Rating Scales for Psychiatry]. Firenze: S.E.E. Società Editrice Europea di Nicodemo Maggiulli & C. Snc.
  9. Curto M., Pompili E., Silvestrini C., Bellizzi P., Navari S., Pompili P., . . . Baldessarini R.J. (2018). A novel SCL-90-R six-item factor identifies subjects at risk of early adverse outcomes in public mental health settings. Psychiatry Research, 267: 376-381.
  10. Delgado S., Strawn J. and Pedapati E. (2015). Contemporary psychodynamic psychotherapy for children and adolescents. Integrating intersubjectivity and neuroscience. Berlin: Springer.
  11. Derogatis L. (1992). SCL-90-R, administration, scoring and procedures manual-II for the R(evised) version and other instruments of the Psychopathology Rating Scale Series. Townson: Clinical Psychometric Research.
  12. Ferrari A. (2014). La complessità dell’approccio clinico al paziente adolescente con tumore: nasce la Società Italiana Adolescenti con Malattie Onco-ematologiche (SIAMO). Recenti Prog Med, 105: 392-393. DOI: 10.1701/1626.1767
  13. First M., Spitzer R., Williams J. and Gibbon M. (1995). Structured Clinical Interview for DSM-IV (SCID). Washington DC: American Psychiatric Association.
  14. Fusacchia M.G. (2001). Funzioni genitoriali e costruzione del setting in adolescenza. Adolescenza e psicoanalisi, 3.
  15. Ge X., Conger R. and Elder G. (2001). Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms. Developmental Psychology, 37: 404-417. DOI: 10.1037//0012-1649.37.3.404
  16. Giacolini T., Ardizzone I., Davis K.L., Ferrara M., Picconi L., Terrinoni A. and Sabatello U. (2017). Brain Emotional Systems: The Italian version of the ANPS-Affective Neuroscience Personality Scales 2.4 (Reliability and Validity). Clinical Neuropsychiatry, 14(4): 263-274.
  17. Perry C.L. (2000). Preadolescent and adolescent influences on health. In: Smedley B.D. and Syme L., Promoting health: Intervention strategies from social and behavioral research (pp. 217-253). National Academy Press: Washington, US.
  18. Pollack W. and Shuster T. (2000). Real boys’ voices. New York: Random House.
  19. Senko K. and Bethany H. (2019). PLAY THERAPY: An Illustrative Case. Innov Clin Neurosci, 16(5-6): 38-40.
  20. Shankman S., Funkhouser C., Klein D., Davila J., Lerner D. and Hee D. (2018). Reliability and validity of severity dimensions of psychopathology assessed using the Structured Clinical Interview for DSM-5 (SCID). Int J Methods Psychiatr Res, 27(1):e1590.
  21. Smith L.K. (1996). The pubertal transition in the play fighting of male rats : developmental byproduct or ontogenetic adaptation? Tratto da: https://www.uleth.ca/dspace/bitstream/handle/10133/42/MM18005.pdf?sequence=3 [Accessed 29 June 2019].
  22. Striegel-Moore R. and Cachelin F. (1999). Body image concerns and disordered eating in adolescent girls: Risk and protective factors. In: Johnson N.G., Roberts M.C. and Worell J.E. (1999). Beyond appearance: A new look at adolescent girls (pp. xvi‐464). Washington DC: American Psychological Association.
  23. Task Force on promotion and dissemination of psychological procedures; Division of Clinical Psychology; American Psychological Association (1995). Training in and dissemination of empirically validated psychological treatments: Report and recommendations. The Clinical Psychologist, 48: 3-24.
  24. Weisz J. (1998). Outcome Findings and Issues in Psychotherapy with Children and Adolescents. Comprehensive Clinical Psychology, 5: 83-106.
  25. Winnicott D.W. (1971). Playing and reality. London and New York: Routledge, 2005.
  26. Paul M.J., Probst C.K., Brown L.M. and de Vries G.J. (2018). Dissociation of Puberty and Adolescent Social Development in a Seasonally Breeding Species. Current Biology, 28: 1116-1123.
