Menstrual cycle symptomatology during the COVID-19 pandemic: The role of interoceptive sensibility and psychological health.

The literature on the COVID-19 pandemic has shown the importance of investigating its impact on mental health during this sensitive period, also in relation to the female menstrual cycle. To this end, interceptive sensibility has emerged as a fundamental construct for studying the mind-body interaction among psychosomatic and pain symptoms, particularly through the distinction between two attentional styles (namely, a "mindful" and a "non-mindful" sensibility). The aim of the following study is to verify the role of mental health and interoceptive sensibility on menstrual symptoms in women of childbearing age, during the pandemic, as well as to identify the specific contribution of the existing dimensions of interoceptive sensibility in the prediction of symptoms' severity. Data were collected through an online survey, for which 5294 women responded on demographic information, menstrual history, symptoms' disturbance, and completed the Italian versions of the GHQ-12 and the MAIA. The analyses showed that symptoms were strongly correlated to either the GHQ-12 and the MAIA subscales Noticing, Emotional Awareness, Trusting and Not-Worrying. This result was further verified via a hierarchical regression, which revealed that the same interoceptive dimensions and mental health strongly predicted the intensity of menstrual symptoms (R2 = 0.177, ΔR2 = 0.143) compared to other considered dimensions (R2 = 0.180, ΔR2 = 0.002). Results are partially in line with the premises but suggest that mental health has a strong impact on the experience of the menstrual cycle and that only a few interoceptive dimensions may be relevant in explaining the severity of menstrual symptoms. It is here suggested that noticing internal bodily signals and being aware of emotional states might become dysfunctional if not reconciled with a good ability to self-regulate internal states, but may rather contribute to the perpetuation of the 'vicious cycle' of heightened affective and attentional reactions to interoceptive sensations.

Delay discounting of compliance with containment measures during the COVID-19 outbreak: a survey of the Italian population.

Aim: Unprecedented community containment measures were taken following the recent outbreak of COVID-19 in Italy. The aim of the study was to explore the self-reported future compliance of citizens with such measures and its relationship with potentially impactful psychological variables. Subjects and methods: An online survey was completed by 931 people (18-76 years) distributed across the Italian territory. In addition to demographics, five dimensions were measured: self-reported compliance with containment measures over time (today, at 7, 14, 30, 60, 90, and 180 days from now) at three hypothetical risk levels (10, 50, 90% of likelihood of contracting the COVID-19), perceived risk, generalized anxiety, intolerance of uncertainty, and relevance of several psychological needs whose satisfaction is currently precluded. Results: The mean compliance scores follow a hyperbolic-like curve, decreasing over time for the lowest level of risk (10%), whilst they tend to flatten for ≥ 50% risk (90%). Significantly higher levels of anxiety, intolerance of uncertainty, and perceived risk were reported by women compared to men (p < 0.001 for each variable). Outdoor sports was the only need associated with the discounting rate of compliance (r s = - 0.08, p = 0.018). Conclusion: The duration of containment measures plays a crucial role in tackling the spread of the disease as people will be less compliant over time. Psychological needs of citizens impacting on the compliance should be taken into account when planning an easing of the lockdown, along with interventions for protecting vulnerable groups from mental distress.

Associations between caregiving worries and psychophysical well-being. An investigation on home-cared cancer patients family caregivers.

PURPOSE: Caregiving to a family member with cancer might have health implications. However, limited research has investigated the psychophysical health of home-cared cancer patients family caregivers. In a previous study, we have found that a prolonged worry in daily life is a crucial variable compared to caregivers' psychophysical symptomatology. This investigation was designed to further examine the well-being of family caregivers, explore the domains of worry, and assess to what extent "content-dependent" worry could be associated with the caregivers' health METHODS: The sample consisted of 100 family caregivers of oncological patients assisted at home. Participants completed a battery of self-report questionnaires (Penn State Worry Questionnaire, Worry Domain Questionnaire, Hospital Anxiety and Depression Scale, Family Strain Questionnaire Short Form, and Psychophysiological Questionnaire of the Battery CBA 2.0). RESULTS: The level of worry was medium-high among participants, and caregivers worry more about their occupation and future. Depression, anxiety, and somatic symptomatology levels resulted mild, while strain level resulted high. Statistical analyses confirm the conclusions of the previous study, revealing a significant positive correlation between worry levels and caregivers' psychophysical health. Innovatively, it has been highlighted that who has higher scores of content-dependent worry shows also higher levels of strain, somatic symptoms, anxiety, and depression CONCLUSIONS: Not only trait-worry ("content-free" measure) but also content-dependent worry is associated with strain and negative health outcomes. People may worry about different targets, and it might be useful to further investigate what are the specific worriers of family caregivers in order to promote their physical and emotional well-being.

Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers.

The cognitive avoidance model of worry assumes that worry has the adaptive function to keep under control the physiological arousal associated with anxiety. This study aimed to test this model by the use of a fear induction paradigm in both pathological and healthy individuals. Thirty-one pathological worriers and 36 healthy controls accepted to be exposed to a fear induction paradigm (white noise) during three experimental conditions: worry, distraction, and reappraisal. Skin conductance (SCR) and heart rate variability (HRV) were measured as indices of sympathetic and parasympathetic nervous system functioning. Worriers showed increased sympathetic and decreased parasympathetic activation during the worry condition compared to non-worriers. There were no differences between groups for the distraction and reappraisal conditions. SCRs to the white noises during worry were higher in worriers versus controls throughout the entire worry period. Intolerance of uncertainty - but not metacognitive beliefs about worry - was a significant moderator of the relationship between worry and LF/HF-HRV in pathological worriers. Results support the cognitive avoidance model in healthy controls, suggesting that worry is no longer a functional attitude when it becomes the default/automatic and pathological response.

Amygdala responses to masked and low spatial frequency fearful faces: a preliminary fMRI study in panic disorder.

Previous studies have demonstrated amygdala activation in response to fearful faces even if presented below the threshold of conscious visual perception. It has also been proposed that subcortical regions are selectively sensitive to low spatial frequency (LSF) information. However, chronic hyperarousal may reduce amygdala activation in panic disorder (PD). Our aim was to establish whether the amygdala is engaged by masked and LSF fearful faces in PD as compared to healthy subjects. Neutral faces were used as the mask stimulus. Thirteen PD patients (seven females, six males; mean age=29.1 (S.D: 5.9)) and 15 healthy volunteers (seven females, eight males; mean age=27.9 (S.D. 4.5)) underwent two passive viewing tasks during a 3T functional magnetic resonance imaging (fMRI) as follows: 1) presentation of faces with fearful versus neutral expressions (17ms) using a backward masking procedure and 2) presentation of the same faces whose spatial frequency contents had been manipulated by low-pass filtering. Level of awareness was confirmed by a forced choice fear-detection task. Whereas controls showed bilateral activation to fearful masked faces versus neutral faces, patients failed to show activation within the amygdala. LSF stimuli did not elicit amygdala response in either group, contrary to the view that LSF information plays a crucial role in the processing of facial expressions in the amygdala. Findings suggest maladaptive amygdala responses to potentially threatening visual stimuli in PD patients.

Worry as a risk factor for mental and somatic diseases. A research on home-cared cancer patients family caregivers.

OBJECTIVE: Cancer patients family caregivers are exposed to several physical and emotional distress. Many recent reviews have provided strong evidence linking negative affective states and dispositions to disease. Moreover, several recent studies suggested that perseverative cognition, as manifested in worry, plays a role in nearly all anxiety disorders and is a crucial factor in somatic health as well. In this study, we tested a group of family caregivers since we wanted to find out whether worry might act directly on psychological and somatic diseases. METHODS: The sample consists of 107 family caregivers. Participants completed a battery of self-report questionnaires including the Caregiver Burden Inventory, the Penn State Worry Questionnaire, the Psychophysiological Questionnaire and the Beck Depression Inventory. They underwent tests at the moment of oncological home-care request. RESULTS: The study has revealed that there is a significant positive correlation between worry measures and mental and physical health of the participants. In fact, the tendency to perseverative cognition resulted as a powerful and solid predictor of physical symptomatology (R = 0.5, beta = 0.67, p < 0.001) and depression level (R = 0.46, beta = 0.52, p < 0.000001). CONCLUSIONS: Worry plays an important role in psychological and physical health and it is a counterproductive attempt at constructive mental problem solving. These results have great practical and operative value. Interventions improving caregiver's ability to cope with stress situations are likely to result in more positive benefits for cancer patients: in fact, if we promote the caregiver's physical and emotional well-being, he or she can provide the best care possible to the patient.

