Differences in Perceived and Experienced Stigma Between Problematic Gamblers and Non-gamblers in a General Population Survey.

We consider a sample of about 700 people, interviewed on the streets, who are sorted into two groups by a self-report, screening questionnaire: namely, non-problematic gamblers/non-gamblers and problematic gamblers. Within each group, we compare both social (perceived) stigma and self-perceived (experienced) stigma, measured by means of other two self-report questionnaires, and we seek for relations between stigma and socio-demographic variables that can help targeting possible interventions to reduce gambling-related stigma. We, then, compare stigma between the two groups of non-(problematic) gamblers and problematic ones, and we also check the hypothesis that higher social stigma is related to higher self-perceived stigma, as well as higher stigma is related to lesser help-seeking. The latter hypothesis is of utmost importance, given that stigma is recognised to be one of the major causes for hindering help-seeking by problematic gamblers. The research is carried out in Italy, one of the first countries in the world for the money spent per capita in gambling activity every year.

Do Competitive Contexts Affect Mindreading Performance?

Mindreading is contingent upon interpersonal context. Little is known about how competitive contexts influence mindreading skills. The idea was that the capacity to think about mental states would decline when individuals experiencing failure in competition. This study aims to assess effects of a competitive experience (a computer competitive PC game) on a sample of healthy subjects (119 participants). The sample was divided into two sub-samples. The experimental group underwent an experience of failure, consisting in a PC game of logic against a hypothetical opponent. The control group was required instead only to discuss past personal experiences of competitive interactions. The Metacognitive Assessment Interview was administered to each sub-sample for evaluating mindreading capacities. Self-report tests were additionally provided for evaluation of trait-based dispositions: self-esteem, perfectionism, narcissism. Results supported our hypothesis: induction of sense of failure compromises ability to describe one's own mental states and mental states of others. This effect was more pronounced in the domain of self-reflection. Results remained significant after controlling for self-esteem, perfectionism, and narcissism. We discuss possible clinical implications of these findings and the importance of evaluating mindreading capacities under the pressure of social rank as well as of other social motive.

Psychological factors and self-rated health: An observative study on cardiological patients.

This study investigated the association of illness representations, awareness of bodily states and health complaints to self-rated health in N = 150 consecutive patients with heart disease (ischaemic disease, heart failure and heart valve disease) and explored differences between 'health optimist' and 'health pessimist' patients. After controlling for medical variables, health complaints accounted for 14.2 per cent of patients' self-rated health, and illness representations contributed for another 16.2 per cent; body awareness was not associated with self-rated health. Also, 'optimists' tended to see less negative consequences from their illness and perceived greater control over illness treatment compared to 'pessimists'. Targeting symptoms and illness representations may optimize rehabilitation outcomes.

Left temporoparietal junction is necessary for representing someone else's belief.

A standard view in the neuroscience literature is that the frontal lobes sustain our ability to process others' mental states such as beliefs, intentions and desires (this ability is often referred to as having 'theory of mind'). Here we report evidence from brain-damaged patients showing that, in addition to involvement of the frontal lobes, the left temporoparietal junction is necessary for reasoning about the beliefs of others.

Exploring the functional and anatomical bases of mirror-image and anatomical imitation: the role of the frontal lobes.

