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Rütgen M, Lamm C. Dissecting shared pain representations to understand their behavioral and clinical relevance. Neurosci Biobehav Rev 2024; 163:105769. [PMID: 38879099 DOI: 10.1016/j.neubiorev.2024.105769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/29/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
Accounts of shared representations posit that the experience of pain and pain empathy rely on similar neural mechanisms. Experimental research employing novel analytical and methodological approaches has made significant advances in both the identification and targeted manipulation of such shared experiences and their neural underpinnings. This revealed that painful experiences can be shared on different representational levels, from pain-specific to domain-general features, such as negative affect and its regulation. In view of direct links between such representations and social behaviors such as prosocial behavior, conditions characterized by aberrant pain processing may come along with heavy impairments in the social domain, depending on the affected representational level. This has wide potential implications in light of the high prevalence of pain-related clinical conditions, their management, and the overuse of pain medication. In this review and opinion paper, we aim to chart the path toward a better understanding of the link between shared affect and prosocial behavior.
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Affiliation(s)
- Markus Rütgen
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.
| | - Claus Lamm
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria; Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria.
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2
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Ebner NC, Horta M, El-Shafie D. New directions for studying the aging social-cognitive brain. Curr Opin Psychol 2024; 56:101768. [PMID: 38104362 PMCID: PMC10939782 DOI: 10.1016/j.copsyc.2023.101768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 12/19/2023]
Abstract
The study of social cognition has extended across the lifespan with a recent special focus on the impacts of aging on the social-cognitive brain. This review summarizes current knowledge on social perception, theory of mind, empathy, and social behavior from a social-cognitive neuroscience of aging perspective and identifies new directions for studying the aging social-cognitive brain. These new directions highlight the need for (i) standardized operationalization and analysis of social-cognitive constructs; (ii) use of naturalistic paradigms to enhance ecological validity of social-cognitive measures; (iii) application of repeated assessments via single-N designs for robust delineation of social-cognitive processes in the aging brain; (iv) increased representation of vulnerable aging populations in social-cognitive brain research to enhance diversity, promote generalizability, and allow for cross-population comparisons.
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Affiliation(s)
- Natalie C Ebner
- Department of Psychology, University of Florida, Gainesville, FL, USA; Institute on Aging, University of Florida, Gainesville, FL, USA; Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL, USA.
| | - Marilyn Horta
- Department of Psychology, University of Florida, Gainesville, FL, USA; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Dalia El-Shafie
- Department of Psychology, University of Florida, Gainesville, FL, USA
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3
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Deng F, Bueber MA, Cao Y, Tang J, Bai X, Cho Y, Lee J, Lin Z, Yang Q, Keshavan MS, Stone WS, Qian M, Yang LH, Phillips MR. Assessing social cognition in patients with schizophrenia and healthy controls using the reading the mind in the eyes test (RMET): a systematic review and meta-regression. Psychol Med 2024; 54:847-873. [PMID: 38173096 DOI: 10.1017/s0033291723003501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The reading the mind in the eyes test (RMET) - which assesses the theory of mind component of social cognition - is often used to compare social cognition between patients with schizophrenia and healthy controls. There is, however, no systematic review integrating the results of these studies. We identified 198 studies published before July 2020 that administered RMET to patients with schizophrenia or healthy controls from three English-language and two Chinese-language databases. These studies included 41 separate samples of patients with schizophrenia (total n = 1836) and 197 separate samples of healthy controls (total n = 23 675). The pooled RMET score was 19.76 (95% CI 18.91-20.60) in patients and 25.53 (95% CI 25.19-25.87) in controls (z = 12.41, p < 0.001). After excluding small-sample outlier studies, this difference in RMET performance was greater in studies using non-English v. English versions of RMET (Chi [Q] = 8.54, p < 0.001). Meta-regression analyses found a negative association of age with RMET score and a positive association of years of schooling with RMET score in both patients and controls. A secondary meta-analysis using a spline construction of 180 healthy control samples identified a non-monotonic relationship between age and RMET score - RMET scores increased with age before 31 and decreased with age after 31. These results indicate that patients with schizophrenia have substantial deficits in theory of mind compared with healthy controls, supporting the construct validity of RMET as a measure of social cognition. The different results for English versus non-English versions of RMET and the non-monotonic relationship between age and RMET score highlight the importance of the language of administration of RMET and the possibility that the relationship of aging with theory of mind is different from the relationship of aging with other types of cognitive functioning.
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Affiliation(s)
- Fei Deng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- University of Nottingham School of Economics (Ningbo China), Zhejiang, China
| | - Marlys A Bueber
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yourong Cao
- Guangxi Medical University School of Public Health, Guangxi, China
- The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Jeff Tang
- New York University, New York, NY, USA
| | - Xinyu Bai
- Guangxi Medical University School of Public Health, Guangxi, China
- Guangxi Academy of Medical Sciences & The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Young Cho
- New York State Psychiatric Institute, New York, NY, USA
| | - Jiwon Lee
- Teachers College, Columbia University, New York, NY, USA
| | - Zhuozhi Lin
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Qi Yang
- Ningxia Medical University School of Public Health, Ningxia, China
| | - Matcheri S Keshavan
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - William S Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Min Qian
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lawrence H Yang
- New York University, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
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Nestor BA, Kossowsky J, Nelson SM. Topical Review: Getting into the head of youth with chronic pain: how theory of mind deficits may relate to the development and maintenance of pediatric pain. J Pediatr Psychol 2024; 49:224-230. [PMID: 38366580 PMCID: PMC10954304 DOI: 10.1093/jpepsy/jsae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE Theory of mind (ToM) is the ability to understand the thoughts, feelings, and mental states of others and is critical for effective social and psychological functioning. ToM deficits have been associated with various psychological disorders and identified in adult pain populations. For youth with chronic pain, ToM deficits may underlie the biological, psychological, and social factors that contribute to their experience of pain, but this remains poorly understood. METHODS This topical review explored the extant literature in the areas of ToM and chronic pain, particularly for pediatric populations, with respect to biological, psychological, and social elements of the biopsychosocial model of pain. RESULTS ToM deficits may be present alongside previously identified biological, psychological, and social correlates of pediatric pain, as a vulnerability, mechanism, and/or consequence. Biologically, ToM deficits may relate to cortisol abnormalities and neurobiological substrates of pain processing. Psychologically, ToM deficits may stem from pain-focused cognitions, thus impacting relationships and fueling impairment. Socially, chronic pain may preclude normative development of ToM abilities through social withdrawal, thereby exacerbating the experience of pain. CONCLUSION Taken together, ToM deficits may be associated with increased risk for the development and/or maintenance of pediatric chronic pain, and pediatric chronic pain may similarly confer risk for ToM deficits. Future research should investigate the nature of ToM abilities in youth with chronic pain to test these hypotheses and ultimately inform ToM-focused and pain-based interventions, as this ability has been demonstrated to be modifiable.
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Affiliation(s)
- Bridget A Nestor
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Sarah M Nelson
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Šalčiūnaitė-Nikonovė L, Leonas L, Sapranavičiūtė-Zabazlajeva L. The Effect of Alexithymia, Attention, and Pain Characteristics on Mentalizing Abilities Among Adults With Chronic Pain. Psychol Rep 2024:332941241226895. [PMID: 38214236 DOI: 10.1177/00332941241226895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Introduction: Impaired mentalizing abilities are found among persons with chronic pain, yet it is still unknown why. The current study focuses on mentalizing abilities and how these could be affected by different pain factors, alexithymia traits, and other aspects of psychological functioning (depression, anxiety, attention) in persons experiencing chronic pain.Methods: 71 participants (80.3% female; mean age 56.1 (SD = 13.1)) with subjectively reported chronic pain conditions participated in the study. Mentalizing abilities were assessed using an objective assessment of the Frith-Happé animations test. Alexithymia was measured using Toronto Alexithymia Scale. Subjectively reported data on various pain characteristics and other related psychological factors (depression, anxiety, attention) were collected. Bivariate linear regression analyses were used to identify variables that had statistically significant relationships with Frith-Happé test scores as dependent variables, which were then used to build multivariate models.Results: Mentalization task scores had no significant associations with alexithymia. However, in bivariate models, greater Frith-Happé animations categorisation score was associated with higher attention task scores (βs = .332, p = .005), higher education (βs = .317, p = .007), and lower level of depressiveness (βs = -.234, p = .049). Greater animations feelings scores were associated with less severe pain intensity (βs = -.322, p = .006), younger age (βs = -.399, p = .001), and better attention (βs = .383, p = .001). In multivariate analysis models predicting both animations categorisation and feelings scores, attention was found to be the only statistically significant factor (respectively, βs = .257, p = .029 and βs = .264, p = .035).Conclusions: No significant correlations were found between mentalizing abilities and alexithymic features in persons with chronic pain. Disruptions of attention was the most significant factor leading to lower mentalizing abilities in persons with chronic pain.
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Affiliation(s)
- Laura Šalčiūnaitė-Nikonovė
- Department of Health Psychology, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Linas Leonas
- Department of Health Psychology, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laura Sapranavičiūtė-Zabazlajeva
- Department of Health Psychology, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Schmidt J, Fritz M, Weisbrod M. Relevance of neurocognition in chronic pain syndrome: a systematic and methodical approach. J Clin Exp Neuropsychol 2023; 45:874-889. [PMID: 38406973 DOI: 10.1080/13803395.2024.2314732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/27/2023] [Indexed: 02/27/2024]
Abstract
INTRODUCTION Subjective and objective deficits in neurocognitive domains are well-documented in patients with chronic pain. However, neurocognitive deficits have not been investigated consistently. The main objective of this study was to conduct a comprehensive assessment of self-rated and objectively assessed cognitive differences between patients with chronic pain (CP) and healthy controls (HC). METHOD The cognitive functioning of 40 CP and 41 HC was assessed using a standardized computer-based test battery, enabling a comparison of subjective and objective neurocognitive factors. To achieve this, the Vienna Test System (VTS) was utilized, incorporating standardized tests from the Cognitive Basic Assessment Battery (COGBAT) with the advantage of objectivity, reliability, validity, efficiency, utility, and standardization. This approach enables the evaluation of cognitive functioning across all pertinent domains. RESULTS CP reported cognitive deficits in overall performance as well as specific functions, such as attention, memory, and executive functions. Across all neurocognitive domains, CP showed a poorer performance. Affected subdomains of attention were intensity and selectivity of attention. Lower performance was found also in concentration performance, obtaining and overview, visual orientation performance and reactive stress tolerance. Regarding memory, CP performed worse in figural episodic memory and recognition tasks. In addition, CP exhibited poorer performance in mental flexibility, working memory, planning ability, and inhibition as components of executive functioning, when compared to HC. CONCLUSIONS CP expressed subjective cognitive deficits and demonstrated impaired neurocognitive performance.
