COVID-19 post-traumatic stress disorder: the role of ACEs, alexithymia, and attachment in the Italian population.

OBJECTIVE: The COVID-19 pandemic is considered a collective traumatic event. Several studies have highlighted high levels of post-traumatic stress disorder (PTSD) symptoms among the general population during the pandemic. The general aim of this research is to explore the role of adverse childhood experiences (ACEs), alexithymia, and anxiety and avoidance attachment dimensions as risk factors that are making individuals more vulnerable to PTSD-COVID-related symptoms. SUBJECTS AND METHODS: The COVID-19-PTSD Questionnaire, 20-Item Toronto Alexithymia Scale (TAS-20), Adverse Childhood Experiences Questionnaire, and the Experiences in Close Relationships-Revised Form (ECR-R) were administered to 224 participants who were between 18 and 65 years of age, and residents of Italy. Socio-demographic variables were also collected. The data was collected between October 2021 and March 2022. RESULTS: The findings of the Spearman correlation analysis showed several significant associations between alexithymia, attachment dimensions, and PTSD symptoms related to COVID-19 diagnosis and age. A multivariable logistic regression model was performed using the COVID-19-PTSD total scores over/under the clinical cut-off as dependent variables and age, gender, anxiety and avoidance attachment scores, ACEs, and total alexithymia as independent variables, with alexithymia total score (B = .071; p = .001), ECR-R Anxiety (B = .034; p = .001) and ECR-R Avoidance (B = -.033; p = .024) showing to respectively increase and reduce the possibility of reporting clinical symptomatology. CONCLUSIONS: Emotional regulation and attachment have been shown to be risk factors for COVID-19 PTSD symptomatology. Focused intervention programs and emotional education can be useful tools for developing protective factors in the general population.

Increased frequency dependence of specific airway resistance in patients with laryngeal hemiplegia.

The aim of this study was to investigate whether patients with laryngeal hemiplegia (LH) show a frequency-dependent increase in specific airway resistance (sRaw), measured by body plethysmography. In addition to the flow-volume loop, usually considered in the functional evaluation of upper airway obstructions, variations in sRaw at respiratory frequencies of 30+/-5 (=0.5 Hz), 60+/-5 (=1 Hz) and 90+5 breaths x min(-1) (=1.5 Hz) in 21 never-smoking patients (LH group, mean age+/-SD 55+/-12.09 yrs; 17 females) whose unilateral vocal-cord paralysis was documented by laryngoscopy and who had no signs or symptoms of other respiratory diseases studied. They were compared to 21 healthy control subjects (C group: 50.1+/-15.44 yrs; 10 females). The sRaw values at 30+/-5 breaths min(-1) were similar in the two groups (5.54+/-1.88 versus 5.68+/-1.06 cmH2O x s(-1); p=NS), but at increasing frequencies (30+/-5, 60+/-5 and 90+/-5 breaths min(-1)), they progressively and significantly increased in the LH patients (from 5.54+/-1.88 to 6.63+/-1.96 and 8.05+/-2.6 mH2O x s(-1); p<0.0005), and not significantly in controls (5.68+/-1.06, 5.85+/-0.95 and 5.9+/-1.12 cmH2O x s(-1); p=NS). Linear discriminant analysis using AsRaw (sRaw at 1.5 Hz-sRaw at 0.5 Hz) and forced inspiratory flow at 50% of the vital capacity made it possible to correctly classify all of the controls and 19 of the 21 patients. In conclusion, the multiple, rapid and noninvasive plethysmographical testing of frequency-dependent increase in specific airway resistance with the flow-volume loop, allows the sufficiently satisfactory discrimination of laryngeal hemiplegia patients from controls.

[Phonorhinorheometric study and laryngeal sonography in subjects affected by velopharyngeal insufficiency]. / Indagine fonorinoreometrica e sonografia laringea in soggetti affetti da insufficienza velofaringea.

The aim of the present study was to evaluate the validity of combining two non invasive diagnostic approaches, (photorhinorheometry and sonography) in order study phonatory pathology in subjects suffering from velopharyngeal insufficiency (VPI). Twenty-six patients with nasal air escape during phonation and/or hyperrhinophonia due to to VPI were evaluated employing both methods. Phonorhinorheometry permitted air escape through the nasal cavities during phonation to be evaluated. Compartmentalization of the pharyngeal and nasal resonators during phonation was measured through MCF (maximal consonantic flow) values and MCV (mean consonantic volume), both normalized to the intensity of sound emission during the consonatic phases of speech. Sonography gave information concerning the phonema of resonance and articulation: a modification of the method, which also permitted sound production through an electroacoustic transductor kept in contact with the prelaryngeal skin, was made. This reduced intrinsic noise and increased dynamic modulations of the resonators of the vocal tract. Comparison between sonographic recordings obtained through a standard microphone and skin transducer permitted evaluation of influence of the vocal tract above the glottis on the phonatory process. In particular, recordings had by skin transducers showed a wider amplitude display and a better identification of vocal attack. Phonorhinorheometry and sonography are useful objective and non-invasive tools in evaluating phonatory pathology in patients suffering from VPI and in monitoring therapeutic approaches.