Suicidal ideation in female individuals with fibromyalgia and comorbid obesity: prevalence and association with clinical, pain-related, and psychological factors.

OBJECTIVE: Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity-a risk factor for suicidal ideation per se-could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation. METHODS: In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected. RESULTS: 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation. DISCUSSION: The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation.

Are eco-sustainable dietary patterns associated with impulsiveness? An insight from Italy.

Impulsivity is known to influence food choices. We explored possible differences in its expression between individuals with or without an eco-sustainable diet and its relationship with cognitions and behaviours about eco-sustainable foods. Participants were categorised as having or not having an eco-sustainable diet. Impulsivity traits and cognitions and behaviours about sustainable food products were measured. Among the 332 participants, 92.78% showed an eco-sustainable diet, whereas only 7.22% had an eco-sustainable diet. No difference between groups emerged about impulsive traits, whereas significant differences emerged in cognitions and behaviours about sustainable foods, with the only exceptions of subjective norms and past behaviour. Impulsive traits were linked to cognitions and behaviours differently within groups. Impulsivity traits may be related to actions towards eco-sustainable foods, with the perception of their availability playing a crucial role. Increasing contextual opportunities may be fundamental for having eco-sustainable consumers.

Body size estimation in obesity: a systematic review and meta-analysis.

Previous research about body size estimation in obesity reported heterogeneous results. This might be related to the fact that the tasks adopted explored different body representations. Classifying the previous studies according to the specific body representation probed (i.e. implicit, explicit or both) might clarify discordant findings. A systematic review and meta-analysis of research articles assessing body size estimation in individuals affected by obesity compared with healthy weight individuals were performed in PubMed and Web of Science. Additional records were identified by reference lists inspection. The last search was run in May 2021. Two independent authors performed data extraction according to predefined criteria. Both groups either overestimated or underestimated the implicit body representation depending on the task used and the body part considered. Conversely, the explicit representation of the body was mainly overestimated by both individuals with obesity and healthy weight. In tasks relying on both these representations, overestimation and underestimation were reported in both groups, possibly depending on the degree of which each procedure relied on the explicit and/or implicit representation of the body. According to the meta-analysis, individuals with obesity tended to be significantly less accurate in body size estimations than participants with healthy weight. We confirmed that heterogeneous findings in body size estimation in obesity are related to the adoption of different tasks, which likely involve different body representations. We discussed the role of body dissatisfaction and altered somatosensation in the lower accuracy observed in obesity.

Obstructive sleep apnea syndrome and Alzheimer's disease pathology: may continuous positive airway pressure treatment delay cognitive deterioration?

PURPOSE: The main aim of the present study was to identify the long-term effects of continuous positive airway pressure (CPAP) treatment in patients co-affected by obstructive sleep apnea syndrome (OSAS) and mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (ADD). METHODS: This retrospective multicentre study included patients affected by MCI or ADD, diagnosed according to the core clinical and biomarkers criteria, and presenting comorbid OSAS. Only patients performing at least a 1-year visit during their follow-up to monitor cognitive deterioration and adherence with CPAP treatment were included. Both Mini-Mental State Examination (MMSE) and clinical dementia rating scale (CDR) were conducted during the baseline and the follow-up visits. RESULTS: Twenty-four patients were included in the study and were distributed according to the diagnosis in MCI (n = 8) or ADD (n = 16). There were no significant differences in the variables analysed at baseline between the CPAP non-adherent and CPAP adherent patients. In the whole group, a significant decrease was found in MMSE scores, and a significant increase was found in CDR scores between baseline and follow-up. No longitudinal changes in ESS scores were statistically significant from baseline to follow-up. A significant difference was found for the mean score change of the CDR since CPAP non-adherent patients showed a higher mean change of CDR compared to CPAP adherent patients. No significant differences were found for the mean change of MMSE. CONCLUSION: These findings highlight the clinical potential of treating OSAS with CPAP to delay cognitive deterioration in patients with MCI or ADD.

Implicit facial emotion recognition of fear and anger in obesity.