Humans are the most imitative species on earth, but how imitation is accomplished and which areas of the brain are directly involved in different kinds of imitation is still under debate. One view is that imitation entails representing observed behaviours as a set of hierarchically organised goals, which subsequently drive the construction of an action pattern [Bekkering, H., Wohlschläger, A., & Gattis, M. (2000). Imitation of gestures in children is goal-directed. The Quarterly Journal of Experimental Psychology, 53, 153-164; Wohlschläger, A., Gattis, M., & Bekkering, H. (2003). Action generation and action perception in imitation: An instance of the ideomotor principle. Philosophical Transactions of the Royal Society of London, 358, 501-515]. On this view, when working memory resources are limited, only the goals at the top-end of the hierarchy will be accurately reproduced. In the present study, neurologically intact participants and patients with frontal and non-frontal lesions were asked to make imitative responses that were either mirror-image (e.g., the observer's right side corresponding to the model's left side) or anatomically (e.g., the observer's right side corresponding to the model's right side) matching. Experiment 1 confirmed that individuals with brain damage, though globally impaired compared with neurologically intact controls, nevertheless followed the same goal hierarchy. However, there was a selective deficit in performing anatomical imitation for the frontal group. Experiment 2 demonstrated that the problem for frontal patients stemmed from an impaired ability to remember and reproduce incompatible stimulus-response mappings, which is fundamental for the selection of the appropriate frame of reference during anatomical imitation.

Testing the domain-specificity of a theory of mind deficit in brain-injured patients: evidence for consistent performance on non-verbal, "reality-unknown" false belief and false photograph tasks.

To test the domain-specificity of "theory of mind" abilities we compared the performance of a case-series of 11 brain-lesioned patients on a recently developed test of false belief reasoning () and on a matched false photograph task, which did not require belief reasoning and which addressed problems with existing false photograph methods. A strikingly similar pattern of performance was shown across the false belief and false photograph tests. Patients who were selectively impaired on false belief tasks were also impaired on false photograph tasks; patients spared on false belief tasks also showed preserved performance with false photographs. In some cases the impairment on false belief and false photograph tasks coincided with good performance on control tasks matched for executive demands. We discuss whether the patients have a domain-specific deficit in reasoning about representations common to both false belief and false photograph tasks.

Mental Fitness for patients with acute coronary syndrome: A randomized clinical trial.

OBJECTIVES: The aim of this study was to verify the efficacy of a manualized, cognitively oriented psychological intervention, called Mental Fitness, in improving the mental and physical health of patients with acute coronary syndrome (ACS). Mental Fitness is a small-group four-session treatment aimed at increasing awareness of one's own bodily perceptions, emotions, and thoughts and is overall tailored on participants' perception of control over their health. DESIGN: Prospective randomized controlled single-blind trial. METHODS: Patients with ACS were recruited within a week from their acute cardiac event. Patients in the intervention group underwent one of two variants of Mental Fitness, depending on their perceived (internal or external) control over their health. Patients in the control group underwent standard treatment. All the patients were submitted to a clinical and psychological follow-up for 8 months. RESULTS: The patients who underwent the Mental Fitness intervention (N = 31) showed, compared to the control patients (N = 34), increased quality of life in its physical, psychological, social and environmental domains, more functional emotional and problem-centred coping strategies, and higher emotional awareness. They also showed improved high-density lipoprotein cholesterol, triglycerides, heart rate, and left ventricular ejection fraction compared to the controls. In addition, they were more successful in maintaining physical exercise. CONCLUSIONS: This study demonstrates the efficacy of Mental Fitness in modifying specific psychological and physical variables conditioning cardiological patients' prognosis. It also confirms the importance of differentiating psychological interventions based on the psychological characteristics of the patients. Statement of contribution What is already known on this subject? Traditional symptom-based interventions in heart disease are aimed at diagnosing and reducing psychological symptomatology (e.g., depression), but recent work has shown the usefulness of orienting psychological interventions to patients' representations of themselves and of the world and to how such representations influence their thoughts, feelings, and behaviours (e.g., Chiavarino et al., ). What does this study add? Mental Fitness, by working on awareness of bodily perceptions, emotions, and thoughts, leads to positive changes in physical and psychological health. Mental Fitness is a cost-effective psychological intervention that adds significantly to the effectiveness of standard medical care.

Theory of mind deficit in adult patients with congenital heart disease.