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Affiliation(s)
- Janna Schmidt
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Fritz
- Department of Neurology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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Timm A, Schmidt-Wilcke T, Blenk S, Studer B. Altered social decision making in patients with chronic pain. Psychol Med 2023; 53:2466-2475. [PMID: 34736548 PMCID: PMC10123842 DOI: 10.1017/s0033291721004359] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 09/10/2021] [Accepted: 10/06/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Chronic pain affects up to 20% of the population, impairs quality of life and reduces social participation. Previous research reported that pain-related perceived injustice covaries with these negative consequences. The current study probed whether chronic pain patients responded more strongly to disadvantageous social inequity than healthy individuals. METHODS We administered the Ultimatum Game, a neuroeconomic social exchange game, where a sum of money is split between two players to a large sample of patients with chronic pain disorder with somatic and psychological factors (n = 102) and healthy controls (n = 101). Anonymised, and in truth experimentally controlled, co-players proposed a split, and our participants either accepted or rejected these offers. RESULTS Chronic pain patients were hypersensitive to disadvantageous inequity and punished their co-players for proposed unequal splits more often than healthy controls. Furthermore, this systematic shift in social decision making was independent of patients' performance on tests of executive functions and risk-sensitive (non-social) decision making . CONCLUSIONS Our findings indicate that chronic pain is associated with anomalies in social decision making (compared to healthy controls) and hypersensitivity to social inequity that is likely to negatively impact social partaking and thereby the quality of life.
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Affiliation(s)
- Alicja Timm
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
| | - Tobias Schmidt-Wilcke
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
| | - Sandra Blenk
- Centre for Pain Medicine, St.Vinzenz Hospital Düsseldorf, Düsseldorf, Germany
| | - Bettina Studer
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Mauritius Hospital Meerbusch, Meerbusch, Germany
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Altered recognition of fearful and angry facial expressions in women with fibromyalgia syndrome: an experimental case-control study. Sci Rep 2022; 12:21498. [PMID: 36513716 PMCID: PMC9747799 DOI: 10.1038/s41598-022-25824-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/04/2022] [Indexed: 12/15/2022] Open
Abstract
Evidence relative to facial emotion recognition and the role played by alexithymia in fibromyalgia syndrome is rare and heterogeneous. In this work, we investigated this ability in fibromyalgia investigating the implicit behaviour in the facial emotion recognition task, focusing on fear and anger. Twenty women with fibromyalgia and twenty healthy women as controls performed a facial emotion recognition of fearful and angry expressions. Their implicit behaviour was scored in accordance with the redundant target effect. The level of alexithymic traits through a standard psychological questionnaire and its effect on behavioral performance were also assessed. Participants affected by fibromyalgia reported a lower level of accuracy in recognizing fearful and angry expressions, in comparison with the controls. Crucially, such a difference was not explained by the different levels of alexithymic traits between groups. Our results agreed with some previous evidence suggesting an altered recognition of others' emotional facial expressions in fibromyalgia syndrome. Considering the role of emotion recognition on social cognition and psychological well-being in fibromyalgia, we underlined the crucial role of emotional difficulties in the onset and maintenance of the symptoms life-span.
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Gourlay C, Collin P, D'Auteuil C, Jacques M, Caron PO, Scherzer PB. Age differences in social-cognitive abilities across the stages of adulthood and path model investigation of adult social cognition. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:1033-1067. [PMID: 34355998 DOI: 10.1080/13825585.2021.1962789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
Accumulating evidence points toward an association between older age and performance decrements in social cognition (SC). We explored age-related variations in four components of SC: emotion recognition, theory of mind, social judgment, and blame attributions. A total of 120 adults divided into three stages (18-34 years, 35-59 years, 60-85 years) completed a battery of SC. Between and within age-group differences in SC were investigated. Path analyses were used to identify relationships among the components. Emotion recognition and theory of mind showed differences beginning either in midlife, or after. Blame attributions and social judgment did not show a significant difference. However, social judgment varied significantly within groups. Path models revealed a relationship between emotion recognition and theory of mind. Findings highlight age-related differences in some components and a link between two components. Strategies promoting social functioning in aging might help to maintain or improve these abilities over time.
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Affiliation(s)
- Catherine Gourlay
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | - Pascal Collin
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | - Camille D'Auteuil
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | - Marie Jacques
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | | | - Peter B Scherzer
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
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Ramos-Henderson M, Calderón C, Toro-Roa I, Aguilera-Choppelo R, Palominos D, Soto-Añari M, López N, Domic-Siede M. The cumulative effect of fibromyalgia symptoms on cognitive performance: The mediating role of pain. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-11. [PMID: 36103582 DOI: 10.1080/23279095.2022.2122828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Fibromyalgia (FMS) is a chronic condition that encompasses widespread pain associated with cognitive impairment and significant emotional distress related to functional disability. This study aimed to obtain evidence of the role of pain in the effect of time since FMS diagnosis and cognitive performance using a novel online protocol of neuropsychological evaluation since the COVID-19 pandemic has challenged traditional neuropsychology testing leading to the need for novel procedures transitioning to tele-neuropsychology. A sample of 70 adult women was evaluated (50 with FMS and 19 controls) using online questionnaires that evaluated pain and executive functioning (impulsivity, inhibition control, monitoring, and planning). Afterward, participants were evaluated by trained neuropsychologists in a 30 min online session using virtually adapted cognitive tests: the Hopkins Verbal Learning Test (memory), the Symbol-Digit Modalities Test (attention and speed processing), the F-A-S test (verbal fluency), and Digit Span tests (working memory). We found that the time of FMS diagnosis has an effect on cognitive functioning predominantly mediated by pain. Our results point out the role of pain as a mediator on cognitive performance, specifically in executive functions which are directly affected by the cumulative effect of the time of diagnosis. Furthermore, the importance of considering a broader perspective for assessment and treatment including novel procedures via tele-neuropsychology.
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Affiliation(s)
- Miguel Ramos-Henderson
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
- Facultad de Salud, Centro de Investigación e Innovación en Gerontología Aplicada CIGAP, Universidad Santo Tomás, Antofagasta, Chile
| | - Carlos Calderón
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Ignacio Toro-Roa
- Escuela de Psicología, Facultad de Ciencias Sociales y de La Comunicación, Universidad Santo Tomás, Antofagasta, Chile
| | - Rocío Aguilera-Choppelo
- Escuela de Psicología, Facultad de Ciencias Sociales y de La Comunicación, Universidad Santo Tomás, Antofagasta, Chile
| | - Diego Palominos
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - Marcio Soto-Añari
- Departamento de Psicología, Universidad Católica San Pablo, Arequipa, Peru
| | - Norman López
- Departamento de Ciencias Sociales, Universidad de la Costa, Barranquilla, Colombia
| | - Marcos Domic-Siede
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
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Di Tella M, Clerico M, Castelli L. Associations between socioemotional alterations, quality of life, and social functioning in multiple sclerosis: A scoping review. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractThe main aim of the present scoping review is to systematically review the available studies that investigated the associations between socioemotional alterations (i.e., social cognition impairments/alexithymia/difficulties in emotion regulation) and both reduced QoL and social functioning in patients with Multiple Sclerosis (MS). The articles were selected from the PubMed, PsycINFO, and Scopus databases. The main exclusion criteria were qualitative studies, articles that did not use validated instruments, and studies that did not investigate the association between socioemotional skills and QoL/social functioning in MS. Of the eight studies fulfilling the inclusion criteria, six found significant associations between social cognitive and emotion regulation abilities and QoL/social functioning in patients with MS, while two found no significant relationships particularly between the performance on social cognition tasks and QoL measures. Overall, the majority of findings seem to highlight that socioemotional alterations contribute to impaired QoL and social functioning in MS. However, given the still limited evidence, future studies are needed to replicate and confirm the available results, paying attention to two principal aspects: the use of standardized and ecological tasks for the assessment of social cognition skills and the recruitment of samples involving patients with different types of MS.
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Abstract
Facial emotion recognition (FER) is extensively investigated in psychological sciences in healthy individuals and clinical conditions. In this paper, we analyzed those studies in which FER was assessed in the case of obesity or fibromyalgia, in relation to the levels of alexithymia. Crucially, these two conditions frequently co-occur; however, no study has explored FER considering both fibromyalgia and obesity. Studies were identified using the electronic search engine of PubMed. The last research was run on 23 July 2021. Two independent lists were generated for the two clinical conditions. Six records were reviewed about obesity, while three records about fibromyalgia. The evidence relative to FER in obesity was not conclusive, whereas the evidence about an altered FER in fibromyalgia seemed more straightforward. Moreover, the role of alexithymia on FER in these clinical conditions was not extensively investigated. In our discussion, we highlighted those factors that should be carefully addressed in investigating FER in these clinical conditions. Moreover, we underlined methodological criticisms that should be overcome in future research.
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The relationship between alexithymia and theory of mind: A systematic review. Neurosci Biobehav Rev 2021; 131:497-524. [PMID: 34599917 DOI: 10.1016/j.neubiorev.2021.09.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 12/19/2022]
Abstract
Theory of Mind (ToM), the ability to represent the mental states of oneself and others, is an essential social skill disrupted across many psychiatric conditions. The transdiagnostic nature of ToM impairment means it is plausible that ToM impairment is related to alexithymia (difficulties identifying and describing one's own emotions), as alexithymia is seen across psychiatric conditions. Whilst many studies have examined links between alexithymia and ToM, results are mixed. Therefore, the purpose of this systematic review is to provide a taxonomy of ToM tests and assess their relationship with alexithymia. Tests are grouped according to whether they assess propensity to engage spontaneously in ToM or accuracy of ToM inferences, with tests further subdivided into those that do, and do not, require emotion recognition. A review of 63 suitable studies suggests that alexithymia is often associated with reduced ToM, and inaccurate ToM when tasks require emotion recognition. This latter finding appears due to impaired emotion recognition, rather than ToM impairment per se. Further directions and considerations for future research are discussed.
