Evolution of Severe Closed Head Injury: Assessing Ventricular Volume and Behavioral Measures at 30 and 90 Days Post-Injury.

Background: Assessing functional outcomes in Severe Closed Head Injury (SCHI) is complex due to brain parenchymal changes. This study examines the Ventricles to Intracranial Volume Ratio (VBR) as a metric for these changes and its correlation with behavioral scales. Methods: Thirty-one SCHI patients were included. VBR was derived from CT scans at 3, 30, and 90 days post-injury and compared with Levels of Cognitive Functioning (LCF), Disability Rating Scale (DRS), and Early Rehabilitation Barthel Index (ERBI) assessments at 30 and 90 days. Results: Ten patients were excluded post-decompressive craniectomy or ventriculoperitoneal shunt. Findings indicated a VBR decrease at 3 days, suggesting acute phase compression, followed by an increase from 30 to 90 days, indicative of post-acute brain atrophy. VBR correlated positively with the Marshall score in the initial 72 h, positioning it as an early indicator of subsequent brain atrophy. Nevertheless, in contrast to the Marshall score, VBR had stronger associations with DRS and ERBI at 90 days. Conclusions: VBR, alongside behavioral assessments, presents a robust framework for evaluating SCHI progression. It supports early functional outcome correlations informing therapeutic approaches. VBR's reliability underscores its utility in neurorehabilitation for ongoing SCHI assessment and aiding clinical decisions.

Interoceptive and Affective Alterations in Body Integrity Dysphoria: An Online Self-Reporting Study.

INTRODUCTION: Body integrity dysphoria (BID) is a rare condition in which individuals experience a long-lasting desire to achieve a specific physical disability. In this study, we tested the hypothesis of interoceptive and affective abnormalities in BID, in line with the evidence of structural and functional alteration of the interoceptive-affective neural system in these individuals. METHOD: Our study involved 68 participants with BID (mean age: 35.6, SD: 16.4). Among these participants, 47 expressed a desire for amputation, 14 desired paralysis, 3 sought sensory deprivation, and 3 desired a combination of these forms. For comparisons, we recruited a control group of 79 participants (mean age: 35.2, SD: 15.8). We administered assessment measures to investigate alexithymia level (TAS-20), disgust sensitivity (DS-R), interoceptive awareness (MAIA-2), and (affective and cognitive) empathy (QCAE). We also administered the Short Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) to identify psychiatric comorbidities. Subgroups with low O-LIFE scores (BID = 31; controls = 43) and subgroups with high O-LIFE scores (BID = 37; controls = 36) were derived through a median-split procedure. RESULTS: Within the BID low O-LIFE group, we found reduced interoceptive sensibility, reduced disgust sensitivity, and increased difficulty in identifying feelings, which refers to a dimension of the alexithymia trait. Within the BID high O-LIFE group, we observed a reduced disgust sensitivity and interoceptive sensibility, accompanied by a diminished score in cognitive empathy. CONCLUSION: Our study suggests that BID can be associated with altered interoceptive and affective processing.

Evidence for a dissociation between moral reasoning and moral decision-making in Tourette syndrome.

Despite the growing interest on how Tourette syndrome (TS) affects social cognition skills, this field remains to date relatively under-explored. Here, we aim to advance knowledge on the topic by studying moral decision-making and moral reasoning in a group of adolescents with TS and a group of healthy controls. Overall, we found higher endorsement (i.e. a greater 'yes' response rate) for utilitarian solutions of incidental and instrumental moral dilemmas in TS compared to controls. By contrast, we reported an overall higher tendency of TS individuals to apply principles described in the moral foundation questionnaire to establish whether something is morally right or wrong. Our results document intact moral reasoning in TS and suggest that a deficit in suppressing inappropriate behaviours and/or altered sense of agency might be responsible for their higher utilitarian moral decision-making.

Disgust as a transdiagnostic index of mental illness: A narrative review of clinical populations.

