Self-efficacy beliefs, faecal incontinence and health-related quality of life in patients born with anorectal malformations

AIM

Anorectal malformations (ARMs) are rare congenital colorectal anomalies with long lasting consequences, among which faecal incontinence is one of the most relevant since it may strongly affect patients' health-related quality of life (HRQoL). Although a growing body of literature supports the importance of self-efficacy in chronic disease health outcomes, only few studies have focused on self-efficacy in ARMs and in faecal incontinence. The purpose of the present study is to examine the mediational role of self-efficacy in the path between faecal incontinence and HRQoL in patients born with ARMs.

METHOD

Ninety-eight adult patients from the Italian Association for Anorectal Malformations (AIMAR) responded to measures of faecal incontinence, self-efficacy for managing ARM consequences, and physical and mental HRQoL (SF-36). Data were analysed by means of structural equation models.

RESULTS

The tested model provides support for the guiding hypothesis. Fit indices indicate that the model fits the data well (χ²  = 33.48, df = 23, P = 0.07; comparative fit index [CFI] = 0.97; root mean square error of approximation [RMSEA] = 0.07; standardized root mean square residual [SRMR] = 0.05). Faecal incontinence has negative effects on both physical and mental HRQoL, as well on self-efficacy. In turn, self-efficacy has a positive and direct effect on mental HRQoL.

CONCLUSION

Faecal incontinence is the most relevant and negative factor influencing HRQoL; in addition, self-efficacy contributes in reducing emotional distress and in improving mental health outcomes. Longitudinal and controlled studies may be helpful to evaluate the effectiveness of self-efficacy interventions in improving mental HRQoL in patients with faecal incontinence.

Insomnia is Associated with Systolic Hypertension in Uremic Patients on Hemodialysis

A newly developed questionnaire was administered to 140 hemodialyzed patients (82 M and 58 F) who have achieved adequate anemia correction according to the best guidelines with the aim: to evaluate the prevalence of clinical/subclinical dyssomnias in these patients; to study the influence of the dialytic shift (morning versus afternoon schedules) on sleep duration and disturbancies; and to evaluate the relationship between clinical sleep disorders and blood pressure values in uremic patients. Results indicated that 85% of uremic patients undergoing hemodialysis complain of clinical insomnia (frequent, persistent and associated with daytime consequences) or subclinical sleep disorders; patients dialyzing in the morning sleep significantly less during the night preceding the treatment, than those dialyzing in the afternoon; older patients complaining of clinical insomnia have a higher risk of failure to achieve target-optimal values in systolic blood pressure.

Sleep Disorders in Hemodialyzed Patients – The Role of Comorbidities

Background

Sleep disorders are very frequent in hemodialyzed patients, but the relationship between these disorders and water withdrawal, urea removal and comorbidities has not been sufficiently clarified.

Methods

The study comprised a group of 88 patients in good nutritional condition, with target hemoglobin concentration, good control of blood pressure and optimal dry weight. After answering a questionnaire (SDQ) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) patients were assigned to one of 3 groups: those with no disturbances (no. 20), those with subclinical disorders (n. 35) and insomniacs (n. 33). Yearly fluid and urea withdrawal by dialysis and the Charlson Comorbity Index were measured.

Results

Sleep disorders were observed in 77.27% of the patients. There was no difference in body fluid and urea withdrawal between groups. In the group of patients with no sleeping disturbances, the Charlson Comorbidity Index was significantly lower (p<0.001) than in patients with subclinical disorders or insomnia and emerged as a strongly associated with sleep disturbances. The study also attributes a predictive role to age, dialytic age, dialysis shift, antihypertensive drugs. The data indicate that, in evaluating sleeping disorders in patients on maintenance hemodialysis, comorbidities should be assessed.

Transition from childhood to adolescence: Quality of life changes 6 years later in patients born with anorectal malformations

BACKGROUND/PURPOSE

Disease-specific quality of life (QoL) may be more or less relevant when children enter preadolescence/adolescence. Few attentions have been given to development and transition periods. Aim of the present longitudinal study is to evaluate ARM specific changes in QoL and the stability of QoL over 6 years.