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Chaves ACS, Reis FJJ, Bandeira PM, Fernandes O, Arruda Sanchez T. Autonomic dysregulation and impairments in the recognition of facial emotional expressions in patients with chronic musculoskeletal pain. Scand J Pain 2021; 21:530-538. [PMID: 33725753 DOI: 10.1515/sjpain-2020-0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/12/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Emotions are involved in the identification of safety cues in the environment, and are also related to social interaction through recognition of emotional facial expressions. Heart rate variability (HRV) can be an indicator of the adaptive response of the autonomic nervous system to stressful conditions, including pain. This study aimed to investigate the emotional processing in a sample of patients with chronic musculoskeletal by measuring the resting-state HRV and the ability to recognize facial emotion expressions. METHODS This cross-sectional study was composed of 40 participants with chronic musculoskeletal pain and 40 asymptomatic participants. Resting HRV was measured for 10 min. The facial emotion recognition task was presented in videos and included modification from a neutral expression to faces of fear, anger, sadness, happiness, and disgust. For the facial emotion recognition task, the hit rate (%) and response time for each emotional category were measured. RESULTS The symptomatic group had a mean high frequency (HF) lower (mean = 34.14; SD = 16.95; p<0.001) than the asymptomatic group (mean = 51.11; SD = 13.01; p<0.001). The emotional facial expressions of disgust (H (1, 80)=7.82; p<0.01), anger (H (1, 80)=13.56; p<0.01), sadness (H (1, 80)=6.58; p=0.01), and happiness (H (1, 80)=12.68; p<0.01) were those for which volunteers from the symptomatic group had a lower hit rate of correct answers compared to the asymptomatic group. The response time to corrected answers showed a major group effect (F (1.77)=21.11; p<0.001) and emotional category (F (4.308)=174.21; p<0.001), without presenting any interaction between the factors (F (4.308)=0.446; p=0.775). The symptomatic group was slower to perform the task of identifying facial emotional expression (7.066 s; SD = 1.188) than the participants in the asymptomatic group (6.298 s; SD = 1.203) for all emotional categories. CONCLUSIONS Participants with chronic musculoskeletal pain presented a lower vagal activity evidenced by HRV. Participants in the symptomatic group showed lower ability to recognize faces of disgust, anger, and sadness when compared to asymptomatic participants. Considering that individuals with low resting HF-HRV have difficulties with regulating their emotions, the lower vagal activity and lower ability to recognize faces of emotional expressions observed in chronic musculoskeletal pain may suggest alterations in emotional processing. This study may shed light on changes in the emotional processing and in the autonomic nervous system in this population.
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Affiliation(s)
- Anna C S Chaves
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Felipe J J Reis
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Pamela M Bandeira
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Orlando Fernandes
- Postgraduate Program in Radiology, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Tiago Arruda Sanchez
- Postgraduate Program in Medicine (Cardiology), Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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15
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Gürsoy SC, Ergün S, Midi İ, Topçuoğlu V. Theory of mind and its relationship with alexithymia and quality of life in patients with psychogenic nonepileptic seizures: Comparisons with generalised epilepsy and healthy controls. Seizure 2021; 91:251-257. [PMID: 34246053 DOI: 10.1016/j.seizure.2021.06.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Psychogenic nonepileptic seizures (PNES) are associated with high alexithymia, social cognition problems and low quality of life (QoL). Theory of Mind (ToM) has been studied in several conditions as a significant predictor of QoL. We aimed to assess the relationship between ToM abilities, alexithymia and subjective QoL in PNES patients and compare with generalised epilepsy (ES) patients and healthy controls. METHOD Patients with PNES (n = 28), ES (n = 28) and healthy volunteers (n = 28) were evaluated for alexithymia and quality of life (QoL) with Toronto Alexithymia Scale-20 (TAS-20) and Short Form-36 (SF-36). Reading the Mind in the Eyes test was used for assessment of affective ToM and Hinting Task and Strange Stories tests for cognitive ToM abilities. RESULTS Analyses revealed lower SF-36 scores and poorer ToM performance in the PNES group compared to healthy group and poorer cognitive ToM performance than ES group. Cognitive ToM performance was inversely correlated with TAS-20 "difficulty identifying feelings" subscale and "physical functioning" subscale of SF-36 in the PNES group. CONCLUSION These results are consistent with previous research on PNES and other somatoform disorders and suggest that PNES is associated with impaired ToM task performance. ToM task performance might be related to specific aspects of alexithymia and QoL.
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Affiliation(s)
- Süha Can Gürsoy
- Marmara University Pendik Education and Research Hospital, Department of Psychiatry, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey.
| | - Serhat Ergün
- Marmara University Pendik Education and Research Hospital, Department of Psychiatry, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey
| | - İpek Midi
- Marmara University Pendik Education and Research Hospital, Deparment of Neurology, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey
| | - Volkan Topçuoğlu
- Marmara University Pendik Education and Research Hospital, Department of Psychiatry, Fevzi Çakmak, Muhsin Yazıcıoğlu Cd No:10, 34899 Pendik/İstanbul, Turkey
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16
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Lardone A, Turriziani P, Sorrentino P, Gigliotta O, Chirico A, Lucidi F, Mandolesi L. Behavioral Restriction Determines Left Attentional Bias: Preliminary Evidences From COVID-19 Lockdown. Front Psychol 2021; 12:650715. [PMID: 33935910 PMCID: PMC8080029 DOI: 10.3389/fpsyg.2021.650715] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
During the COVID-19 lockdown, individuals were forced to remain at home, hence severely limiting the interaction within environmental stimuli, reducing the cognitive load placed on spatial competences. The effects of the behavioral restriction on cognition have been little examined. The present study is aimed at analyzing the effects of lockdown on executive function prominently involved in adapting behavior to new environmental demands. We analyze non-verbal fluency abilities, as indirectly providing a measure of cognitive flexibility to react to spatial changes. Sixteen students (mean age 20.75; SD 1.34), evaluated before the start of the lockdown (T1) in a battery of psychological tasks exploring different cognitive domains, have been reassessed during lockdown (T2). The assessment included the modified Five-Point Test (m-FPT) to analyze non-verbal fluency abilities. At T2, the students were also administered the Toronto Alexithymia Scale (TAS-20). The restriction of behaviors following a lockdown determines increased non-verbal fluency, evidenced by the significant increase of the number of new drawings. We found worsened verbal span, while phonemic verbal fluency remained unchanged. Interestingly, we observed a significant tendency to use the left part of each box in the m-FPT correlated with TAS-20 and with the subscales that assess difficulty in describing and identifying feelings. Although our data were collected from a small sample, they evidence that the restriction of behaviors determines a leftward bias, suggesting a greater activation of the right hemisphere, intrinsically connected with the processing of non-verbal information and with the need to manage an emotional situation.
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Affiliation(s)
- Anna Lardone
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Patrizia Turriziani
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Pierpaolo Sorrentino
- Institut de Neuroscience des Systemès, Aix-Marseille University, Marseille, France
| | - Onofrio Gigliotta
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Andrea Chirico
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Lucidi
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Laura Mandolesi
- Department of Humanities, University of Naples Federico II, Naples, Italy
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17
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Fischer-Jbali LR, Montoro CI, Montoya P, Halder W, Duschek S. Central nervous activity during implicit processing of emotional face expressions in fibromyalgia syndrome. Brain Res 2021; 1758:147333. [PMID: 33539799 DOI: 10.1016/j.brainres.2021.147333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/12/2021] [Accepted: 01/22/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain accompanied by symptoms like fatigue, insomnia, depression, anxiety and cognitive impairments. In addition to central nervous pain sensitization, emotional dysregulation may be involved in FMS pathogenesis. This study investigated central nervous correlates of affective and attentional processing in FMS using an implicit task. METHODS Event-related potentials (ERPs) of the EEG were recorded in 25 FMS patients and 37 healthy controls while they had to name the frame color of pictures displaying emotional expressions (angry, painful, happy, neutral). The actual picture had to be ingored. Symptoms of pain, depression and anxiety were also assessed. RESULTS Patients exhibited smaller P2 and late positive potential (LPP) amplitudes, and a greater N250 amplitude, than controls. The N250 amplitude varied according to the emotional expressions displayed in patients, but not in controls. No group differences arose for the P1 or N170 amplitudes. Patients had longer reaction times and made more errors on the task; task performance was more closely related to pain severity than to other symptoms. CONCLUSION The reduced P2 and LPP amplitudes indicate deficient short-term mobilization of attentional resources and sustained attention in FMS; the greater N250 amplitude may reflect greater engagement in the decoding of complex facial features, which is necessary to compensate for attentional impairments. Affective modulation of the N250 suggests that the neural mechanisms underlying complex visual processes are particularly susceptible to emotional influences in FMS. The behavioral data confirm attentional deficits in the disorder and implicate clinical pain therein.
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Affiliation(s)
- L R Fischer-Jbali
- UMIT Tirol - University for Health Sciences, Medical Informatics and Technology, Austria.
| | - C I Montoro
- University of Jaén, Department of Psychology, Jaén, Spain.
| | - P Montoya
- University of the Balearic Islands, Department of Psychology, Spain.
| | - W Halder
- County Hospital Hochzirl, Austria.
| | - S Duschek
- UMIT Tirol - University for Health Sciences, Medical Informatics and Technology, Austria.
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18
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Alteration of Postural Balance in Patients with Fibromyalgia Syndrome-A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2021; 11:diagnostics11010127. [PMID: 33467458 PMCID: PMC7830486 DOI: 10.3390/diagnostics11010127] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/11/2023] Open
Abstract
Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.
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On the (lack of) association between theory of mind and executive functions: a study in a non-clinical adult sample. Sci Rep 2020; 10:17283. [PMID: 33057089 PMCID: PMC7560896 DOI: 10.1038/s41598-020-74476-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/01/2020] [Indexed: 11/08/2022] Open
Abstract
We investigated in a sample of non-clinical adults the association between Theory of Mind (ToM) and Executive Functions (EFs), that is the set of skills that allow people to control and modulate lower-level cognitive processes in order to produce appropriate behaviour. To this aim, we assessed both affective (i.e., understanding other people's emotions and feelings) and cognitive (i.e., understanding others' beliefs and intentions) ToM, as well four subcomponents of EFs, that is Updating, Shifting, Inhibition, and Access. The association between ToM and non-verbal fluid intelligence, verbal reasoning, and cognitive estimation abilities was also investigated. Eighty-one healthy participants were recruited, and a set of psychometrically validated tests was administered. Multiple regression analyses were run to assess significant predictors of ToM performance when potentially confounding predictors (sociodemographic variables) were controlled for. Results showed a lack of association between affective/cognitive ToM and EFs, whereas non-verbal fluid intelligence for cognitive ToM and verbal reasoning for affective ToM were found to be significant predictors of ToM performance. These results represent a contribution toward a deeper understanding of the ToM-EFs relationships and highlight the importance of broadening the analysis of these relationships to the role played by other domain-general functions in both affective and cognitive ToM.
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20
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Effects of COMT Genotypes on Working Memory Performance in Fibromyalgia Patients. J Clin Med 2020; 9:jcm9082479. [PMID: 32752289 PMCID: PMC7464119 DOI: 10.3390/jcm9082479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/23/2022] Open
Abstract
Growing research has reported the presence of a clear impairment of working memory functioning in fibromyalgia. Although different genetic factors involving dopamine availability (i.e, the COMT gene) have been associated with the more severe presentation of key symptoms in fibromyalgia, scientific evidence regarding the influence of COMT genotypes on cognitive impairment in these patients is still lacking. To this end, 167 participants took part in the present investigation. Working memory performance was assessed by the application of the SST (Spatial Span Test) and LNST (Letter and Number Sequence Test) belonging to the Weschler Memory Scale III. Significant working memory impairment was shown by the fibromyalgia patients. Remarkably, our results suggest that performance according to different working memory measures might be influenced by different genotypes of the COMT gene. Specifically, fibromyalgia patients carrying the Val/Val genotype exhibited significantly worse outcomes for the span of SST backward, SST backward score, SST total score and the Working Memory Index (WMI) than the Val/Val healthy carriers. Furthermore, the Val/Val patients performed worse on the SST backward and SST score than heterozygotes. Our findings are the first to show a link between the COMT gene and working memory dysfunction in fibromyalgia, supporting the idea that higher COMT enzyme activity would contribute to more severe working memory impairment in fibromyalgia.
