Memory Phenotypes In Early, De Novo Parkinson's Disease Patients with Mild Cognitive Impairment.

BACKGROUND: Memory deficits in mild cognitive impairment related to Parkinson's disease (PD-MCI) are quite heterogeneous, and there is no general agreement on their genesis. OBJECTIVES: To define memory phenotypes in de novo PD-MCI and their associations with motor and non-motor features and patients' quality of life. METHODS: From a sample of 183 early de novo patients with PD, cluster analysis was applied to neuropsychological measures of memory function of 82 patients with PD-MCI (44.8%). The remaining patients free of cognitive impairment were considered as a comparison group (n = 101). Cognitive measures and structural magnetic resonance imaging-based neural correlates of memory function were used to substantiate the results. RESULTS: A three-cluster model produced the best solution. Cluster A (65.85%) included memory unimpaired patients; Cluster B (23.17%) included patients with mild episodic memory disorder related to a "prefrontal executive-dependent phenotype"; Cluster C (10.97%) included patients with severe episodic memory disorder related to a "hybrid phenotype," where hippocampal-dependent deficits co-occurred with prefrontal executive-dependent memory dysfunctions. Cognitive and brain structural imaging correlates substantiated the findings. The three phenotypes did not differ in terms of motor and non-motor features, but the attention/executive deficits progressively increased from Cluster A, through Cluster B, to Cluster C. This last cluster had worse quality of life compared to others. CONCLUSIONS: Our results demonstrated the memory heterogeneity of de novo PD-MCI, suggesting existence of three distinct memory-related phenotypes. Identification of such phenotypes can be fruitful in understanding the pathophysiological mechanisms underlying PD-MCI and its subtypes and in guiding appropriate treatments. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Untying a Gordian knot: Exploring the nomological network of resilience.

OBJECTIVE: This study investigates the relations of resilience with coping, personality traits, emotional intelligence, sense of coherence and maladaptive personality traits. METHOD: The study employs network analysis techniques to the study of resilience, showcasing how these methods can estimate a model that is simple to interpret while still retaining the most important relations and that can even suggest the direction of causality despite using a cross-sectional design (N = 305). RESULTS: The results highlight several important variables that should be considered for fostering resilience, foremost among them the use of positive reappraisal coping, sense of coherence, and the social management aspect of emotional intelligence. CONCLUSIONS: The results successfully replicated known associations between resilience and other psychological constructs (emotional intelligence, personality, sense of coherence, coping) and shed light on relations between resilience and maladaptive personality traits. Network analysis considered all these constructs together, so as to take into account the complex pattern of relations between them and offer a bird's eye view of the whole network of associations centred on resilience. The resulting model is parsimonious and easy to interpret while still striving to preserve the complexity of the variables' interrelations.

Measurement invariance of the Liebowitz Social Anxiety Scale-Self-Report.

OBJECTIVE: The Liebowitz Social Anxiety Scale-Self Report (LSAS-SR) is a self-report measure of social anxiety (SA), which has shown adequate psychometric properties across cultures. However, no study has systematically evaluated its measurement invariance (MI) between (a) individuals with and without a diagnosis of social anxiety disorder (SAD) and (b) males and females. The current study addresses this issue. METHODS: We collected data on 257 (158 females) Italian individuals diagnosed with SAD and 356 (232 females) community-dwelling adults. RESULTS: We initially found support for the unidimensionality of the Italian LSAS-SR measurement model in all samples. Using the Graded Response Model, we obtained evidence of partial MI and differential item functioning between community-dwelling and SAD-diagnosed individuals and evidence of strong MI between male and female participants. CONCLUSIONS: The results of this study suggest that the Italian LSAS-SR measures the same trait in the same way across the symptom continuum and sexes, making it a psychometrically sound tool for assessment, screening, and research purposes.

Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool-Caregivers.

