Narrative identity in addictive disorders: a conceptual review.

Narrative identity allows individuals to integrate their personal experiences into a coherent and meaningful life story. Addictive disorders appear to be associated with a disturbed sense of self, reflected in problematic and disorganized self-narratives. In recent literature, a growing body of research has highlighted how narrative approaches can make a dual contribution to the understanding of addiction: on the one hand, by revealing crucial aspects of self structure, and, on the other, by supporting the idea that addiction is a disorder related to unintegrated self-states in which dissociative phenomena and the resulting sense of 'loss of self' are maladaptive strategies for coping with distress. This conceptual review identified the main measures of narrative identity, i.e., narrative coherence and complexity, agency, and emotions, and critically examines 9 quantitative and qualitative studies (out of 18 identified in literature), that have investigated the narrative dimension in people with an addictive disorder in order to provide a synthesis of the relationship between self, narrative and addiction. These studies revealed a difficulty in the organization of narrative identity of people with an addictive disorder, which is reflected in less coherent and less complex autobiographical narratives, in a prevalence of passivity and negative emotions, and in a widespread presence of themes related to a lack of self-efficacy. This review points out important conceptual, methodological and clinical implications encouraging further investigation of narrative dimension in addiction.

Defining the Characteristics of Story Production of Autistic Children: A Multilevel Analysis.

Several studies suggest that a valuable tool to examine linguistic skills in communication disorders is offered by procedures of narrative discourse assessment. Following this line of research, we present an exploratory study aimed to investigate storytelling abilities of autistic children to better define the characteristics of their story production. Participants included 41 autistic children and 41 children with typical development aged between 7.02 and 11.03 years matched on age, gender, level of formal education, intelligence quotient, working memory, attention skills, theory of mind, and phonological short-term memory. Narrative production was assessed by analysing the language samples obtained through the "Nest Story" description task. A multilevel analysis including micro- and macro-linguistic variables was adopted for narrative assessment. Group differences emerged on both micro- and macro-linguistic dimensions: autistic children produced narratives with more phonological errors and semantic paraphasias (microlinguistic variables) as well as more errors of global coherence and a fewer number of visible events and inferred events (macrolinguistic variables) than the control group.This study shows that even autistic children with adequate cognitive skills display several limitations in their narrative competence and that such weaknesses affect both micro- and macrolinguistic aspects of story production.

Introspective self-narrative modulates the neuronal response during the emphatic process: an event-related potentials (ERPs) study.

Empathy is the ability to perceive and understand others' emotional states generating a similar mental state in the self. Previous behavioural studies have shown that self-reflection can enhance the empathic process. The present event-related potentials' study aims to investigate whether self-reflection, elicited by an introspective self-narrative task, modulates the neuronal response to eye expressions and improves the accuracy of empathic process. The 29 participants included in the final sample were divided into two groups: an introspection group (IG) (n = 15), who received an introspective writing task, and a control group (CG) (n = 14), who completed a not-introspective writing task. For both groups, the electroencephalographic and behavioural responses to images depicting eye expressions taken from the "Reading the Mind in the Eyes" Theory of Mind test were recorded pre- (T0) and post- (T1) 7 days of writing. The main result showed that only the IG presented a different P300 amplitude in response to eye expressions at T1 compared to T0 on the left centre-frontal montage. No significant results on accuracy at T1 compared to T0 were found. These findings seem to suggest that the introspective writing task modulates attention and implicit evaluation of the socio-emotional stimuli. Results are discussed with reference to the hypothesis that such neuronal modulation is linked to an increase in the embodied simulation process underlying affective empathy.

Attachment style dimensions are associated with neural activation during projection of mental states.