Disgust is a basic emotion of rejection, providing an ancestral defensive mechanism against illness. Based on research that documents altered experiences of disgust across several psychopathological conditions, we conducted a narrative review to address the hypothesis that altered disgust may serve as a transdiagnostic index of mental illness. Our synthesis of the literature from past decades suggests that, compared to healthy populations, patients with mental disorders exhibit abnormal processing of disgust in at least one of the analyzed dimensions. We also outline evidence of alterations in brain areas relevant to disgust processing, such as the insula and the interconnected limbic network. Overall, we provide preliminary support for the hypothesis that altered disgust processing may serve as a transdiagnostic index of mental illness.

Alexithymia and asthma: a systematic review.

Growing evidence from scientific research elucidates the important role of alexithymia in chronic immune diseases. This Review aims to explore the presence of alexithymia in patients affected by asthma and clarify its associations with other involved psychological and physical factors. In January 2023, according to PRISMA guidelines, a systematic search using PubMed and Scopus was conducted. Twenty-six studies were eligible based on inclusion criteria. Alexithymia was significantly present in asthma patients, with most studies reporting a higher prevalence (from 9 to 62.8%) than in control groups (approximately 10%). The coexistence of asthma and alexithymia was associated with a worse quality of life, psychiatric comorbidity, poor symptom control, and difficulty in recognizing exacerbations of the disease. These results suggest that alexithymia can negatively impact the management of asthma. For this reason, we recommend an accuracy assessment in clinical settings and the implementation of psychological interventions to promote the emotional and physical wellbeing of asthmatic patients.

Social cognition in hyperkinetic movement disorders: a systematic review.

Numerous lines of research indicate that our social brain involves a network of cortical and subcortical brain regions that are responsible for sensing and controlling body movements. However, it remains unclear whether movement disorders have a systematic impact on social cognition. To address this question, we conducted a systematic review examining the influence of hyperkinetic movement disorders (including Huntington disease, Tourette syndrome, dystonia, and essential tremor) on social cognition. Following the PRISMA guidelines and registering the protocol in the PROSPERO database (CRD42022327459), we analyzed 50 published studies focusing on theory of mind (ToM), social perception, and empathy. The results from these studies provide evidence of impairments in ToM and social perception in all hyperkinetic movement disorders, particularly during the recognition of negative emotions. Additionally, individuals with Huntington's Disease and Tourette syndrome exhibit empathy disorders. These findings support the functional role of subcortical structures (such as the basal ganglia and cerebellum), which are primarily responsible for movement disorders, in deficits related to social cognition.

Interrelations between clinical-psychological features and bone mineral density changes in post-menopausal women undergoing anti-osteoporotic treatment: a two-year follow-up.

Introduction: Psychological features have been bidirectionally associated with osteoporosis, but it is still unclear whether patient's anxiety fluctuations during the anti-osteoporotic treatment can have an impact on bone mineral density (BMD) variation. The aim of this study was to investigate the interrelations between psychological distress features, such as anxiety, depression, health-related QoL (HRQoL) and bone health in women receiving anti-osteoporotic treatment. Methods: 192 post-menopausal osteoporotic women were treated with alendronate or risedronate according to the standard procedure. The levels of anxiety, depression, and perceived HRQoL, along with BMD, were assessed at baseline and at a 2-year follow-up. Results: At the end of the study, the patients showed a statistically significant increase of both psychic and somatic anxiety (p<0.0001) and exhibited a worsening of depressive symptoms (p<0.0001), whereas HRQoL showed no change. BMD improved and no incident fractures occurred. BMD variation (ΔBMD) at lumbar spine was significantly associated with anxiety levels (r=0.23, p=0.021). Multiple regression analysis showed that both patients' worsening anxiety levels (ß = -0.1283, SE=0.06142, p=0.04) and their treatment adherence (ß=0.09, SE=0.02, p=0.0006) were independently associated with ΔBMD. Discussion: The findings of the current follow-up study suggest that BMD in post-menopausal women undergoing anti-osteoporotic treatment was predicted by treatment adherence and anxiety change over time.

Evidence of abnormal scalar timing property in alexithymia.

