THE INFLUENCE OF CHILDHOOD ABUSE ON LONGITUDINAL COURSE OF RECOVERY IN PSYCHIATRIC REHABILITATION

Background: Empirical outcome studies have identified specific symptomatic, cognitive, emotional and functional sequelae of childhood abuse in people with severe mental illness (SMI). These findings illuminate the need for an integrated understanding of biological, psychological, environmental, and developmental aspects of SMI. Purpose: The purpose of the present study includes the following: 1) to examine reliability and validity of the comprehensive child abuse rating system in a sample of individuals with SMI, 2) to examine the influence of childhood abuse severity on recovery of psychotic symptoms, neurocognition and social-cognition, and social functioning in people with SMI during 12 months of inpatient psychiatric rehabilitation, and 3) to examine moderating effects of social cognition on the relationship between severity of different types of child abuse history and social functioning. Results: In Study I (N=171), the child abuse rating system produced reliable ratings and some subtypes of child abuse history were related to poorer premorbid functioning and cognition, higher overall psychiatric symptoms, and lower social functioning. In Study II (N=161), the longitudinal factor pattern invariance of the measures of social functioning, externality, and psychiatric symptoms were confirmed across 3 time points (e.g., at admission, at 6 months, and at 12 months). In addition, significant but varied linear relationships between subtypes of child abuse and each level of assessment of functioning were identified. In Study III (N=143), the results showed that higher baseline social inference, independent of history of child physical abuse (CPA), played a protective role in improvements in social functioning. High externality appeared to be counter-therapeutic for individuals with no history of CPA but protective for individuals with a more severe history of CPA. Conclusion: The child abuse rating system appears to provide reliable and valid assessment of subtypes of child abuse history of individuals with SMI. Considering the extreme heterogeneity in both SMI and child maltreatment, the current finding sheds light on providing individualized treatment and assessment planning for individuals with SMI and a history of childhood abuse.

Elementos visuais no shoujo mangá: expressando sensações, emoções e sentimentos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Capacidade funcional de idosos dependentes cadastrados na estratégia saúde da família do município de Londrina,PR

Pós-graduação em Saúde Coletiva - FMB

A dog at the keyboard: using arbitrary signs to communicate requests

As a consequence of domestication, dogs have a special readiness for communication with humans. We here investigate whether a dog might be able to acquire and consistently produce a set of arbitrary signs in her communication with humans, as was demonstrated in ""linguistic"" individuals of several species. A female mongrel dog was submitted to a training schedule in which, after basic command training and after acquiring the verbal labels of rewarding objects or activities, she learned to ask for such objects or activities by selecting lexigrams and pressing keys on a keyboard. Systematic records taken during spontaneous interaction with one of the experimenters showed that lexigrams were used in an appropriate, intentional way, in accordance with the immediate motivational context. The dog only utilized the keyboard in the experimenter`s presence and gazed to him more frequently after key pressing than before, an indication that lexigram use did have communicative content. Results suggest that dogs may be able to learn a conventional system of signs associated to specific objects and activities, functionally analogous to spontaneous soliciting behaviors and point to the potential fruitfulness of the keyboard/lexigram procedure for studying dog communication and cognition. This is the first report to systematically analyze the learning of arbitrary sign production in dogs.