OBJECTIVE: To develop a short, flexible, and comprehensive tool to measure psychological distress in caregivers of malignant mesothelioma (MM) patients: the Mesothelioma Psychological Distress Tool-Caregivers version (MPDT-C). METHODS: Based on a systematic review of the relevant literature, aspects associated with caregiver distress were derived. Expert researchers/clinicians developed a pool of items for each identified aspect. Content validity was assessed through a multiple mixed-methods approach. A multicenter study was conducted to explore the factorial structure of the 47-item MPDT-C through Bayesian factor analysis. RESULTS: The Bayesian exploratory factor analysis revealed an underlying three-factor structure. Factors were labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. All scales showed sufficient reliability and corrected item-total correlations. Females scored higher than males for Engagement in Caring. CONCLUSIONS: Taking care of malignant mesothelioma patients is a stressful process that influences the caregiver's physical, emotional, and social wellbeing. Our study offers preliminary evidence in support of the adequate psychometric properties of the MPDT-C, and these should now be replicated. Results suggest that the MPDT-C is a reliable tool with which to detect the psychological distress of this traumatized population.

Validation of new diagnostic criteria for fatigue in patients with Parkinson disease.

BACKGROUND AND PURPOSE: Although disabling fatigue is common in Parkinson disease (PD), available consensus-based diagnostic criteria have not yet been empirically validated. The aim of this study was to evaluate the clinimetric properties of the criteria. METHODS: A sample of outpatients with PD was evaluated for demographic, clinical, behavioral, and cognitive features. Fatigue was diagnosed according to the new diagnostic criteria and was rated by means of the Parkinson Fatigue Scale (PFS) and Fatigue Severity Scale (FSS). Acceptability, concurrent and discriminant validity, and interrater reliability were evaluated with binary logistic regression analyses and Cohen kappa (κ). RESULTS: Of 241 included patients, 17 (7.1%) met the diagnostic criteria for PD-related fatigue. Eight of nine symptoms described in Section A of the diagnostic criteria occurred in >50% of patients with fatigue. Acceptability (missing data = 0.8%) of the criteria was good, as was their concurrent validity with the PFS (odds ratio = 3.65) and FSS (odds ratio = 3.63). The discriminant validity of fatigue criteria with other PD-related behavioral and cognitive features was good (odds ratio < 1.68). The interrater reliability was excellent (κ = 0.92). CONCLUSIONS: This is the first study to test the clinimetric properties of case definition diagnostic criteria for PD-related fatigue. Our results suggest that current diagnostic criteria may be useful in both clinical practice and research. Future longitudinal studies should examine their long-term stability.

Inhibition and individual differences in behavior and emotional regulation in adolescence.

The Impulsivity/Reflexivity issue in inhibitory control ability has seldom been investigated in terms of individual differences in typically developing populations. Although there is evidence of changes in executive functioning (EF), including inhibition, in adolescence, very little is known about the role of individual differences. Using the data from 240 14-to-19-year-old high school students who completed a battery of EF tasks (Flanker, Go No-Go, Antisaccade, and Stop signal task), measures of emotion regulation strategies and behavioral difficulties, we performed a latent profile analysis to identify qualitatively distinct score profiles. The results showed the existence in adolescence of two inhibition profiles, Impulsive vs Reflexive, differing in performances at the inhibition tasks. The two profiles were not associated with socio-demographic characteristics, or to psychological variables, such as behavioral characteristics and emotional regulation strategies.

Implicit evidence on the dissociation of identity and emotion recognition.

Recognition of identity and of emotional facial expressions of individuals are both based on processing of the human face. While most studies show these abilities to be dissociated, some others find evidence of a connection. One possible explanation for these contradictory results comes from neurological evidence, which points to identity recognition being mostly based on holistic processing, while emotion recognition seems to be based on both an explicit, fine-grained process, and an implicit, mostly-holistic one. Our main hypothesis, that would explain the contradictory findings, is that holistic implicit emotion recognition, specifically, would be related to identity recognition, while explicit emotion recognition would be a process separate to identity recognition. To test this hypothesis, we employed an experimental paradigm in which spatial frequencies of visual stimuli are manipulated so that automatic, holistic-based, implicit emotion recognition influences perceived friendliness of unfamiliar faces. We predicted the effect to be related to identity recognition ability, since they both require holistic face processing. After a successful replication study, we employed the paradigm with 140 participants, measuring also identity recognition ability and explicit emotion recognition ability. Results showed that the effect is not moderated by these two variables (p = .807 and .373, respectively), suggesting that the independence of identity and emotion recognition holds even when considering, specifically, implicit emotion recognition.

Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis.

Background: Obstructive sleep apnea (OSA) has been associated with mental disorders, but the strength of this association is unknown. The aim of our study was to investigate the association among OSA, depression, and anxiety in adults and to quantitatively summarize the results. Methods: A literature search in Medline, PubMed, PsycInfo, Scopus, and Web of Science was conducted. Seventy-three articles were selected for study. Results: The pooled prevalence of depressive and anxious symptoms in OSA patients was 35% (95% CI, 28-41%) and 32% (95% CI, 22-42%), respectively. Conclusions: The association between OSA, anxiety, and depression indicates the value of an early diagnosis and personalized treatment of OSA to improve mental disorders conditioning compliance to therapy. These conditions share a probably bidirectional relationship.

Shaping our personal past: Assessing the phenomenology of autobiographical memory and its association with object and spatial imagery.

A new instrument has been developed that allows a comprehensive assessment of the relevant dimensions of the phenomenology of autobiographical memories (Assessment of the Phenomenology of Autobiographical Memory, APAM), and their association with visual object and spatial imagery has been examined. An initial version of APAM consisting of 30 items (the first 28 measured on a seven-point Likert-type scale) was developed and administered to a sample of 138 undergraduates. To test whether each item consistently measured the same dimension across different memories, all questions were rated for 12 cues. Results showed that 25 Likert-type items possessed adequate levels of internal consistency and unidimensionality across cues. We also found that higher levels of visual object imagery were associated with more sensory details and recollective qualities of memory, and with stronger experience of sensory and emotional reliving. The theoretical and practical usefulness of APAM as well as the relevance of visual object imagery in the phenomenology of autobiographical memory are discussed.

Regression-based normative data and equivalent scores for Trail Making Test (TMT): an updated Italian normative study.

OBJECTIVES: The Trail Making Test (TMT) is widely used to assess psychomotor speed and attentional set-shifting. Since the regression-based norms and equivalent scores (ESs) for the TMT Italian version trace back to more than 20 years ago, we aimed at providing updated normative data for basic (Part A and Part B) and derived (Score B-A and Score B/A) TMT scores collected in a larger sample with an extended age range. METHODS: Three hundred fifty-five Italian volunteers stratified for sex (166 men), age decades (age range 20-90 years), and educational level (from primary school to university) completed the TMT and the Montreal Cognitive Assessment (MoCA). RESULTS: Multiple linear regression analyses revealed that age and educational level significantly influenced performances on basic and derived TMT scores except for B/A, which was associated only with the educational level. From the derived linear equations, correction grids for basic and derived TMT raw scores were developed. Inferential cutoff scores, estimated using a non-parametric technique, and ES were computed. Basic and derived TMT scores showed a good test-retest reliability (all rs ≥ 0.50); Part B (rs = - 0.48, p < 0.001) and Score B-A (rs = - 0.49, p < 0.001) were moderately associated with MoCA total score. CONCLUSIONS: This study confirms the association of basic and derived TMT raw scores with sociodemographic variables and provides updated correction grids and ES for assessing the attentional/executive functions in clinical and research fields.

Comparison of alternate and original forms of the Montreal Cognitive Assessment (MoCA): an Italian normative study.

