Does the Meeting Centre Support Programme decrease the experience of stigmatisation among people with cognitive deficits?

OBJECTIVES: This is the first study to focus on the role and impact of a psychosocial intervention, the Meeting Centre Support Programme (MCSP), for people living with dementia and mild cognitive impairment (MCI) on the experience of stigmatisation across three different European countries. METHOD: A pre/post-test control group study design compared outcomes for 114 people with dementia (n=74) and MCI (n=40) in Italy, Poland and the UK who received either the MCSP or usual care (UC). The 'Stigma Impact Scale, neurological disease' (SIS) was administered at two points in time, 6 months apart. The Global Deterioration Scale (GDS) was used to assess the level of cognitive impairment. RESULTS: Although statistical analysis did not show any significant differences between MCSP and UC at pre/post-test for the 3 countries combined, there were significant results for individual countries. In Italy, the level of SIS was significantly lower (p=0.02) in the MCSP group following the intervention. The level of Social Isolation increased significantly (p=0.05) in the UC group at follow-up in Poland. The level of Social Rejection was significantly higher (p=0.03) over time for UK participants receiving MCSP compared to UC. CONCLUSION: The experience of stigma by people living with dementia and MCI is complex and there may be different country specific contexts and mechanisms. The results do not enable us to confirm or disconfirm the impact of a social support programme, such as MCSP, on this experience. Difficulties in directly measuring the level of stigma in this group also requires further research.

Meeting centres support programme highly appreciated by people with dementia and carers: a European cross-country evaluation.

BACKGROUND: The Meeting Centres Support Programme (MCSP) offers a combined approach to providing practical, emotional and social support to people living with mild to moderately severe dementia and their family carers in the community. METHODS: A mixed methods explanatory design was used. The evaluation took place within the framework of the international Joint Programme - Neurodegenerative Disease Research (JPND) - MEETINGDEM study in nine Meeting Centres in Italy, Poland and the United Kingdom. Eighty-seven people with dementia and 81 family carers completed a user evaluation survey after three months and 83 people with dementia and 84 carers after 6 months of participation in MCSP. Thirty-two people with dementia and 30 carers took part in focus groups after nine months. RESULTS: The percentage of people with dementia who were very satisfied with the programme increased significantly over time (p = 0.05). The majority of carers reported that they felt less burdened after three months of participation in MCSP (48.1% much less; 35.4% a little less). After six months, this percentage increased significantly to 91% (p = 0.04, 57.7% much less; 33.3% little less). Focus group analysis showed that people with dementia and carers in all countries/centres improved their ability to maintain emotional balance. CONCLUSIONS: The MCSP is highly appreciated by people with dementia and carers in all countries and it confirms the results of previous research into MCSP in the Netherlands. Our findings indicate that MCSP is a model that can help its users to increase their capacity to deal with the challenges caused by dementia and can promote emotional balance.

The impact of the implementation of the Dutch combined Meeting Centres Support Programme for family caregivers of people with dementia in Italy, Poland and UK.

Objectives: The MEETINGDEM research project aimed to implement the combined Dutch Meeting Centre Support Programme (MCSP) for community-dwelling people with dementia and caregivers within Italy, Poland and UK and to assess whether comparable benefits were found in these countries as in the Netherlands.Method: Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared to usual care (UC) on caregiver outcomes measuring competence (SSCQ), mental health (GHQ-12), emotional distress (NPI-Q) and loneliness (UCLA) analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. Interviews using standardised measures were completed with caregivers.Results: Pre/post data were collected for 93 caregivers receiving MCSP and 74 receiving UC. No statistically significant differences on the outcome measures were found overall. At a country level MC caregivers in Italy showed significant better general mental health (p = 0.04, d = 0.55) and less caregiver distress (p = 0.02, d = 0.62) at post-test than the UC group. Caregiver satisfaction was rated on a sample at 3 months (n = 81) and 6 months (n = 84). The majority of caregivers reported feeling less burdened and more supported by participating in MCSP.Conclusion: The moderate positive effect on sense of competence and the greater mental health benefit for lonely caregivers using the MCSP compared to UC as found in the original Dutch studies were not replicated. However, subject to study limitations, caregivers in Italy using MCSP benefitted more regarding their mental health and emotional distress than caregivers using UC. Further evaluation of the benefits of MCSP within these countries in larger study samples is recommended.

Evaluation of the implementation of the Meeting Centres Support Program in Italy, Poland, and the UK; exploration of the effects on people with dementia.