The aim of the present study was to investigate the association between attachment dimensions and neural correlates in response to the Rorschach inkblots. Twenty-seven healthy volunteers were recruited for the electroencephalographic registration during a visual presentation of the Rorschach inkblots and polygonal shapes. The Attachment Style Questionnaire (ASQ) was administered to participants. Correlations between the ASQ scores and standardized low-resolution brain electromagnetic tomography (sLORETA) intensities were performed. The Rorschach inkblots elicited several projective responses greater than the polygonal shapes (distortions, human and total movements, and embellishments). Only during the Rorschach inkblots presentation, discomfort with closeness and relationships as secondary subscales were negatively correlated with the activation of right hippocampus, parahippocampus, amygdala, and insula; need for approval subscale was negatively correlated with the activation of orbital and prefrontal cortex and left hippocampus. Moreover, the correlations between attachment dimensions and neural activation during the Rorschach inkblots were significantly higher compared to the same correlations in response to polygonal shapes. These findings suggest that attachment style can modulate brain activation during the projective activity of the Rorschach inkblots.

Does the character-based dimension of stories impact narrative processing? An event-related potentials (ERPs) study.

This event-related potentials (ERPs) study investigated online processes of integration of information relating to characters in narrative comprehension. The final sample included twenty-nine participants who read short third-person stories in which the plausibility of the characters' actions was manipulated. Stories were administered in three conditions: a character-based congruent condition including a target word that was consistent with the character's job; a character-based incongruent condition with a target word inconsistent with the character's job; a character-based neutral condition, narrating the action of a character presented by his/her proper name without information about his/her job. Results comparing the ERPs elicited by the experimental conditions revealed a greater negative amplitude of the N400 in the right temporal regions in response to the character-based incongruent compared to the character-based congruent narratives. This finding shows that implicit background character-based information affects the N400, with readers rapidly using this information to comprehend narratives.

Self-projection in middle childhood: a study on the relationship between theory of mind and episodic future thinking.

Growing evidence suggests that theory of mind (ToM) and episodic future thinking (EFT) are closely related at both brain and functional level. This study explored the relationship between ToM and EFT in 96 Italian-speaking children with typical development aged between 8 and 10.11 using a behavioral design. ToM was assessed through an emotional facial expression recognition task. EFT was assessed with a task where participants were required to project themselves forward in time by anticipating future states of the self; this resulted in two scores: a nonverbal measure and a verbal explanation measure. Results showed that the participants' performance on the task assessing ToM correlated with and predicted the nonverbal measure of the EFT task. These findings are discussed in the light of theories suggesting that each of these abilities is governed by a common system devoted to self-projection.

Neural correlates of sex-related differences in attachment dimensions.

The purpose of this study was to investigate sex-related differences in the electrophysiological response to socioemotional stimuli (positive, negative, and ambiguous) depicting couple interactions. The associations between anxiety and avoidance attachment dimensions (measured with the Experiences in Close Relationships-Revised questionnaire) and the strength of cortico-limbic circuit intensity was explored, recorded using a 256-Hydrocel Geodesic Sensor-Net. Event-related potentials (ERPs) and standardized low-resolution electromagnetic tomography (sLORETA) data were analyzed for a total sample of 74 participants. Regression analyses showed that the women presented increased brain intensity compared with that in men, and the avoidance score was positively associated with brain intensity, particularly in response to negative socioemotional stimuli. The interaction sex per avoidance was a significant predictor of intensity in many brain areas, with women displaying significantly more pronounced positive associations between avoidance and brain intensity than men. In conclusion, the findings of the present study showed that women appeared to be more emotionally involved during the socioemotional task. Avoidance was positively associated with intensity of the cingulate and prefrontal regions, and these associations were more pronounced in women than in men. These findings suggested that avoidance seems to represent two different socioemotional strategies, in which women appear to activate an avoidant strategy to modulate increased emotional involvement in relationships, whereas men appear to adopt avoidance with a more intense emotional suppression.

Different Electrophysiological Responses to Pain-Related Visual Stimuli Between Fibromyalgia and Chronic low Back Pain Women: A Pilot Case-Control Study.