Reduced serum levels of adiponectin in elderly patients with major depression

Recent studies have implicated adiponectin and other adipocytokines in brain function, particularly in processes related to memory and cognition. Blood levels of adiponectin are reduced in patients with primary cognitive disorders, such as Alzheimer's disease and mild cognitive impairment, and in adult patients with major depression. The aim of the present study is to determine serum levels of adiponectin in a sample of elderly patients with major depressive disorder (MOD) as compared to healthy older adults, and to examine the correlations between adiponectin levels and parameters indicative of mood and cognitive state. We recruited fifty-one unmedicated outpatients with late-life depression (LLD) and 47 age-matched controls in this study. The diagnosis of MDD was made according to the DSM-IV criteria, and the severity of depressive episode was determined with the 21-item Hamilton Depression Scale (HORS). Cognitive state was ascertained with the Cambridge Cognitive Test (CAMCOG) and the Mini-Mental State Examination (MMSE). Serum concentrations of adiponectin were determined using a sandwich ELISA method. Serum levels of adiponectin were significantly reduced in individuals with LLD (F = p < 0.001). Adiponectin level remained significantly reduced in after controlling for BMI index, scores on the CAMCOG, MMSE and HDRS and educational level (p < 0.001). Adiponectin levels showed a negative correlation with HORS scores (r = -0.59, p < 0.001) and BMI index (r = -0.42, p < 0.001); and showed a positive correlation with CAMCOG (r = 0.34, p < 0.01) and MMSE scores (r = 0.20, p = 0.05). The availability of circulating adiponectin is reduced in older adults with major depression, with likely implications on cognitive and mood state. Additional studies are required to determine whether this abnormality pertains to the pathophysiology of geriatric depression per se, or is a consequence of the morbid state. (C) 2012 Elsevier Ltd. All rights reserved.

Scene di violenza, esperienze emotive e condotte aggressive

The aim of this research is to estimate the impact of violent film excerpts on university students (30 f, 30 m) in two different sequences, a “justified” violent scene followed by an “unjustified” one, or vice versa, as follows: 1) before-after sequences, using Aggressive behaviour I-R Questionnaire, Self Depression Scale and ASQ-IPAT Anxiety SCALE; 2) after every excerpt, using a self-report to evaluate the intensity and hedonic tone of emotions and the violence justification level. Emotion regulation processes (suppression, reappraisal, self-efficacy) were considered. In contrast with the “unjustified” violent scene, during the “justified” one, the justification level was higher; intensity and unpleasantness of negative emotions were lower. Anxiety (total and latent) and rumination diminished after both types of sequences. Rumination decreases less after the JV-UV sequence than after the UV-JV sequence. Self-efficacy in controlling negative emotions reduced rumination, whereas suppression reduced irritability. Reappraisal, self-efficacy in positive emotion expression and perceived emphatic selfefficacy did not have any effects.

Risk factors for postoperative delirium in the elderly

Background: Delirium is defined as an acute disorder of attention and cognition. Delirium is common in hospitalized elderly patient and is associated with increased morbidity, length of stay and patient care costs. Although Delirium can develop at any time during hospitalization, it typically presents early in the post-operative period (Post-Operative Delirium, POD) in the surgery context. The molecular mechanism and possible genetics basis of POD onset are not known, as well as all the risk factors are not completely defined. Our hypothesis is that genetic risk factor involving the inflammatory response could have possible effects on the immunoneuroendocrine system. Moreover, our previous data (inflamm-aging) suggest that aging is associated with an increase of inflammatory status, favouring age-related diseases such as neurodegenerative diseases, frailty, depression among other. Some pro-inflammatory or anti-inflammatory cytokines, seem to play a crucial role in increasing the inflammatory status and in the communication and regulation of immunoneuroendocrine system. Objective: this study evaluated the incidence of POD in elderly patients undergoing general surgery, clinical/physical and psychological risk factors of POD insurgency and investigated inflammatory and genetic risk factors. Moreover, this study evaluated the consequence of POD in terms of institutionalization, development of permanent cognitive dysfunction or dementia and mortality Methods: patients aged over 65 admitted for surgery at the Urgency Unit of S.Orsola-Malpighi Hospital were eligible for this case–control study. Risk factors significantly associated with POD in univariate analysis were entered into multivariate analysis to establish those independently associated with POD. Preoperative plasma level of 9 inflammatory markers were measured in 42 control subjects and 43 subjects who developed POD. Functional polymorphisms of IL-1 α , IL-2, IL-6, IL-8, IL-10 and TNF-alpha cytokine genes were determined in 176 control subjects and 27 POD subjects. Results: A total of 351 patients were enrolled in the study. The incidence of POD was 13•2 %. Independent variables associated with POD were: age, co-morbidity, preoperative cognitive impairment, glucose abnormalities. Median length of hospital stay was 21 days for patients with POD versus 8 days for control patients (P < 0•001). The hospital mortality rate was 19 and 8•4 % respectively (P = 0•021) and mortality rate after 1 year was also higher in POD (P= 0.0001). The baseline of IL-6 concentration was higher in POD patients than patients without POD, whereas IL-2 was lower in POD patients compared to patients without POD. In a multivariate analysis only IL-6 remained associated with POD. Moreover IL-6, IL-8 and IL-2 are associated with co-morbidity, intra-hospital mortality, compromised functional status and emergency admission. No significant differences in genotype distribution were found between POD subjects and controls for any SNP analyzed in this study. Conclusion: In this study we found older age, comorbidity, cognitive impairment, glucose abnormalities and baseline of IL-6 as independent risk factors for the development of POD. IL-6 could be proposed as marker of a trait that is associated with an increased risk of delirium; i.e. raised premorbid IL-6 level predict for the development of delirium.

