Impact of psychosocial, behavioral and lifestyle factors on subjective cognitive complaints and perceived quality of life in a large cohort of Italian breast cancer patients.

The impact of psychosocial and behavioral factors on Cancer Related Cognitive Impairment manifestations is still under debate. Study's purpose is to determine the prevalence rate of cancer related cognitive impairment in a cohort of Italian breast cancer patients and to evaluate the implication of specific behavioral factors. For these purposes, a total of 233 women (106 breast cancer patients and 127 age-matched controls without oncological diagnosis) completed a questionnaire investigating cognitive functionality (FACT-Cog v3.0), sociodemographic characteristics, clinical information, psychosocial and behavioral factors (cognitive reserve, sleep quality, dietary habits, physical activity). The results indicated a higher prevalence rate of subjective cognitive complaints in breast cancer patients (37%) compared to a representative sample of women in the same age group without an oncological diagnosis (p < 0.001). Moreover, breast cancer patients showed significantly lower levels of cognitive reserve (p < 0.05) and worse sleep quality (p < 0.01) compared to age-matched controls. Further analysis revealed that breast cancer patients reporting subjective cognitive complaints differed significantly from breast cancer patients without subjective cognitive complaints on measures of perceived cognitive abilities (p < 0.001) and on the impact of cognitive difficulties on perceived quality of life (p < 0.01). Future studies are needed to examine behavioral directed interventions to prevent subjective cognitive deficits in breast cancer patients.

Impact of sleep deprivation on attentional networks: disentangling orienting components.

While it is well accepted that sleep deprivation (SD) negatively affects overall vigilance and performance, research on the extent to which SD affects discrete components of attention has produced inconsistent results. The present study aims at exploring the effects of SD on attentional components and their interactions using the revised attentional network test (ANT-R) which allows to examine the three attentional networks: alerting, orienting and executive control. Additionally, it allows the evaluation of subcomponents of orienting. The ANT-R was administered following two sleep conditions: Baseline (BL) - a regular night of uninterrupted sleep, and SD - 24 h of wakefulness. Our data show that SD selectively affects the three attentional networks. We have found a significant slowing down of executive control and a slight detriment of alerting. As far as orienting is concerned, the disengagement component was affected, while validity effect remained unaffected by SD. Our findings have relevant implications for intervention research, highlighting the importance of targeting specifically disengagement and executive control processes.

Individual differences in working memory efficiency modulate proactive interference after sleep deprivation.

Whether and how sleep loss affects executive functioning are still under debate. In this study, we examined the role of individual differences in determining the levels of working memory (WM) efficiency and proactive interference (PI) after sleep deprivation. Fifty-two participants performed a test battery included a modified Sternberg task and the Jonides' 2-back task under two sleep conditions: baseline (BL, a night of regular sleep), and total sleep deprivation (SD, 24 h of wakefulness). In general, we replicated Tucker and colleagues' (2010) results. However, when we divided the subjects into two groups according to WM efficiency after SD, participants that showed a greater efficiency were more susceptible to PI, while those with lower WM efficiency showed a level of resistance to PI similar to BL. These results indicate that resistance to PI after SD is dependent on WM efficiency, highlighting the importance of individual differences in sleep deprivation studies.

Cognitive inflexibility and over-attention to detail: The Italian validation of the DFlex Questionnaire in patients with eating disorders.

OBJECTIVE: Cognitive inflexibility and over-attention to detail are two cognitive styles common to eating disorders (ED) and other psychopathologies characterized by rigid perfectionism. Despite many options to assess the above styles, the only self-report tool that simultaneously permits their specific assessment is the Detail and Flexibility Questionnaire (DFlex), originally developed to investigate the ED domain. The aim of this study was to validate the Italian version of the DFlex. METHOD: 170 patients (149 females) with ED and 148 controls (100 females) completed the Italian version of the DFlex. RESULTS: A Confirmatory Factor Analysis showed that the two-factor model originally proposed in the literature was a good fit to the data. Item factor loadings were largely equivalent across clinical and control groups, with intercept distributions showing higher values for the clinical group compared to controls. Both DFlex subscales showed good internal reliability and were able to predict membership to the group condition. CONCLUSIONS: The DFlex is a reliable tool for investigation in the ED population. However, because DFlex items do not explicitly assess food and body shape domains, it is possible to extend its use to other psychopathologies characterized by rigid perfectionism. We propose the use of the DFlex in research and clinical practice as a useful tool for better understanding patients' cognitive functioning and in order to support treatment planning.

Adolescents' Appraisal of Homophobic Epithets: The Role of Individual and Situational Factors.

