Online psychological counselling during lockdown reduces anxiety symptoms and negative affect: Insights from Italian framework.

Several studies have shown how COrona VIrus Disease 2019 (COVID-19) and the consequent isolation and quarantine measures could affect physical and mental well-being. Therefore, the increased request for support and assistance represents a critical challenge for clinicians requiring a reorganization of care systems. In this regard, online counselling has been identified as a useful tool in providing psychological assistance and support. Thus, the main purpose of the current study was to investigate the clinical usefulness of a single online counselling session in reducing psychopathological symptoms (i.e., state anxiety and negative affect) and increasing individual well-being and positive affect during the first Italian lockdown. Fifty-three subjects were enrolled and randomly assigned to receive an online counselling session [Online Counselling Group (OCG) = 26] or to act as controls [Waiting List Group (WLG) = 27]. In the post-assessment, compared to WLG, the OCG showed a significant decrease in negative affect (18.04 ± 6.30 vs. 30.26 ± 8.61; F1:47 = 29.45; p < .001; dppc2 = .92) and state anxiety (36.65 ± 8.35 vs. 48.04 ± 11.51; F1:47 = 17.86; p < .001; dppc2 = .49). Taking into account the cyclical nature of COVID-19, with the possibility of new peaks and waves, it would be appropriate to consider the versatility and usefulness of online psychological counselling in the management of COVID-19-related distress.

Is resting state frontal alpha connectivity asymmetry a useful index to assess depressive symptoms? A preliminary investigation in a sample of university students.

BACKGROUND: Frontal alpha asymmetry (FAA) has been widely investigated in depressive disorders (DDs) with contradictory and not conclusive results. The main aim of the current study was to explore the association between a new neurophysiological index, the so-called frontal alpha connectivity asymmetry index (FACA-I), and depressive symptoms. METHODS: One hundred and thirteen participants (45 men and 68 women, mean age: 22.83 ±â€¯2.26 years) were enrolled. Electroencephalographic (EEG) recordings were performed during 5 min of resting state (RS). FACA-I was computed by subtracting connectivity at left frontal regions from right frontal regions and dividing by their sum. RS FAA were also computed and compared to the FACA-I in all analyses. RESULTS: After controlling for the presence of potential confounding variables (i.e., sex, age and anxiety symptoms), only FACA-I scores between medial prefrontal cortex and subgenual anterior cingulate cortex were negatively associated with both somatic and cognitive/affective depressive symptoms and were lower in individuals with significant level of depressive symptoms. LIMITATIONS: We focused on a sample of university students with no formal diagnosis of depression and we did not assess FAA and FACA-I during cognitive and/or emotional tasks, which make our interpretation specific to the RS condition. CONCLUSIONS: Taken together our data suggest that alpha connectivity asymmetry between medial prefrontal cortex and subgenual anterior cingulate cortex may be a useful neurophysiological index in the assessment of depressive symptoms.

Activating attachment memories affects default mode network in a non-clinical sample with perceived dysfunctional parenting: An EEG functional connectivity study.

Dysfunctional parenting constitutes a factor of psychopathological vulnerability affecting development both at neurobiological and psychological level. The default mode network (DMN), a large scale network for brain functional integration, is supposed to play a crucial role in those psychological functions altered by dysfunctional parenting. Here we investigate electroencephalography DMN functional connectivity in relation to perceived dysfunctional parenting (PDP) in a non-clinical sample. We hypothesized that participants with high PDP would exhibit decreased DMN connectivity after the activation of attachment memories. Our results support this hypothesis: participants with high PDP showed a decrease of theta connectivity between left temporoparietal junction and right anterior cingulate cortex after the activation of attachment memories, and, compared to participants with low PDP, showed a decrease of delta connectivity in the same brain areas. We interpret these decreased DMN connectivity in participants with high PDP as the "neurophysiological signature" of the impaired ability to mentalize their own relational experiences with significant others after the activation of early attachment memories. Thus, the activation of attachment memories in individuals exposed to dysfunctional parenting could lead to a transitory failure of functional brain connectivity and consequent disturbance of high integrative mental functions, such as emotional regulation and mentalization.