OBJECTIVES: MEETINGDEM investigated whether the Dutch Meeting Centres Support Programme (MCSP) could be implemented in Italy, Poland, and the UK with comparable benefits. This paper reports on the impact on people living with dementia attending pilot Meeting Centres in the 3 countries. METHODS: Nine pilot Meeting Centres (MCs) participated (Italy-5, Poland-2, UK-2). Effectiveness of MCSP was compared with Usual Care (UC) on outcomes measuring behavioural and psychological symptoms (NPI), depression (CSDD), and quality of life (DQoL, QOL-AD), analysed by ANCOVAs in a 6-month pre-test/post-test controlled trial. RESULTS: Pre/post data were collected for 85 people with dementia and 93 carers (MCSP) and 74 people with dementia /carer dyads' receiving UC. MCSP showed significant positive effects for DQoL [Self-esteem (F = 4.8, P = 0.03); Positive Affect (F = 14.93, P < 0.00); Feelings of Belonging (F = 7.77, P = 0.01)] with medium and large effect sizes. Higher attendance levels correlated with greater neuropsychiatric symptom reduction (rho = 0.24, P = 0.03) and a greater increase in feelings of support (rho = 0.36, P = 0.001). CONCLUSIONS: MCSPs showed significant wellbeing and health benefits compared with UC, building on the evidence of effectiveness from the Netherlands. In addition to the previously reported successful implementation of MCSP in Italy, Poland, and the UK, these findings suggest that further international dissemination of MCSP is recommended.

Cues of control modulate the ascription of object ownership.

Knowing whether an object is owned and by whom is essential to avoid costly conflicts. We hypothesize that everyday interactions around objects are influenced by a minimal sense of object ownership grounded on respect of possession. In particular, we hypothesize that tracking object ownership can be influenced by any cue that predicts the establishment of individual physical control over objects. To test this hypothesis we used an indirect method to determine whether visual cues of physical control like spatial proximity to an object, temporal priority in seeing it, and touching it influence this minimal sense of object ownership. In Experiment 1 participants were shown a neutral object located on a table, in the reaching space of one of two characters. In Experiment 2 one character was the first to find the object then another character appeared and saw the object. In Experiments 3 and 4, spatial proximity, temporal priority, and touch are pitted against each other to assess their relative weight. After having seen the scenes, participants were required to judge the sensibility of sentences in which ownership of the object was ascribed to one of the two characters. Responses were faster when the objects were located in the reaching space of the character to whom ownership was ascribed in the sentence and when ownership was ascribed to the character who was the first to find the object. When contrasting the relevant cues, results indicate that touch is stronger than temporal priority in modulating the ascription of object ownership. However, all these effects were also influenced by contextual social cues like the gender of both characters and participants, the presence of a third-party observer, and the co-presence of characters. Consistently with our hypothesis, results indicate that many different cues of physical control influence the ascription of ownership in daily social contexts.

Acting in perspective: the role of body and language as social tools.

We investigated how the reach-to-grasp movement is influenced by the presence of another person (friend or non-friend), who was either invisible (behind) or located in different positions with respect to an object and to the agent, and by the perspective conveyed by linguistic pronouns ("I", "You"). The interaction between social relationship and relative position influenced the latency of both maximal fingers aperture and velocity peak, showing shorter latencies in the presence of a non-friend than in the presence of a friend. However, whereas the relative position of a non-friend did not affect the kinematics of the movement, the position of a friend mattered: latencies were significantly shorter with friends only in positions allowing them to easily reach for the object. Finally, the investigation of the overall reaching movement time showed an interaction between the speaker and the pronoun: participants reached the object more quickly when the other spoke, particularly if she used the "I" pronoun. This suggests that speaking, and particularly using the "I" pronoun, evokes a potential action. Implications of the results for embodied cognition are discussed.

Heaven can wait. How religion modulates temporal discounting.

Evidence suggests that religious systems have specific effects on attentional and action control processes. The present study investigated whether religions also modulate choices that involve higher-order knowledge and the delay of gratification in particular. We tested Dutch Calvinists, Italian Catholics, and Atheists from both countries/cultures using an intertemporal choice task where participants could choose between a small immediate and a larger delayed monetary reward. Based on the Calvinist theory of predestination and the Catholic concept of a cycle of sin-confession-expiation, we predicted a reduced delay tolerance, i.e., higher discount rate, for Italian Catholics than for Dutch Calvinists, and intermediate rates for the two atheist groups. Analyses of discount rates support our hypotheses. We also found a magnitude effect on temporal discounting and faster responses for large than for small rewards across religions and countries/cultures. We conclude that temporal discounting is specifically modulated by religious upbringing rather than by generic cultural differences.

Disentangling the sense of ownership from the sense of fairness.