METHODS

Questionnaires were sent to families of the AIMAR Association (in 2007 and in 2013/2014). They included the Hirschsprung's Disease/ARM QoL Questionnaire (HAQL, [1]). Rank correlations and within group comparisons for the HAQL subscales were conducted analyzing the scores of time 1 vs time 2. Gender effects were tested.

RESULTS

134 parents answered the questionnaires at time 1 and 73 at time 2. Results of the repeated Analyses of Variance indicated improvements in the continence subscales ("Presence of Diarrhea," "Fecal Continence"). QoL significantly worsened in "Social and Emotional Functioning" and in "Body Image" areas. The analysis of stability of change indicates that QoL scores remain stable, with the exception of the Body Image area.

CONCLUSIONS

Despite improvements in the continence areas, parents reported worse levels of QoL in the psychosocial areas, as their child grow. As patients grow, they might have more difficulties in daily and social activities, and feel more frequently ashamed and more dissatisfied with their body.

Does mothers' perception of social support mediate the relationship between fecal incontinence and quality of life of the child?

PURPOSE

Fecal incontinence is a common problem in children and adolescents with anorectal malformation (ARM) and may negatively impact psycho-social well-being. Mothers' perception of social support has been proved to contribute to children's quality of life (QOL). Considering ARM studies, the role of family and social resources have received little attention. The aim of the present study was to analyze whether mothers' perception of social support mediates the impact of child fecal incontinence on his/her QOL.

METHODS

One hundred and nine mothers with a child born with ARM (aged 6-15 years old; mean age = 11 years) completed questionnaires including the fecal incontinence subscale of the Hirschsprung's Disease/Anorectal Malformation QOL Questionnaire, the Pediatric QOL Inventory, and a social relationship questionnaire. Structural equation models were used to explore the relations hypothesized.

RESULTS

No differences were found in the QOL scores across gender. The hypothesized model fits the data well; mothers' perception of social support partially mediated the relationship between fecal incontinence and QOL.

CONCLUSIONS

An important direction for pediatric surgeons and their interdisciplinary teams may be to develop strategies to strengthen mothers' social relationships.

Validity of a short insomnia questionnaire: the SDQ

The SDQ is a brief self-report insomnia questionnaire, which permits the rapid evaluation of insomnia based on the DSM-IV and ICSD-R criteria. The SDQ was developed to provide a fast and valid instrument both for the pre-screening of subjects who complain of insomnia and for epidemiological studies based on standardized definitions of this sleep disorder. Two studies were carried out in order to assess the validity of the SDQ as a self-report measure of insomnia. In the first study the convergent validity of the SDQ was assessed with respect to the global score of the Pittsburgh Sleep Quality Index (PSQI) in a sample of general practitioners' patients. The second study assessed the sensitivity and the specificity of the SDQ in discriminating between insomniacs or normal sleepers in a sample of college students who were given an extensive sleep evaluation within an insomnia counseling program. The SDQ classifications have a good convergent validity with the global sleep quality scores of the PSQI and its classifications of students who complain of or who do not complain of problems of insomnia have a sensitivity of 95% and a specificity of 87%. Results indicate that the SDQ is a valid paper and pencil instrument to screen insomnia.

Internal consistency, convergent validity and reliability of a brief questionnaire on disordered eating (DEQ)

Clinical interviews are considered the gold standard for the evaluation of the specific psychopathology associated with eating disorders. However, there are situations in which brief but valid and reliable self-report questionnaires can be helpful. For this reason, we have developed a new questionnaire, called the DEQ (Disordered Eating Questionnaire), brief enough to be used in epidemiological screenings, that evaluates the frequency and intensity of disordered eating attitudes and behaviours within a time frame of three months and addresses face valid questions to the general population. The aim of this study was to evaluate the dimensionality, reliability and convergent validity of this questionnaire. The DEQ was filled in by Italian secondary school girls and boys, together with the Contour Drawing Rating Scale (CDRS) and with the Eating Attitudes Test (EAT-26). The results showed a single component that explain a portion of variance of around 36%. The reliability of the scale is highly satisfactory. The scale is also valid, since scores on the DEQ scale are significantly and highly correlated with body dissatisfaction, measured by the CDRS, with body mass inex (BMI) and with all the subscales of the EAT-26. As expected, there were gender differences, given that DEQ scores were higher in females than in males.