BACKGROUND: Fibromyalgia is a chronic pain syndrome which occurs in the absence of an organic damage, whom causes is still unclear. Aims of this pilot study were to investigate the neural correlates of fibromyalgia in response to pain-related visual stimuli and explore the psychological differences among fibromyalgia, chronic low back pain (CLBP) and healthy conditions. METHODS: After a clinical assessment, electrophysiological responses to pain-related visual stimuli were recorded using a 256-Hydrocel Geodesic-Sensor-Net. Event-related potentials (ERPs), standardised low-resolution electromagnetic tomography (sLORETA), and psychological (Symptom Checklist-90-Revised) data were analysed for a total sample of 23 women (5 healthy volunteers, 12 fibromyalgia patients, 6 CLBP patients). RESULTS: The main finding was that fibromyalgia women reported a different brain response to pain-related visual stimuli on the frontal montage compared to women with CLBP (p = .028). Moreover, fibromyalgia women showed an increased activity mainly on the hippocampus (p = .003) and the posterior cingulate cortex (p ≤ .001) in response to algic stimuli compared to not algic ones. Lastly, these women presented higher scores on the somatization (p = .002), obsession-compulsion (p = .045), depression (p = .043) and positive symptom distress (p = .023) dimensions compared to the healthy women. CONCLUSIONS: These preliminary results suggest that although the painful symptoms are similar, the central elaboration of pain could be different between women with fibromyalgia and those with CLBP. Moreover, these findings provide preliminary evidences about the great alert and the central sensitivity to pain-related information regarding fibromyalgia patients.

Neurophysiological correlates of emotional face perception consciousness.

Aim of the present study was to investigate the neurophysiologic correlates of the conscious and not conscious perception of faces (presented for 14, 40, 80 ms) with happy and sad emotional valence. Electroencephalographic data of 22 participants during a report-based visual task were recorded. Both happy and sad faces presented for 14 ms showed a longer N170 latency compared to the faces presented for 40 and 80 ms. A shorter latency of early components (before N170) was found in the right hemisphere and a longer latency in the left one in response to the happy faces presented for 14 ms compared to those presented for longer times. The faces presented for 14 ms, declared as consciously perceived, evoked a higher brain response compared to those declared as not perceived. Parietal and cingulate brain areas showed a lower intensity of the brain response to the consciously perceived faces in the early components. Happy faces showed a greater brain response when consciously detected, while the sad faces induced a greater brain response when not consciously detected. The findings suggest that the N170 may be the epiphenomenon of an earlier consciously detection. Moreover, these preliminary results seem to support a main role of parietal and cingulate brain areas into not conscious perception.

An investigation of visual narrative comprehension in children with autism spectrum disorders.

The present study analyzed the comprehension of visual narrative in a group of twelve children with autism spectrum disorders (ASD). Their performances were compared to a control group of fifteen children with typical development (TD) matched for age, level of formal education, and IQ. Visual narrative comprehension was assessed by administering a task that required children to understand narrative's global coherence by arranging in the correct order the constituent parts of stories presented in pictures. Specifically, the task evaluated children's ability to grasp how single events connected (causally and temporally) each other and how these connections led to the ending of the story. Results showed that children with ASD obtained significantly lower scores than children with TD. These results open to alternative interpretations of narrative impairments often reported in individuals with ASD, which might not be restricted to the linguistic code but stem from a deeper deficit in narrative processing that is independent from the expressive modality.

Neurophysiological correlate of emotional regulation in cognitive and motor deficits in Tourette's syndrome.

