The psychological burden of routine prenatal ultrasound on women's state anxiety across the three trimesters of pregnancy.

OBJECTIVE: Although obstetric ultrasound examination has recognizable clinical and psychological benefits, it also involves some psychological burdens, mainly in terms of the woman's state anxiety, the level of which can change during pregnancy. This research aimed to study the influence of routine ultrasound examination on the woman's state anxiety and its relation with her personality background in the three trimesters of pregnancy. STUDY DESIGN: This work was a prospective interventional study. Women who underwent routine-screening ultrasound examinations in the first, second, or third trimester of pregnancy were recruited. The state anxiety level was assessed using the State-Trait Anxiety Inventory - subscale S (S-Anxiety), administered immediately before and after the exams. More stable personality characteristics were evaluated before ultrasound, assessing trait anxiety by State-Trait Anxiety Inventory - subscale T (T-Anxiety) and psychological coping by Coping Orientations to Problem Experienced (COPE). The S-Anxiety scores, collected immediately before and after the exams, were compared by two-tailed paired t-test. Moreover, S-Anxiety scores collected in each one of the three-trimester groups immediately before and after the exams were compared by one-way between groups ANOVA. Relations among S-Anxiety scores with more stable aspects of personality (T-Anxiety and COPE scores) were also studied, by correlation analysis. RESULTS: A total of 285 women were recruited. In all trimesters, S-Anxiety scores decreased significantly after the exam (P < 0.001), with a more relevant reduction in women with higher T-Anxiety scores (P < 0.001). A gradual decrease in S-Anxiety scores before the examination was seen across the three trimesters, with significantly higher scores in the first trimester (P = 0.016). Before ultrasound, S-Anxiety score resulted positively correlated with avoidance coping strategies (P < 0.001), while it was inversely related to active coping style (P < 0.001) and positive aptitude (P < 0.001). CONCLUSIONS: The psychological burden of prenatal ultrasound in the different trimesters of pregnancy was studied. Clinicians should be sensitive to women's state anxiety during prenatal routine-screening ultrasound examination, using a personalized approach. Particular attention should be paid to the psychological burden associated with ultrasound evaluation of the first trimester, when the level of the anxiety state is higher.

Maternal cortical response to baby pain and postpartum depressive symptoms.

Decreased maternal empathic abilities toward infants have been reported with postpartum depression (PPD). The aims of this study were: (1) To identify mothers' cortical regions activated by the observation of their own newborn's pain; (2) To study the relation between such cortical activation and PPD symptoms. By optical topography, a functional neuroimaging system, we assessed mothers' cortical activation when watching their own newborns during a heel-prick. PPD symptoms and newborn's pain expression were also assessed. Watching their newborn in pain activated mothers' left somatosensory cortex (P=0.003) and right superior temporal cortex (P=0.002). PPD score showed a negative correlation with left somatosensory cortex activation (rs=-0.41; P=0.026), that decreased as PPD symptoms increased. To conclude, an activation of cortical areas, previously associated with empathy for pain, can be demonstrated in the mother shortly after birth. Such response appeared to be dampened by PPD symptoms.

Validation of the Italian translation of the affective neuroscience personality scales.

The theoretical perspective on affective neuroscience advanced by Panksepp, identified six basic innate affective systems: the SEEK, FEAR, ANGER, SADNESS, PLAY, and CARE systems. (3) It has been proposed that the fundamental elements of human personality and its variants may be based on the different expressions of these basic emotional systems and their combinations. A self-report inventory, the Affective Neuroscience Personality Scales (ANPS), has been devised with the aim of studying and evaluating personality from this perspective. This study reports data on the initial validation of ANPS Italian translation on a sample of 418 adult participants. Descriptive statistics for each scale were calculated, assessing also their internal consistency, as a measure of reliability and factorial validity. Acceptable internal consistency was found in all but one scale (SADNESS), and a second-order factor analysis identified a more general affective feature of personality hinging on relational characteristics, independent of the dimensions of general positive and negative affect.

Differences in time course activation of dorsolateral prefrontal cortex associated with low or high risk choices in a gambling task.

Prefrontal cortex plays an important role in decision making (DM), supporting choices in the ordinary uncertainty of everyday life. To assess DM in an unpredictable situation, a playing card task, such as the Iowa Gambling Task (IGT), has been proposed. This task is supposed to specifically test emotion-based learning, linked to the integrity of the ventromedial prefrontal cortex (VMPFC). However, the dorsolateral prefrontal cortex (DLPFC) has demonstrated a role in IGT performance too. Our aim was to study, by multichannel near-infrared spectroscopy, the contribution of DLPFC to the IGT execution over time. We tested the hypothesis that low and high risk choices would differentially activate DLPFC, as IGT execution progressed. We enrolled 11 healthy adults. To identify DLPFC activation associated with IGT choices, we compared regional differences in oxy-hemoglobin variation, from baseline to the event. The time course of task execution was divided in four periods, each one consisting of 25 choices, and DLPFC activation was distinctly analyzed for low and high risk choices in each period. We found different time courses in DLPFC activation, associated with low or high risk choices. During the first period, a significant DLPFC activation emerged with low risk choices, whereas, during the second period, we found a cortical activation with high risk choices. Then, DLPFC activation decreased to non-significant levels during the third and fourth period. This study shows that DLPFC involvement in IGT execution is differentiated over time and according to choice risk level. DLPFC is activated only in the first half of the task, earlier by low risk and later by high risk choices. We speculate that DLPFC may sustain initial and more cognitive functions, such as attention shifting and response inhibition. The lack of DLPFC activation, as the task progresses, may be due to VMPFC activation, not detectable by fNIRS, which takes over the IGT execution in its second half.