Both evolutionary and developmental research indicate that humans are adapted to respecting property rights, independently (and possibly orthogonally) of considerations of fairness. We offer evidence from psychological experiments suggesting that enforcing one's rights and respecting others' possessions are basic cognitive mechanisms automatically activated and grounded in humans' sensory-motor system. This may entail an independent motivation that is more profound than considerations of fairness and impartiality.

Sustainable materials: a linking bridge between material perception, affordance, and aesthetics.

The perception of material properties, which refers to the way in which individuals perceive and interpret materials through their sensory experiences, plays a crucial role in our interaction with the environment. Affordance, on the other hand, refers to the potential actions and uses that materials offer to users. In turn, the perception of the affordances is modulated by the aesthetic appreciation that individuals experience when interacting with the environment. Although material perception, affordances, and aesthetic appreciation are recognized as essential to fostering sustainability in society, only a few studies have investigated this subject matter systematically and their reciprocal influences. This scarcity is partially due to the challenges offered by the complexity of combining interdisciplinary topics that explore interactions between various disciplines, such as psychophysics, neurophysiology, affective science, aesthetics, and social and environmental sciences. Outlining the main findings across disciplines, this review highlights the pivotal role of material perception in shaping sustainable behaviors. It establishes connections between material perception, affordance, aesthetics, and sustainability, emphasizing the need for interdisciplinary research and integrated approaches in environmental psychology. This integration is essential as it can provide insight into how to foster sustainable and durable changes.

Compatibility effects with destination and origin of motion.

Previous studies highlighted spatial compatibility effects other than those strictly arising from stimulus-response locations. In particular, the so-called Destination Compatibility (DC) effect refers to faster responses for dynamic (i.e., moving) stimuli the end point of which is spatially compatible with the response key. Four experiments examined whether the DC effect also occurs with static visual stimuli symbolically representing either motion destination alone (Experiment 1a), or both motion origin and destination (Experiments 1b, 2a, and 2b). Overall, our results are consistent in showing a DC effect; most importantly, the present findings reveal a predominance of the effect of destination of motion over that of origin, even when both the starting and ending positions of the stimulus are symbolically represented and participants are instructed to respond according to motion origin. This finding suggests that the DC effect is independent from other stimulus-response compatibility (SRC) effects.

Which body for embodied cognition? Affordance and language within actual and perceived reaching space.

The mental representation of one's own body does not necessarily correspond to the physical body. For instance, a dissociation between perceived and actual reach-ability has been shown, that is, individuals perceive that they can reach objects that are out of grasp. We presented participants with 3D pictures of objects located at four different distances, namely near-reaching space, actual-reaching space, perceived-reaching space and non-reaching space. Immediately after they were presented with function, manipulation, observation or pointing verbs and were required to judge if the verb was compatible with the object. Participants were faster with function and manipulation verbs than with observation and pointing verbs. Strikingly, with both function and manipulation verbs participants were faster when objects were presented in actual than the perceived reaching space. These findings suggest that our knowledge of the world is implicitly built online through behaviour, and is not necessarily reflected in explicit estimates or conscious representations.

Costs and cost-effectiveness of the meeting centres support programme for people living with dementia and carers in Italy, Poland and the UK: The MEETINGDEM study.

We examined the costs and cost-effectiveness of the Meeting Centre Support Programme (MCSP) implemented and piloted in the UK, Poland and Italy, replicating the Dutch Meeting Centre model. Dutch Meeting Centres combine day services for people with dementia with carer support. Data were collected over 2015-2016 from MCSP and usual care (UC) participants (people with dementia-carer dyads) at baseline and 6 months. We examined participants' health and social care (HSC), and societal costs, including Meeting Centre (MC) attendances. Costs and outcomes in MCSP and UC groups were compared. Primary outcomes: Persons with dementia: quality-adjusted life years (EQ-5D-5L-derived); QOL-AD. DQoL was examined as a secondary outcome. Carers: Short Sense of Competence Questionnaire (SSCQ). Incremental cost-effectiveness ratios (ICER) and cost-effectiveness acceptability curves were obtained by bootstrapping outcome and cost regression estimates. Eighty-three MCSP and 69 UC dyads were analysed. The 6-month cost of providing MCSP was €4,703; participants with dementia attended MC a mean of 45 times and carers 15 times. Including intervention costs, adjusted 6-month HSC costs were €5,941higher in MCSP than in UC. From the HSC perspective: in terms of QALY, the probability of cost-effectiveness was zero over willingness-to-pay (WTP) ranging from €0 to €350,000. On QOL-AD, the probability of cost-effectiveness of MCSP was 50% at WTP of €5,000 for a one-point increase. A one-point gain in the DQoL positive affect subscale had a probability of cost-effectiveness of 99% at WTP over €8,000. On SSCQ, no significant difference was found between MCSP and UC. Evidence for cost-effectiveness of MCSP was mixed but suggests that it may be cost-effective in relation to gains in dementia-specific quality of life measures. MCs offer effective tailored post-diagnostic support services to both people with dementia and carers in a context where few evidence-based alternatives to formal home-based social services may be available.

