The relationship to the face: from the normal subject to the Alzheimer patient, from the naked face to the masked face, from a humanistic neuropsychology to an embodied ethics / La relation au visage : du sujet normal au malade Alzheimer, du visage nu au visage masqué, d'une neuropsychologie humaniste à une éthique incarnée

The relationship to the face weaves close links with identity and otherness. It is not just a means of inter-human knowledge; it is also a major means of self/other communication underpinned by those mentalization networks that open up the attribution of intentions and emotions to others (theory of mind) as well as that particular disposition known as empathy, which enables us to put ourselves in another person's shoes by feeling and understanding what they are experiencing while remaining ourselves. Neuropsychology attempts to shed light on the brain processes that underlie this encounter with the face and that may be altered by neurodegenerative diseases, and in particular by Alzheimer's disease. The pandemic period also leads us to examine the clinical consequences of wearing a mask both in normal subjects and in subjects suffering from diseases that affect the relationship with the face of others. A humanistic neuropsychology must integrate an embodied ethics that attempts to discern what, in the perception of the Other, contributes to hindering the expression of otherness, which is inseparable from the human condition. In the pandemic context linked to Covid-19, neuropsychology with its clinical requirements and ethics with its performative aim on care practices, can thus cross-fertilize each other to propose compromises that are certainly attentive to public health but also to the well-being of each human being, especially the most vulnerable.

La relation au visage tisse des liens étroits avec l'identité et avec l'altérité. Elle n'est pas qu'un dispositif de connaissance interhumaine ; elle est aussi un dispositif majeur de la communication soi-autrui sous-tendue par ces réseaux de mentalisation qui ouvrent à l'attribution à autrui d'intentions et d'émotions (théorie de l'esprit) comme à cette disposition particulière qu'est l'empathie, qui permet de se mettre à la place d'autrui en ressentant et en comprenant ce qu'il éprouve tout en restant soi. La neuropsychologie tente d'éclairer les processus cérébraux qui sous-tendent cette rencontre du visage et qui peuvent être altérés par les maladies neurodégénératives, et en particulier par la maladie d'Alzheimer. La période pandémique conduit aussi à s'interroger sur les conséquences cliniques du port du masque tant chez les sujets normaux que chez les sujets atteints de maladies qui affecte la relation au visage d'autrui. Une neuropsychologie humaniste doit intégrer une éthique incarnée qui tente de discerner ce qui, dans la perception d'autrui, contribue à entraver l'expression de l'altérité, indissociable de la condition humaine. Dans le contexte pandémique lié à la Covid-19, la neuropsychologie, avec ses exigences cliniques, et l'éthique, avec sa visée performative sur les pratiques de soins, peuvent ainsi se féconder mutuellement pour proposer des compromis attentifs certes à la santé publique mais aussi au bien-être de chaque être humain et notamment des plus vulnérables.

An international cross-sectional investigation on social media, fitspiration content exposure, and related risks during the COVID-19 self-isolation period.

With the global COVID-19 pandemic, governments from many countries in the world implemented various restrictions to prevent the SARS-Cov-2 virus's spread, including social distancing measures, quarantine, in-home lockdown, and the closure of services and public spaces. This led to an in-creased use of social media platforms to make people feel more connected, but also to maintain physical activity while self-isolating. Concerns about physical appearance and the desire to keep or reach a muscular and toned ideal body, might have further reinforced the engagement in fitness-related social media activities, like sharing progresses in training achievements or following more fitness contents on popular profiles. To better understand the underlying relation among these factors, the present study investigates 729 responses to the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), the Self-Compassion Scale (SCS) and their association to social media usage and compares the results cross-culturally in five countries (Spain, Lithuania, United Kingdom, Japan, and Hungary). Findings highlight significant differences between males and females, espe-cially in regard to the time spent online (U = 477.5, p = 0.036). Greater levels of appearance anxiety were associated with the exposure to fitness-related contents on social media. These results strongly confirm the previously highlighted association between fitspiration media and body image anxiety predominantly in females. Clinical implications and future considerations in terms of prevention and treatment in a situation of global emergency are also discussed.