The thrill of reckless driving in patients with Parkinson's disease: an additional behavioural phenomenon in dopamine dysregulation syndrome?

We report two male patients with Parkinson's disease who developed compulsive risk-seeking driving behaviour as a result of self-administering high doses of L-dopa despite an adequate therapeutic response at lower doses. When L-dopa reduction was feasible, it resulted in cessation of unsafe driving. We believe that this impairment in driving performance, due to deliberate overuse of dopaminergic medication, should be included as a new behavioural phenomenon in dopamine dysregulation syndrome.

"Far from the heart far from the eye": evidence from the Capgras delusion.

INTRODUCTION: Capgras syndrome is characterised by the belief that a significant other has been replaced by an identical-looking impostor. These patients have no difficulties with visual recognition but fail to show a skin conductance response (SCR) to the objects of the delusion. A case of Capgras delusion (YY), specifically characterised by the absence of brain lesions, constituted a good opportunity to test the relationship between SCR hyporesponsiveness and eye movement patterns to familiar and unfamiliar faces. METHODS: Visual scan path and SCR were recorded for YY and 8 controls during the presentation of family members' photographs matched with unfamiliar faces of the same sex, age, and physical likeness. Eye movement patterns were explored by selecting three specific areas of interest (AOI) involving the eyes, the mouth, and the face regions. RESULTS: In contrast with controls, YY showed a reduction in number and sum of fixation durations to the eyes (p<.01) and no differential SCRs (p>.05) to familiar vs. nonfamiliar faces. SCR and fixation duration to family members' eyes were significantly correlated (r=.77) in both YY and controls. CONCLUSIONS: Eye region exploration seems to be related to the autonomic reactivity elicited by the affective valence of familiar faces.

Prevalence of pathological gambling in patients with Parkinson's disease.

Pathological gambling (PG) is a psychiatric disorder characterized by loss of control of gambling, which has repercussions on family, personal, and professional life. Several recent studies have reported the relationship between PG and the treatment of Parkinson's disease (PD), but no prevalence study has yet been conducted to investigate this correlation. The purpose of this study was to evaluate the prevalence of PG in Italian patients with PD on dopamine replacement therapy. The prevalence of PG in a PD sample (n = 98) and in an age- and sex-matched control group (n = 392) was obtained. The prevalence of PG results significantly higher (P = 0.00001) in PD patients than in control subjects (6.1% vs. 0.25%). Our results emphasize that PG in patients with idiopathic PD on dopamine replacement therapy is an emergent comorbidity, but probably at present the condition is not properly diagnosed because it is mostly unknown.

Postural control after a night without sleep.

The present study analysed the efficiency of postural control after 12 h of nocturnal forced wakefulness using Romberg's test comprising 1 min of recording with eyes-open and 1 min of recording with eyes-closed, with a 1 min break between the two sessions. Our aim was to see if the decreased postural control efficiency after a sleepless night was unspecific (in both eyes-closed and eyes-open conditions) or selective (in only one of the conditions). A total of 55 students spent a whole night awake at our laboratory and were tested at 22:00 and 08:00 h. In general, the results showed that postural sway increased, performing the recording from eyes-open to eyes-closed condition. The statokinesigram length (SL or efficiency of the postural system) increased after the sleepless night, while in eyes-open condition, the length in function of surface (LFS or accuracy of postural control) and Romberg's index (or contribution of vision to maintain posture) significantly decreased. This could indicate that after a night without sleep, there is a slower elaboration of visual inputs in the postural control process. On the basis of these results, the effects of sleep deprivation on cognitive performance were considered from a neuropsychological point of view.

Long-term effects of vaccination on attentional performance.

To investigate the possible influence of stimulation of the immune system on cognitive tasks, healthy volunteers were vaccinated against hepatitis B and tested over a 6 month-period in a simple reaction times and the Stroop task. In general, the "Stroop effect" demonstrates that both the name and meaning of a word are automatically processed even when voluntary attention is trying hard not to process them. Unlike placebo group, vaccinated subjects showed a persistent lack of the classical Stroop effect. These findings may be explained by a constraint satisfaction model of the Stroop task, assuming a selective weakening of the connection matrix, and suggest that immune-cognitive effects may occur, besides the well known immune-cognitive influences like those elicited by emotional stress.