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Mazza M, Donne IL, Vagnetti R, Attanasio M, Paola Greco M, Chiara Pino M, Valenti M. Normative values and diagnostic optimisation of three social cognition measures for autism and schizophrenia diagnosis in a healthy adolescent and adult sample. Q J Exp Psychol (Hove) 2024; 77:511-529. [PMID: 37129426 DOI: 10.1177/17470218231175613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Awareness of the importance of assessing social cognition skills under conditions showing atypical social behaviours has increased over the years. However, the evaluation of the psychometric properties of the measures and the availability of normative values for the clinical context are still limited. This study aims to revise, provide normative values, and evaluate the clinical validity of the Italian version of three social cognition measures: Advanced Theory of Mind (A-ToM) task, the Emotion Attribution Task (EAT), and the Social Situation Task (SST). Measures were administered to 580 adolescents and adult healthy controls (age range 14-50). We performed differential item functioning and Rasch analysis to revise each task, so normative data of the revised measures were calculated. Moreover, the revised measures were administered to 38 individuals with autism spectrum disorder (ASD) and 35 individuals with schizophrenia spectrum disorders (SSD): ASD and SSD were matched by age, gender, and IQ with a control sample to evaluate clinical validity. ROC analysis showed that the SST is the best measure differentiating between healthy and clinical groups, compared to the A-ToM (AUCASD = 0.70; AUCSSD = 0.65) and EAT (AUCASD = 0.67; AUCSSD = 0.50), which showed poorer performance. For SSD diagnosis, two SST subscales (Violation and Gravity score) indicated the best accuracy (AUCs of 0.88 and 0.84, respectively); for the ASD diagnosis, we propose a combined score between the SST subscale and A-ToM (AUC = 0.86). The results suggest that the proposed measures can be used to support the diagnostic process and clinical practice.
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Affiliation(s)
- Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Ilenia Le Donne
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Roberto Vagnetti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Margherita Attanasio
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Maria Paola Greco
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Maria Chiara Pino
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Marco Valenti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
- Abruzzo Region Health System, Reference Regional Centre for Autism, L'Aquila, Italy
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Pino MC, Donne IL, Vagnetti R, Tiberti S, Valenti M, Mazza M. Using the Griffiths Mental Development Scales to Evaluate a Developmental Profile of Children with Autism Spectrum Disorder and Their Symptomatologic Severity. Child Psychiatry Hum Dev 2024; 55:117-126. [PMID: 35763176 PMCID: PMC10796491 DOI: 10.1007/s10578-022-01390-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/03/2022]
Abstract
Early diagnosis is crucial for Autism spectrum disorder (ASD) and is achieved through a screening of developmental indicators to recognise children who are at risk of autism. One of the most widely used instruments in clinical practice for assessing child development is the Griffiths Mental Development Scale (GMDS). We sought (a) to assess longitudinally whether children diagnosed with ASD, with a mean age of 33.50 months (SD 7.69 months), show a developmental delay of abilities measured by the GMDS over time and (b) to analyse which skills of the GMDS could be associate to the symptomatologic severity of ASD. Our results showed lower scores of General Quotient and all sub-quotients of GMDS from first (T0) to second assessment (T1), except for the Performance sub-quotient. Three sub-quotients (Personal-Social, Hearing and Language and Practical Reasoning) also associate symptom severity at the time when the diagnosis of ASD is made.
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Affiliation(s)
- Maria Chiara Pino
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy.