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21
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Di Tella M, Adenzato M, Catmur C, Miti F, Castelli L, Ardito RB. The role of alexithymia in social cognition: Evidence from a non-clinical population. J Affect Disord 2020; 273:482-492. [PMID: 32560944 DOI: 10.1016/j.jad.2020.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/05/2020] [Accepted: 05/09/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alexithymia is a personality construct characterised by difficulty in identifying and describing one's emotions. We investigated whether people with alexithymia, who struggle with emotion-processing abilities, have diminished emotion-related social cognitive competencies, where social cognition encompasses the set of abilities that allows one to navigate one's social environment. METHODS We assessed alexithymia and four components of social cognition: recognition of others' emotions, representation of others' affective and cognitive mental states, empathy, and regulation of one's own feelings. We investigated whether alexithymia could significantly predict each of these components, beyond the effect of other individual difference variables (i.e., anxiety/depressive symptoms), which have been previously associated with both social cognition and alexithymia. Two hundred six participants were recruited. Multiple hierarchical regression analyses were performed to assess the possible relationships between alexithymia and social cognition skills. RESULTS Alexithymia significantly predicted emotion recognition, empathy, and emotional regulation, even after controlling for the effect of potentially competing factors (i.e., anxiety/depressive symptoms). Alexithymia did not predict representation of others' affective and cognitive mental states. LIMITATIONS The present study adopted a cross-sectional design, which does not permit us to draw firm conclusions about the causality of the emergent relationships. CONCLUSIONS These data provide support for the argument that recognising others' emotions and feelings relies on the ability to identify correctly one's own feelings. Our results also indicate the importance of taking into consideration individual differences in levels of alexithymia when investigating social cognition in non-clinical populations, as alexithymia appears to be clearly related to social cognitive functioning.
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Affiliation(s)
- Marialaura Di Tella
- Department of Psychology, University of Turin, via Verdi 10, Turin 10124, Italy
| | - Mauro Adenzato
- Department of Psychology, University of Turin, via Verdi 10, Turin 10124, Italy.
| | | | - Francesca Miti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, via Verdi 10, Turin 10124, Italy
| | - Rita B Ardito
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
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22
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Enhancing theory of mind in behavioural variant frontotemporal dementia with transcranial direct current stimulation. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 18:1065-1075. [PMID: 29995274 DOI: 10.3758/s13415-018-0622-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Behavioural variant frontotemporal dementia (bvFTD) is a form of frontotemporal degeneration characterized by early changes in personality, emotional blunting, and/or loss of empathy. Recent research has highlighted that these features may be at least partially explained by impairments in the theory of mind (ToM; i.e., the ability to understand and predict other people's behaviour by attributing independent mental states to them). The aim of this randomized, double-blind, placebo-controlled study was to test the hypothesis that transcranial direct current stimulation (tDCS) over the medial frontal cortex (MFC) selectively enhances communicative intention processing, a specific ToM ability. Using a single-session online design, we administered a ToM task that measures the ability to represent other people's private and communicative intentions during active or sham tDCS to 16 bvFTD patients. To assess the impact of dementia on performance on the ToM task, we included 16 age-matched healthy volunteers who were asked to perform the entire experimental ToM task. BvFTD is characterized by an impairment in the comprehension of both communicative and private intentions relative to a healthy control group and by a disproportional impairment in communicative intention compared with private intention processing. Significant and selective accuracy improvement in the comprehension of communicative intentions after active stimulation was observed in patients with bvFTD. This is the first study that analyses ToM ability in patients with bvFTD using tDCS stimulation. Our findings could potentially contribute to the development of an effective, noninvasive brain stimulation treatment of ToM impairments in patients with bvFTD.
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Bunk S, Preis L, Zuidema S, Lautenbacher S, Kunz M. Executive Functions and Pain. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2019. [DOI: 10.1024/1016-264x/a000264] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. A growing body of literature suggests that chronic-pain patients suffer from problems in various neuropsychological domains, including executive functioning. In order to better understand which components of executive functioning (inhibition, shifting and/or updating) might be especially affected by pain and which mechanisms might underlie this association, we conducted a systematic review, including both chronic-pain studies as well as experimental-pain studies. The chronic-pain studies (N = 57) show that pain is associated with poorer executive functioning. The findings of experimental-pain studies (N = 28) suggest that this might be a bidirectional relationship: Pain can disrupt executive functioning, but poorer executive functioning might also be a risk factor for higher vulnerability to pain.
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Affiliation(s)
- Stefanie Bunk
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
| | - Lukas Preis
- Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
| | | | - Miriam Kunz
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, The Netherlands
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Okur Güney ZE, Sattel H, Witthöft M, Henningsen P. Emotion regulation in patients with somatic symptom and related disorders: A systematic review. PLoS One 2019; 14:e0217277. [PMID: 31173599 PMCID: PMC6555516 DOI: 10.1371/journal.pone.0217277] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/08/2019] [Indexed: 12/28/2022] Open
Abstract
Background Somatic symptoms and related disorders (SSD) are prevalent phenomena in the health-care system. Disturbances in emotion regulation (ER) are commonly observed in patients suffering from SSD. Objectives This review aimed to examine ER processes that characterize SSD by a systematic analysis of the available empirical studies. Data sources PsycINFO and PubMed databases for the articles published between January 1985 and June 2018. Search terms “emotion/al regulation” or “affect regulation” and various forms of SSD. Study eligibility criteria Empirical studies that a) assigned adolescent or adult patients suffering from SSD based on a clinical diagnosis, and b) examined the relationship between ER and SSD, were included. Study synthesis methods A tabular summary of the articles was generated according to study characteristics, study quality, variables, and findings. The findings were organized based on ER variables used in the articles and diagnoses of SSD, which were then re-organized under the main constituents of ER (attention, body, and knowledge). Results The findings of the 64 articles largely supported the association between SSD and disturbances in ER, which are usually shared by different diagnoses of SSD. The results indicate that patients show a reduced engagement with cognitive content of emotions. On the other hand, bodily constituents of ER seem to depict an over-reactive pattern. Similarly, the patients tend to encounter difficulties in flexibly disengaging their (spontaneous) attention from emotional material. Limitations There is a scarcity of longitudinal designs, randomized controlled trials, experiments, and diary studies suited to investigate the short- and long-term causal relationship between ER and SSD. Symptoms of SSD and measures to assess emotion regulation are heterogeneous. Conclusions and implications Assessment of ER processes is potentially useful to understand SSD and for treatment planning. Furthermore, a concurrent investigation of the dynamic interaction of the ER modalities promises insights for better understanding of the role of ER in development, course, and maintenance of SSD.
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Affiliation(s)
- Zeynep Emine Okur Güney
- Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy Technical University of Munich, Munich, Germany
- Johannes Gutenberg University of Mainz, Department of Clinical Psychology, Psychotherapy and Experimental Psychology, Mainz, Germany
- * E-mail:
| | - Heribert Sattel
- Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy Technical University of Munich, Munich, Germany
| | - Michael Witthöft
- Johannes Gutenberg University of Mainz, Department of Clinical Psychology, Psychotherapy and Experimental Psychology, Mainz, Germany
| | - Peter Henningsen
- Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy Technical University of Munich, Munich, Germany
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25
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Vucurovic K, Dupont-Gaudin C, Raucher-Chéné D, Kaladjian A, Cuervo-Lombard CV. Fibromyalgia patients make scarce reference to pain in self-defining memories. Compr Psychiatry 2019; 90:30-36. [PMID: 30684830 DOI: 10.1016/j.comppsych.2018.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Self-defining memories (SDMs) are vivid, emotionally intense and well-rehearsed autobiographical memories that provide fundamental information about one's cognitive affective motivational representation of self. Exploring SDMs in fibromyalgia (FM) is of interest for understanding the psychopathology of this disorder and improving clinical interventions. Our aim was to compare patients and healthy controls (HC) on SDM characteristics. METHOD We included 25 patients with FM and 24 HC matched for age, sex and education level. Each participant described five SDMs, which were coded for content, specificity, integration, tension, redemption, contamination, affective response, date, and reference to pain. We statistically controlled our results for the most plausible confounding factors related to FM that could affect SDM recall, namely depression, anxiety, cognitive inhibition, pain severity and medication. RESULTS Compared with HC, patients retrieved less specific SDMs with a more negative emotional valence but less tension. They reported more relationship-related memories, and fewer redemptive ones, with less meaning-making. The number of memories referring to physical or psychological pain did not differ between groups. None of the confounding factors we analysed could explain (either alone or in combination) the statistical differences between groups for SDMs characteristics. CONCLUSION We discuss functional avoidance and alexithymia as two main factors for poor reference to pain in patients' SDMs that further reveal affective dysregulation in FM. In clinical practice, remediating the way in which pain is integrated into SDMs in FM may help to mitigate its negative impact on everyday life.
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Affiliation(s)
- Ksenija Vucurovic
- Laboratoire Cognition, Santé, Société (C2S), Reims Champagne-Ardenne University, Reims, France; Department of Psychiatry, University Hospital, Reims, France.
| | | | - Delphine Raucher-Chéné
- Laboratoire Cognition, Santé, Société (C2S), Reims Champagne-Ardenne University, Reims, France; Department of Psychiatry, University Hospital, Reims, France
| | - Arthur Kaladjian
- Laboratoire Cognition, Santé, Société (C2S), Reims Champagne-Ardenne University, Reims, France; Department of Psychiatry, University Hospital, Reims, France
| | - Christine-Vanessa Cuervo-Lombard
- Department of Psychiatry, University Hospital, Reims, France; Centre for Studies and Research on Health Psychology and Psychopathology (CERPPS), Department of Psychology, Toulouse 2 Jean Jaurès University, Toulouse, France
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Abd Elghany SE, Al Ashkar DS, El-Barbary AM, El Khouly RM, Aboelhawa MA, Nada DW, Darwish NF, Hussein MS, Rageh ES, Abo-Zaid MH, Eldesoky IF, Afifi S. Regenerative injection therapy and repetitive transcranial magnetic stimulation in primary fibromyalgia treatment: A comparative study. J Back Musculoskelet Rehabil 2019; 32:55-62. [PMID: 30149440 DOI: 10.3233/bmr-181127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study compared the effectiveness of regenerative injection therapy (RIT), i.e. prolotherapy, and repetitive transcranial magnetic stimulation (rTMS) in the treatment of fibromyalgia syndrome. PATIENTS AND METHODS This study included 120 female, age-matched fibromyalgia patients. All patients underwent a clinical examination, pain assessment by VAS, assessment of tender points, psychiatric and functional assessment using the Beck Depression Inventory (BDI), Fibromyalgia Impact Questionnaire Revised (RFIQ), and measurement of cortical auditory evoked potentials CAEPs elicited at 1000 Hz. Patients were divided into two equal groups; Group 1 received prolotherapy three times, two weeks apart, and Group 2 received rTMS sessions every other day for one month. Assessment was performed before treatment, immediately after treatment, and one month later. RESULTS A significant improvement of pain measured by the mean score of VAS was remarked in Group 1 compared to Group 2 immediately after treatment and one month later. There was statistically significant difference of mean scores for the number of tender points in Group 1 compared to Group 2 after treatment and one month later. The patients improved functionally, with a statistically significant difference in mean score of RFIQ, in Group 1 compared to Group 2 one month after treatment. However, there was a significant difference in mean score of BDI in Group 2 compared to Group 1 after treatment and one month later. Further, CAEPs showed better improvement, with a significant difference in Group 2, one month after treatment. CONCLUSION RIT had the advantage in clinical and functional improvement in fibromyalgia patients, while rTMS had better results regarding depression and the cortical component of AEPs. These results might draw attention to the evaluability of a combination of both techniques for a better therapeutic response.