Sleep and migraine: an actigraphic study

The aim of the study was to evaluate sleep of children with migraine during the interictal period and the modifications of sleep which precede, are concomitant with, or follow migraine attacks. Eighteen patients with migraine without aura were compared with a group of 17 healthy age-matched children. Sleep parameters were monitored for two full weeks by means of actigraphs and self-report diaries. Headache diaries were also filled out in order to evaluate the occurrence and the characteristics of migraine attacks. Fifty-seven attacks were recorded during the monitoring period. During the interictal period, sleep parameters of children suffering from migraine did not differ from those of controls; only sleep onset latency was slightly prolonged in the migraine group. Timing of the attack affected nocturnal motor activity which presented the lowest values on the night preceding the attack, indicating a decrease in cortical activation during sleep preceding migraine attacks. Further studies should clarify if the observed reduction in nocturnal motor activity close to the attack is related to neurotransmitter imbalance.

The assessment of daytime sleep propensity: a comparison between the Epworth Sleepiness Scale and a newly developed Resistance to Sleepiness Scale

INTRODUCTION

The Epworth sleepiness scale (ESS) is widely used as a way of measuring subjective sleep propensity in research and clinical practice. Psychometric studies do not rule out the presence of more than one latent dimension underlying the items.

OBJECTIVE

Aims of the present study were to: (a) evaluate psychometric proprieties of the ESS by means of classic psychometric techniques; (b) compare them with those from a newly developed resistance to sleepiness scale (RSS); (c) evaluate, following the latent trait theory, whether the items of both ESS and RSS could be conceptualized as different levels of an interval variable representative of a single latent trait related to sleep propensity.

METHODS

One hundred and forty-six inpatients suffering from different sleep disorders filled in both the RSS and ESS in a sleep disorder centre.

RESULTS

Indexes of fit derived by the application of the extended logistic model are consistent with the idea that each ESS item can be conceptualized as different levels of an interval variable representative of a single latent trait. However, most of the ESS items are found to be located at the opposite extremes of this continuum.

CONCLUSIONS

The under representation of situations characterized by an intermediate soporific nature in the ESS could limit ESS sensitivity to detect intermediate variations of sleep propensity.

Brain function and effects of shift work: implications for clinical neuropharmacology

Night or shift work is to a relevant extent unavoidable, suits a growing preference for flexibility and is predicted to spread. However, a significant percentage of shift workers report discomfort or health problems and they often (15-20% of cases) move to different occupations. Apart from social implications, the issue has medical and scientific relevance, with evidence suggesting that the circadian rhythm phases are neither equivalent nor interchangeable with respect to function and performance. Shift work may affect the gastrointestinal and cardiovascular functions, alter the hormonal and sleepiness cycles, favor sleep disturbances of medical relevance, interfere with behavior and social life and increase the risk of accidents (e.g. road accidents). The implications for clinical (neuro)pharmacology are relevant and, in several instances, critical. Shift work can interfere with mechanisms regulating drug kinetics in peripheral compartments and action at selective brain sites, either directly or through effects on the gastrointestinal/hormonal cycles. In this paper, the relevant literature is reviewed and original data on the effects of shift work are reported. Basic and clinical research should take into account the possible effects on drug action of an active life and working schedule in inappropriate phases of the circadian cycles and the risk of inadequate drug dosing or unexpected abnormal action in subjects under long-term or chronic treatment. A scientific approach, action by the scientific community involved in pharmacological research and monitoring by the regulating agencies are advisable. Regulation may help reduce the medical and social impact and improve quality of life.

