The relationship of psychological health and primary emotional traits in medical students.

INTRODUCTION: Several studies have called for attention to medical students' well-being. Building on the neuroevolutionary affective neuroscience perspective that views primary emotional systems as central to well-being and the foundation of personality, this study investigated the facets of medical students' psychological well-being that are challenged and the relationships between emotional traits, psychological well-being, and depression. METHODS: In a single-center cross-sectional study, medical students' primary emotional traits (SEEKING, FEAR, ANGER, SADNESS, CARE, PLAY and Spirituality), psychological well-being dimensions (autonomy, environmental mastery, positive relations, self-acceptance, purpose in life, and personal growth), and depressive symptoms were assessed using the Affective Neuroscience Personality Scale; the Psychological Well-being Scale, which provides normative data; and the Beck Depression Inventory. RESULTS: Compared with the normative data, the medical students perceived lower psychological autonomy, positive relations, and self-acceptance but higher purpose in life. The medical students' emotional traits were related to specific psychological well-being facets and depression. SEEKING and, inversely, FEAR were related to well-being across dimensions and depressive symptoms. CONCLUSION: Our findings are the first to show a link between emotional traits and specific facets of psychological health in medical students. Thus, this study encourages medical teachers to set learning environments that target multiple facets of well-being that harness primary emotional traits.

Emotion recognition in medical students: effects of facial appearance and care schema activation.

CONTEXT: Identifying the factors that may interfere with or sharpen the ability to recognise emotions when observing patients is a critical goal in medical education. This study addressed these issues by investigating the effects of facial appearance bias on medical students' emotion recognition (Experiment 1) and whether such bias is modulated by the activation of relational caregiving schema (Experiment 2). METHODS: In Experiment 1, medical students were asked to recognise the emotions expressed by individuals differing in facial appearance (trustworthy, neutral and untrustworthy). In Experiment 2, they completed the same type of emotion recognition task after activating and anchoring themselves to the representation of the relational/human competences typical of a competent professional caregiver or after a control non-representation condition. RESULTS: In both experiments, emotion recognition was affected by facial appearance bias: medical students were less accurate and slower in their recognition of emotions displayed by untrustworthy-looking individuals than in their recognition of emotions exhibited by individuals evoking more positive inferences. In Experiment 2, the activation of care schema enhanced medical students' emotion recognition ability regardless of facial appearance-based inferences. CONCLUSIONS: Medical students' emotion recognition is affected by appearance-based bias, but such bias may be weakened by techniques that harness medical students' personal affective/relational and representational resources. Thus, the results provide a basis for designing curricula aimed at challenging implicit negative bias and promoting medical students' emotion recognition ability starting in the early stages of their education.

Sleep habits, circadian preference, and school performance in early adolescents.

OBJECTIVE: This study aimed to cast light on the relationships between sleep habits, perceived sleep problems and school performance in Evening-type (E-type) compared with Morning-type (M-type) early adolescents. METHODS: Comparison of questionnaire data of E-type and M-type adolescents random-selected from a large sample of eight-grade adolescents who took part in a national survey of competence in mathematics and science. RESULTS: The proportions of sleep problems that were observed to occur more than once per week and the frequency of struggling to fall asleep and/or falling asleep in distinct everyday situations were much higher in E-type than in M-type adolescents. Moreover, E-type adolescents showed more disturbed and poorer sleep during both school and weekend days and reported lower grades in mathematics, science and Italian. CONCLUSIONS: E-type adolescents showed a partial recovery of sleep debt during weekend days. This finding suggests that they could improve their school performance if tests and classwork would be scheduled on their most alert school days, namely the post-weekend ones.

Temperamental and character profiles of preschool children with ODD, ADHD, and anxiety disorders.