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Affiliation(s)
| | - Doaa S Al Ashkar
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Amal M El-Barbary
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Radwa M El Khouly
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Marwa A Aboelhawa
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Doaa W Nada
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Nivine F Darwish
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Manal S Hussein
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - El Sayed Rageh
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Mohamed H Abo-Zaid
- Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University, Tanta, Egypt
| | - Islam F Eldesoky
- Neurology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samah Afifi
- Neurology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Galvani C, Caramaschi P, Mura P, Paladini A, Piroli A, Arnaudo E, De Franceschi L, Evangelista M, Pari A, Ongaro G, Finco G, Ciannameo A, Carletto A, Varrassi G, Biasi D. Postural counseling represents a novel option in pain management of fibromyalgia patients. J Pain Res 2019; 12:327-337. [PMID: 30666151 PMCID: PMC6333156 DOI: 10.2147/jpr.s164714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Chronic pain is a key symptom in fibromyalgia (FM), and its management is still challenging for rheumatologists in daily practice. FM patients show psychological and psychiatric manifestations, going from mood and emotional disorders to depression and alexithymia that negatively impact their quality of life, limiting their daily activities. Since pharmacological strategies have a limited efficacy in FM pain, alternative or complementary non-pharmacological approaches have been introduced in the clinical management of FM. Patients and methods This is a retrospective study on FM patients (n=52) treated with a novel integrated postural counseling (PC) rehabilitation program carried out by a counselor physiotherapist. The clinical impact of PC was evaluated by 1) a semi-structured interview using an ad hoc modified questionnaire McGill Illness Narrative Interview (MINI) 1 to obtain data on pain management by highlighting everyday experience of living with pain and 2) an FM impact questionnaire (FIQ) total score. Results Two main structures of narrative emplotment of FM illness were recognized: 1) the cumulative life narrative structure (46.15%) and 2) the broken life (53.85%) narrative structure. Baseline FIQ score was 77.38±7.77, and it was significantly reduced after PC to 39.12±13.27 (P<0.0001). Although well-being still requires further definition as outcome in pain management, it is important for FM patients, dealing with pain-related sensations, thoughts and feelings and limiting their daily activities. In our study, 87.5% of interviewed FM patients reported an improvement in their well-being after PC. Conclusion Our data suggest that an integrated PC program positively impacts chronic pain and fatigue based on self-management strategies. PC allows FM patients to resume their own life and regenerate their own image. Finally, we propose the introduction of the evaluation of the ability to resume daily activities as the target of rehabilitation programs in FM.
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Affiliation(s)
- Carla Galvani
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Paola Caramaschi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Paolo Mura
- Anesthesia, Intensive Care and Pain Therapy Unit, Department of Medical Science "M. Aresu", University of Cagliari, Cagliari, Italy
| | | | - Alba Piroli
- Department of MESVA, University of L'Aquila, L'Aquila, Italy
| | - Elisa Arnaudo
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Lucia De Franceschi
- Internal Medicine Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Evangelista
- Emergency Department, Institute of Anesthesia, Resuscitation and Pain Medicine, Catholic University of Sacred Heart, Rome, Italy
| | - Alice Pari
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Giovanna Ongaro
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Gabriele Finco
- Anesthesia, Intensive Care and Pain Therapy Unit, Department of Medical Science "M. Aresu", University of Cagliari, Cagliari, Italy
| | - Anna Ciannameo
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Antonio Carletto
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Giustino Varrassi
- Department of MESVA, University of L'Aquila, L'Aquila, Italy.,Paolo Procacci Foundation, Rome, Italy
| | - Domenico Biasi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
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Adenzato M, Manenti R, Enrici I, Gobbi E, Brambilla M, Alberici A, Cotelli MS, Padovani A, Borroni B, Cotelli M. Transcranial direct current stimulation enhances theory of mind in Parkinson's disease patients with mild cognitive impairment: a randomized, double-blind, sham-controlled study. Transl Neurodegener 2019; 8:1. [PMID: 30627430 PMCID: PMC6322239 DOI: 10.1186/s40035-018-0141-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/18/2018] [Indexed: 12/30/2022] Open
Abstract
Background Parkinson’s Disease (PD) with mild cognitive impairment (MCI) (PD-MCI) represents one of the most dreaded complications for patients with PD and is associated with a higher risk of developing dementia. Although transcranial direct current stimulation (tDCS) has been demonstrated to improve motor and non-motor symptoms in PD, to date, no study has investigated the effects of tDCS on Theory of Mind (ToM), i.e., the ability to understand and predict other people’s behaviours, in PD-MCI. Methods In this randomized, double-blind, sham-controlled study, we applied active tDCS over the medial frontal cortex (MFC) to modulate ToM performance in twenty patients with PD-MCI. Twenty matched healthy controls (HC) were also enrolled and were asked to perform the ToM task without receiving tDCS. Results In the patients with PD-MCI, i) ToM performance was worse than that in the HC, ii) ToM abilities were poorer in those with fronto-executive difficulties, and iii) tDCS over the MFC led to significant shortening of latency for ToM tasks. Conclusions We show for the first time that active tDCS over the MFC enhances ToM in patients with PD-MCI, and suggest that non-invasive brain stimulation could be used to ameliorate ToM deficits observed in these patients.
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Affiliation(s)
- Mauro Adenzato
- 1Department of Psychology, University of Turin, Turin, Italy.,Neuroscience Institute of Turin, Turin, Italy
| | - Rosa Manenti
- 3Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Ivan Enrici
- 4Department of Philosophy and Educational Sciences, University of Turin, via Gaudenzio Ferrari 9, 10124 Turin, Italy
| | - Elena Gobbi
- 3Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Michela Brambilla
- 3Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
| | - Antonella Alberici
- 5Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Sofia Cotelli
- 5Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- 5Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Barbara Borroni
- 5Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maria Cotelli
- 3Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, Brescia, Italy
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Teodoro T, Edwards MJ, Isaacs JD. A unifying theory for cognitive abnormalities in functional neurological disorders, fibromyalgia and chronic fatigue syndrome: systematic review. J Neurol Neurosurg Psychiatry 2018; 89:1308-1319. [PMID: 29735513 PMCID: PMC6288708 DOI: 10.1136/jnnp-2017-317823] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/24/2018] [Accepted: 04/10/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Functional cognitive disorder (FCD) describes cognitive dysfunction in the absence of an organic cause. It is increasingly prevalent in healthcare settings yet its key neuropsychological features have not been reported in large patient cohorts. We hypothesised that cognitive profiles in fibromyalgia (FM), chronic fatigue syndrome (CFS) and functional neurological disorders (FNDs) would provide a template for characterising FCD. METHODS We conducted a systematic review of studies with cognition-related outcomes in FM, CFS and FND. RESULTS We selected 52 studies on FM, 95 on CFS and 39 on FND. We found a general discordance between high rates of subjective cognitive symptoms, including forgetfulness, distractibility and word-finding difficulties, and inconsistent objective neuropsychological deficits. Objective deficits were reported, including poor selective and divided attention, slow information processing and vulnerability to distraction. In some studies, cognitive performance was inversely correlated with pain, exertion and fatigue. Performance validity testing demonstrated poor effort in only a minority of subjects, and patients with CFS showed a heightened perception of effort. DISCUSSION The cognitive profiles of FM, CFS and non-cognitive FND are similar to the proposed features of FCD, suggesting common mechanistic underpinnings. Similar findings have been reported in patients with mild traumatic brain injury and whiplash. We hypothesise that pain, fatigue and excessive interoceptive monitoring produce a decrease in externally directed attention. This increases susceptibility to distraction and slows information processing, interfering with cognitive function, in particular multitasking. Routine cognitive processes are experienced as unduly effortful. This may reflect a switch from an automatic to a less efficient controlled or explicit cognitive mode, a mechanism that has also been proposed for impaired motor control in FND. These experiences might then be overinterpreted due to memory perfectionism and heightened self-monitoring of cognitive performance.
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Affiliation(s)
- Tiago Teodoro
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK.,Instituto de Medicina Molecular Faculdade de Medicina, Universidade de Lisboa & Serviço de Neurologia Hospital de Santa Maria, Lisboa, Portugal
| | - Mark J Edwards
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Jeremy D Isaacs
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
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30
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Pidal-Miranda M, González-Villar AJ, Carrillo-de-la-Peña MT, Andrade E, Rodríguez-Salgado D. Broad cognitive complaints but subtle objective working memory impairment in fibromyalgia patients. PeerJ 2018; 6:e5907. [PMID: 30498630 PMCID: PMC6252063 DOI: 10.7717/peerj.5907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/09/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cognitive dysfunction in fibromyalgia (FM) encompasses objective cognitive difficulties, as measured in neuropsychological tests, and self-reported cognitive complaints. Although it has been suggested that FM patients display problems in working memory, the data are inconsistent, and the overall working memory status of the patients is unclear. It is also not clear whether the working memory problems are related to cognitive complaints or how the dyscognition is affected by the characteristic clinical symptoms of FM. METHODS To clarify these aspects, we explored the neuropsychological performance for different components of working memory and the subjective self-perception of cognitive status in a sample of 38 women with FM. They were compared with a matched group of 32 healthy women. RESULTS Our findings suggested that the FM patients do not differ from healthy controls in their overall working memory functioning. Only a poor performance was found in a single task of visuospatial working memory, mediated by the presence of depressive symptoms, fatigue and pain. The FM patients also displayed a higher level of perception of cognitive difficulties than healthy controls, and this difference was mediated by depression and fatigue. Furthermore, cognitive complaints in FM patients were only associated with a lower verbal WM capacity. DISCUSSION FM patients have a subtle specific impairment in their working memory functioning, as well as elevated concern about their cognitive status. These findings suggest a disconnection between neuropsychological performance and subjective complaints. In FM patients, clinical variables such as pain, fatigue, and depression play an important role in dyscognition, as assessed by both objective and subjective measures, and should be taken into account in future research.