Analisi della relazione tra temperamento, stati psicobiosociali e variabili psicofisiche rispetto ai diversi compiti e strategie metodologiche

L’attività fisica produce effetti benefici a livello mentale (Biddle et al.,2004) e sembra agire sull’emozione modificando attitudini e motivazioni verso la pratica motoria (Digelidis et al., 2003) a partire da sensazioni come il piacere o la noia del fare (Spray et al., 1999). Da questi presupposti il progetto che comprendeva l’analisi di due studi volti a verificare gli effetti dell’attività motoria e sportiva in ambito scolastico, sui comportamenti di adattamento sociale e self efficacy dei bambini. Un terzo studio, di analisi qualitativa, in ambito calcistico, per verificare correlazioni tra orientamento motivazionale genitoriale e comportamenti di adattamento sociale dei figli. Gli strumenti di rilevazione dei livelli di adattamento sociale (Caprara et al, 1992) e self efficacy (Colella, 2008), sono stati somministrati prima e dopo il trattamento delle relative attività motorie mentre, l’orientamento motivazionale dei genitori (Borgogni et al, 2004) è stato rilevato una volta e confrontato con l’adattamento sociale dei figli. Il modulatore del primo studio, l’attività ad alto contenuto emotivo o aggressivo, ha mostrato variazioni significative (p<.05) nei livelli di aggressività fisica-verbale e di comportamento pro sociale tra i 2 gruppi, confermando la letteratura sull’argomento (Pellegrini, in Storch e Roth, 2005; Vaughn, 2005; Tappern e Boulton, 2005). Il modulatore del secondo studio, rappresentato dal giocosport rugby, sempre realizzato nelle ore curricolari di educazione fisica, ha evidenziato differenze significative (p<.05) nell’aumentata self efficacy da parte del gruppo sperimentale, con effetto preponderante sulle femmine rispetto ai maschi. Il terzo studio, descrittivo, ha evidenziato la correlazione tra orientamento motivazionale dei genitori e instabilità emotiva dei figli in risposta a profili genitoriali tendenti alla leadership o al successo nell’ambito lavorativo. I risultati evidenziati mostrano effetti significativi (p<.05), successivi al trattamento, sui comportamenti di adattamento sociale, aggressivo e sulla self efficacy a conferma, della letteratura, sull’importanza di determinate esperienze motorie in età scolare.