Evidence suggests that incidental modulation of affective states affects the ability to keep track of time. Alexithymia represents an ideal condition to further address the emotion-time processing link, as it refers to a trait characterized by a deficit of affective processing. 31 healthy participants completed an online version of the TAS-20 scale, which measures alexithymia, and a time reproduction task of visual stimuli related to positive (i.e., happiness) and negative (i.e., anger) facial expressions. Results documented a positive correlation between TAS-20 score and the variability in reproducing sub-second durations of the anger expression stimuli We also found an overestimation of sub-second durations of non-affective expressions in borderline/alexithymic participants. Finally, in line with the literature, we confirmed the overall tendency to overestimate the duration of anger expression stimuli. These findings, which can be interpreted in terms of abnormal scalar timing property in alexithymia, expand previous investigations linking this personality trait with abnormal processing of negative emotions. The evidence that alexithymia predicts the reproduction variability of sub-second durations of negative affective stimuli corroborates previous neuroimaging studies documenting cerebellar deficits in these individuals.

The impact of the COVID-19 pandemic on academic performance: a comparative analysis of face-to face and online assessment.

Introduction: Survey studies yield mixed results on the influence of the COVID-19 pandemic on academic performance, with limited direct evidence available. Methodology: Using the academic platform from the Italian university system, a large-scale archival study involving 30,731 students and 829 examiners encompassing a total of 246,416 exams (oral tests only) to scrutinize the influence of the COVID-19 pandemic on the likelihood of passing exams was conducted. Examination data were collected both in face-to-face and online formats during the pandemic. In the pre-pandemic period, only face-to-face data were accessible. Results: In face-to-face examination, we observed a lower probability of passing exams during the pandemic as opposed to pre-pandemic periods. Notably, during the pandemic we found an increased chance of passing exams conducted through online platforms compared to face-to-face assessments. Discussion and conclusions: These findings provide the first direct evidence of an adverse impact of the COVID-19 pandemic on academic performance. Furthermore, the results align with prior survey studies underscoring that using telematics platforms to evaluate students' performance increases the probability of exam success. This research significantly contributes to ongoing efforts aimed to comprehend how lockdowns and the widespread use of online platforms impact academic assessment processes.

Psychological impairment in inflammatory bowel diseases: the key role of coping and defense mechanisms.

A comprehensive investigation of psychological features in chronic patients is very important for tailoring effective treatments. In this study we tested anxiety, depression, health related quality of life (HR-QoL), alexithymia, coping styles, and defense mechanisms, in eighty-four patients with Crohn disease (CD) and ulcerative colitis (UC). Participants reported low to moderate HRQoL and anxiety, apart from alexithymia. Women experienced lower QoL and higher levels of anxiety and depressive symptoms. Coping and defense strategies were related to distress symptoms and QoL. Positive attitude and principalization, showed negative associations with depression, anxiety and alexithymia and were also found to be associated with mental health. CD patients used significantly more turning against objects (p=0.02) and projections (p=0.01) and UC patients used more reversal (p=0.04). Elderly women showed higher anxiety symptoms and lower perceived QoL. Multiple regression analysis revealed anxiety and depression were independently associated with QoL. Significant differences emerged in defense styles among CD and UC. CD participants used more maladaptive coping and defense styles which were related to mental distress, depression and anxiety, together with higher level of alexithymia. Findings suggest that psychological aspects play a key role in mental health in patients suffering from inflammatory bowel diseases. A multi-integrated clinical strategy including psychotherapeutic interventions should be considered in treating CD and UC.

Neuro-Inflammaging and Psychopathological Distress.

Inflammaging is a low degree of chronic and systemic tissue inflammation associated with aging, and is intimately linked to pro-inflammatory mediators. These substances are involved in the pathogenesis of chronic inflammatory diseases and related psychopathological symptoms. When inflammation and aging affect the brain, we use the term neuro-inflammaging. In this review, we focused on the neuro-inflammatory process typical of advanced ages and the related psychopathological symptoms, with particular attention to understanding the immune-pathogenetic mechanisms involved and the potential use of immunomodulatory drugs in the control of clinical psychological signs. Inflammation and CNS were demonstrated being intimately linked in the neuro-inflammatory loop. IL-1, IL-6, TNF-a, COX and PGE are only partially responsible. BBB permeability and the consequent oxidative stress resulting from tissue damage make the rest. Some authors elaborated the "theory of cytokine-induced depression". Inflammation has a crucial role in the onset symptoms of psychopathological diseases as it is capable of altering the metabolism of biogenic monoamines involved in their pathogenesis. In recent years, NSAIDs as an adjunct therapy in the treatment of relevant psychopathological disorders associated with chronic inflammatory conditions demonstrated their efficacy. Additionally, novel molecules have been studied, such as adalimumab, infliximab, and etanercept showing antidepressant and anxiolytic promising results. However, we are only at the beginning of a new era characterized by the use of biological drugs for the treatment of inflammatory and autoimmune diseases, and this paper aims to stimulate future studies in such a direction.