BACKGROUND: The aim of the present research was to identify profiles of Cloninger's temperament and character dimensions associated with anxiety disorders, oppositional defiant disorder (ODD) and attention- deficit/hyperactive disorder (ADHD) in preschoolers. METHOD: The parents of 120 children (mean age=4.65 years; S.D.=.88) completed the Preschool Temperament and Character Inventory (PsTCI). The sample consisted of 4 groups (n=30 per group): ADHD, anxious, ODD and control children. To diagnose the different disorders, the Preschool Age Psychiatric Assessment and Child Behavior Checklist 1.5-5 was administered to the parents. RESULTS: The discriminant analysis showed that three temperamental dimensions (Harm Avoidance, Novelty Seeking and Persistence) enabled the correct classification of 75% of cases within their own group, which demonstrated an adequate accuracy rate. The ADHD children showed a temperamental profile that was characterized by high Novelty Seeking, low Reward Dependence and low Persistence, while the anxious children obtained high scores in Harm Avoidance. The profiles of the ODD children shared some common features (high Novelty Seeking) with the ADHD children, but the ODD children were characterized by higher Persistence and Harm Avoidance compared with ADHD children. CONCLUSIONS: The present results indicate that Cloninger's temperamental dimensions allow to differentiate the three most frequent psychiatric disorders in preschoolers.

Impulsivity, intelligence and P300 wave: an empirical study.

The aim of this study was to analyze the relationships among impulsivity, intelligence and P300, a well-known component of the event-related potential widely studied in personality and intelligence research. Eighty-two males completed the Barratt Impulsiveness Scale and the two-subtest form of the Wechsler Abbreviated Scale of Intelligence. A subsample of 45 participants (mean age=24.4, SD=4.6) performed a visual oddball task, consisting of a two-letter recognition task, during which psychophysiological data were recorded. Although no significant relationships emerged for P300 latency, overall results suggest that the P300 amplitude was positively related to IQ and negatively related to impulsivity. Those who scored high on impulsivity (high impulsives) had lower P300 amplitudes than low impulsives, but this relationship was not significant when controlling for individual differences in mental ability. The results also showed an inverse relationship between mental ability and impulsivity. That is, high impulsives demonstrated reduced cognitive performance on intelligence testing and it is reflected in their reduced P300 amplitude. These findings are likely due to high impulsives' less efficient ability to inhibit task-irrelevant information or to ignore additional information intake. It was suggested that impulsivity exerts a disadvantageous influence on the performance of tasks (such as those used on intelligence tests) in which exclusive concentration and sustained attention are necessary.

The social-cognitive mechanisms regulating adolescents' use of doping substances.

In this study, we assessed the longitudinal effects of social-cognitive mechanisms on the self-reported use of doping substances and supplements among Italian high school students. In total, 1232 students completed questionnaires measuring various psychological factors hypothesized to influence students' intention to use substances. Three months later, 762 of the students completed the same questionnaires a second time and also reported their use of substances during the time between assessments. Overall, the percentages of students using doping substances (2.1%) or supplements (14.4%) were consistent with values reported in the literature. Analysis of the data showed that adolescents' intention to use doping substances increased with stronger attitudes about doping, stronger beliefs that significant others would approve of their use, a stronger conviction that doping use can be justified, and a lowered capacity to resist situational pressure or personal desires. In turn, stronger intentions and moral disengagement contributed to a greater use of doping substances during the previous 3 months. Doping use was also correlated significantly to supplementation. In conclusion, our results provide novel information about some of the psychological processes possibly regulating adolescents' use of doping substances and supplements. The results also highlight possible areas for future study and intervention, focusing on the prevention of adolescents' substance use.

Sleep habits and circadian preference in Italian children and adolescents.

Sleep habits and circadian preference (morningness/eveningness, M/E) have been extensively analyzed in adolescents and young adults, while few studies were conducted on children and early adolescents. Aim of the present study was to investigate the developmental changes of circadian preference and to analyze its relationship with sleep habits, sleep problems and circadian preference in a large sample by means of a school-based survey. One thousand seventy-three participants (50.8% boys and 49.2% girls; mean age = 10.6; range = 8-14 years), recruited from four schools randomly extracted within the district of Rome, completed a modified version of School Sleep Habits Survey developed by Carskadon et al. The questionnaire included items about sleep habits during schooldays and weekends; a Sleepiness Scale; a Sleep-Wake Problems Behaviour Scale; a Morningness/Eveningness scale. The results show a consistent age-related change in sleep habits, particularly in the weekends. The difference in sleep duration between schooldays and weekends increases linearly with age. No gender difference was observed in morningness/eveningness, while a significant linear increase in evening preference was found with increasing ages. M/E total scores correlated significantly with both self-reported sleep/wake problems and daytime sleepiness indicating a higher prevalence of sleep complaints in evening-type subjects. Overall, the present results support the existence of consistent age-related changes in sleep habits and M/E dimension in the 8- to 14-year age range.