BACKGROUND: Previous evidence about facial emotion recognition capability in obesity is few and not conclusive. OBJECTIVE: We investigated the capability of female individuals affected by obesity to recognize the emotions of fear and anger through a facial emotion recognition task grounded on the implicit redundant target effect. METHODS: 20 women affected by obesity and 20 healthy-weight women were enrolled. We administered an implicit facial emotion recognition task. Both reaction time and level of accuracy were computed. Moreover, the level of alexithymia was measured through the standard questionnaire. RESULTS: Selective difficulties in recognizing the emotion of fear were observed in participants with obesity, when their performance was contrasted with healthy-weight controls. Instead, they showed the implicit redundant target effect when anger was the target. However, the two groups reported globally similar scores at the standard questionnaire relative to the level of alexithymia. CONCLUSIONS: Our result might agree with the hypothesis about affected individuals' difficulties in being attentive to negative facial emotions, and specifically in the case of fearful expression. This study might encourage future research in which emotional processing will be investigated through subjective judgments and implicit/objective measurements. LEVEL I: Experimental study.

Performance at the clock drawing test of individuals affected by Parkinson's disease and healthy subjects: a retrospective study.

Clock drawing test (CDT) is a screening tool used in neuropsychological assessment for evaluating comprehensively multiple cognitive functions. Aberrant performance at CDT was observed in Parkinson's disease, due to impaired executive functioning as well as visuospatial difficulties. However, previous studies suffered from different limitations, such as reduced sample size as well as no comparison with healthy individuals. This retrospective study aimed to verify CDT accuracy in discriminating between 240 patients with idiopathic Parkinson's disease and 205 healthy subjects. We verified CDT accuracy in discriminating patients when classified according to their global cognitive functioning measured through the Mini-Mental State Examination and the Frontal Assessment Battery. Our results showed that affected individuals reported a worse performance in CDT than healthy controls. Instead, no difference was found between patients when categorized according to their performance at the Mini-Mental State Examination or Frontal Assessment Battery. We confirmed that patients with Parkinson's disease reported low performance at the CDT. We encouraged the use of CDT for early detection of possible cognitive difficulties in Parkinson's disease for clinical and research purposes.

Mental representation of the body in action in Parkinson's disease.

Mixed findings characterize studies in Parkinson's disease (PD): some studies indicate a relationship between physical impairments and the ability to mentally represent the body, while others suggest spared abilities for this cognitive function. To clarify the matter, in the present study we explored the mental representations of the body in action in the same PD patients, taking also into account lateralization of symptoms and visual imagery skills. 10 PD patients with left- (lPD), 10 with right (rPD) lateralized symptoms (lPD), and 20 matched healthy controls have been recruited for the study. All patients were screened for neuropsychological impairments. To explore a more implicit component we used the hand laterality task (HLT), while the mental motor chronometry (MMC) was used to explore a more explicit one. Two control tasks, with objects instead of body parts, were administered to control for visual imagery skills. In the HLT, we detected the effects of biomechanical constraints effects in both controls and PD patients. In the latter group, importantly, this was true independently from lateralization of symptoms. In the MMC, we found the expected positive correlation between executed and imagined movements for both hands in controls only, while all PD patients, again independently form lateralization, only showed this effect for the left hand. In terms of visual imagery, only rPD patients differed from controls when asked to implicitly rotate letters, and in terms of accuracy only. However, this difference is explained by executive functions measured through the neuropsychological assessment rather than by a "pure" visual imagery impairment. In summary, our findings suggest that two different aspects of the mental representations of the body in action, one more implicit and the other more explicit, can be differently affected by PD. These impairments are unlikely explained by a basic visual imagery deficit. When present, impairments concern a higher dimension, related to motor functions and awareness, and not driven by sensory impairments, as shown by the independence of effects from physical laterality of symptoms.

Utility of Boston Qualitative Scoring System for Rey-Osterrieth Complex Figure: evidence from a Parkinson's Diseases sample.

This study examined the ability of the Boston Qualitative Scoring System (BQSS) in comparison to the Osterrieth scoring method to separate Parkinson's Disease patients without dementia from healthy controls at the Rey-Osterrieth Complex Figure (ROCF) copy. 30 PD participants and 30 healthy participants completed ROCF copy. The performance was scored according to both methods. The results indicated that PD patients performed significantly worse on ROCF. According to ROC analyses, BQSS Copy Total score represented the most suitable index to distinguish between the two groups: a score below or equal to 16 indicates an impaired performance. Moreover, PD participants reported lower performance in the BQSS scores of Planning and Neatness. PD patients' poor performance in ROCF copy was related to executive difficulties, specifically in terms of planning and impulsivity, instead of global visuo-constructional impairments. An extensive evaluation of copy drawings allowing to disentangle between different involved cognitive domains would be suitable, specifically in those clinical conditions like PD, in which motor impairments affect drawing performance.

How many segments are there in an orange: normative data for the new Cognitive Estimation Task in an Italian population.