Language-induced motor activity in bi-manual object lifting.

Language comprehension requires a simulation process that taps perception and action systems. How specific is this simulation? To address this question, participants listened to sentences referring to the lifting of light or heavy objects (e.g., pillow or chest, respectively). Then they lifted one of two boxes that were visually identical, but one was light and the other heavy. We focused on the kinematics of the initial lift (rather than reaching) because it is mostly shaped by proprioceptive features derived from weight that cannot be visually determined. Participants were slower when the weight suggested by the sentence and the weight of the box corresponded. This effect indicates that language can activate a simulation which is sensitive to intrinsic properties such as weight.

Re-enacting the Bodily Self on Stage: Embodied Cognition Meets Psychoanalysis.

The embodied approach to cognition consists in a range of theoretical proposals sharing the idea that our concepts are constitutively shaped by the physical and social constraints of our body and environment. Still far from a mutually enriching interplay, in recent years embodied and psychoanalytic approaches are converging on similar constructs as the ones of intersubjectivity, bodily self, and affective quality of verbal communication. Some efforts to cope with the sentient subject were already present in classical cognitivism: having expunged desires and conflicts from the cognitive harmony, bodily emotions re-emerged but only as a noisy dynamic friction. In contrast, the new, neural, embodied cognitive science with its focus on bodily effects/affects has enabled a dialogue between neuro-cognitive perspectives and clinic-psychological ones, through shared conceptual frameworks. I will address crucial issues that should be faced on this reconciling path. With reference to two kinds of contemporary addictions - internet addiction disorder and eating disorders - I will introduce a possible therapeutic approach that is built upon the core role of the acting-sentient bodily self in a dynamic-social and affective environment. In Psychoanalytic Psychodrama, the spontaneous re-enactment of a past (socially and physically constrained) experience is actualized by means of the other, the Auxiliary Ego. This allows homeostatic and social-emotional affects, i.e., drives and instincts, to be re-experienced by the agent, the Protagonist, in a safe scenario. The director-psychoanalyst smoothly traces back this simulation to the motivated, and constrained, early proximal embodied interactions with significant others, and to the related instinctual conflicting aims. The psychoanalytic reframing of classical psychodrama does not merely exploit its original cathartic function, rather stands out for exploring the interpersonal constitution of the self, through an actual "re-somatization" of psychoanalytic therapy. Unspoken/unspeakable feelings pop up on stage: the strength of this treatment mainly rests on re-establishing the priority of the embodied Self over the narrative Self. By pointing out the possible conflicts between these two selves, this method can broaden the embodied cognition perspective. The psychodramatic approach will be briefly discussed in light of connectionist models, to finally address linguistic and methodological pivotal issues.

Sentence comprehension and action: effector specific modulation of the motor system.

The purpose of the paper is to study whether sentence comprehension modulates the motor system. Participants were presented with 24 pairs of nouns and verbs that could be referred to hand and mouth actions (e.g., to unwrap vs. to suck the sweet), in the first block, or, in the second block, to 24 hand and foot actions (e.g., to throw vs. kick the ball). An equal number of non-sensible pairs were presented. Participants' task consisted of deciding whether the combination made sense or not: 20 participants responded by saying yes loudly into a microphone, 20 by pressing a pedal. Results support embodied theories of language comprehension, as they suggest that sentence processing activates an action simulation. This simulation is quite detailed, as it is sensitive to the effector involved. Namely, it leads to a facilitation in responses to 'mouth sentences' and 'foot sentences' compared to 'hand sentences' in case of congruency between the effectors - mouth and foot - involved in the motor response and in the sentence.