| | - Ilenia Le Donne
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
- Abruzzo Region Health System, Reference Regional Centre for Autism, L'Aquila, Italy
| | - Roberto Vagnetti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Sergio Tiberti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Marco Valenti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
- Abruzzo Region Health System, Reference Regional Centre for Autism, L'Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
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Valenti M, Mazza M, Arduino GM, Keller R, Le Donne I, Masedu F, Romano G, Scattoni ML. Diagnostic assessment, therapeutic care and education pathways in persons with autism spectrum disorder in transition from childhood to adulthood: the Italian National Ev.A Longitudinal Project. Ann Ist Super Sanita 2023; 59:304-312. [PMID: 38088398 DOI: 10.4415/ann_23_04_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
INTRODUCTION The transition from childhood to adulthood is one of the main critical points in the network of services for taking care of people with autism spectrum disorder (ASD). Within the framework of the national research programs on autism, an exploratory longitudinal multicentre study was conducted. This research program, called "Ev.A Project (Developmental and Adult Age)", was proposed by the Italian National Institute of Health (Istituto Superiore di Sanità, ISS) and the aim was the development and testing of a diagnostic, therapeutic, assistance and educational pathway (PDTAE) for autism. AIM The present study aimed to evaluate two impact outcomes of the care protocol: the response obtained by the ASD person, and the perception of the change in the family context. METHODS Participants underwent an initial clinical evaluation and then after one year. Over the course of the year, participants undertook a program of intervention. The measures of adaptive functioning, need for support, psychiatric symptomatology and family quality of life were used for the outcome assessment. Linear mixed models were constructed for each measure to estimate the explanatory/predictive behavior of the intensity of the interventions, adjusted for the participant's level of symptom severity. RESULTS The results estimate a main effect of Intervention Group (b=-27.22, p<0.001) and severity level (b=-41.87, p<0.001) on the adaptive functioning of the ASD person, but no effect on performance on the dimension of Family Quality of Life (b=0.523, p=0.455). CONCLUSIONS The most significant predictor of the impact on the ASD person is the activation of the service network, which must take into account the level of severity of the presented symptoms.
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Affiliation(s)
- Marco Valenti
- dTextAnchor003>1Centro di Riferimento Regionale per l'Autismo della Regione Abruzzo, L'Aquila, Italy
| | - Monica Mazza
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
| | | | - Roberto Keller
- Centro Regionale Adulti per l'Autismo della Regione Piemonte, Turin, Italy
| | - Ilenia Le Donne
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Francesco Masedu
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli Studi dell'Aquila, L'Aquila, Italy
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Attanasio M, Giuliani A, Romano L, Laidò C, Di Poggiovalle G, Le Donne I, Di Fonzo V, Tiberti S, Valenti M, Mazza M. Psychopathological factors and personality dimensions on dysfunctional eating behaviors in a sample of individuals with obesity. Front Psychol 2023; 14:1140890. [PMID: 37794917 PMCID: PMC10546769 DOI: 10.3389/fpsyg.2023.1140890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Obesity and eating disorders are considered to be part of a broad spectrum of disorders associated with weight issues and maladaptive eating styles. Several studies show that psychopathological and personality characteristics contribute to the development and maintenance of obesity and dysfunctional eating behaviors, showing a bidirectional relationship. The purpose of this study was to understand the role of psychopathological factors and personality dimensions on dysfunctional eating behaviors in a sample of individuals with obesity. Methods The study was conducted with 96 individuals with obesity (31 males and 65 females) who underwent psychological assessment. The instruments administered included the Cognitive Behavioral Assessment 2.0 - Primary Scales, the Minnesota Multiphasic Personality Inventory-2, and the Eating Disorder Inventory. Relationships between dysfunctional eating behaviors and personality and psychopathological factors were explored through mediation analysis. Results and discussion Our results showed that difficulties related to impulse control and behavior, along with negative and dysphoric emotions, may be associated with difficulties in eating behavior. Mediation analysis showed that the combination of depressive and obsessive-compulsive symptomatology may exacerbate or contribute to the occurrence of eating disorders. These psychopathological aspects should be taken into account during the assessment of patients who decide to undergo bariatric surgery and should be targets of specific psychological interventions.
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Affiliation(s)
- Margherita Attanasio
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Antonio Giuliani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Surgery, San Salvatore Hospital, L'Aquila, Italy
| | - Lucia Romano
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Surgery, San Salvatore Hospital, L'Aquila, Italy
| | - Cristina Laidò
- Istituto Romano di psicoterapia e psicodinamica integrata, Rome, Italy
| | - Gilda Di Poggiovalle
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Ilenia Le Donne
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Valentina Di Fonzo
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Sergio Tiberti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Marco Valenti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
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Le Donne I, Attanasio M, Bologna A, Vagnetti R, Masedu F, Valenti M, Mazza M. Autism and intention attribution test: a non-verbal evaluation with comic strips. Ann Gen Psychiatry 2023; 22:29. [PMID: 37573317 PMCID: PMC10422844 DOI: 10.1186/s12991-023-00461-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Despite autism spectrum disorder (ASD) and mentalization being two words often associated in the literature, the assessment of this ability in individuals with ASD in the clinical setting is still limited. Indeed, there are no standardized Theory of Mind (ToM) tests that are adaptable to different cognitive profiles, such as individuals with language poverty, and intellectual or memory impairments. This study proposes a non-verbal test (Intentions Attribution-Comic Strip Test; IA-CST) to evaluate the ability to infer the intentions of others, a basic component of ToM, in the clinical setting. METHOD In Study 1, the test was administered to 261 healthy individuals and we performed structural validation using Exploratory Graph Analysis. In Study 2, the final version of the test was administered to 32 individuals with ASD to assess the known group validity of the measure by comparing their scores with a sample of IQ-matched controls. Moreover, we performed logistic regression and ROC curve to preliminarily assess the diagnostic performance of the IA-CST. RESULTS The IA-CST resulted in a 3-dimension measure with good structural stability. Group comparison indicated that the ASD group shows significantly lower performance in intention attribution but not in inferring causal consequences. The test demonstrated known group validity and that, preliminarily, it is suitable for implementation within the clinical practice. CONCLUSIONS The results support the IA-CST as a valid non-verbal task for evaluating intentions attribution in the clinical setting. Difficulties in ToM are early and relevant in ASD, so assessing these aspects is valuable for structuring individualized and evidence-based interventions.