Relationship Between Sensitivity to Disgust and Irritable Bowel Syndrome: A Study on Healthy Individuals.

Objective: Irritable bowel syndrome (IBS) is a psychosomatic gastrointestinal disorder involving the dysfunctional activation of specific brain regions crucial for interoception and disgust processing. Yet, no study has ever investigated the link between this socio-affective/visceral experience and IBS. Method: The present study investigated whether disgust sensitivity and disgust propensity, which can be socially relevant, relate with IBS symptoms in a nonclinical population.105 healthy participants were asked to complete the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R), the Irritable Bowel Syndrome-Quality of Life Measure (IBS-QOL), and the Chronic Urticaria Quality of Life Measure (CU-Q2OL), as control condition. Results: Results showed higher disgust sensitivity scores in individuals with high IBS-QOL score, compared to individuals with low IBS-QOL score. The correlation analysis corroborates this result by showing a positive relationship between disgust sensitivity and respective IBS-QOL scores. Conclusions: This research provides new insights into understanding the etiopathogenesis of IBS, suggesting the relevance of a socially relevant personality trait such as disgust sensitivity as a potential trigger and / or predisposition factor for this chronic inflammatory disease.

What Is the Role of Psychological Factors in Long COVID Syndrome? Latent Class Analysis in a Sample of Patients Recovered from COVID-19.

Background: This study aimed to identify clusters of long COVID-19 symptoms using latent class analysis and investigate the psychological factors involved in the onset of this syndrome. Method: Five hundred and six subjects recovering from COVID-19 completed a series of standardized questionnaires to evaluate the personality traits, alexithymia, and post-traumatic stress. Results: Five classes were identified: Brain fog (31.82%), No symptoms (20.95%), Sensory disorders (18.77%), Breath impairment (17.59%), and Multiple disorders (10.87%). Women reported post-COVID-19 respiratory symptoms and multiple disorders to a greater extent than men. Hospitalized subjects were more likely to report persistent symptoms after COVID-19 than asymptomatic or home-treated subjects. Antagonism, hyperarousal, and difficulty identifying emotions significantly predicted post COVID-19 symptoms. Conclusions: These findings open new questions for research on long COVID-19 and how states of emotional dysregulation can alter the physiological processes of the body and contribute to the onset of organic pathologies.

Traumatic Distress, Alexithymia, Dissociation, and Risk of Addiction During the First Wave of COVID-19 in Italy: Results from a Cross-sectional Online Survey on a Non-clinical Adult Sample.

This study aimed to explore the prevalence of post-traumatic distress, alexithymia, dissociation, and addictive behaviors during the stressful situation of the COVID-19 pandemic. It also aimed to determine whether trauma, alexithymia, and dissociation can effectively predict the risk of addiction in non-clinical subjects during the COVID-19 pandemic. Two hundred nineteen subjects completed a web survey during the first COVID-19 lockdown in Italy, including the Impact of Event Scale-Revised (IES-R), the Dissociative Experience Scale-II (DES-II), and the Addictive Behavior Questionnaire (ABQ). Females reported higher levels of COVID-19-related traumatic stress than males (p = 0.009). A greater fear of getting COVID-19 was associated with significantly high IES-R scores (p < 0.0005). IES-R total score was significantly lower in the "not internet-addicted" group than that in the "internet-addicted" group (p < 0.0005). Furthermore, DES-II total score was significantly higher in the "internet-addicted" group than that in the "non internet-addicted" group (p < 0.0005). No statistically significant score differences were highlighted in the "alcohol" group. Future research with longitudinal studies and larger samples will have to clarify whether trauma, alexithymia, and dissociation can effectively predict the risk of addiction in non-clinical subjects during the COVID-19 pandemic.