Homophobic epithets have become commonly used insults among adolescents. However, evidence suggests that there are differences in how these homophobic epithets are evaluated based on beliefs held by the observer and the context in which they are used. To examine this, Italian high school students were asked to rate the offensiveness of homophobic epithets, as well as to consider how they or others would react to homophobic epithets across various situations. Homophobic beliefs and beliefs about the social acceptability of homophobic epithets were also examined. It was found that greater perceived social acceptability of homophobic epithets was related to dismissive reactions to their use, whereas homophobic beliefs were predictive of negative emotional reactions but in varying ways depending on the specific context. The results indicate that homophobic epithets may not always be perceived as homophobic by adolescents, and that attempts to alter the social acceptability of these insults may be an effective manner of reducing their use.

Twenty-four hours of total sleep deprivation selectively impairs attentional networks.

Performance decrements after sleep loss have been extensively studied and are usually attributed to generic attentional deficits. This claim, however, is based on the view of attention as a unitary construct, despite evidence that it should be considered a multidimensional cognitive ability. The aim of the present study was to evaluate the impact of one night of sleep deprivation on the efficiency of three attentional networks, defined by Posner and Raichle (1994) in anatomical and functional terms, as alerting, orienting, and executive control. Thirty participants performed the Attention Network Test at 9:00 a.m. following two different sleep conditions: baseline (a normal night of sleep) and deprivation (24 hrs of wakefulness). Results showed an overall slowing in reaction times and a significant decrease in accuracy after sleep deprivation. Sleep deprivation selectively affected the three attentional networks, given that only executive control efficacy significantly decreased after sleep deprivation. By contrast, phasic alerting and orienting showed no differences in the two sleep conditions. Thus, performance deficits following sleep deprivation do not reflect global attentional deficits.

Age-related differences in the attention network test (ANT).

This study investigates the effect of aging on alerting, orienting, and conflict resolution by assessing younger (mean age = 25.8) and older (mean age = 67.9) adults' performance in the Attention Network Test that combines, in a single experimental paradigm, a flanker task with alerting and orienting cues. The analyses of response times indicated equivalent orienting and conflict resolution effects in younger and older adults. By contrast, alerting was found to be significantly reduced in the elderly. This result is only marginally in accordance with recent studies addressing the issues of age-related differences in alerting, which provide mixed results. The possible role of methodological differences across studies in accounting for the controversial results concerning the aging affect on alerting is discussed.

Comparing sleep-loss sleepiness and sleep inertia: lapses make the difference.

To compare the behavioral effects of sleep-loss sleepiness (performance impairment due to sleep loss) and sleep inertia (period of impaired performance that follows awakening), mean response latencies and number of lapses from a visual simple reaction-time task were analyzed. Three experimental conditions were designed to manipulate sleepiness and sleep-inertia levels: uninterrupted sleep, partial sleep reduction, and total sleep deprivation. Each condition included two consecutive nights (the first always a night of uninterrupted sleep, and the second either a night of uninterrupted sleep, a night when sleep was reduced to 3 h, or a night of total sleep deprivation), as well as two days in which performance was assessed at 10 different time points (08:00, 08:30, 09:00, 09:30, 10:00, 11:00, 14:00, 17:00, 20:00, and 23:00 h). From 08:00 to 09:00 h, reaction times in the partial sleep-reduction and total sleep-deprivation conditions were at a similar level and were slower than those observed in the uninterrupted sleep condition. In the same time period, the frequency of lapses in the total sleep-deprivation condition was higher than in the partial sleep-reduction condition, while this latter condition never differed from the uninterrupted sleep condition. The results indicate that both sleep inertia and sleep-loss sleepiness lead to an increase in response latencies, but only extreme sleepiness leads to an increase in lapse frequency. We conclude that while reaction times slow as a result of both sleep inertia and sleep-loss sleepiness, lapses appear to be a specific feature of sleep-loss sleepiness.

Effects of sleep reduction on spatial attention.

To investigate the effects exerted by sleep loss on specific attentive components the performance to a simple reaction time task and to a cued reaction time task were recorded at regular intervals during days following either 8 or 3 h of uninterrupted sleep. Eleven subjects took part in the experiment. The results show that, notwithstanding a general reduction of alertness produced by sleep curtailment (as indicated by the increase of reaction times in the simple reaction time task), in the cued reaction time task only the reaction times to invalidly cued targets significantly increase, while no difference is observed when attention is summoned by a valid cue. This result suggests that the mechanisms underlying orienting of attention are differentially affected by the reduction of alertness level.

Heart rate variability during sleep as a function of the sleep cycle.

In this work, in order to evaluate whether autonomic differences distinguish REM sleep and NREM sleep through the whole sleeping period, statistical analysis on spectral power associated with low frequency and high frequency bands were performed on the whole polysomnographic recording, considering the sleep cycle as a unit of sleep. Our results from nine subjects show that power associated with low frequency is higher in REM sleep than in NREM sleep, while power associated with high frequency is significantly higher in NREM sleep than in REM sleep. Differences between REM sleep and NREM sleep are not of the same magnitude within the whole sleep episode and, independent of sleep stages, specific trends are observable in the autonomic control of heart rate during the night.