La représentation du pathétique masculin dans le roman sentimental européen: une réflexion sur l'imaginaire littéraire

Ce travail est une analyse de la représentation du pathétique masculin dans le roman dit sentimental dans la deuxième moitié du dix-huitième siècle en Europe, ou plutôt dans les littératures anglaise, française, allemande et italienne. La thèse soutenue est celle de la dérivation du pathétique romanesque de l’âge des Lumières des pratiques de prédication religieuse du siècle précédent et donc de la valeur normative du roman sentimental à ses débuts : celui-ci aurait relayé le rôle des manuels de conduite des siècles précédents et se serait posé comme un répertoire d’exempla comportementaux adaptés aux différentes situations de la vie. Nous avons suivi les évolutions historiques du genre à travers l’analyse thématique du motif des larmes masculines. Pour ce faire, nous avons examiné la complexe proxémique de représentation de l’émotion et la diégèse qui en résulte, qui peut être nuancée, selon une terminologie récente, en pathétique attendrissant, sentimental et spectaculaire. Cela a entraîne la prise en compte de diverses formes artistiques, de la peinture au théâtre. La méthodologie utilisé conjugue l’histoire des idées et l’étude des formes de l’imaginaire, le pathétique appartenant au domaine de la philosophie autant qu’à celui de la représentation artistique : le concept glisse au dix-huitième siècle du champ rhétorique et stylistique à une dimension esthétique et anthropologique. Le travail a donc été divisé en trois grandes parties qui analysent les trois dimensions anthropologiques fondamentales : l’imaginaire religieux et l’héritage des anciens, c’est–à-dire le rapport que l’époque établit avec la tradition culturelle qui la précède ; l’imaginaire amoureux, qui se concentre sur les rapports entre les deux sexes et sur la « féminisation » du héros romanesque sentimental ; l’imaginaire familial, qui aborde les conséquences de ce changement dans la représentation de la masculinité au sein de la représentation de la famille et des rapports intergénérationnels.

Deficit in the Emotional Embodiment in Alexithymia

Alexithymia refers to difficulties in recognizing one’s own emotions and others emotions. Theories of emotional embodiment suggest that, in order to understand other peoples’ feelings, observers re-experience, or simulate, the relevant component (i.e. somatic, motor, visceral) of emotion’s expressed by others in one’s self. In this way, the emotions are “embodied”. Critically, to date, there are no studies investigating the ability of alexithymic individuals in embodying the emotions conveyed by faces. In the present dissertation different implicit paradigms and techniques falling within the field of affective neuroscience have been employed in order to test a possible deficit in the embodiment of emotions in alexithymia while subjects were requested to observe faces manifesting different expression: fear, disgust, happiness and neutral. The level of the perceptual encoding of emotional faces and the embodiment of emotions in the somato-sensory and sensory-motor system have been investigated. Moreover, non-communicative motor reaction to emotional stimuli (i.e. visceral reactions) and interoceptive abilities of alexithymic subjects have been explored. The present dissertation provided convergent evidences in support of a deficit in the processing of fearful expression in subjects with high alexithymic personality traits. Indeed, the pattern of fear induced changes in the perceptual encoding, in the somato-sensory and in the somato-motor system (both the communicative and non communicative one) is widely and consistently altered in alexithymia. This support the hypothesis of a diminished responses to fearful stimuli in alexithymia. In addition, the overall results on happiness and disgust, although preliminary, provided interesting results. Indeed, the results on happiness revealed a defective perceptual encoding, coupled with a slight difficulty (i.e. delayed responses) at the level of the communicative somato-motor system, and the emotion of disgust has been found to be abnormally embodied at the level of the somato-sensory system.