This article provides the first assessment of theory of mind, that is, the ability to reason about mental states, in adult patients with congenital heart disease. Patients with congenital heart disease and matched healthy controls were administered classical theory of mind tasks and a semi-structured interview which provides a multidimensional evaluation of theory of mind (Theory of Mind Assessment Scale). The patients with congenital heart disease performed worse than the controls on the Theory of Mind Assessment Scale, whereas they did as well as the control group on the classical theory-of-mind tasks. These findings provide the first evidence that adults with congenital heart disease may display specific impairments in theory of mind.

Is automatic imitation based on goal coding or movement coding? A comparison of goal-directed and goal-less actions.

A key issue for research on automatic imitation is whether it occurs primarily at the level of movements, that is, by automatically activating a representation of the movement/effector involved in the execution of the observed action, or at the level of goals, that is, by triggering a representation of the action goal, irrespective of how the motor act is physically instantiated. The present study presents two experiments aimed at investigating the contribution of movement coding and goal coding to automatic imitation, by assessing participants' performance in a spatial compatibility task where the observed stimuli were goal-directed and goal-less actions, which have been demonstrated to elicit, respectively, goal and movement coding. We found a significant automatic imitation effect both when the stimuli were goal-less actions and when they were actions directed toward a goal. However, the effect was stronger for the goal-less actions, even after controlling for saliency effects. These results suggest that goal coding contributes to automatic imitation, but to a lesser degree compared to movement coding. The implications of these results for theory and research on automatic imitation are discussed.

Are you approaching me? Motor execution influences perceived action orientation.

Human observers are especially sensitive to the actions of conspecifics that match their own actions. This has been proposed to be critical for social interaction, providing the basis for empathy and joint action. However, the precise relation between observed and executed actions is still poorly understood. Do ongoing actions change the way observers perceive others' actions? To pursue this question, we exploited the bistability of depth-ambiguous point-light walkers, which can be perceived as facing towards the viewer or as facing away from the viewer. We demonstrate that point-light walkers are perceived more often as facing the viewer when the observer is walking on a treadmill compared to when the observer is performing an action that does not match the observed behavior (e.g., cycling). These findings suggest that motor processes influence the perceived orientation of observed actions: Acting observers tend to perceive similar actions by conspecifics as oriented towards themselves. We discuss these results in light of the possible mechanisms subtending action-induced modulation of perception.

Emotional coping is a better predictor of cardiac prognosis than depression and anxiety.

OBJECTIVE: We compared, in a prospective study on patients with acute coronary syndrome, the predictive effect of a depression or anxiety diagnosis and of emotion-focused, problem-focused and dysfunctional coping strategies, as detected early after an acute event, on patients' left ventricular ejection fraction (LVEF), a reliable prognostic index of disease severity, at a three-month follow up. METHODS: Ninety consecutive patients following an acute coronary syndrome event (83.3% men; mean age 56.9 ± 8.9 years) were included in the study. Demographic and clinical characteristics, presence of depression and anxiety disorders (MINI), and active use of emotion-focused, problem-focused and dysfunctional coping strategies (Brief Cope) were assessed at the time of enrolment. LVEF at a three-month follow up was used as the outcome measure. RESULTS: The medical predictors of LVEF accounted for 10.6% of the variance of LVEF at follow up. Emotion-focused coping strategies significantly contributed for an additional 6.1%, while the presence of a depression and/or anxiety disorder was not a significant predictor of LVEF at follow up, nor were dysfunctional and problem-focused coping strategies. CONCLUSION: Emotion-focused coping strategies at the time of the cardiac event were the only reliable psychological predictor of disease severity at a three-month follow up. These findings hint to the possibility that variables such as emotional coping may be a fruitful target for psychological treatments directed at cardiac patients in primary care settings.

Distinguishing intentions from desires: contributions of the frontal and parietal lobes.