Insomnia is associated with systolic hypertension in uremic patients on hemodialysis

A newly developed questionnaire was administered to 140 hemodialyzed patients (82 M and 58 F) who have achieved adequate anemia correction according to the best guidelines with the aim: to evaluate the prevalence of clinical/subclinical dyssomnias in these patients; to study the influence of the dialytic shift (morning versus afternoon schedules) on sleep duration and disturbancies; and to evaluate the relationship between clinical sleep disorders and blood pressure values in uremic patients. Results indicated that 85% of uremic patients undergoing hemodialysis complain of clinical insomnia (frequent, persistent and associated with daytime consequences) or sub-clinical sleep disorders; patients dialyzing in the morning sleep significantly less during the night preceding the treatment, than those dialyzing in the afternoon; older patients complaining of clinical insomnia have a higher risk of failure to achieve target-optimal values in systolic blood pressure.

Effects of different sleep reductions on daytime sleepiness

This study evaluated the effects of different amounts of sleep and SWS restriction on the ensuing day-time sleepiness. Six healthy selected males, after one adaptation night and an initial 8-hr baseline night, were allowed to sleep 5, 4, 3, 2, and 1 hr with a 1-week interval between conditions. The following day, 4 sleep onset MSLT trials and 2 Wilkinson Auditory Vigilance Task (WAVT) were administered. Before each MSLT, self evaluations of sleepiness and activation on a visual analogue scale (ADAS) were assessed. Each restriction night was followed by an 8-hr recovery night, and a final 8-hr baseline night was recorded. The day after each night the same diurnal tests were repeated. Results indicated a linear increase in the propensity to sleep (MSLT) and of subjective sleepiness as a function of the increase in sleep restrictions. Performance scores (WAVT) showed that vigilance is partially affected by sleep restrictions. For each measure, regression analyses showed that the effect of sleep reduction is better predicted by the total duration of sleep than by the amount of SWS. Correlations between measures were negligible with the exception of those between performance and subjective sleepiness measures.

Actigraphic motor asymmetries during sleep

Much evidence indicates that during sleep there is a repatterning of motor asymmetries with a relative advantage of the left hand (i.e., the left hand moves more than the right). This could be due to the ability of the right hemisphere in operating at levels of reduced arousal (arousal hypothesis) or to its superior spatial abilities (motor specificity hypothesis), or it could indicate a greater need for sleep in the left hemisphere (homeostatic hypothesis). Since only the latter hypothesis predicts that the repatterning should be present in the first part of sleep (i.e., when the homeostatic processes are more pronounced), the present study evaluated whether actigraphic data are consistent with this prediction. Sixteen right-handed college students wore actigraphs (AMI 16K) on both upper and lower limbs for about 56 hours. Factorial ANOVAS were carried out on side (left vs right) and part (first vs second) of the recording period during sleep and waking. During waking, the right hand showed more intense motor activity as compared to the left. During sleep, in the first part of the night, the right hand lost this advantage, while in the second part of the night it regained its superiority. Since this repatterning was specific for hand movements and no difference was found in overall motor activity and in arousal between the two parts of the sleep period, the results are interpreted as consistent with the homeostatic hypothesis.

Assessing vigilance through a brief pencil and paper letter cancellation task (LCT): effects of one night of sleep deprivation and of the time of day

Behavioural effects of the lack of sleep in normal subjects have been investigated mostly by experimenter-paced choice reaction times in prolonged stimulus detection tasks. However, length and procedure complexity of these tasks limit their use in research on larger numbers of subjects. The aim of the present study was to assess the effectiveness of a brief subject-paced pencil and paper performance task, i.e. letter cancellation task (LCT) in revealing the effects of one night of sleep deprivation. In addition, the authors evaluated sleep loss and time of day effects on six Visual Analogue Scales (VAS) measuring subjective activation-deactivation. Results show that a LCT is sensitive in revealing the effects of time of day and of 24 h of sleep deprivation. Effects of sleep deprivation were also revealed by VAS data. Sleepiness, tiredness and energy scales on the VAS were also affected by time of day. Despite the sensitivity of both the LCT and VAS, there was little correspondence between performance and subjective measures.

