The role of affective temperaments as a factor of vulnerability to seasonal affective disorder.

BACKGROUND: Growing evidence suggests the relevance of affective temperaments in the development of mood disorders. This study aims to assess their potential role as a vulnerability factor for seasonal affective disorder (SAD) and subsyndromal SAD (S-SAD) in a sample of young individuals without a history of clinical diagnosis. METHODS: Eight hundred and forty-six university students were enrolled in a cross-sectional study. Participants were evaluated for exclusion and inclusion criteria and divided into Control, S-SAD, and SAD groups. They filled out two self-administered questionnaires to assess the degree of seasonality problems and the predominant type of affective temperaments, the Seasonal Pattern Assessment Questionnaire (SPAQ), and the Temperament Evaluation Instrument of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire version scale (briefTEMPS-M version). We conducted a multinomial logistic regression model to explore the relationship between affective temperaments and seasonality. RESULTS: Our results evidenced that cyclothymic [χ2 (2) = 33.486, p < 0.001] and anxious [χ2 (2) = 86.991, p < 0.001] temperaments were significant predictors in the model, suggesting that individuals with cyclothymic and anxious temperaments are at increased risk of developing SAD, due to heightened seasonal changes in mood and behavior. In contrast, people with hyperthymic temperament appear less susceptible to experiencing seasonal problems. LIMITATIONS: The homogeneity of the sample; only retrospective self-reported data were considered; measures of temperament and seasonality were simultaneously assessed. CONCLUSIONS: Understanding which affective temperaments may constitute a potential predisposing factor for vulnerability to seasonal changes can aid in better assessing SAD and predicting its outcome.

Declarative Memory Impairment and Emotional Bias in Recurrent Depression with a Seasonal Pattern: The Interplay between Emotion and Cognition in Seasonal Affective Disorder.

Seasonal Affective Disorder (SAD) is a subtype of Major Depressive Disorder (MDD) with a seasonal pattern. Although it is a pathological condition limited to specific seasons of the year, during the symptomatic period, patients may experience a significant impairment of well-being and daily quality of life as a result of the depressed mood, associated with other symptoms defined as atypical of MDD. While extensive evidence of memory deficits has been found in MDD, explicit memory impairments in SAD are insufficiently studied. This study aims to investigate the cognitive processing of emotional stimuli in women with SAD, in particular the interplay between emotions and declarative memory. One hundred and twenty young women, screened from an initial number of 1125 university students, were divided into two groups, an experimental one that included 60 medically untreated women affected by "winter type SAD" and a control group of 60 non-SAD women. Different subjects were randomly submitted to two types of audio−visual stories, neutral or arousal, and then their memory performances were analyzed by means of a free-recall test and a recognition memory test. In both the free-recall test (p < 0.008) and in the recognition memory test (p < 0.002), the SAD group showed impaired memory performances. Taken together, our novel key findings suggest that SAD is characterized by impairment in declarative memory and attentional bias for emotional negative stimuli.

Assessment of premenstrual symptoms: validation of the Italian version of the Premenstrual Symptoms Screening Tool.

PURPOSE: The aim of this study was to provide an Italian validation of the Premenstrual Symptoms Screening Tool (PSST). The PSST is a retrospective questionnaire, originally developed in English language, used for the screening of Premenstrual Syndrome (PMS) and of Premenstrual Dysphoric Disorder (PMDD). PMDD and PMS are common, but are often not adequately recognized and treated, although they can heavily interfere on women's quality of life. METHODS: An Italian version of the PSST from English was prepared using the "forward-backward" procedure, and submitted to a sample of 520 women over 18 years of age (mean age of 23.6; DS=±3.1). The content validity, the internal consistency, the test-retest reliability, and the convergent validity were evaluated. The factorial structure underlying the questionnaire was assessed with the use of both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). RESULTS: Among the 520 participants to the study, 337 experienced no or mild premenstrual symptoms (64.8%), while 158 women evidenced a positive screening for moderate or severe PMS (30.4%), and 23 for PMDD (4.4%). The Italian PSST displayed adequate content validity and a very good internal consistency, with a Cronbach's alpha of 0.89. The test-retest reliability showed satisfactory results, with a Spearman's ρ for the overall score of 0.80, and the intra-class correlation coefficient (ICC) of 0.810 (95% CI=0.761-0.862; p<0.001). The EFA was performed using the principal component analysis, followed by varimax rotation. The CFA was conducted on EFA results and supported a four-factor model, yielding the best fit indices [χ2/df=1.76; CFI=0.920; TLI=0.904; RMSEA=0.054 (0.043-0.065)]. The convergent validity, evaluated using the Spearman's correlation coefficient between the overall score of the Italian version of PSST and the Beck Depression Inventory (BDI) score showed a good value (ρ=0.647 p<0.001). CONCLUSION: Our results support the cross-cultural validity of the questionnaire, suggesting that the Italian version is a reliable and valid tool, as well as easy to use, to screen women in need of treatment for their premenstrual symptoms.

Effects of sex steroid hormones on memory.