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Affiliation(s)
- Marina Pidal-Miranda
- Department of Clinical Psychology and Psychobiology, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Jacobo González-Villar
- Department of Clinical Psychology and Psychobiology, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Elena Andrade
- Department of Social, Basic and Methodological Psychology, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Dolores Rodríguez-Salgado
- Department of Clinical Psychology and Psychobiology, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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31
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Conversano C, Marchi L, Rebecca C, Carmassi C, Contena B, Bazzichi LM, Gemignani A. Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review. Clin Pract Epidemiol Ment Health 2018; 14:223-232. [PMID: 30294356 PMCID: PMC6166394 DOI: 10.2174/1745017901814010223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/10/2018] [Accepted: 07/28/2018] [Indexed: 01/25/2023]
Abstract
Introduction: Fibromyalgia (FM) is the second most common rheumatic disease with many effects on patient's quality of life. It has been described as a chronic condition characterized by widespread musculo-skeletal pain, sleep disorders and prominent fatigue. Regarding the role of personality factors in fibromyalgia, researchers have focused both on personality traits and psychopathological aspects showing inconsistent results. In particular, several studies have examined the role of alexithymia in FM patients, a trait of personality characterized by difficulty in identification, recognition and description of emotions and feelings, while others have focused on a specific type of personality, such as type D personality (distressed personality). Other studies investigated personality in FM patients referring to Cloninger’s model, a psychobiological model of personality that includes both temperamental and character dimensions of personality. Analyzing scientific literature on this subject seems well suited to provide a critical review of the latest studies and their results. Methods: The method used for this review satisfies the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). We identified PsycInfo and PubMed as databases for our research. Results: Personality is studied under many aspects and a reference model is not always present. Many studies underline high levels of alexithymia and type D personality in FM patients but when depression is controlled, these results do not differ from those of healthy controls. Conclusion: Studies that use a comprehensive model of personality present a different theoretical approach and use alternatively the Big-Five model, Eysenck’s and Cloninger’s models. The use of a comprehensive model of personality and the control of psychopathological disorders, such as anxiety and depression, seem to be very relevant for a better understanding of a specific personality profile associated with fibromyalgia.
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Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Laura Marchi
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Ciacchini Rebecca
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | | | - Laura Maria Bazzichi
- Department of Clinical and Experimental Medicine, Rheumatologic Clinic, University of Pisa, via Roma 67, 56100 Pisa, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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32
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Bravo C, Skjaerven LH, Guitard Sein-Echaluce L, Catalan-Matamoros D. Experiences from group basic body awareness therapy by patients suffering from fibromyalgia: A qualitative study. Physiother Theory Pract 2018; 36:933-945. [PMID: 30247934 DOI: 10.1080/09593985.2018.1517286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to obtain a deeper understanding of how patients with fibromyalgia experienced movement awareness through a basic body awareness therapy group treatment program. A total of 19 participants with fibromyalgia diagnosis were interviewed individually and in groups. Data collection was done from three sources: (1) interviews from the Basic Body Awareness Rating Scale (BARS) part 2 at baseline, at end of treatment, as well as at 12 and 24 weeks follow up; (2) focus group discussions that took place at the end of each session, and at the end of treatment; and (3) an in-depth focus group. Giorgi's method was followed for data construction and analysis. The researchers conducted 57 individual interviews, 10 focus groups, and one in-depth focus group. The findings revealed the following categories: "creating a new relation to self"; "change the pattern of body awareness"; "being in a group"; and "experiencing physical capacity", showing influences among them. Body awareness seems to have an impact in the therapeutic process in patients suffering from fibromyalgia.
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Affiliation(s)
- Cristina Bravo
- Department of Nursing and Physiotherapy, University of Lleida , Lleida, Spain
| | - Liv H Skjaerven
- Department of Physiotherapy, Faculty of Health and Social Sciences, Bergen University College , Bergen, Norway
| | | | - Daniel Catalan-Matamoros
- Research Group CTS 451 "Health Sciences", University of Almeria , Almeria, Spain.,Science/Health Communication. University Carlos III of Madrid , Madrid, Spain
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Abstract
OBJECTIVE Cognitive dysfunction has been reported in individuals with fibromyalgia. However, findings regarding cognitive function examined using neuropsychological tests have been inconsistent. The aim of the study was to determine domain-specific cognitive impairment in patients with fibromyalgia compared with healthy controls. METHODS We conducted a meta-analysis that systematically searched six databases (PubMed, Ovid MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science) for articles published before September 2017. RESULTS Twenty-three case-control studies with a total of 2096 participants were included in the meta-analysis. Cognitive function was significantly lower (g = 0.87, 95% confidence interval [CI] = 0.60-1.15) in individuals with fibromyalgia than in healthy controls. Large effect sizes were found in learning/memory and attention/psychomotor speed (g = 0.94, p = .013; g = 1.22, p < .001, respectively); medium effect sizes were reported in executive function and working memory (g = 0.72, p < .001; g = 0.75, p < .001, respectively). Depression and anxiety scores were associated with the effect size of group differences in cognitive function (B = 0.11, p < .001, 95% CI = 0.09-0.13; B = 0.02, p < .001, 95% CI = 0.01-0.02, respectively). CONCLUSIONS Cognitive impairment across different cognitive domains was found in individuals with fibromyalgia compared with healthy controls. Mood states (depression and anxiety) may explain the heterogeneity across studies.
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34
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Bravo C, Skjaerven LH, Espart A, Guitard Sein-Echaluce L, Catalan-Matamoros D. Basic Body Awareness Therapy in patients suffering from fibromyalgia: A randomized clinical trial. Physiother Theory Pract 2018; 35:919-929. [PMID: 29723080 DOI: 10.1080/09593985.2018.1467520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Cristina Bravo
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Liv Helvik Skjaerven
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - Anna Espart
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group, GRECS, Biomedical Research Institute of Lleida, Lleida, Spain
| | | | - Daniel Catalan-Matamoros
- Health Sciences Research Group CTS-451, University of Almeria, Almeria, Spain
- Department of Journalism and Communication, University Carlos III of Madrid, Madrid, Spain
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35
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Galvez-Sánchez CM, Reyes del Paso GA, Duschek S. Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem. Front Psychol 2018; 9:377. [PMID: 29623059 PMCID: PMC5874325 DOI: 10.3389/fpsyg.2018.00377] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/07/2018] [Indexed: 12/11/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain accompanied by symptoms like depression, anxiety, sleep disturbance and fatigue. In addition, affected patients frequently report cognitive disruption such as forgetfulness, concentration difficulties or mental slowness. Though cognitive deficits in FMS have been confirmed in various studies, not much is known about the mechanisms involved in their origin. This study aimed to investigate the contribution of affect-related variables to cognitive impairments in FMS. For this purpose, 67 female FMS patients and 32 healthy control subjects completed a battery of cognitive tests measuring processing speed, attention, visuospatial and verbal memory, cognitive flexibility and planning abilities. In addition, participants completed self-report questionnaires pertaining to positive and negative affect, alexithymia, pain catastrophizing and self-esteem. Clinical characteristics including pain severity, symptoms of depression and anxiety, insomnia and fatigue were also assessed. FMS patients showed markedly poorer performance than healthy controls in all of the cognitive domains assessed, in addition to greater levels of depression, anxiety, negative affect, alexithymia and pain catastrophizing, and lower self-esteem and positive affect. In exploratory correlation analysis in the FMS sample, lower cognitive performance was associated with higher pain severity, depression, anxiety, negative affect, alexithymia and pain catastrophizing, as well as lower self-esteem and positive affect. However, in regression analyses, pain, self-esteem, alexithymia, and pain catastrophizing explained the largest portion of the variance in performance. While interference effects of clinical pain in cognition have been previously described, the present findings suggest that affective factors also substantially contribute to the genesis of cognitive impairments. They support the notion that affective disturbances form a crucial aspect of FMS pathology, whereas strategies aiming to improve emotional regulation may be a beneficial element of psychological therapy in the management of FMS.
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Affiliation(s)
| | | | - Stefan Duschek
- Department of Psychology, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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36
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Higgins DM, Martin AM, Baker DG, Vasterling JJ, Risbrough V. The Relationship Between Chronic Pain and Neurocognitive Function: A Systematic Review. Clin J Pain 2018; 34:262-275. [PMID: 28719507 PMCID: PMC5771985 DOI: 10.1097/ajp.0000000000000536] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Understanding the relationship between chronic pain and neurocognition has important implications for the assessment and treatment of patient experiencing pain. This paper provides an overview of the current literature examining the neurocognition-chronic pain relationship and suggests future avenues of research, along with a discussion of clinical implications of the literature findings. Consideration of potential moderators and mediators of this relationship, as well as a brief discussion of the importance of future research in special populations at particular risk for these problems, are also a focus of this paper. METHODS This systematic review summarizes the findings of clinical studies in which neurocognitive performance was measured in chronic pain samples. A literature search led to the inclusion of 53 articles in the review. RESULTS Studies of neurocognitive performance in clinical chronic pain samples support a relationship between chronic pain and neurocognitive abnormalities, particularly on tests of memory, attention, and processing speed, with mixed data regarding executive functioning. DISCUSSION Several factors may moderate or mediate the relationship between chronic pain and neurocognitive functioning, including mood symptoms, medication side effects, and intensity and/or chronicity of pain. Limitations in the literature include a paucity of methodologically rigorous studies controlling for confounding variables (eg, opioid analgesia) and a limited number of studies examining the relationship between chronic pain and traumatic brain injury (a potential precipitant of both pain and neurocognitive impairment). Nonetheless, findings from the existing literature have significant clinical implications, including for populations with heightened risk of both pain and neurocognitive disorders.
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Affiliation(s)
- Diana M. Higgins
- VA Boston Healthcare System, Boston, MA
- Boston University School of Medicine, Boston, MA
| | | | - Dewleen G. Baker
- University of California San Diego, San Diego, CA
- VA Center of Excellence for Stress and Mental Health and San Diego Healthcare System, San Diego, CA
| | | | - Victoria Risbrough
- University of California San Diego, San Diego, CA
- VA Center of Excellence for Stress and Mental Health and San Diego Healthcare System, San Diego, CA
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Tella MD, Enrici I, Castelli L, Colonna F, Fusaro E, Ghiggia A, Romeo A, Tesio V, Adenzato M. Alexithymia, not fibromyalgia, predicts the attribution of pain to anger-related facial expressions. J Affect Disord 2018; 227:272-279. [PMID: 29127814 DOI: 10.1016/j.jad.2017.10.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/12/2017] [Accepted: 10/30/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Fibromyalgia (FM) is a syndrome characterized by chronic, widespread musculoskeletal pain, occurring predominantly in women. Previous studies have shown that patients with FM display a pattern of selective processing or cognitive bias which fosters the encoding of pain-related information. The present study tested the hypothesis of an increased attribution of pain to facial expressions of emotions (FEE), in patients with FM. As previous studies have shown that alexithymia influences the processing of facial expressions, independent of specific clinical conditions, we also investigated whether alexithymia, rather than FM per se, influenced attribution of pain to FEE. METHODS One hundred and twenty-three women (41 with FM, 82 healthy controls, HC) were enrolled in this cross-sectional case-control study. We adopted two pain-attribution tasks, the Emotional Pain Estimation and the Emotional Pain Ascription, both using a modified version of the Ekman 60 Faces Test. Psychological distress was assessed using the Hospital Anxiety and Depression Scale, and alexithymia was assessed using the Toronto Alexithymia Scale. RESULTS Patients with FM did not report increased attribution of pain to FEE. Alexithymic individuals demonstrated no specific problem in the recognition of basic emotions, but attributed significantly more pain to angry facial expression. LIMITATIONS Our study involved a relatively small sample size. The use of self-reported instruments might have led to underestimation of the presence of frank alexithymia in individuals having borderline cut-off scores. CONCLUSIONS Alexithymia, rather than FM per se, plays a key role in explaining the observed differences in pain attribution to anger-related facial expressions.