Polymeric diet alone versus corticosteroids in the treatment of active pediatric Crohn's disease: a randomized controlled open-label trial.

BACKGROUND & AIMS: Nutritional therapy has been reported to have an almost equivalent efficacy of corticosteroids in achieving clinical remission in active Crohn's disease (CD). However, the effects of both treatments on intestinal mucosal inflammation rarely are reported. In a randomized controlled trial in children with active CD we compared the efficacy of nutritional therapy alone or corticosteroids on clinical variables and intestinal mucosal healing. METHODS: In a prospective, 10-week open-label trial, children with active, naive CD were randomized to orally polymeric formula alone or oral corticosteroids. The clinical activity index and nutritional and activity serum variables were evaluated at week 0 and then every 2 weeks; intestinal mucosal inflammation was assessed through endoscopy and histology at weeks 0 and 10. Primary efficacy outcomes were clinical remission and mucosal healing. RESULTS: Of the 37 children randomized, 19 received polymeric formula and 18 received corticosteroids. At week 10, on an intention-to-treat basis, the proportion of patients achieving clinical remission was comparable between the 2 groups (polymeric formula: 15/19 [79%; 95% confidence interval (CI), 56%-92%]; corticosteroid group: 12/18 [67%; 95% CI, 44%-84%]; P = .4; not significant). On the contrary, the proportion of children showing mucosa healing was significantly higher in the polymeric (14/19; 74%; 95% CI, 51%-89%) than the corticosteroid group (6/18 [33%; 95% CI, 16%-57%]; P < .05). At week 10 both endoscopic and histologic scores significantly decreased only in the polymeric group (P < .001). CONCLUSIONS: In children with active and recently diagnosed CD, a short course of polymeric diet is more effective than corticosteroids in inducing healing of gut inflammatory lesions.

Sleep disturbances and teacher ratings of school achievement and temperament in children.

BACKGROUND: The current study examined the relationships between academic achievement, sleep, temperament and demographic-historical data in school-age children. METHODS: Teachers were asked to fill out the teacher temperament questionnaire and a form for school achievement, while mothers filled out a demographic-historical form and the sleep disturbance scale for children (SDSC), a 26-item questionnaire that consisted of six factors: difficulty in initiating and maintaining sleep (DIMS), sleep breathing disorders (SBD), arousal disorders (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DOES), sleep hyperhydrosis (SHY). From a sample of 380 school children, 264 (70%) were suitable for the analyses (141 M and 123 F aged 8-11 years, mean 9.6 years). A school achievement index (SAI) was derived, summing up four items (reading ability, reading comprehension, mathematics, executive ability) of the teacher form for school achievement. RESULTS: SAI mean for the total sample was 11.1 (SD=2.8). A significant gender difference was found: females have higher SAI than males. The analysis of the demographic-historical form showed that only two factors appeared to affect SAI score: enuresis and the low educational level of the mother. The pattern of correlations showed that (a) the SAI was negatively related to the SDSC total score, in particular to DIMS and DOES sub-factors, and (b) the SAI was significantly and positively correlated with the temperamental traits of task-orientation and personal-social flexibility. A multiple stepwise regression analysis showed that the temperamental traits task-orientation and personal-social flexibility are the most predictive factors for SAI while the mother's educational level and the SDSC total score, although they contributed significantly to the prediction of SAI, accounted for only a small portion of variance. CONCLUSIONS: Temperament and sleep are important factors influencing school achievement, and their assessment could help to identify children at risk regarding school achievement.