OBJECTIVE: The Montreal Cognitive Assessment (MoCA) is a screening test widely used in clinical practice and suited for detection of Mild Cognitive Impairment. Alternate forms of the MoCA were developed to avoid "learning effect" in serial assessments, and the present study aimed at investigating inter-form parallelism and at providing normative values for the Italian versions of MoCAs 2 and 3. METHOD: Three separate convenience samples were recruited: the first (n = 78) completed three alternate MoCA versions for ascertaining inter-form parallelism; the second (n = 302) and the third (n = 413) samples were administered MoCA 2 or 3 to compute normative data. RESULTS: A three-step procedure complemented by confirmatory factor analysis and a mixed factorial ANOVA suggested that the three MoCA versions are not strictly parallel. Multiple linear regression analysis revealed that age and education significantly influenced MoCA 2 and 3 total scores. No significant effect of sex was found. From the derived linear equation, correction grids for MoCA 2 and 3 raw scores were built and equivalent scores computed. Inferential cutoff for adjusted scores, estimated using a non-parametric technique, were 17.49 for MoCA 2 and 18.34 for MoCA 3. Correlation analysis showed strong correlations of MoCA 2 (r = 0.69, p < .001) and MoCA 3 (r = 0.61, p < .001) adjusted total scores with MMSE adjusted scores. CONCLUSION: The three MoCA forms are not strictly parallel. Specifically developed normative data must be adopted for using MoCA in serial cognitive assessments for clinical and research studies.

Space-time interaction: visuo-spatial processing affects the temporal focus of mind wandering.

Our understanding of mind wandering (MW) has dramatically increased over the past decade. Studies have shown that in the vast majority of cases, MW is directed to times other than the present, and a bias toward the future has been reported (prospective bias). The processing of time is not independent of the processing of space: humans represent time along a spatial continuum, on a "mental time line" (MTL). In cultures with a left to right reading/writing system, the MTL expands from left to right. Capitalizing on these findings, here we aimed at investigating the effects of visuo-spatial processing on the temporal orientation of spontaneous MW, and specifically we asked whether we could steer the temporal focus of MW towards the past or the future, by experimentally inducing a leftward and a rightward orienting of attention, respectively. To this aim, we experimentally manipulated the spatial orientation demands associated with the focal task in two independent groups, with a leftward orienting of attention (left-pointing arrows, LA group) and a rightward orienting of attention (right-pointing arrows, RA group). We found that the temporal orientation of MW critically depended on the spatial orientation demands of the task: specifically, the proportion of spontaneous past-oriented MW episodes was higher under the induction of a leftward orienting attention (LA group) than under the induction of a rightward orienting attention (RA group). The opposite pattern was found for spontaneous future-oriented MW episodes. Possible mechanisms involved in this effect and their implications for research on MW and spontaneous cognition are discussed.

Visual attentional load affects the frequency of involuntary autobiographical memories and their level of meta-awareness.

Involuntary autobiographical memories (IAMs) are memories of past events that come to mind without deliberate retrieval attempts. Common in everyday life, IAMs have recently become a topic of experimental investigations with laboratory procedures. In the present study, we build on the recent methodological advancements in the study of IAMs, and we investigate the effects of manipulating the attentional load on the incidence of IAMs, as well as on the level of meta-awareness of these memories. In two experiments, attentional load was manipulated by varying the demands of the focal vigilance task, and reports of IAMs were collected. In Experiment 1, participants were instructed to stop the vigilance task whenever mental contents unrelated to the task came to their minds (self-caught method). In Experiment 2, participants were intermittently interrupted and probed regarding the contents of their experience (probe-caught method) and the level of meta-awareness for these contents. In both experiments, we found a reduction in the frequency of reported IAMs under increased attentional load. Moreover, in Experiment 2, IAMs were characterized by varied levels of meta-awareness, which was reduced by increased attentional load. These results indicate that allocation of attentional resources toward a focal task reduces reporting of IAMs experienced while performing this task because attentional resources play a role in both retrieval of IAMs and the realization that one is experiencing a memory.

Now you see me, now you don't: detecting sexual objectification through a change blindness paradigm.