Exploring the Relationship Between Mental Well-Being, Exercise Routines, and the Intake of Image and Performance Enhancing Drugs During the Coronavirus Disease 2019 Pandemic: A Comparison Across Sport Disciplines.

Introduction: Physical distancing under the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on lifestyles, including exercise routines. In this study, we examined the relationship between mental health and addictive behaviors, such as excessive exercise and the use of image and performance enhancing drugs (IPEDs) across 12 sport disciplines. Materials and methods: A large cross-sectional sample of the adult population (N = 2,295) was surveyed. The mean age was 33.09 (SD = 11.40). The number of male participants was 668 (30.0%). The use of IPEDs was assessed in conjunction with psychometric measures such as the Exercise Addiction Inventory (EAI) and the Appearance Anxiety Inventory (AAI). The participants were grouped into activity group (AG) and non-activity group (NAG) according to the presence or absence of their exercise habits. The results were compared between these groups, as well as across sport disciplines, while taking into account the relationship between different psychological measures and IPEDs consumption. Results: The frequency of IPEDs use was higher among AG (34.6%) than NAG (14.6%), although AG participants reported less history of addictions (7.1%) than NAG (11.8%). The logistic regression analysis revealed that scores equal to or above cutoff points, in both the EAI and AAI, predicted the IPEDs use. Regarding the differences across the various sport disciplines, those who were involved in practicing Weight Lifting and Cross Fit were found to be more at risk of excessive exercising and more inclined to use a wide range of IPEDs. Conclusions: Although exercise could help to increase well-being and prevent addictions during the COVID-19 pandemic, our results show that those in the AG are particularly vulnerable to excessive IPEDs use. Sport disciplines associated with higher EAI and AAI scores have also shown a higher tendency to excessive IPEDs use. Furthermore, the factor of having above the cutoff scores in EAI or AAI in each sport could indicate larger IPEDs consumption regardless of the discipline. In light of the current findings, it is necessary to better define the "non-excessive" levels of exercise in various sport disciplines and an adequate intake of IPEDs to ensure the safety and well-being of people during a pandemic.

Exercise and Use of Enhancement Drugs at the Time of the COVID-19 Pandemic: A Multicultural Study on Coping Strategies During Self-Isolation and Related Risks.

Introduction: Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance. Objectives: To assess the role of anxiety about appearance and self-compassion on the practice of physical exercise and use of IPEDs during lockdown. Methods: An international online questionnaire was carried out using the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS) in addition to questions on the use of IPEDs. Results: The sample consisted of 3,161 (65% female) adults from Italy (41.1%), Spain (15.7%), the United Kingdom (UK) (12.0%), Lithuania (11.6%), Portugal (10.5%), Japan (5.5%), and Hungary (3.5%). The mean age was 35.05 years (SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise with peaks registered in the UK (11.0%) and Spain (5.4%). The sample reported the use of a wide range of drugs and medicines to boost image and performance (28%) and maintained use during the lockdown, mostly in Hungary (56.6%), Japan (46.8%), and the UK (33.8%), with 6.4% who started to use a new drug. Significant appearance anxiety levels were found across the sample, with 18.1% in Italy, 16.9% in Japan, and 16.7% in Portugal. Logistic regression models revealed a strong association between physical exercise and IPED use. Anxiety about appearance also significantly increased the probability of using IPEDs. However, self-compassion did not significantly predict such behavior. Anxiety about appearance and self-compassion were non-significant predictors associated with engaging in physical exercise. Discussion and Conclusion: This study identified risks of problematic exercising and appearance anxiety among the general population during the COVID-19 lockdown period across all the participating countries with significant gender differences. Such behaviors were positively associated with the unsupervised use of IPEDs, although no interaction between physical exercise and appearance anxiety was observed. Further considerations are needed to explore the impact of socially restrictive measures among vulnerable groups, and the implementation of more targeted responses.