A finger-tapping task and a reaction time task as behavioral measures of the transition from wakefulness to sleep: which task interferes less with the sleep onset process

The aim of this study was to assess whether a finger-tapping task (FTT), in which normal subjects repeatedly tap on a button while falling asleep, could be less disturbing and provide comparable information on the sleep onset period (SOP) with respect to a reaction-time task (RTT) to acoustic stimuli, in which the onset of sleep can be delayed by the arousing effect of the acoustic stimuli. Twelve subjects slept at their homes and six slept in a sleep laboratory for four consecutive nights. After one adaptation night and one baseline night, subjects were required to fall asleep in the third and fourth nights, bimanually performing either a RTT or a FTT. The results indicate that the FTT interfaces less with the SOP compared to the RTT and suggest that the FTT provides further advantages as a behavioral measure of the transition from wakefulness to sleep. In fact, the tapping task is associated with significantly shorter behavioral and polysomnographic sleep onset latencies and with a greater proportion of slow-wave sleep (SWS) during the transition from wakefulness to sleep compared with the RTT. Furthermore, correlations among subjective, behavioral, and electroencephalograph (EEG) latencies confirm the validity of the finger-tapping task as a behavioral measure of sleep onset.

Effects of different sleep duration on delta sleep in recovery nights

The study assessed the effects of different amounts of sleep restriction on slow wave sleep (SWS) in the ensuing recovery nights. After one adaptation night and an 8-hr baseline night, six healthy men were individually studied during and following five nights in which sleep was reduced to 5, 4, 3, 2, and 1 hr with a 1-week interval between conditions. Each sleep reduction was followed by an 8-hr recovery night. Finally, a second 8-hr baseline night was recorded. A trend analysis revealed that SWS amount in recovery nights increases with decreasing previous sleep duration. Regression analyses showed that, within each participant, the rebound of SWS after a sleep reduction is predicted better by the total duration of sleep than by the specific amount of SWS lost.

Rapid eye movements density as a measure of sleep need: REM density decreases linearly with the reduction of prior sleep duration

In the recovery nights from total and partial sleep deprivation there is a reduction of oculomotor activity during paradoxical sleep as compared to baseline nights. Aims of the present within-subjects study are to contribute in understanding the nature of the relationship between REM density and sleep need and to evaluate whether an inverse relationship exists between REM density and slow wave sleep (SWS) amount. Six healthy subjects were studied for 7 consecutive weeks with standard polysomnographic recordings. Variations in REM density were assessed in the recovery nights following a gradual sleep restriction, obtained by postponing the sleep onset time while maintaining the final awakening time constant. Results indicate that sleep curtailment decreases REM density in the ensuing recovery nights; the decrease is linearly related to the amount of sleep curtailment. The decrease in REM density parallels an increase in SWS, while no corresponding variation was found neither in the duration of paradoxical sleep nor in the latency of any other sleep stage. These results suggest that REM density could be used as a measure of sleep need.

Left movers' advantage in heartbeat discrimination: a replication and extension

Lateral eye movers are subjects who consistently shift their gaze either leftward or rightward while reflecting on visuospatial or verbal questions. When reliably assessed, prevalent direction of gaze can be assumed as a valid index of hemispheric asymmetry. The present study evaluated discrimination of heartbeat (HB) and of spontaneous changes of finger temperature in 24 right-handed females reliably selected as lateral movers. Results replicate and extend previous findings by showing that left movers' superiority in HB discrimination is present also in females and concerns the perception of a different vascular function, that is, peripheral finger temperature. Differences between right movers and left movers were not due to activation level during the test or to body composition.