Default mode network alterations in individuals with high-trait-anxiety: An EEG functional connectivity study.

BACKGROUND: Although several researches investigated Default Mode Network (DMN) alterations in individuals with anxiety disorders, up to now no studies have investigated DMN functional connectivity in non-clinical individuals with high-trait-anxiety using quantitative electroencephalography (EEG). Here, the main aim was to extend previous findings investigating the association between trait anxiety and DMN EEG functional connectivity. METHODS: Twenty-three individuals with high-trait-anxiety and twenty-four controls were enrolled. EEG was recorded during 5 min of resting state (RS). EEG analyses were conducted by means of the exact Low-Resolution Electromagnetic Tomography software (eLORETA). RESULTS: Compared to controls, individuals with high-trait-anxiety showed a decrease of theta connectivity between right medial prefrontal cortex (mPFC) and right posterior cingulate/retrosplenial cortex. A decrease of beta connectivity was also observed between right mPFC and right anterior cingulate cortex. Furthermore, DMN functional connectivity strength was negatively related with STAI-T total score (i.e., lower connectivity was associated with higher trait anxiety), even when controlling for potential confounding variables (i.e., sex, age, and general psychopathology). LIMITATIONS: Small sample size makes it difficult to draw definitive conclusions. Furthermore, we did not assess state variation of anxiety, which make our interpretation specific to trait anxiety. CONCLUSIONS: Taken together, our results suggest that high-trait-anxiety individuals fail to synchronize DMN during RS, reflecting a possible top-down cognitive control deficit. These results may help in the understanding of the individual differences in functional brain networks associated with trait anxiety, a crucial aim in the prevention and in the early etiology understanding of clinical anxiety and related sequelae.

Feedback-Based Treatments for Eating Disorders and Related Symptoms: A Systematic Review of the Literature.

The effectiveness of biofeedback and neurofeedback has been investigated in a range of psychiatric disorders. However, to date, there are few studies on the clinical usefulness of feedback-based techniques for eating disorders (EDs) and EDs-related symptoms (e.g., food craving). A systematic search of PubMed, Scopus and PsychINFO identified 162 articles. Among these, thirteen studies exploring the therapeutic use of biofeedback and neurofeedback in EDs or EDs-related symptoms were included. Biofeedback and neurofeedback were implemented respectively in five and eight of all reviewed articles. No studies incorporated different feedback modalities or both biofeedback and neurofeedback. The considered studies provide preliminary data of the usefulness of feedback-based techniques in the treatment of several dysfunctional eating behaviors (e.g., food craving, rumination). Although no significant effect has been reported for other important EDs-related symptoms (i.e., body image disturbance), feedback-based techniques are also associated with significant modifications of both sympathetic reaction to food-related stimuli and brain activity in several regions of the reward system (e.g., insula). Taken together the results of the present review suggest that feedback-based treatments may be useful in the treatment of several dysfunctional eating behaviors operating both on top-down and bottom-up individual coping strategies. Methodological and clinical issues are also discussed.

The Association among Default Mode Network Functional Connectivity, Mentalization, and Psychopathology in a Nonclinical Sample: An eLORETA Study.

AIMS: We investigated default mode network (DMN) electroencephalography (EEG) functional connectivity differences between individuals with self-reported high mentalization capability and low psychopathological symptoms, versus participants with mentalization impairments and high psychopathological symptoms. METHODS: Forty-nine students (35 women) with a mean age of 22.92 ± 2.53 years were administered the Mentalization Questionnaire (MZQ) and the Symptom Checklist-90-Revised. Five minutes of EEG during resting state were also recorded for each participant. DMN functional connectivity analyses were conducted by means of the exact Low Resolution Electric Tomography software (eLORETA). RESULTS: Compared to the individuals with high mentalization capability and lower self-reported psychopathological symptoms, participants with mentalization impairments and high psychopathological symptoms showed a decrease of EEG beta connectivity between: (i) the right and left medial frontal lobe, and (ii) the left medial frontal lobe and the right anterior cingulate cortex. Furthermore, while MZQ total score was positively associated with DMN network connections (i.e., right and left medial frontal lobes), several psychopathological symptoms (i.e., interpersonal sensitivity, depression, and psychoticism) were negatively associated with DMN connectivity. CONCLUSION: Our results may reflect a top-down emotion regulation deficit which is associated with both internalizing and externalizing behavior problems.