The Cognitive Estimation Test (CET) is widely used by clinicians to assess frontal executive dysfunction. In the present work, the Italian standardization of a new version of the CET is provided. This version consists of two 9-item parallel forms (A and B) that were administered to two hundred and twenty-seven healthy Italian male and female participants aged between 19 and 91 years with 5-24 years of full-time education. Performance on the CET was not related to age or level of education; both forms showed a male CET advantage. The new CET is a useful tool for clinicians and researchers to administer the CET more than once without practice effects, which is considered important when assessing frontal executive abilities.

Disentangling the relationship between cognitive estimation abilities and executive functions: a study on patients with Parkinson's disease.

The cognitive estimation test (CET) measures cognitive estimation abilities: it assesses the ability to apply reasoning strategies to answer questions that usually cannot lead to a clear and exact reply. Since it requires the activation of an intricate ensemble of cognitive functions, there is an ongoing debate in the literature regarding whether the CET represents a measurement of global cognitive abilities or a pure measure of executive functions. In the present study, CET together with a neuropsychological assessment focused on executive functions was administered in thirty patients with Parkinson's disease without signs of dementia. The CET correlated with measures of verbal working memory and semantic knowledge, but not with other dimensions of executive domains, such as verbal phonemic fluency, ability to manage real-world interferences, or visuospatial reasoning. According to our results, cognitive estimation abilities appeared to trigger a defined cognitive path that includes executive functions, namely, working memory and semantic knowledge.

Spontaneous Changes in Attentional Capabilities and Reasoning After an Alcohol Rehabilitation Treatment: Evidence About the Role of Age and Alcohol Use.

Purpose: In this study, we evaluated changes in attentional capabilities and reasoning among early abstinent alcohol-dependent individuals after a 28-day residential rehabilitation program (not including cognitive treatment). Furthermore, we explored the role of individual characteristics and disease-related factors (i.e., length of alcohol use, history of polysubstance dependence, severity of alcohol use) on spontaneous cognitive recovery. Patients and Methods: Fifty-five patients with a diagnosis of Alcohol Use Disorder (AUD) were consecutively recruited from a residential rehabilitation hospital in Northern Italy. The majority were male (67.3%) with a mean age of 47.83 years (SD = 8.21). The computerized Psychology Experiment Building Language Test Battery was used to assess the performance at the Posner Cueing Test, Go/no-go Task, Trail Making Test (TMT), Tower of London (TOL), and Balloon Analog Risk Scale. The evaluation was performed twice: at the beginning (T0) and at its end (T1, before the hospital discharge). Results: We observed statistically improvements over time in the performance at the: 1) TOL in the time amount required to solve the task (p < 0.001); and 2) TMT in the indexes relative to the number of errors (p = 0.003) and the total time required to solve the task (p < 0.001). Age played a significant role on the changes observed in the score relative to the time amount used by participants to solve the task in TMT (test (p = 0.03) and in TOL (p = 0.02). Moreover, the length of alcohol dependence had an effect on the change observed for the time amount to solve the TMT (time) (p = 0.01). Conclusion: We found spontaneous recovery after alcohol detoxification on some, but not all, cognitive functions assessed in our study. The neuropsychological assessment and the identification of patients with cognitive impairment and specific risk factors (e.g., older age and longer history of alcohol use) is important to orient cognitive rehabilitation and increase the efficacy of AUD treatments.

The perception of affective touch in women affected by obesity.

Introduction: Pleasant and comforting bodily contacts characterized intimate and affective interactions. Affective touch informs us about others' emotions and intentions, sustains intimacy and closeness, protecting from loneliness and psychological distress. Previous evidence points to an altered experience of affective touch in clinical populations reporting interpersonal difficulties. However, there is no investigation of affective touch in obesity, which is often associated with negative affective-relational experiences since childhood. Methods: This study aimed to provide the first evidence about the experience of affective touch in obesity by comparing 14 women with obesity with 14 women with healthy weight. Participants rated the pleasantness of both imagined and actual tactile stimuli, which consisted of (i) soft-brush strokes, (ii) touches of the experimenter's hand, and (iii) of a plastic stick (as control, non-affective, stimulation). Participants should report the pleasantness of each kind of touch. Moreover, we explored lifespan experiences of affective touch and interpersonal pleasure in social contexts through self-report questionnaires. Results: No differences emerged for the pleasantness of affective touch (in both the real and imagery task) between the two groups. However, participants with obesity reported less frequent and less satisfying early experiences of affective touch when compared with the controls. Discussion: Our results spoke in favor of a preserved experience of affective touch when experimentally probed in obesity, despite a limited early exposure to bodily affective contacts. We interpreted our results in the light of the social reconnection hypothesis. Nevertheless, we provided crucial methodological considerations for future research, considering that both the experimenter's and the brush touch may not resemble adequately real-life experiences, in which affective touch involves intimate people.