  27. Panksepp J., Normansell L., Cox J.F. and Siviy S.M. (1994). Effects of neonatal decortication on the social play of juvenile rats. Physiol Behav, 56(3): 429-443. DOI: 10.1016/0031-9384(94)90285-2
  28. Panksepp J. and Yovell Y. (2014). Preclinical Modeling of Primal Emotional Affects (SEEKING, PANIC and PLAY): Gateways to the Development of New Treatments for Depression. Psychopathology, 47: 383-393. DOI: 10.1159/00036620
  29. Panksepp J. and Biven L. (2014). Archeologia della mente. Origini neuroevolutive delle emozioni umane. Milano: Raffaello Cortina Editore.
  30. Panksepp J. (2010). Affective neuroscience of the emotional BrainMind: evolutionary perspectives and implications for understanding depression. Dialogues in Clinical Neuroscience, 12(4): 533-545.
  31. Panksepp J. (2008). Play, ADHD, and the Construction of the Social Brain. Should the first class each day be recess? American Journal of Play, 55-79.
  32. Panksepp J. (2007). Can PLAY Diminish ADHD and Facilitate the Construction of the Social Brain? J Can Acad Child Adolesc Psychiatry, 16(2): 57-66.
  33. Panksepp J. (2004). Chapter 15: Rough and Tumble Play: The Brain Sources of Joy. In: Affective Neuroscience: The Foundations of Human and Animal Emotions. Oxford: Oxford University Press.
  34. Palma A. and Pancheri P. (1999). Scale di valutazione e di misura dei sintomi psichiatrici. In: Cassano G.B., Pancheri P., editors. Trattato Italiano di Psichiatria. 2nd ed., Masson: Milano, Italy.
  35. Monniello G. (2004). Azioni terapeutiche nella psicoterapia psicoanalitica con gli adolescenti nelle istituzioni. Adolescenza e psicoanalisi, 2. Tratto da http://www.psychomedia.it/aep/2004/numero-2/monniello.htm
  36. Mariani R., Renzi A., Di Monte C., Petrovska E. and Di Trani M. (2021). The Impact of the COVID-19 Pandemic on Primary Emotional Systems and Emotional Regulation. Int J Environ Res Public Health, 18(11): 5742.
  37. MacLean P.D. (1984). Evoluzione del cervello e comportamento umano. Studi sul cervello trino. Torino: Einaudi.
  38. Krueger R., Caspi A., Moffitt T. and Silva P. (1998). The structure and stability of common mental disorders (DSM III-R): A longitudinal-epidemiological study. Journal of Abnormal Psychology, 107: 216-227.
  39. Kipke M. (1999). Adolescent development and the biology of puberty: Summary of a workshop on new research. Washington DC: National Academy Press.
  40. IBM Corp. (Released 2017). Armonk, NY Brevetto n. Version 25.0.
  41. Harrison M., McKay M. and Bannon W. (2004). Inner-city child mental health service use: the real question is why youth and families do not use services. Community Ment Health J, 40: 119-131.
  42. Halje K., Timpka T., Tylestedt P., Adler A., Fröberg L., Schyman T., . . . Dahl K. (2015). Self-referral psychological treatment centre for young adults: a 2-year observational evaluation of routine practice before and after treatment. BMJ Open, 17(5).
  43. Halasz G. (2017). Special population – child and adolescent psychotherapy. Australasian Psychiatry, 25(3): 222-224. DOI: 10.1177/103985621668962
  44. Gray, P. (2016). The Decline of Play and the Rise of Psychopathology in Children and Adolescents. American Journal of Play, 3(4): 443-463.
  45. Gopalan G., Goldstein L., Klingenstein K., Sicher C., Blake C. and McKay M. (2010). Engaging families into child mental health treatment: updates and special considerations. J Can Acad Child Adolesc Psychiatry, 19: 182-196.

Guido Trabucchi, Simona Pelaccia, Mario Biagiarelli, Rachele Mariani, Elena Petrovska, Cinzia Sarlatto, Maurizio Pompili, A PLAY-based approach for adolescent patients: The Importance of Panksepp’s Primary Emotional System of PLAY in Engagement with Adolescent Psychiatric Patients in "PSICOLOGIA DELLA SALUTE" 3/2023, pp 64-84, DOI: 10.3280/PDS2023-003004