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Affiliation(s)
- Ilenia Le Donne
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy.
| | - Margherita Attanasio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Antony Bologna
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Roberto Vagnetti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Francesco Masedu
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Marco Valenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
- Regional Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, 67100, L'Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
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Mazza M, Pino MC, Keller R, Vagnetti R, Attanasio M, Filocamo A, Le Donne I, Masedu F, Valenti M. Qualitative Differences in Attribution of Mental States to Other People in Autism and Schizophrenia: What are the Tools for Differential Diagnosis? J Autism Dev Disord 2021; 52:1283-1298. [PMID: 33909212 PMCID: PMC8854268 DOI: 10.1007/s10803-021-05035-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/26/2022]
Abstract
The differential diagnosis between schizophrenia spectrum disorders (SSD) and autism spectrum disorders (ASD) remains an important clinical question, because they have overlap in clinical diagnosis. This study explored the differences between ASD (n = 44) and SSD patients (n = 59), compared to typically developing peers (n = 63), in completing an advanced Theory of Mind (ToM) task. The outcome found several differences between groups. The SSD patients showed greater difficulty in understanding social scenarios, while ASD individuals understood the stories, but did not correctly identify the protagonist’s intention. The interesting aspect of the results is that some ToM stories are more informative about the mentalistic reasoning of the two clinical groups, namely, the stories that investigate pretend, persuasion, double bluff and ironic joke constructs.
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Affiliation(s)
- Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Roberto Keller
- Reference Centre for Adult Autism of the Piemonte Region, DSM Local Health Unit ASL Città di Torino, Turin, Italy
| | - Roberto Vagnetti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
| | - Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Angela Filocamo
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Ilenia Le Donne
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
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Vagnetti R, Pino MC, Masedu F, Peretti S, Le Donne I, Rossi R, Valenti M, Mazza M. Exploring the social cognition network in young adults with autism spectrum disorder using graph analysis. Brain Behav 2020; 10:e01524. [PMID: 31971664 PMCID: PMC7066354 DOI: 10.1002/brb3.1524] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 11/15/2019] [Accepted: 12/09/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is characterized by an impairment in social cognition (SC). SC is a cognitive construct that refers to the capacity to process information about social situations. It is a complex network that includes distinct components. Exploring how SC components work together leads to a better understanding of how their interactions promote adequate social functioning. Our main goal was to use a novel statistical method, graph theory, to analyze SC relationships in ASD and Typically Developing (TD) individuals. METHODS We applied graph theory to SC measures to verify how the SC components interact and to establish which of them are important within the interacting SC network for TD and ASD groups. RESULTS The results showed that, in the TD group, the SC nodes are connected; their network showed increased betweenness among nodes, especially for the Theory of Mind. By contrast, in the SC network in the ASD group the nodes are highly disconnected, and the efficient connection among the components is absent. CONCLUSION ASD adults do not show SC competencies and functional communication among these skills. Under this regard, specific components are crucial, suggesting they could represent critical domains for ASD SC.
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Affiliation(s)
- Roberto Vagnetti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.,Regional Centre for Autism, Abruzzo Region Health System, L'Aquila, Italy
| | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Sara Peretti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Ilenia Le Donne
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Department of Mental Health of Modena, AUSL Modena, Modena, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.,Regional Centre for Autism, Abruzzo Region Health System, L'Aquila, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.,Regional Centre for Autism, Abruzzo Region Health System, L'Aquila, Italy
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