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Affiliation(s)
| | - Ivan Enrici
- Department of Philosophy and Educational Sciences, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy.
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
| | - Fabrizio Colonna
- A.O.U. "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Enrico Fusaro
- A.O.U. "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | | | | | - Mauro Adenzato
- Department of Psychology, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy
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Bell T, Trost Z, Buelow MT, Clay O, Younger J, Moore D, Crowe M. Meta-analysis of cognitive performance in fibromyalgia. J Clin Exp Neuropsychol 2018; 40:698-714. [PMID: 29388512 DOI: 10.1080/13803395.2017.1422699] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Fibromyalgia is a condition with symptoms of pain, physical function difficulties, and emotional problems, but is also characterized by complaints of poor cognition (often called "FibroFog"). Over the last two decades, a number of studies have examined cognitive differences between individuals with and without fibromyalgia. The purpose of the current study was to conduct a quantitative synthesis of these differences across multiple cognitive domains. METHOD Following Cochrane guidelines, we identified 37 eligible studies for analysis where persons with fibromyalgia (total n = 964) were compared to participants from age-matched control groups without fibromyalgia (total n = 1025) on a range of neuropsychological measures. Group differences between persons with fibromyalgia and healthy controls were examined for cognitive domains including processing speed, long- and short-term memory, and executive functions (inhibitory control, set shifting, updating, and accessing). Random-effect meta-analyses were conducted to determine effect sizes for these differences in cognitive performance. RESULTS Fibromyalgia was significantly and negatively associated with performance on all domains of cognitive function. The largest effect size was found for inhibitory control (g = 0.61), followed by memory (g = 0.51 for short-term, 0.50 for long-term memory). The smallest cognitive difference between those with fibromyalgia and controls was for set shifting (g = 0.30). CONCLUSION These findings support the hypothesis that the self-reported cognitive impact of fibromyalgia is also found in objective neuropsychological measures. Routine screening for cognitive dysfunction in those with fibromyalgia may be warranted in addition to assessment of the traditional fibromyalgia symptoms.
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Affiliation(s)
- Tyler Bell
- a Psychology Department , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Zina Trost
- a Psychology Department , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Melissa T Buelow
- b Department of Psychology , The Ohio State University Newark, Newark, OH, USA
| | - Olivio Clay
- a Psychology Department , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Jarred Younger
- c Department of Psychology and Department of Anesthesiology , University of Alabama at Birmingham , Birmingham , AL , USA
| | - David Moore
- d School of Natural Sciences and Psychology , Liverpool John Moores University, Liverpool, UK
| | - Michael Crowe
- a Psychology Department , University of Alabama at Birmingham , Birmingham , AL , USA
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Selfridge NJ. Fibromyalgia. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Di Tella M, Tesio V, Ghiggia A, Romeo A, Colonna F, Fusaro E, Geminiani GC, Bruzzone M, Torta R, Castelli L. Coping strategies and perceived social support in fibromyalgia syndrome: Relationship with alexithymia. Scand J Psychol 2017; 59:167-176. [PMID: 29110306 DOI: 10.1111/sjop.12405] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 10/04/2017] [Indexed: 02/03/2023]
Abstract
Fibromyalgia (FM) is a chronic pain syndrome characterized by high levels of psychological distress and alexithymia, a personality disposition affecting emotional self-awareness. The main aim of the present study was to investigate for the first time the relationship between alexithymia and coping strategies on the one hand, and alexithymia and perceived social support on the other, in a sample of FM patients. To reach this aim, 153 FM patients completed a battery of tests assessing coping strategies, perceived social support, alexithymia, psychological distress and pain intensity. Four regression analyses were performed to assess whether alexithymia was still a significant predictor of coping strategies and perceived social support, after controlling for psychological distress. High levels of both psychological distress and alexithymia were found in our sample of FM patients. Regarding coping strategies, FM patients reported higher scores on problem-focused coping, with respect to the other two coping strategies. The regression analyses showed that the externally-oriented thinking factor of alexithymia significantly explained both problem- and emotion-focused coping, while the difficulty-describing feelings factor of alexithymia proved to be a significant predictor of perceived social support. Only the variance of dysfunctional coping ceased to be uniquely explained by alexithymia (difficulty identifying feelings factor), after controlling for psychological distress, particularly anxiety. These results highlight a negative relationship between alexithymia and both the use of effective coping strategies and the levels of perceived social support in FM patients. An adequate assessment of both alexithymia and psychological distress should therefore be included in clinical practice with these patients.
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Affiliation(s)
| | | | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Fabrizio Colonna
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Enrico Fusaro
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Giuliano Carlo Geminiani
- Department of Psychology, University of Turin, Turin, Italy.,A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Maria Bruzzone
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy
| | - Riccardo Torta
- A.O.U. 'Città della Salute e della Scienza' Hospital, Turin, Italy.,Department of Neuroscience, University of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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Enrici I, Mitkova A, Castelli L, Lanotte M, Lopiano L, Adenzato M. Deep Brain Stimulation of the subthalamic nucleus does not negatively affect social cognitive abilities of patients with Parkinson's disease. Sci Rep 2017; 7:9413. [PMID: 28842656 PMCID: PMC5573348 DOI: 10.1038/s41598-017-09737-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/19/2017] [Indexed: 12/19/2022] Open
Abstract
Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a treatment option for patients with advanced idiopathic PD successful at alleviating disabling motor symptoms. Nevertheless, the effects of STN-DBS on cognitive functions remain controversial and few studies have investigated modification of social cognitive abilities in patients with PD treated with STN-DBS. Here we expanded the typically-investigated spectrum of these abilities by simultaneously examining emotion recognition, and both affective and cognitive Theory of Mind (ToM). By means of a cross-sectional study, 20 patients with PD under dopaminergic replacement therapy, 18 patients with PD treated with STN-DBS, and 20 healthy controls performed the Ekman 60-Faces test, the full version of the Reading the Mind in the Eyes test, and the Protocol for the Attribution of Communicative Intentions. There were no differences between the PD groups (treated and not treated with STN-DBS) on any of the social cognitive tests. Our results suggest that patients with PD who are treated with STN-DBS do not experience detrimental effects on their social cognitive abilities. The present study, the first one examining a wide spectrum of social cognitive abilities after DBS of the STN, suggests that this surgical procedure can be considered safe from this standpoint.
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Affiliation(s)
- Ivan Enrici
- Department of Philosophy and Educational Sciences, University of Turin, Turin, Italy.,Center for Cognitive Science, University of Turin, Turin, Italy.,Neuroscience Institute of Turin, Turin, Italy
| | - Antonia Mitkova
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale S. Giuseppe, Piancavallo, VCO, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy.
| | - Michele Lanotte
- Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Mauro Adenzato
- Center for Cognitive Science, University of Turin, Turin, Italy.,Neuroscience Institute of Turin, Turin, Italy.,Department of Psychology, University of Turin, Turin, Italy
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Ardito RB, Pirro PS, Re TS, Bonapace I, Menardo V, Bruno E, Gianotti L. Mindfulness-Based Stress Reduction Program on Chronic Low-Back Pain: A Study Investigating the Impact on Endocrine, Physical, and Psychologic Functioning. J Altern Complement Med 2017; 23:615-623. [DOI: 10.1089/acm.2016.0423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Rita B. Ardito
- Department of Psychology, University of Torino, Torino, Italy
- Center for Cognitive Science, University of Torino, Torino, Italy
| | | | - Tania S. Re
- UNESCO Chair, Anthropology of Health, Biosphere and Healing Systems, University of Genova, Genova, Italy
| | | | - Valentino Menardo
- Pain Management Unit, Department of Medical Emergency, ASO S. Croce & Carle Hospital, Cuneo, Italy
| | - Emanuela Bruno
- Pain Management Unit, Department of Medical Emergency, ASO S. Croce & Carle Hospital, Cuneo, Italy
| | - Laura Gianotti
- Division of Endocrinology and Metabolism, Department of Internal Medicine, ASO S. Croce & Carle Hospital, Cuneo, Italy
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Aloi M, Rania M, Caroleo M, De Fazio P, Segura-García C. Social Cognition and Emotional Functioning in Patients with Binge Eating Disorder. EUROPEAN EATING DISORDERS REVIEW 2017; 25:172-178. [DOI: 10.1002/erv.2504] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/05/2016] [Accepted: 01/24/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Matteo Aloi
- Department of Health Sciences; University Magna Graecia of Catanzaro; Catanzaro Italy
| | - Marianna Rania
- Department of Health Sciences; University Magna Graecia of Catanzaro; Catanzaro Italy
| | - Mariarita Caroleo
- Department of Health Sciences; University Magna Graecia of Catanzaro; Catanzaro Italy
| | - Pasquale De Fazio
- Department of Health Sciences; University Magna Graecia of Catanzaro; Catanzaro Italy
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Di Tella M, Ghiggia A, Tesio V, Romeo A, Colonna F, Fusaro E, Torta R, Castelli L. Pain experience in Fibromyalgia Syndrome: The role of alexithymia and psychological distress. J Affect Disord 2017; 208:87-93. [PMID: 27750065 DOI: 10.1016/j.jad.2016.08.080] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/21/2016] [Accepted: 08/27/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic pain syndrome with a high prevalence of alexithymia, a personality disposition that affects emotional self-awareness. The present study aimed to investigate the relationship between alexithymia and pain, differentiating between the sensory and affective components of pain experience, in a sample of FM patients. METHODS One hundred and fifty-nine FM patients completed a battery of tests assessing pain experience, pain intensity, alexithymia and psychological distress. In order to characterize the clinical profile of alexithymic FM patients, alexithymic and non-alexithymic groups were compared on the different measures. Two regression analyses were performed on the total sample, in order to investigate the relationship between alexithymia and pain, controlling for psychological distress. RESULTS Alexithymic FM patients presented higher scores on all the clinical measures compared to non-alexithymic ones. Positive correlations were found between alexithymia and the affective, but not the sensory, dimension of pain experience variables. Regression analyses showed that alexithymia (difficulty identifying feelings factor) ceased to uniquely predict affective pain, after controlling for psychological distress, particularly anxiety. In addition, none of the alexithymia variables significantly explained pain intensity variance. Finally, a significant effect of anxiety in mediating the relationship between alexithymia and affective pain was found. LIMITATIONS No longitudinal data were included. CONCLUSIONS These findings show the presence of higher levels of pain and psychological distress in alexithymic vs. non-alexithymic FM patients, and a relevant association between alexithymia and the affective dimension of pain experience. Specifically, this relationship appears to be significantly mediated by anxiety.