Objectives: The present study investigated the role of different emotions in the expression of cognitive and motor control abilities of children having Tourette's syndrome (TS) compared to healthy controls.Methods: The electroencephalography activity of 33 children (mean age in final sample: TS (n = 10) = 10.5 ± 2.3; control (n = 10) = 10.1 ± 2.9) was recorded during a visual task consisting of four emotional face cues (anger, happiness, neutral and sadness) followed by a target in congruent or incongruent position with emotional cue. The participants were asked to indicate the target location.Results: The TS patients showed a shorter latency of the P1 and N170 only for anger cues compared to controls. In addition, sLORETA results showed an increased activation in the left occipital area and a decreased activation in the left amygdala, temporal and cingulate for anger cues in TS patients. Coherently, TS patients showed a lower accuracy of response only with anger cue and severity of tics resulted correlated with the event-related potentials data and behavioural responses linked to anger cue.Conclusions: These results suggest that children with TS process emotions (in particular the anger) differently from the controls, and that its regulation seems to have an important role in the cognitive and motor deficits in TS.

Violence in video game produces a lower activation of limbic and temporal areas in response to social inclusion images.

Exposure to violence in video games has been associated with a desensitization toward violent content, a decrease of empathy, and prosocial behavior. Moreover, violent video games seem to be related to a reduction of neural activation in the circuits linked to social emotional processing. The purpose of the present study was to compare the neural response to social inclusion images after violent and nonviolent video game playing. Electroencephalographic data of the 32 participants were recorded during a visual task with three presentations (T0, T1, T2) of 60 stimuli (30 social inclusion vs. 30 neutral images). After the T0 presentation, the participants played with a video game (orientation or violent). After the T1 presentation, the participants played with the other video game (orientation or violent). The two types of video games were randomly displayed. Event-related potential (ERP) components and low-resolution electromagnetic tomography (sLORETA) were analyzed. The main findings showed a longer latency of the P2 component on occipito-temporal montage and a lower activation of the limbic and temporal areas in response to the social inclusion images post violent video game compared with the post orientation video game. The findings suggest a reduction of emotional engagement in social processing after playing violent video game.

Neurophysiological Correlates of Collective Trauma Recall in 2009 L'Aquila Earthquake Survivors.

In the present study, we aimed to explore neural correlates of survivors of the 2009 L'Aquila, Italy earthquake in response to being shown pictures featuring their own city before and after an earthquake as well as those of an unfamiliar city. Moreover, we explored the associations among psychological variables and brain responses to the pictures of L'Aquila after the earthquake. Our final sample (N = 30 adults) comprised 15 survivors (M age = 31.40 years, SD = 9.42) and 15 controls (M age = 30.53 years, SD = 10.01). Participants' electroencephalographic (EEG) data were recorded during a visual task that included earthquake-related stimuli. Participants were assessed for posttraumatic and dissociation symptoms and event-related potential components, and low-resolution electromagnetic tomography (sLORETA) were analyzed. Compared to the control group, source localization in survivors indicated a lower intensity of the amygdala, hippocampal, parahippocampal, and temporopolar areas in response to visual stimuli concerning the earthquake, p < .001 to p < .0001. Results indicated a reduced limbic activation in response to visual stimuli that evoked the recall of earthquake in survivors. This finding suggests that survivors likely adopted a distancing strategy toward stimuli that may have elicited an emotional activation related to collective trauma.

Neural correlate of Internet use in patients undergoing psychological treatment for Internet addiction.

BACKGROUND: The new version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5th) proposed the Internet Gaming Disorder for the diagnosis of Internet addiction (IA) considering the neurobiological evidence of the craving. AIMS: The aim was to test the neural correlate in response to the Internet cue in patients with IA. METHODS: Sixteen males with IA diagnosis (clinical group) and 14 healthy male (control group) were recruited for an experimental visual task composed of Internet images and emotional images. During the visual presentation of Internet cue, electroencefalographic data were recorded using Net Station 4.5.1 with a 256-channels HydroCel Geodesic Sensor Net. Event-related potential (ERP) components and low-resolution electromagnetic tomography (sLoreta) were analysed. RESULTS: sLoreta analyses showed that patients from the clinical group presented a higher primary somatosensorial cortex and lower paralimbic, temporal and orbito-frontal activation in response to both Internet and emotional images compared to those of the control group. CONCLUSIONS: These results suggest that clinically recognized pathological use of Internet could be linked to dissociative symptoms.