Predicting Falls in Musculoskeletal Rehabilitation: A Retrospective Multisite Study.

BACKGROUND: Fall represents one of the highest concerns in the healthcare system, especially in medical rehabilitation settings. However, there is a lack of instruments for the assessment of risk falls in the context of musculoskeletal rehabilitation. METHODS: This retrospective multisite study aimed to assess the sensitivity and specificity of four fall risk assessment tools (the Functional Independence Measure, the Fall Risk Assessment, the Schmid Fall Risk Assessment Tool, and the ePA-AC) in predicting falls in patients admitted to musculoskeletal rehabilitation in Swiss inpatient facilities. RESULTS: The data relative to 6970 individuals (61.5% females) were analyzed and 685 (9.83% of patients) fall events were registered. The area under the curve (AUC) relative to the Functional Independence Measure was 0.689, 0.66 for the Fall Risk Assessment, 0.641 for the Schmid Fall Risk Assessment Tool, and 0.675 for the ePA-AC. Among the four tools, the Functional Independence Measure had an acceptable discriminatory power in distinguishing between significant events (i.e., patients' falls) and non-events (no falls). CONCLUSION: None of the assessed tools showed highly satisfying levels of statistical sensitivity or sensibility. However, the Functional Independence Measure could be used to assess the fall risk assessment in musculoskeletal rehabilitation settings, although with some caution, since this questionnaire was not designed for this diagnostic purpose. We strongly suggest urgently designing a tool for risk assessment that is specific to this population and the rehabilitative setting.

Short-Term Benefits of Continuous Positive Airway Pressure Treatment on Cognition in the Obstructive Sleep Apnea Syndrome: A Retrospective Study.

The Obstructive Sleep Apnea Syndrome (OSAS) significantly impacts cognitive functioning. The prolonged use (more than 3 months) of ventilotherapy with continuous positive airway pressure (CPAP) seems to have positive effects in restoring cognitive difficulties. However, there is poor evidence about its possible short-term effect. We investigated whether the short use (less than 15 days at testing) of CPAP improved the cognitive functioning in fifty individuals with OSAS by collecting retrospective neuropsychological measures about verbal memory and learning, information processing speed, attention (i.e., alerting, orienting, and executive system), and executive functions (i.e., strategic reasoning, problem-solving, and mental planning). The predictive role of days of CPAP use on the neuropsychological scores was assessed by hierarchical multiple linear regression analyses, over and above the possible role of demographics, body mass index, level of OSAS severity, and the level of anxiety and depression. The average number of days since CPAP adaptation was 4.70 (SD = 3.90; range = 0-15). As the days of CPAP adaptation increased, verbal learning and long-term memory significantly improved, contrary to the other assessed domains. Our results show a significant improvement in some cognitive functions even after a short treatment with CPAP, pointing to the importance of the early use of ventilotherapy to rapidly improve cognitive functioning. Identifying which cognitive functions can or cannot be restored with CPAP use may enable the design of complementary neuropsychological interventions focused on those residual difficulties, possibly enhancing patients' compliance to the treatment.

Affective touch in anorexia nervosa: Exploring the role of social anhedonia and lifespan experiences.

BACKGROUND: The pleasantness of a gentle and slow, namely affective, touch experienced in interpersonal interactions motivates social closeness. In anorexia nervosa (AN), independent evidence suggests lower pleasantness of affective touch, as well as social withdrawal. We aim to probe both the experience of affective touch and its possible association with social anhedonia and lifespan experiences of affective bodily contacts in AN. METHODS: The pleasantness of affective and non-affective touch was compared between fourteen women with AN and fourteen healthy women. Stimuli were traditionally delivered with a brush, with the experimenter's hand, as novelty, and with a stick, as control. The pleasantness of imagined and real touch was probed. Self-report questionnaires assessed social anhedonia and lifespan experiences of affective touch. RESULTS: A preserved pleasantness of affective touch emerged in AN in both the imagery and real task, despite higher social anhedonia and less lifespan experience of affective touch than healthy women. LIMITATIONS: Affective touch involves loved ones; thus, the experimenter's touch may not resemble real-life interactions. Future research may take advantage of imagery procedures to solve this issue. CONCLUSIONS: Body-oriented therapy for AN recognizes touch as a therapeutic tool: ascertaining how touch is experienced is crucial to maximize rehabilitative outcomes. Furthermore, clarifying the possible interplay between interpersonal difficulties in AN and affective touch is especially relevant considering the possible role of the attachment style, which is intensively debated in AN, on affective touch.