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Affiliation(s)
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy.
| | | | | | - Fabrizio Colonna
- A.O.U. Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Enrico Fusaro
- A.O.U. Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Riccardo Torta
- Department of Neuroscience, University of Turin, Turin, Italy; A.O.U. Città della Salute e della Scienza Hospital of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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Alcocer-Gómez E, Culic O, Navarro-Pando JM, Sánchez-Alcázar JA, Bullón P. Effect of Coenzyme Q 10 on Psychopathological Symptoms in Fibromyalgia Patients. CNS Neurosci Ther 2017; 23:188-189. [PMID: 28052569 DOI: 10.1111/cns.12668] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 11/24/2016] [Accepted: 11/25/2016] [Indexed: 12/21/2022] Open
Affiliation(s)
- Elísabet Alcocer-Gómez
- Research Laboratory, Oral Medicine Department, University of Sevilla, Sevilla, Spain.,Centro Andaluz de Biología del Desarrollo (CABD), Universidad Pablo de Olavide-CSIC-Junta de Andalucía and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Sevilla, Spain
| | - Ognjen Culic
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - José M Navarro-Pando
- Unidad de Reproducción Humana y Cirugía Endoscópica, Instituto para el Estudio de la Biología de la Reproducción Humana (INEBIR), Seville, Spain
| | - José A Sánchez-Alcázar
- Centro Andaluz de Biología del Desarrollo (CABD), Universidad Pablo de Olavide-CSIC-Junta de Andalucía and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII, Sevilla, Spain
| | - Pedro Bullón
- Research Laboratory, Oral Medicine Department, University of Sevilla, Sevilla, Spain
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De Gregori M, Muscoli C, Schatman ME, Stallone T, Intelligente F, Rondanelli M, Franceschi F, Arranz LI, Lorente-Cebrián S, Salamone M, Ilari S, Belfer I, Allegri M. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach. J Pain Res 2016; 9:1179-1189. [PMID: 27994480 PMCID: PMC5153285 DOI: 10.2147/jpr.s115068] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Recently, attention to the lifestyle of patients has been rapidly increasing in the field of pain therapy, particularly with regard to the role of nutrition in pain development and its management. In this review, we summarize the latest findings on the role of nutrition and nutraceuticals, microbiome, obesity, soy, omega-3 fatty acids, and curcumin supplementation as key elements in modulating the efficacy of analgesic treatments, including opioids. These main topics were addressed during the first edition of the Study In Multidisciplinary Pain Research workshop: “FYD (Feed Your Destiny): Fighting Pain”, held on April 7, 2016, in Rome, Italy, which was sponsored by a grant from the Italian Ministry of Instruction on “Nutraceuticals and Innovative Pharmacology”. The take-home message of this workshop was the recognition that patients with chronic pain should undergo nutritional assessment and counseling, which should be initiated at the onset of treatment. Some foods and supplements used in personalized treatment will likely improve clinical outcomes of analgesic therapy and result in considerable improvement of patient compliance and quality of life. From our current perspective, the potential benefit of including nutrition in personalizing pain medicine is formidable and highly promising.
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Affiliation(s)
- Manuela De Gregori
- Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Study in Multidisciplinary Pain Research Group; Young Against Pain Group, Parma, Italy
| | - Carolina Muscoli
- Study in Multidisciplinary Pain Research Group; Department of Health Sciences, Institute of Research for Food Safety and Health, University "Magna Graecia" of Catanzaro, Parma, Italy; IRCCS San Raffaele Pisana, Roccelletta di Borgia, Catanzaro, Italy
| | - Michael E Schatman
- Study in Multidisciplinary Pain Research Group; US Pain Foundation, Bellevue, WA, USA
| | | | - Fabio Intelligente
- Study in Multidisciplinary Pain Research Group; Chronic Pain Service Anestesia Day-Surgery, IRCCS Humanitas Research Hospital, Rozzano
| | - Mariangela Rondanelli
- Study in Multidisciplinary Pain Research Group; Department of Public Health, Section of Human Nutrition and Dietetics, Azienda di Servizi alla Persona di Pavia, University of Pavia, Pavia
| | - Francesco Franceschi
- Study in Multidisciplinary Pain Research Group; Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
| | - Laura Isabel Arranz
- Study in Multidisciplinary Pain Research Group; Department of Nutrition, Food Sciences and Gastronomy, University of Barcelona, Barcelona
| | - Silvia Lorente-Cebrián
- Study in Multidisciplinary Pain Research Group; Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Maurizio Salamone
- Study in Multidisciplinary Pain Research Group; Metagenics Italia srl, Milano; Italian Lifestyle Medicine Association, Bari, Italy
| | - Sara Ilari
- Study in Multidisciplinary Pain Research Group; IRCCS San Raffaele Pisana, Roccelletta di Borgia, Catanzaro, Italy
| | - Inna Belfer
- Study in Multidisciplinary Pain Research Group; Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Massimo Allegri
- Study in Multidisciplinary Pain Research Group; Department of Surgical Sciences, University of Parma; Anesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliero, Universitaria of Parma, Parma, Italy
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Enrici I, Adenzato M, Ardito RB, Mitkova A, Cavallo M, Zibetti M, Lopiano L, Castelli L. Emotion processing in Parkinson's disease: a three-level study on recognition, representation, and regulation. PLoS One 2016. [PMID: 26110271 DOI: 10.1371/journal.pone.013147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is characterised by well-known motor symptoms, whereas the presence of cognitive non-motor symptoms, such as emotional disturbances, is still underestimated. One of the major problems in studying emotion deficits in PD is an atomising approach that does not take into account different levels of emotion elaboration. Our study addressed the question of whether people with PD exhibit difficulties in one or more specific dimensions of emotion processing, investigating three different levels of analyses, that is, recognition, representation, and regulation. METHODOLOGY Thirty-two consecutive medicated patients with PD and 25 healthy controls were enrolled in the study. Participants performed a three-level analysis assessment of emotional processing using quantitative standardised emotional tasks: the Ekman 60-Faces for emotion recognition, the full 36-item version of the Reading the Mind in the Eyes (RME) for emotion representation, and the 20-item Toronto Alexithymia Scale (TAS-20) for emotion regulation. PRINCIPAL FINDINGS Regarding emotion recognition, patients obtained significantly worse scores than controls in the total score of Ekman 60-Faces but not in any other basic emotions. For emotion representation, patients obtained significantly worse scores than controls in the RME experimental score but no in the RME gender control task. Finally, on emotion regulation, PD and controls did not perform differently at TAS-20 and no specific differences were found on TAS-20 subscales. The PD impairments on emotion recognition and representation do not correlate with dopamine therapy, disease severity, or with the duration of illness. These results are independent from other cognitive processes, such as global cognitive status and executive function, or from psychiatric status, such as depression, anxiety or apathy. CONCLUSIONS These results may contribute to better understanding of the emotional problems that are often seen in patients with PD and the measures used to test these problems, in particular on the use of different versions of the RME task.
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Affiliation(s)
- Ivan Enrici
- Department of Philosophy and Educational Sciences, University of Turin, Turin, Italy; Center for Cognitive Science, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy
| | - Mauro Adenzato
- Center for Cognitive Science, University of Turin, Turin, Italy; Neuroscience Institute of Turin, Turin, Italy; Department of Psychology, University of Turin, Turin, Italy
| | - Rita B Ardito
- Center for Cognitive Science, University of Turin, Turin, Italy; Department of Psychology, University of Turin, Turin, Italy
| | | | - Marco Cavallo
- eCampus University, Novedrate, Como, Italy; Azienda Sanitaria Locale Torino 3, Turin, Italy
| | | | - Leonardo Lopiano
- Neuroscience Institute of Turin, Turin, Italy; Department of Neuroscience, University of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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Enrici I, Adenzato M, Ardito RB, Mitkova A, Cavallo M, Zibetti M, Lopiano L, Castelli L. Emotion processing in Parkinson's disease: a three-level study on recognition, representation, and regulation. PLoS One 2015; 10:e0131470. [PMID: 26110271 PMCID: PMC4482447 DOI: 10.1371/journal.pone.0131470] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/02/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is characterised by well-known motor symptoms, whereas the presence of cognitive non-motor symptoms, such as emotional disturbances, is still underestimated. One of the major problems in studying emotion deficits in PD is an atomising approach that does not take into account different levels of emotion elaboration. Our study addressed the question of whether people with PD exhibit difficulties in one or more specific dimensions of emotion processing, investigating three different levels of analyses, that is, recognition, representation, and regulation. METHODOLOGY Thirty-two consecutive medicated patients with PD and 25 healthy controls were enrolled in the study. Participants performed a three-level analysis assessment of emotional processing using quantitative standardised emotional tasks: the Ekman 60-Faces for emotion recognition, the full 36-item version of the Reading the Mind in the Eyes (RME) for emotion representation, and the 20-item Toronto Alexithymia Scale (TAS-20) for emotion regulation. PRINCIPAL FINDINGS Regarding emotion recognition, patients obtained significantly worse scores than controls in the total score of Ekman 60-Faces but not in any other basic emotions. For emotion representation, patients obtained significantly worse scores than controls in the RME experimental score but no in the RME gender control task. Finally, on emotion regulation, PD and controls did not perform differently at TAS-20 and no specific differences were found on TAS-20 subscales. The PD impairments on emotion recognition and representation do not correlate with dopamine therapy, disease severity, or with the duration of illness. These results are independent from other cognitive processes, such as global cognitive status and executive function, or from psychiatric status, such as depression, anxiety or apathy. CONCLUSIONS These results may contribute to better understanding of the emotional problems that are often seen in patients with PD and the measures used to test these problems, in particular on the use of different versions of the RME task.
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Affiliation(s)
- Ivan Enrici
- Department of Philosophy and Educational Sciences, University of Turin, Turin, Italy
- Center for Cognitive Science, University of Turin, Turin, Italy
- Neuroscience Institute of Turin, Turin, Italy
| | - Mauro Adenzato
- Center for Cognitive Science, University of Turin, Turin, Italy
- Neuroscience Institute of Turin, Turin, Italy
- Department of Psychology, University of Turin, Turin, Italy
- * E-mail:
| | - Rita B. Ardito
- Center for Cognitive Science, University of Turin, Turin, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Marco Cavallo
- eCampus University, Novedrate, Como, Italy
- Azienda Sanitaria Locale Torino 3, Turin, Italy
| | | | - Leonardo Lopiano
- Neuroscience Institute of Turin, Turin, Italy
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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