The challenge of abstract concepts.

concepts ("freedom") differ from concrete ones ("cat"), as they do not have a bounded, identifiable, and clearly perceivable referent. The way in which abstract concepts are represented has recently become a topic of intense debate, especially because of the spread of the embodied approach to cognition. Within this framework concepts derive their meaning from the same perception, motor, and emotional systems that are involved in online interaction with the world. Most of the evidence in favor of this view, however, has been gathered with regard to concrete concepts. Given the relevance of abstract concepts for higher-order cognition, we argue that being able to explain how they are represented is a crucial challenge that any theory of cognition needs to address. The aim of this article is to offer a critical review of the latest theories on abstract concepts, focusing on embodied ones. Starting with theories that question the distinction between abstract and concrete concepts, we review theories claiming that abstract concepts are grounded in metaphors, in situations and introspection, and in emotion. We then introduce multiple representation theories, according to which abstract concepts evoke both sensorimotor and linguistic information. We argue that the most promising approach is given by multiple representation views that combine an embodied perspective with the recognition of the importance of linguistic and social experience. We conclude by discussing whether or not a single theoretical framework might be able to explain all different varieties of abstract concepts. (PsycINFO Database Record

Reaching for Objects or Asking for Them: Distance Estimation in 7- to 15-Year-Old Children.

This study aims to determine if, in children, subjective perception of space is modulated by the experience of reaching distal objects by means of tools and verbal labels. We presented 7-15-year-old participants with objects located in the near and far space, and in the threshold area between these spaces (border space). Before and after a training session, separate groups of participants estimated objects' location by providing a verbal estimation of their distance (n = 12) or by rolling a toy car to match their location (motor-based estimation; n = 16). The training session required interaction with the targets (i.e., actively experiencing the perceived distance) and included use of a rake or a linguistic label when far objects were involved. A control condition in which training implied use of a short, ineffective tool was also tested (n = 6). Results showed that verbal estimations were not affected by the training phase (p > .05). In contrast, training modulated motor-based estimations relative to border space. Specifically, maximal distance of toy car displacements was reduced following all kinds of training (p < .01). These results indicate that, similarly to adults, the boundary between near and far space is not fixed in children and that both active tool use and verbal labels can modulate this uncertain boundary.

Square bananas, blue horses: the relative weight of shape and color in concept recognition and representation.

The present study investigates the role that shape and color play in the representation of animate (i.e., animals) and inanimate manipulable entities (i.e., fruits), and how the importance of these features is modulated by different tasks. Across three experiments participants were shown either images of entities (e.g., a sheep or a pineapple) or images of the same entities modified in color (e.g., a blue pineapple) or in shape (e.g., an elongated pineapple). In Experiment 1 we asked participants to categorize the entities as fruit or animal. Results showed that with animals color does not matter, while shape modifications determined a deterioration of the performance - stronger for fruit than for animals. To better understand our findings, in Experiments 2 we asked participants to judge if entities were graspable (manipulation evaluation task). Participants were faster with manipulable entities (fruit) than with animals; moreover alterations in shape affected the response latencies more for animals than for fruit. In Experiment 3 (motion evaluation task), we replicated the disadvantage for shape-altered animals, while with fruits shape and color modifications produced no effect. By contrasting shape- and color- alterations the present findings provide information on shape/color relative weight, suggesting that the action based property of shape is more crucial than color for fruit categorization, while with animals it is critical for both manipulation and motion tasks. This contextual dependency is further revealed by explicit judgments on similarity - between the altered entities and the prototypical ones - provided after the different tasks. These results extend current literature on affordances and biofunctionally embodied understanding, revealing the relative robustness of biofunctional activity compared to intellectual one.

Naming a Lego world. The role of language in the acquisition of abstract concepts.

While embodied approaches of cognition have proved to be successful in explaining concrete concepts and words, they have more difficulties in accounting for abstract concepts and words, and several proposals have been put forward. This work aims to test the Words As Tools proposal, according to which both abstract and concrete concepts are grounded in perception, action and emotional systems, but linguistic information is more important for abstract than for concrete concept representation, due to the different ways they are acquired: while for the acquisition of the latter linguistic information might play a role, for the acquisition of the former it is instead crucial. We investigated the acquisition of concrete and abstract concepts and words, and verified its impact on conceptual representation. In Experiment 1, participants explored and categorized novel concrete and abstract entities, and were taught a novel label for each category. Later they performed a categorical recognition task and an image-word matching task to verify a) whether and how the introduction of language changed the previously formed categories, b) whether language had a major weight for abstract than for concrete words representation, and c) whether this difference had consequences on bodily responses. The results confirm that, even though both concrete and abstract concepts are grounded, language facilitates the acquisition of the latter and plays a major role in their representation, resulting in faster responses with the mouth, typically associated with language production. Experiment 2 was a rating test aiming to verify whether the findings of Experiment 1 were simply due to heterogeneity, i.e. to the fact that the members of abstract categories were more heterogeneous than those of concrete categories. The results confirmed the effectiveness of our operationalization, showing that abstract concepts are more associated with the mouth and concrete ones with the hand, independently from heterogeneity.