The predictive role of fatigue and neuropsychological components on functional outcomes in COVID-19 after a multidisciplinary rehabilitation program.

OBJECTIVE: To verify the impact of altered cognitive functioning and higher levels of mental fatigue, both reported after coronavirus disease 2019 (COVID-19), on rehabilitation treatment outcomes. METHODS: In this real-practice retrospective pre-post intervention cohort study, cognitive functioning, measured through standardized neuropsychological measures, and individual levels of fatigue, depression and anxiety symptoms, were evaluated at admission to a rehabilitation program in individuals who had been hospitalized for COVID-19. The rehabilitation program effectiveness was measured through the Functional Independence Measure. RESULTS: Among the patient sample (n = 66), 87.88% reported experiencing high levels of fatigue at admission, while 16.67% reported depressive symptoms, and 22.73% reported anxiety symptoms. After rehabilitation, the sample displayed a significant decrease in the level of disability, in both the motor and cognitive subscales. Neuropsychological and psychological functioning did not play a predictive role. The 45 patients who received mechanical ventilation during intensive care, representing 68.18% of the sample, benefited more from rehabilitation treatment. CONCLUSIONS: The results support the importance of an early rehabilitation program after COVID-19 infection, independent of the initial neuropsychological and psychological functioning. Respiratory assistance may represent a crucial factor for short-term neuropsychological disease after-effects. Future studies on the long-term neuropsychological effect of COVID-19 infection on individual levels of disability are necessary.

"I cannot see your fear!" Altered recognition of fearful facial expressions in anorexia nervosa.

Background: The evidence about facial emotion recognition in anorexia nervosa as the role of alexithymic traits on this emotional ability is conflicting and heterogeneous. Objective: We assessed the capability of recognizing facial expressions of two primary emotions, fear, and anger, in the context of anorexia nervosa. Methods: Women affected by anorexia nervosa were compared with healthy weight women in a well-established implicit facial emotion recognition task. Both reaction time and level of accuracy were computed. Moreover, the individual levels of alexithymia were assessed through a standard self-report questionnaire. Results: Participants with anorexia nervosa reported a significantly lower performance in terms of reaction time and accuracy when the emotion of fear-but not anger-was the target. Notably, such an alteration was linked to the levels of alexithymia reported in the self-report questionnaire. Conclusion: In anorexia nervosa, difficulties in processing facial fearful (but not angry) expressions may be observed as linked to higher expressions of alexithymic traits. We suggested future research in which emotional processing will be investigated taking into account the role of the bodily dimensions of emotional awareness.

Executive Attentional Dyscontrol as a Core Cognitive and Behavioral Feature of Individuals with Obesity and Cardiovascular Disease: A Cross-Sectional Investigation.

Executive attention as a frontal domain ability that is effective in potentially blocking distracting information, reconciling conflicts among simultaneous attentional demands, and regulating impulsive behavior may be impaired in individuals with obesity and cardiovascular disease (CVD). This study aimed (i) to explore the presence of selected cognitive (global cognitive impairment, sensitivity to interference, and attention) and psychological (quality of life, depression, anxiety, and impulsivity) dimensions and (ii) to examine the interactive relationship between attentional dyscontrol-both as a psychological and as a cognitive measure-and the above-mentioned variables in a sample of patients with CVD attending a cardiac rehabilitation program across different body mass index (BMI) levels. Clinical information of 104 patients with CVD was retrospectively collected. Participants were classified into three groups according to their BMI as follows: normal weight (NW = 30), overweight (OW = 19), and obese (OB = 55). Individuals with CVD and a higher BMI showed problems in controlling executive attention-through both neuropsychological and behavioral measures. Specifically, OB patients demonstrated reduced sensitivity to cognitive interference, lower capabilities in divided attention during visual-tracking tasks, and greater impulsivity compared to NW patients. This behavioral characteristic was also found to be correlated with higher levels of anxiety and depression and a lower quality of life. Implications for cognitive rehabilitation were discussed to offer directions for better management of patients with CVD and obesity.

Corrigendum: Improving CPAP adherence in adults with obstructive sleep apnea syndrome: A scoping review of motivational interventions.

[This corrects the article DOI: 10.3389/fpsyg.2021.705364.].