Alpha/Theta Neurofeedback Increases Mentalization and Default Mode Network Connectivity in a Non-Clinical Sample.

Several studies showed the effectiveness of alpha/theta (A/T) neurofeedback training in treating some psychiatric conditions. Despite the evidence of A/T effectiveness, the psychological and neurobiological bases of its effects is still unclear. The aim of the present study was to explore the usefulness of the A/T training in increasing mentalization in a non-clinical sample. The modifications of electroencephalographic (EEG) functional connectivity in Default Mode Network (DMN) associated with A/T training were also investigated. Forty-four subjects were enrolled in the study and randomly assigned to receive ten sessions of A/T training [neurofeedback group (NFG) = 22], or to act as controls [waiting list group (WLG) = 22]. All participants were administered the mentalization questionnaire (MZQ) and the Symptom Checklist-90-Revised (SCL-90-R). In the post training assessment, compared to WLG, NFG showed a significant increase of MZQ total scores (3.94 ± 0.73 vs. 3.53 ± 0.77; F1;43 = 8.19; p = 0.007; d = 0.863). Furthermore, A/T training was also associated with a significant increase of EEG functional connectivity in several DMN brain areas (e.g. Posterior Cingulate Cortex). Taken together our results support the usefulness of the A/T training in enhancing mentalization and DMN connectivity.

Coping food craving with neurofeedback. Evaluation of the usefulness of alpha/theta training in a non-clinical sample.

The aim of the present study was to explore the usefulness of the alpha/theta (A/T) training in reducing Food Craving (FC) in a non-clinical sample. The modifications of electroencephalographic (EEG) power spectra associated with A/T training was also investigated. Fifty subjects were enrolled in the study and randomly assigned to receive ten sessions of A/T training [neurofeedback group (NFG)=25], or to act as controls [waiting list group (WLG)=25]. All participants were administered the Food Cravings Questionnaire-Trait, the Eating Disorder Examination Questionnaire and the Symptom Checklist-90-Revised. In the post training assessment, compared to the WLG, the NFG showed a significant reduction of intentions and plans to consume food (F1; 49=4.90; p=.033; d=0.626) and of craving as a physiological state (F1; 49=8.09; p=.007; d=803). In NFG, changes in FC persisted after 4months follow-up. Furthermore, A/T training was associated with significant a increase of resting EEG alpha power in several brain areas involved in FC (e.g., insula) and food cue reactivity (e.g., parahippocampal gyrus, inferior and superior temporal gyrus). Taken together, our results showed that ten sessions of A/T training are associated with a decrease of self-reported FC in a non-clinical sample. These findings suggest that this brain-directed intervention may be useful in the treatment of dysfunctional eating behaviors characterized by FC.

Default Mode Network alterations in alexithymia: an EEG power spectra and connectivity study.

Recent neuroimaging studies have shown that alexithymia is characterized by functional alterations in different brain areas [e.g., posterior cingulate cortex (PCC)], during emotional/social tasks. However, only few data are available about alexithymic cortical networking features during resting state (RS). We have investigated the modifications of electroencephalographic (EEG) power spectra and EEG functional connectivity in the default mode network (DMN) in subjects with alexithymia. Eighteen subjects with alexithymia and eighteen subjects without alexithymia matched for age and gender were enrolled. EEG was recorded during 5 min of RS. EEG analyses were conducted by means of the exact Low Resolution Electric Tomography software (eLORETA). Compared to controls, alexithymic subjects showed a decrease of alpha power in the right PCC. In the connectivity analysis, compared to controls, alexithymic subjects showed a decrease of alpha connectivity between: (i) right anterior cingulate cortex and right PCC, (ii) right frontal lobe and right PCC, and (iii) right parietal lobe and right temporal lobe. Finally, mediation models showed that the association between alexithymia and EEG connectivity values was directed and was not mediated by psychopathology severity. Taken together, our results could reflect the neurophysiological substrate of some core features of alexithymia, such as the impairment in emotional awareness.