Variations in sleep mentation as a function of time of night

Mentation reports collected from sleep onset, Stage 2 and REM Stage awakenings, in the first part and in the second part of the night were analyzed both with systematic psycholinguistic and global measures. Results confirm the relationship between activation and the length of sleep mentation report shown by Antrobus. Length of the report increases with sleep time, but time does not modulate qualitative inter-stage differences. By partialling out the length of the report, many inter-stage differences disappeared; however significant differences remain in the global measure of bizarreness and in the psycholinguistic measure of visual imagery. These results cannot be explained entirely by differences in attention and memory and point to more basic differences in mental activity.

The complementary relationship between waking and REM sleep in the oculomotor system: an increase of rightward saccades during waking causes a decrease of rightward eye movements during REM sleep

Since an inverse relationship between waking and REM sleep eye movements (EMs) has been found with respect to frequency, amplitude and direction of EMs, we evaluated variations in the percentages of horizontal rapid eye movements (REMs) during REM sleep after having increased rightward saccades during waking by means of a unilateral tachistoscopic visual test administered prior to sleep. In another condition subjects were given the same 4 h testing condition prior to sleep, the only difference being that they were instructed not to move their gaze; therefore only "attentional movements" were possible. This condition served as a control for the role of oculomotor activity in the complementary relationship between waking and REM sleep eye movements. The actual increase of rightward saccades during waking resulted in a significant decrease of rightward REMs. This effect has been observed only in the condition in which rightward eye movements were increased and it is specific for REMs of amplitude similar to those which were increased during waking by the lateralized test.

Which hemisphere falls asleep first?

Behavioral tasks (reaction times to acoustic stimuli and finger tapping tasks) performed by normal subjects when sleepy or attempting to fall asleep have been used as indices of hemispheric asymmetries during the sleep onset period. Results show a stronger impairment of the left hemisphere (right hand) both in reacting to external stimuli and in sustaining endogenous motor programs. The left hemisphere seems to fall asleep earlier than the right hemisphere.

Increase of REM duration and decrease of REM latency after a prolonged test of visual attention

Following one adaptation night, the nocturnal sleep of nine female college students was recorded for two baseline and two experimental nights. In both experimental nights, prior to sleep the subjects performed a 4 hour long visual task requiring the recognition of letters tachistoscopically presented in the right visual hemifield. In the first experimental night eye movements were permitted, while in the second subjects were allowed only covert movements of attention while keeping their gaze on a fixation point. Results show that, as a consequence of the experimental manipulation, there is an increase of REM duration and a shortening of REM latency without any concomitant significant change in REM density and in the duration and latency of the other sleep stages. The increase of REM duration was greater in the night in which only attentional "movements" were permitted (i.e., when there is a covert orienting of attention), suggesting that a load of spatial attention might have a role in increasing REM pressure.

Generation of skeletal and multipart mental visual images in the cerebral hemispheres: a study in normal subjects

In a series of three experiments the hemispheric lateralization of structures generating the details and the holistic properties of mental images was investigated in three different samples of normal right-handed subjects. In the first experiment the left hemisphere was faster in discriminating at an imagery level whether animals had short or long tails. No hemispheric dominance was found when the imagery task required the discrimination of the holistic features of objects and a decision of whether they were taller than wider, or vice versa. In the second experiment no hemispheric dominance was found when the same tasks had to be performed perceptually. In the third experiment no hemispheric dominance was found in the speed of lexical recognition of the names that in the first experiment elicited the generation of multipart and skeletal mental images, although the left hemisphere was generally more accurate. These findings provide support to the hypothesis advanced by Kosslyn that multipart mental images are generated by the left hemisphere and skeletal images by both hemispheres. Results are discussed both in terms of Kosslyn's computational theory of imagery generation and in terms of theories advanced by other authors.