How Self-Control Predicts Moral Decision Making: An Exploratory Study on Healthy Participants.

Research on moral reasoning calls into question self-control, which encompasses impulsivity, compulsivity, and inhibitory control. However, a thorough investigation exploring how these three dimensions can affect moral reasoning in response to different scenarios is unavailable. We addressed this topic by testing the predictive role of these three dimensions of self-control on appraisals for ethical violations related with different types of scenarios. Overall, our results suggest that all three dimensions of self-control are involved in moral reasoning, depending on the type of appraisal and provided moral scenarios.

No Evidence of Perceptual Pseudoneglect in Alexithymia.

Neuroscience research links alexithymia, the difficulty in identifying and describing feelings and emotions, with left hemisphere dominance and/or right hemisphere deficit. To provide behavioral evidence for this neuroscientific hypothesis, we explored the relationship between alexithymia and performance in a line bisection task, a standard method for evaluating visuospatial processing in relation to right hemisphere functioning. We enrolled 222 healthy participants who completed a version of the 20-item Toronto Alexithymia Scale (TAS-20), which measures alexithymia, and were asked to mark (bisect) the center of a 10-cm horizontal segment. The results document a significant rightward shift in the center of the line in participants with borderline and manifest alexithymia compared with non-alexithymic individuals. The higher the TAS-20 score, the greater the rightward shift in the line bisection task. This finding supports the right hemisphere deficit hypothesis in alexithymia and suggests that visuospatial abnormalities may be an important component of this mental condition.

Time Processing, Interoception, and Insula Activation: A Mini-Review on Clinical Disorders.

Time processing is a multifaceted skill crucial for managing different aspects of life. In the current work, we explored the relationship between interoception and time processing by examining research on clinical models. We investigated whether time processing deficits are associated with dysfunction of the interoceptive system and/or insular cortex activity, which is crucial in decoding internal body signaling. Furthermore, we explored whether insular activation predicts the subjective experience of time (i.e., the subjective duration of a target stimulus to be timed). Overall, our work suggests that alteration of the interoceptive system could be a common psychophysiological hallmark of mental disorders affected by time processing deficits.

Quality of life and psychological functioning in postmenopausal women undergoing aromatase inhibitor treatment for early breast cancer.

INTRODUCTION: Aromatase inhibitors (AIs) dramatically increased breast cancer (BC) survival, leading to enhanced attention to their long-term consequences on psychological functioning. Conflicting data has been examined regarding the association between AIs administration and the clinical psychological features in BC survivors (BCSs). PURPOSE: As psychological symptoms often occur in such chronic diseases, our study aimed at exploring anxious and depressive symptoms and the perceived quality of life (QoL) in BCSs assessed for osteoporosis. METHODS: The total sample consisted of a clinical sample of 51 outpatient postmenopausal women, diagnosed with BC, and a control group composed of 51 healthy postmenopausal women. All recruited participants were evaluated through the clinical gold standard interview and completed the following self-rating scales: the Hamilton Anxiety Rating Scale, Beck Depression Inventory II edition, and 36-Item Short Form Health Survey, which were administered at baseline and after 6 months in BCSs in AIs treatment, compared with controls. Moreover, all participants were assessed for vitamin D status, bone mineral density (BMD) and subclinical vertebral fractures. Data regarding age, age at menopause, body mass index (BMI), smoking habits and alcohol consumption was collected. RESULTS: BCSs (n = 51) showed higher anxious and depressive symptoms, and lower perceived QoL vs. controls (n = 51) (p<0.05 for all). After 6 months of treatment with AIs, BCSs showed significant reduction of anxious and depressive symptoms and a significantly higher perceived QoL for both physical and mental components, vs. controls. CONCLUSIONS: The improvement of clinical psychological features and perceived QoL was associated with AIs treatment in women being treated with, for early breast cancer. Further studies are needed to obtain a deeper comprehension of the correlation between clinical psychological and physical features in BCSs.