The ability to represent desires and intentions as two distinct mental states was investigated in patients with parietal (N=8) and frontal (N=6) lesions and in age-matched controls (N=7). A task was used where the satisfaction of the desire and the fulfilment of the intention did not co-vary and were manipulated in a 2 × 2 set. In two experiments we show that lesions to the frontal lobe may impair the ability to deal with desires when their outcome is not congruent with that of the intention, and that parietal damage - especially if it encompasses the left temporo-parietal junction - may cause severe difficulties in the processing of both desires and intentions. The implications of the results for the neuropsychological and the developmental literature are discussed.

Frontal and parietal lobe involvement in the processing of pretence and intention.

We assessed whether different processes might be at play during pretence understanding by examining breakdowns of performance in participants with acquired brain damage. In Experiment 1 patients with frontal or parietal lesions and neurologically intact adults were asked to categorize videos of pretend and real actions. In Experiment 2 participants saw three types of videos: real intentional actions, real accidental actions, and pretend actions. In one session they judged whether the actions they saw were intentional or accidental, and in a second session they judged whether the actions were real or pretend. Parietal patients had particular difficulties in the identification of pretend actions, and both parietal and frontal patients were more impaired than controls in understanding the intentional nature of pretence. Analyses of individual patients' performance revealed that parietal lesions, and in particular lesions to the temporo-parietal junction, impaired the ability to discriminate pretend from real actions. However, this did not necessarily affect the discrimination of intentional from unintentional actions, which instead may be independently disrupted by damage to frontal areas. Moreover, spared ability to discriminate pretend actions from real actions, and intentional actions from accidental actions, did not grant a full conceptual understanding of the intentional nature of pretence. The implications for pretence understanding are discussed.

The effect of action goal hierarchy on the coding of object orientation in imitation tasks: evidence from patients with parietal lobe damage.

In order to explore parietal patients' difficulties in the processing of orientation information, we asked parietal patients (N = 8) and healthy and brain-damaged controls to imitate multicomponent actions where object orientation was one component. In Experiment 1 orientation was not the most relevant aspect of the action to be imitated, and the parietal group showed significant difficulties in processing object orientation. However, in Experiment 2, where orientation was placed at the top end of the goal hierarchy, the parietal group were able to process stimulus orientation sufficiently to place it within the goal hierarchy of the action and to reproduce it accurately. We conclude that patients with parietal lesions might be able to include object orientation in a goal hierarchy, but if their processing of orientation information is impaired they might be disproportionately prone to errors when object orientation is lower in the goal hierarchy and so not prioritized for processing resources.

Is belief reasoning automatic?

Understanding the operating characteristics of theory of mind is essential for understanding how beliefs, desires, and other mental states are inferred, and for understanding the role such inferences could play in other cognitive processes. We present the first investigation of the automaticity of belief reasoning. In an incidental false-belief task, adult subjects responded more slowly to unexpected questions concerning another person's belief about an object's location than to questions concerning the object's real location. Results in other conditions showed that responses to belief questions were not necessarily slower than responses to reality questions, as subjects showed no difference in response times to belief and reality questions when they were instructed to track the person's beliefs about the object's location. The results suggest that adults do not ascribe beliefs to agents automatically.

Frontal and temporo-parietal lobe contributions to theory of mind: neuropsychological evidence from a false-belief task with reduced language and executive demands.

A model of the functional and anatomical basis of belief reasoning is essential for understanding the relationship between belief reasoning and other cognitive processes in both normal development and pathology. Studies of brain-damaged patients can give valuable insights into the nature of belief processing but pose unique methodological problems. The current study addresses these problems by using a nonlinguistic belief-reasoning task with substantially reduced executive demands. A case series of 12 brain-damaged patients is presented. The belief-reasoning errors of four patients with damage to the prefrontal cortex appeared to arise from these patients' executive function problems. The belief-reasoning errors of three patients with damage to the temporo-parietal junction could not easily be accounted for in this way, raising the possibility that this brain region has a necessary role in representing beliefs, rather than handling the executive demands of belief-reasoning tasks. We discuss the importance of gaining empirical evidence about the scope of ''theory of mind'' impairments, and the important role for neuropsychological studies in this project.