Prevalent direction of reflective lateral eye movements and ear asymmetries in a dichotic test of musical chords

Subjects who consistently move their gaze either to the right or to the left while reflecting on visuo-spatial or verbal questions are usually called "lateral eye movers". This study evaluated auditory asymmetries to a dichotic test of musical chords in 23 right-handed females, selected through test-retest as reliable lateral eye movers; 12 were "left movers" (LMs) and 11 were "right movers" (RMs). During the assessment of the prevalent direction of gaze as well as during the dichotic test, the oculomotor activity was controlled through a video camera. The hypothesis was that the left ear advantage usually found with dichotic chords is enhanced in LMs and reduced in RMs, and that this effect is not due to the facilitating influence of lateral eye movements occurring during the task. Results show that: (a) left movers exhibit a marked advantage of the left ear while right movers do not exhibit any significant ear advantage; (b) despite the instruction to fix a central point, lateral movers tend to show unwarranted eye movements in their usual direction; (c) the effect of the prevalent direction of gaze on the dichotic advantage is not due to eye movements made during the dichotic test. These findings give further support to the hypothesis that the tendency to consistently shift the gaze to one side is related to hemispheric asymmetries as measured by lateralized tests.

Feedback and autonomic awareness: the ability to discriminate the direction of spontaneous changes in peripheral body temperature

Forty-eight Ss were requested to discriminate spontaneous changes of at least 0.1 degree C in their peripheral finger temperature (PFT). They were randomly assigned to one of 3 groups: in the first group ("KR") Ss were given a feedback after each discrimination; in the second group ("NKR") Ss were given no feedback after each discrimination; in the third group ("RKR") Ss were given a random feedback after each discrimination. Results indicated that in the "Knowledge-of-Results" group discrimination was significantly higher than in both "No-Knowledge-of-Results" and "Random-Knowledge-of-Results" groups. Within the first group, there was a significant difference in a discrimination index between Ss "aware" and Ss "unaware" of their PFT changes, which remained significant even when the effects of individual variability of PFT and of the regularity of PFT changes were partialled out.

Patterns of hemispheric lateralization in dream recallers and non-dream recallers

Eighteen right handed females reporting 6 or more dreams per week on a home dream and sleep diary (Dream Recallers: DR), and 11 reporting 1 or 0 dreams per week (Non Dream Recallers: NDR) drawn from a sample of 233 college students, were individually tested on two tasks assessing the hemispheric lateralization of visuo-constructive and verbal-semantic functions. NDR showed a significant degree of hemispheric asymmetry of both visuo-constructive (right asymmetry of both visuo-constructive (right hemisphere advantage) and semantic (left hemisphere advantage) functions. DR showed no hemispheric advantage on both tasks. The two groups of subjects did not differ in mean daily amount of sleep time. In keeping with previous studies showing that NDR have an imbalance of interhemispheric activation upon REM awakenings, results from the present research suggest that DR and NDR can be characterized by a different pattern of hemispheric lateralization of cognitive skills. This finding may stimulate further research aimed at evaluating both the possible existence of differences in the lateralization of functions not considered in this study and the concomitance of REM sleep dependent differences in balance of hemispheric functioning.

Hemispheric differentiation and dream recall: subjective estimates of sleep and dreams in different handedness groups

Previous investigations pointed to a relationship between hemispheric asymmetry and dream recall. Since handedness may reflect the extent to which cerebral organization is lateralized, it was hypothesized that differences in dream recall might exist between different handedness groups. A selected sample of 78 college students (38 right-handers, 25 left-handers, 15 mixed-handers) completed a seven-day sleep and dream diary upon final awakening, at home. Results showed that significantly more dreams are recalled by females compared to males and by right-handers compared to mixed-handers and left-handers. The latter finding is tentatively interpreted as due to a more direct access to aspects of oneiric material structured in the left hemisphere by right-handers, whose language centers are located in the same hemisphere. Unexplained findings of the only other investigation concerning handedness and sleep variables (Hicks, Pellegrini & Hawkins, 1979), which showed greater variability of sleep duration in mixed-handers, were not confirmed by the present study.