Many evidences have elucidated relevant mechanisms of action of estrogen, progesterone, and testosterone on cognition, including learning and memory processes, both in animal models and humans. This influence may depend on their modulator role on several neurotransmitter systems, and the extensive presence of their receptors in cerebral areas, involved in cognitive functions, including the amygdala, hippocampal formation, and cerebral cortex. The present brief review summarizes data of our research and others with the aim of clarifying, in mammals, the involvement of sex hormones on memory. In particular, after an introduction illustrating the general mechanisms of sex hormones modulation on memory processes, the specific role of estrogen, progesterone and testosterone in memory is described in three different sections. Besides summarizing the most relevant actions of sex steroid hormones in the modulation of learning and memory, in this review is also emphasized that many aspects and mechanisms are still not completely\r\nunderstood and extensive future research is necessary to elucidate them.

An instrument for the evaluation of muscle dysmorphia: The Italian validation of the adonis complex questionnaire.

BACKGROUND AND AIMS: Muscle dysmorphia (MDM), or bigorexia, is a subcategory of body dysmorphic disorder (BDD), also known as "Adonis Complex" in nonscientific contexts. One of the most used tools to investigate MDM is the Adonis Complex Questionnaire (ACQ). The ACQ is a 13-item US questionnaire, designed for male subjects only, related to the dissatisfaction and concerns about physical appearance. The aim of the current study was to evaluate the validity of the Italian version of the ACQ. METHODS: The instrument was administered to a sample of 322 male adults, recruited from the general population. We used the maximum-likelihood confirmatory factorial analysis (CFA), analyzing the covariance matrices with AMOS 24.0, to evaluate the different factorial models proposed in the literature. RESULTS: The evaluation of the factorial structure of the Italian version of the ACQ demonstrates the greater stability and internal consistency of the two-factor model, compared to the original three-factor model. The factors have no correlation with the demographic characteristics of the sample. CONCLUSIONS: The present study confirms the validity and the reliability of the Italian two-factor version of the ACQ and highlights the general tendency, among Italian males, to have concerns about their own physical appearance with recurring thoughts and eating behaviors finalized to improve it. Our study represents an advance in the use of adequate and reliable instruments to assess concerns about physical appearance in the Italian male population.

Night Eating Syndrome, circadian rhythms and seasonality: a study in a population of Italian university students.

PURPOSE: The aim of this research was to assess the prevalence of Night Eating Syndrome (NES) in a university student population and to clear up the relationship between NES, depression and chronotype. The relation between NES and seasonality was also investigated. METHODS: The data were collected from a sample of 1136 students of the L'Aquila University, Italy. All subjects were invited to answer to the Sociodemographic Information Form and to take a self-report battery composed by four questionnaires: the Night Eating Questionnaire (NEQ), the Morningness Eveningness Questionnaire (MEQ), the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Beck Depression Inventory (BDI). RESULTS: The 5.3% of our population (60 subjects) reached the criteria for NES. The distribution of chronotypes in the sample was: Morning Type 15.3%, Intermediate 64.3% and Evening Type 20.4%. The 36.7% of the participants reaching the criteria for NES, obtained low scores on the MEQ. The data indicated that NEQ and MEQ scores are significantly inversely correlated (r=-.22; p<.01, two-tailed test). The 3.6% of our population (41 subjects) reached the criteria for Seasonal Affective Disorder (SAD) and 10.7% for subclinical SAD (121 subjects). Furthermore, the 11.7% of subjects with NES presented SAD and the 5% presented Subclinical SAD. The data demonstrated that NES and Global Seasonality Score (GSS) are significantly associated (r=.22; p<0.01, two-tailed test). CONCLUSIONS: The main finding of this study is the strong relation between NES and eveningness dimension. Our results help to clear up the literature debate about the role of eveningness dimension in the night eating, suggesting that subjects with NES present a circadian delay, not only in the food intake, but in the entire functioning. At the best of one knowledge this study is the first one to examine the relationship between NES and seasonality. This research found preliminary evidence that, similarly to the findings of previous studies in subjects with Bulimia Nervosa (BN) and Binge Eating Disorder (BED), night eating symptoms may vary significantly across the seasons; subjects with NES experience seasonal variation in their mood and in their eating patterns.

Electrophysiological and Behavioral Indices of the Role of Estrogens on Memory Processes for Emotional Faces in Healthy Young Women.

It is well known that estrogens influence cognitive activities, such as memory, and emotional states. The objective of the present study was to investigate the role of estrogens in the short-term memory processing of basic emotional face expressions, by means of event-related potentials (ERPs) and a recognition memory (RM) behavioral task. Healthy young women were divided into a periovulatory (PO) group, characterized by high levels of estrogens and low levels of progesterone, and an early follicular (EF) group, characterized by low levels of both estrogens and progesterone. During the RM task, all subjects viewed images of faces expressing six basic emotions (happiness, anger, disgust, sadness, surprise, fear) and one neutral expression while their electrophysiological activity was recorded. We considered P300 components, amplitude, and latency in response to each stimulus. Soon after the presentation of each stimulus face, a target image was presented, consisting of two faces, one of which was the same, while the other was a chimerical face, obtained by mixing the upper or lower halves of the faces of the stimulus image with a different emotion. The subjects had to choose between the two alternatives, and the reaction time (RT) and accuracy of response (RM errors) were measured. The main findings of this study showed that P300 amplitudes are significantly higher in response to the expressions of happiness, but significantly lower for sadness, in PO compared to EF. The P300 data are consistent with performance in the RM task and with the measures of RT. The interest in the emotion of happiness, unlike sadness, during the PO phase may reflect the evolutionary significance of female sex hormones linked to mating behavior.