The goal of this work is to provide evidence for the cognitive objectification of sexualized targets via a change blindness paradigm. Since sexual objectification involves a fragmented perception of the target in which individuating features (i.e., the face) have less information potential than sexualized features (i.e., body parts), we hypothesized that changes in faces of sexualized targets would be detected with less accuracy than changes in faces of nonsexualized targets. Conversely, we expected that changes in body parts would be detected with higher accuracy for sexualized than nonsexualized targets. These hypotheses were supported by the results of two studies that employed a change blindness task in which stimuli with changes both to faces and bodies of sexualized and nonsexualized images were presented. Unexpectedly, the hypothesized effects emerged both for female and male targets.

Adaptation of non-technical skills behavioural markers for delivery room simulation.

BACKGROUND: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations. However, the observation, assessment and feedback on these skills is particularly complex, because the process needs expert observers and the feedback is often provided in judgmental and ineffective ways. The aim of this study was therefore to develop and test a set of observation and rating forms for the NTS behavioural markers of multi-professional teams involved in delivery room emergency simulations (MINTS-DR, Multi-professional Inventory for Non-Technical Skills in the Delivery Room). METHODS: The MINTS-DR was developed by adapting the existing tools and, when needed, by designing new tools according to the literature. We followed a bottom-up process accompanied by interviews and co-design between practitioners and psychology experts. The forms were specific for anaesthetists, gynaecologists, nurses/midwives, assistants, plus a global team assessment tool. We administered the tools in five editions of a simulation training course that involved 48 practitioners. Ratings on usability and usefulness were collected. RESULTS: The mean ratings of the usability and usefulness of the tools were not statistically different to or higher than 4 on a 5-point rating scale. In either case no significant differences were found across professional categories. CONCLUSION: The MINTS-DR is quick and easy to administer. It is judged to be a useful asset in maximising the learning experience that is provided by the simulation.

The Parkinson's Disease-Cognitive Rating Scale (PD-CRS): normative values from 268 healthy Italian individuals.

The Parkinson's Disease-Cognitive Rating Scale (PD-CRS) is a cognitive screening battery that includes subtests to assess cortical and subcortical functions. It is a valid screening tool for mild cognitive impairment (MCI) in Parkinson's disease (PD) and is recommended for diagnosing PD-MCI-Level I. Until now, no study has provided population-based norms for the Italian population. The aim of the present study was to collect normative values in a sample of Italian healthy subjects. Two hundred and sixty-eight (125 men) participants of different ages (age range 30-79 years) and educational levels (from primary school to university) underwent the PD-CRS. Regression-based norming was used to explore the influence of demographic variables (age, education level, and gender) on PD-CRS total score, frontal-subcortical and instrumental-cortical sub-scores, and score achieved on each task of the PD-CRS. Multiple linear regression analysis revealed that age and education significantly predicted the total score, the two sub-scores and the score on each task of the PD-CRS. No significant effect of gender was found. From the derived linear equations, a correction grid for raw scores was developed. Inferential cut-off scores, estimated using a non-parametric technique, were 71.25 for PD-CRS total score and 46.25 and 20.17 for frontal-subcortical and instrumental-cortical sub-score, respectively. Since the use of adjusted scores is more informative when they are standardized, we have converted adjusted scores into equivalent scores. The present study provides normative data for the PD-CRS, being useful and recommended by Movement Disorders Society task force to identify PD-MCI-Level I, at several stages of the disease.

Facial expressions and speech acts: experimental evidences on the role of the upper face as an illocutionary force indicating device in language comprehension.

Language scientists have broadly addressed the problem of explaining how language users recognize the kind of speech act performed by a speaker uttering a sentence in a particular context. They have done so by investigating the role played by the illocutionary force indicating devices (IFIDs), i.e., all linguistic elements that indicate the illocutionary force of an utterance. The present work takes a first step in the direction of an experimental investigation of non-verbal IFIDs because it investigates the role played by facial expressions and, in particular, of upper-face action units (AUs) in the comprehension of three basic types of illocutionary force: assertions, questions, and orders. The results from a pilot experiment on production and two comprehension experiments showed that (1) certain upper-face AUs seem to constitute non-verbal signals that contribute to the understanding of the illocutionary force of questions and orders; (2) assertions are not expected to be marked by any upper-face AU; (3) some upper-face AUs can be associated, with different degrees of compatibility, with both questions and orders.