Die Einheit des Bewusstseins und das Phänomen der Synästhesie

Synästhetiker schmecken Berührungen, sehen Farben und Formen, wenn sie Musik hören oder einen Duft riechen. Es wurden auch so außergewöhnliche Formen wie Wochentage-Farben-, Berührung-Geruch- oder Schmerz-Farben-Synästhesien gefunden. Die von Neuro- wissenschaftlern und Philosophen als „Bindung“ genannte Fähigkeit mehrere Reize, die in verschiedenen Hirnarealen verarbeitet werden, miteinander zu koppeln und zu einer einheitlichen Repräsentation bzw. erfahrenen Einheit des Bewusstseins zusammenzufassen, betrifft jeden gesunden Mensch. Synästhetiker sind aber Menschen, deren Gehirne zur „Hyperbindung“ oder zum hyperkohärentem Erleben befähigt sind, da bei ihnen wesentlich mehr solcher Kopplungen entstehen. Das Phänomen der Synästhesie ist schon seit mehreren Jahrhunderten bekannt, aber immer noch ein Rätsel. Bisher glaubten Forscher, solche Phänomene beruhten bloß auf überdurchschnittlich dichten neuronalen Verdrahtungen zwischen sensorischen Hirnregionen. Aus der aktuellen Forschung kann man jedoch schließen, dass die Ursache der Synästhesie nicht allein eine verstärkte Verbindung zwischen zwei Sinneskanälen ist. Laut eigener Studien ist der Sinnesreiz selbst sowie seine fest verdrahteten sensorischen Pfade nicht notwendig für die Auslösung des synästhetischen Erlebens. Eine grundlegende Rolle spielt dabei dessen Bedeutung für einen Synästhetiker. Für die Annahme, dass die Semantik für die synästhetische Wahrnehmung das Entscheidende ist, müssten synästhetische Assoziationen ziemlich flexibel sein. Und genau das wurde herausgefunden, nämlich, dass normalerweise sehr stabile synästhetische Assoziationen unter bestimmten Bedingungen sich auf neue Auslöser übertragen lassen. Weitere Untersuchung betraf die neu entdeckte Schwimmstil-Farbe-Synästhesie, die tritt hervor nicht nur wenn Synästhetiker schwimmen, aber auch wenn sie über das Schwimmen denken. Sogar die Namen dieser charakteristischen Bewegungen können ihre Farbempfindungen auslösen, sobald sie im stimmigen Kontext auftauchen. Wie man von anderen Beispielen in der Hirnforschung weiß, werden häufig benutzte neuronale Pfade im Laufe der Zeit immer stärker ausgebaut. Wenn also ein Synästhetiker auf bestimmte Stimuli häufig stoßt und dabei eine entsprechende Mitempfindung bekommt, kann das mit der Zeit auch seine Hirnanatomie verändern, so dass die angemessenen strukturellen Verknüpfungen entstehen. Die angebotene Erklärung steht also im Einklang mit den bisherigen Ergebnissen. Die vorliegende Dissertation veranschaulicht, wie einheitlich und kohärent Wahrnehmung, Motorik, Emotionen und Denken (sensorische und kognitive Prozesse) im Phänomen der Synästhesie miteinander zusammenhängen. Das synästhetische nicht-konzeptuelle Begleiterlebnis geht mit dem konzeptuellen Inhalt des Auslösers einher. Ähnlich schreiben wir übliche, nicht-synästhetische phänomenale Eigenschaften den bestimmten Begriffen zu. Die Synästhesie bringt solche Verschaltungen einfach auf beeindruckende Weise zum Ausdruck und lässt das mannigfaltige Erleben stärker integrieren.

Anomalous global effects induced by 'blind' distractors in visual hemifield defects

Previous research has revealed that a stimulus presented in the blind visual field of participants with visual hemifield defects can evoke oculomotor competition, in the absence of awareness. Here we studied three cases to determine whether a distractor in a blind hemifield would be capable of inducing a global effect, a shift of saccade endpoint when target and distractor are close to each other, in participants with lesions of the optic radiations or striate cortex. We found that blind field distractors significantly shifted saccadic endpoints in two of three participants with lesions of either the striate cortex or distal optic radiations. The direction of the effect was paradoxical, however, in that saccadic endpoints shifted away from blind field distractors, whereas endpoints shifted towards distractors in the visible hemifields, which is the normal global effect. These results provide further evidence that elements presented in the blind visual field can generate modulatory interactions in the oculomotor system, which may differ from interactions in normal vision.