Reflective lateral eye movements: individual styles, cognitive and lateralization effects

The direction of gaze shifts following verbal and spatial questions was recorded by direct observation in two separate sessions in 80 right-handed Ss. Ocular events were stable over the sessions, and some Ss were classified reliably as lateral, vertical or bidirectional eye movers. No effect for type of question was found in lateral direction either in the general sample or in the bidirectional sample. Verbal questions elicited more downward movements than spatial questions. Less eye movements were found for spatial and for easy questions. These findings suggest a link between ocular motility and cognition independent of the lateralization issue.

[The direction of rapid eye movements as an indication of hemispheric asymmetry during REM sleep. II]

The hypothesis of right hemisphere predominance in REM sleep and of an increase in left activity throughout the night have been tested by analyzing the distribution of vertical and of horizontal rapid eye movements (REMs) to the right and to the left during the first and the last REM periods in 5 right-handed subjects. Neither the expected superiority of REMs to the left nor variations along the REM periods were found. For vertical eye movements our data suggest a superiority of upward movements during REM. In waking some empirical evidences suggest a relationship between upward eye movements and right hemisphere functioning although to date no hemispheric model can explain it.

[Hemispheric asymmetries in cortical electrical activity during sleep. I]

The hypothesis of a predominance of the right hemisphere in stage REM as compared to NREM has been tested through a spectral analysis of the EEG recorded from left (T3) and right (T4) temporal sites in 5 young healthy right-handed male subjects. Variations in the asymmetry coefficient R - L/R + L in different sleep stages have been analyzed by one way ANOVAs and Sheffé's tests. The hypothesis of a progressive increase in left hemisphere activity throughout different REM cycles as one approaches final awakenings have been investigated by comparing variations in the asymmetry coefficient for epochs of REM and stage 2 NREM sampled in different phases of the REM cycle. EEG results do not support either the hypothesized stage dependent or cycle dependent variation in EEG activity during sleep. We question whether variations in EEG amplitude and synchronization can be used as indices of hemispheric asymmetries during sleep.

Electrodermal responses in patients with unilateral brain damage

Skin conductance responses (SCR) to emotional and to nonemotional stimuli were measured in 16 right and 16 left unilateral brain-damaged patients. Replicating findings by Morrow, Vrtunski, Kim and Boller (1981), those patients with a lesion in the left hemisphere showed higher SCR's to emotional than to nonemotional stimuli while those with a right lesion showed no difference between them. This pattern of results remained when variance in performance on a Facial Expression Recognition task was partialled out, suggesting that the absence of differentiated arousal in right-brain-damaged patients is unrelated to their impairment in perceptual analysis.

Independence of REM density from other REM sleep parameters before and after REM deprivation

The aim of our work was to investigate the interrelationships among rapid eye movement (REM) percent, latency, and density and their variations during different nights in an adequate REM-deprivation study. Twenty male subjects slept for 7 consecutive nights in the laboratory: 2 adaptation, 1 base line, 2 deprivation, and 2 recovery. Wilcoxon's test showed a significant increase in REM percent and a decrease in REM latency from base line to recovery nights. REM density on the contrary showed a decrease, possibly due to dilution caused by increased time spent in stage REM. Eye movement activity appears to remain stable after REM deprivation. Furthermore, REM density showed no correlation with other REM sleep measures, while its highly significant correlations across nights make it a reliable and stable descriptor of an individual's sleep pattern. The independence of eye movement activity with respect to other parameters of REM sleep is suggested.

[Inclination of the visual field and postural deviations induced in CD1 mice. 2]

The effect of conflicting visual and kinesthetic information on body position in the mice has been investigated. Riess et al. (1950) reported that rats posture was different for 10 degrees to the right us. 10 degrees to the left inclination of the visual field. Neither this nor other effects on body position were observed submitting random breed mice to a similar procedure suggesting that a cognitive difference exists between the two species.

[Vertical discrimination in a pure strain of mice (DBA). I]

With the perspective of developing a model of field dependence in small mammals, 10 DBA mice were tested for their ability to choose between a vertical and 25 degree tilted alley in a tridimensional maze. Results have shown that when alternative strategies are prevented, mice have considerable difficulty in discriminating verticality on the basis of kinesthetic and visual cues.