Neural Correlates of Outcome of the Psychotherapy Compared to Antidepressant Therapy in Anxiety and Depression Disorders: A Meta-Analysis.

The most prevalent mental disorders, anxiety and depression, are commonly associated with structural and functional changes in the fronto-limbic brain areas. The clinical trials investigating patients with affective disorders showed different outcome to different treatments such as psychotherapy or pharmacotherapy. It is, however, still unexplored how these interventions approach affect the functional brain. This meta-analysis aims to compare the effects of psychotherapy compared to antidepressant therapy on functional brain activity in anxiety and depression disorders. Twenty-one samples with psychotherapy and seventeen samples with antidepressant therapy were included. The main finding showed an inverse effect of the two treatments on the right paracingulate activity. The patients undergoing psychotherapy showed an increase in the right paracingulate activity while pharmacological treatment led to a decrease of activation of this area. This finding seems to support the recent studies that hypothesize how psychotherapy, through the self-knowledge and the meaning processing, involves a top-down emotional regulation.

Neural correlate of the projection of mental states on the not-structured visual stimuli.

Projection is a spontaneous and complex mental activity responsible for the subjective meaning attribution. The hypotheses of this study were that the neural correlate of projection may involve frontal, parietal, and temporal brain areas, and that alexithymia may be negatively associated with intensities in limbic and paralimbic areas during projection. EEG data were recorded continuously at 250 Hz using NetStation 4.5.1 with 256-channels HydroCel Geodesic Sensor Net in 20 healthy subjects during the presentation of structured and not-structured visual stimuli. The tasks were paying attention to the stimuli and thinking about the possible meaning of each image. Event related potential (ERP) components and low-resolution electromagnetic tomography (sLoreta) were analyzed. Participants were administered the 20-Item Toronto Alexithymia Scale before stimulus presentation. Source analyses (sLORETA) showed a greater activated source in the left primary somatosensory cortex (BA1) compared to all the others BA in both conditions through all the ERP components. An involvement of the frontal (right-BA4, left- and right-BA9, left-BA11) and parietal (left and right-BA2 and left-BA7) areas was found in projective response to not-structured visual stimuli. Alexithymia levels were negatively correlated with the anterior (right-BA32) and posterior (left-BA29) cingulate cortex. Findings show the relevance of fronto-parieto circuits during projection, where the internally generating somatosensory representations could drive an intermodal meaning attribution during the task. Moreover, high alexithymia levels were associated with a reduced activation of the cingulated cortex.

The role of the eyes in processing an intact face and its scrambled image: a dense array ERP and low-resolution electromagnetic tomography (sLORETA) study.

The aim of the present study was to test whether the eyes of an intact face produced a specific brain response compared to the mouth, nose, or hair and whether their specificity was also maintained in a scrambled face. Fifteen subjects were asked to focus visual attention on global and single elements in intact faces and in their scrambled image. EEG data were recorded from 256-Hydrocel Geodesic Sensor-Net200. Event-related potentials (ERPs) analyses showed a difference between the intact face and the scrambled face from N170 component until 600 ms on the occipito-temporal montage and at 400-600 ms on the frontal montage. Only the eyes showed a difference between conditions (intact/scrambled face) at 500 ms. The most activated source detected by sLORETA was the right middle temporal gyrus (BA21) for both conditions and for all elements. Left BA21 resulted in significantly more activation in response to eyes in the intact face compared to the eyes in the scrambled face at 500 ms. The left BA21 has a central role in high-level visual processing and in understanding others' intentions. These findings suggest a specificity of the eyes and indicate that the eyes play the social and communicative role of comprehending the nonverbal intentions of others only when inserted in an intact face.