Development and validation of a new Italian short measure of disgust propensity: The Disgust Propensity Questionnaire (DPQ).

Although a few measures of disgust propensity are available in Italy, most of them take a long time to administer and/or have not shown replicable and sound psychometric properties. In the current study, the authors developed an Italian nine-item self-report measure of disgust propensity (particularly of pathogen disgust)-the Disgust Propensity Questionnaire (DPQ)-to address the limitations of currently available measures. In Study 1, the DPQ was developed through exploratory and confirmatory factor analyses from an initial pool of 33 items that were administered to 784 nonclinical participants. The DPQ showed evidence of an adequate factorial and construct validity as well as internal consistency and temporal stability. In Study 2, additional evidence of the sound psychometric properties of the DPQ was provided by analyzing an independent sample of 315 nonclinical participants and a sample of 208 patients with obsessive-compulsive disorder. This study also showed that the DPQ can discriminate between obsessive-compulsive disorder patients with and without contamination-related concerns, patients with anxiety disorders, and nonclinical participants. KEY PRACTITIONER MESSAGE: An Italian nine-item self-report disgust propensity measure was developed to address the limitations of currently available tools. The Disgust Propensity Questionnaire (DPQ) was evaluated using two independent studies in nonclinical and clinical samples. The DPQ showed adequate factorial and construct validity, internal consistency, and temporal stability. It could discriminate between patients with obsessive-compulsive disorder with contamination-related concerns and all other groups. It is a very short and psychometrically sound measure to assess disgust propensity in Italian samples.

Nurses Work Functioning Questionnaire (NWFQ): refinement and validation of the Italian version.

BACKGROUND: The availability of an assessment measure for work impairment in nurses, or nursing students, is of crucial importance for early detection of workers/students at risk. Recently, a new measure, the Nurses Work Functioning Questionnaire (NWFQ), has become available, but there is no validated Italian version. OBJECTIVES: The aim of this study was to develop and validate an Italian version of the NWFQ. METHODS: We evaluated the factor structure, the internal consistency, and the convergent and discriminant construct validity with respect to organizational justice and job strain of the Italian NWFQ using data from 645 nursing students. RESULTS: Results suggested that a single-factor, 34-item measurement model could be a more parsimonious alternative (CFI=.915, TLI=.910, RMSEA=.039 e CFI=.907, TLI=.901, RMSEA=.046 in in two random subsamples; median factor loading .50, range .26-.63) to the original seven-factor structure. The score on this version of the NWFQ showed excellent internal consistency and construct validity, as higher scores were significantly associated with lower perceived distributive (r=-.30) and interpersonal justice (r=-.43), decision latitude (r=-.33), and social support (r=-.58). CONCLUSIONS: The Italian refinement of the NWFQ seems to have adequate psychometric properties and it is thus suitable for the assessment of impairment of work functioning in nursing students.

Visual object imagery and autobiographical memory: Object Imagers are better at remembering their personal past.

In the present study we examined whether higher levels of object imagery, a stable characteristic that reflects the ability and preference in generating pictorial mental images of objects, facilitate involuntary and voluntary retrieval of autobiographical memories (ABMs). Individuals with high (High-OI) and low (Low-OI) levels of object imagery were asked to perform an involuntary and a voluntary ABM task in the laboratory. Results showed that High-OI participants generated more involuntary and voluntary ABMs than Low-OI, with faster retrieval times. High-OI also reported more detailed memories compared to Low-OI and retrieved memories as visual images. Theoretical implications of these findings for research on voluntary and involuntary ABMs are discussed.