The Covid-19 pandemic is burning all over the world. National healthcare systems are facing the contagion with incredible strength, but concern regarding the psychosocial and economic effects is ...growing quickly. The PsyCovid Study assessed the influence of psychosocial variables on individual differences from the perceived impact of the Covid-19 outbreak on the issues of health and economy in the Italian population. Italian volunteers from different regions completed an online anonymous survey. The main outcomes were the perceived impact of the Covid-19 outbreak on health and the economy. A two-way MANOVA evaluated differences in the main outcomes, with geographical area (northern, central, and southern regions) and professional status (healthcare workers or not) as factors. We then tested the relationship linking psychosocial variables (i.e. perceived distress and social isolation, empathy, and coping style) to the main outcomes through two different mediation models. 1163 responders completed the survey (835 females; mean age: 42 ± 13.5 y.o.; age range: 18-81 y.o.) between March 14 and 21, 2020. Healthcare workers and people living in northern Italy reported a significantly worse outbreak impact on health, but not on the economy. In the whole sample, distress and loneliness were key variables influencing the perceived impact of the Covid-19 outbreak on health, while empathy and coping style affected the perceived impact on the economy. The Covid-19 pandemic is a worldwide emergency in terms of psychological, social, and economic consequences. Our data suggests that in the Italian population, actual differences in individual perception of the Covid-19 outbreak severity for health are dramatically modulated by psychosocial frailty (i.e., distress and loneliness). At the same time, problem-oriented coping strategies and enhanced empathic abilities increase people's awareness of the severity of the impact of the Covid-19 emergency on economics. There is an immediate need for consensus guidelines and healthcare policies to support interventions aimed to manage psychosocial distress and increase population resilience towards the imminent crisis.
The development of alcohol habits is considered a form of maladaptive reinforced learning, with sustained alcohol use resulting in the strengthening of associative links between consumption and ...either rewarding, or the lack of aversive, experiences. Despite recent efforts in characterizing decision-making skills in alcohol-use-disorder (AUD), it is still unknown whether impaired behavioural learning in AUD patients reflects a defective processing and anticipation of choice-related, cognitively mediated, emotions such as regret or relief for what might have been under a different choice. We administered a Wheel-of-Fortune (WoF) task to 26 AUD patients and 19 healthy controls, to investigate possible alterations in adjusting choices to the magnitude of experienced regret/relief, and in other facets of decision-making performance such as choice latency. AUD patients displayed both longer deliberation time than healthy controls, and impaired adaptations to previous outcome-related negative emotions. Although further evidence is needed to unveil the cognitive mechanisms underlying AUD patients' abnormal choice, the present results highlight important implications for the clinical practice, e.g. in terms of cognitive treatments aiming to shape faulty perceptions about negative emotions associated with excessive alcohol exposure.
Covid-19 pandemic is exerting a tragic impact all around the world. First-person experience of life-threatening and stressful events can modify individuals' risk perception, and, consequently, ...risk-taking behaviours. Here we investigated risk-taking profiles in 130 Italian residents, and compared healthcare to non-healthcare workers, during the lockdown phase. We ad hoc developed the "Covid-19 Risk Task", including the classic monetary Holt-Laury Paired Lottery Task (Monetary Condition, MC) and two new ecological conditions exploring Covid-19 related risk-taking aptitudes in relation to different health (Health Status Condition, HsC) and employment (Employment Status Condition, EsC) outcomes. Results showed that, in the whole sample, individuals were more risk-averse in MC than in HsC and EsC. Moreover, a payoff increase produced a shift toward more risk-averse behaviours in MC, but not in HsC and EsC, where we found an opposite trend suggesting a more risk-loving behaviour. Finally, we found that healthcare workers were significantly less risk-averse compared to non-healthcare workers in EsC, but not in MC and HsC. These findings provided evidence of the possible effects of Covid-19 outbreak on risk-taking aptitudes. The negative impact on human choices and, consequently, on the whole world economy of this catastrophic life event must not be underestimated.
Alcohol Use Disorder (AUD) entails chronic effects on brain structure. Neurodegeneration due to alcohol toxicity is a neural signature of executive impairment typically observed in AUD, previously ...related to both gray-matter volume/density and white-matter abnormalities. Recent studies highlighted the role of meso-cortico-limbic structures supporting the salience and executive networks, in which the extent of neurostructural damage is significantly related to patients' executive performance. Here we aim to integrate multimodal information on gray-matter and white-matter features with a multivariate data-driven approach (joint Independent Component Analysis, jICA), and to assess the relationship between the extent of damage in the resulting neurostructural superordinate components and executive profile in AUD. Twenty-two AUD patients and 18 matched healthy controls (HC) underwent a Magnetic Resonance Imaging (MRI) protocol, alongside clinical and neuropsychological examinations. We ran jICA on five neurostructural features, including gray-matter density and different diffusion tensor imaging metrics. We extracted 12 Independent Components (ICs) and compared the resulting mixing coefficients in patients vs. HC. Finally, we correlated significant ICs with executive and clinical variables. One out of 12 ICs (IC11) discriminated patients from healthy controls and correlated positively both with executive performance in all subjects, and with lifetime duration of alcohol abuse in patients. In line with previous related evidence, this component involved widespread gray-matter and white-matter patterns including key nodes and fiber tracts of salience, default-mode and central executive networks. These findings highlighted the role of multivariate data integration as a valuable approach revealing superordinate hallmarks of neural changes related to cognition in neurological and psychiatric populations.
•Alcohol User Disorder (AUD) entails widespread white-matter (WM) alterations.•WM alterations underlie the typical profile of executive impairment in AUD.•Executive profile in AUD is related to WM ...tracts connecting large-scale networks.•Altered large-scale structural connections may promote maladaptive behavior in AUD.
Alcohol Use Disorders (AUD) is associated with negative consequences on global functioning, likely reflecting chronic changes in brain morphology and connectivity. Previous attempts to characterize cognitive impairment in AUD addressed patients’ performance in single domains, without considering their cognitive profile as a whole. While altered cognitive performance likely reflects abnormal white-matter microstructural properties, to date no study has directly addressed the relationship between a proxy of patients’ cognitive profile and microstructural damage. To fill this gap we aimed to characterize the microstructural damage pattern, and its relationship with cognitive profile, in treatment-seeking AUD patients.
Twenty-two AUD patients and 18 healthy controls underwent a multimodal MRI protocol including diffusion tensor imaging (DTI), alongside a comprehensive neurocognitive assessment. We used a principal component analysis (PCA) to identify superordinate components maximally explaining variability in cognitive performance, and whole-brain voxelwise analyses to unveil the neural correlates of AUD patients’ cognitive impairment in terms of different white-matter microstructural features, i.e. fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD).
PCA revealed a basic executive component, significantly impaired in AUD patients, associated with tasks tapping visuo-motor processing speed, attention and working-memory. Within a widespread pattern of white-matter damage in patients, we found diverse types of relationship linking WM microstructure and executive performance: (i) in the whole sample, we observed a linear relationship involving MD/RD metrics within both ‘superficial’ white-matter systems mediating connectivity within large-scale brain networks, and deeper systems modulating their reciprocal connections; (ii) in AUD patients vs. controls, a performance-by-group interaction highlighted a MD/AD pattern involving two frontal white-matter systems, including the genu of corpus callosum and cingulum bundle, mediating structural connectivity among central executive, salience and default mode networks.
Alterations of prefrontal white-matter pathways are suggestive of abnormal structural connectivity in AUD, whereby a defective interplay among large-scale networks underpins patients’ executive dysfunction. These findings highlight different directions for future basic and translational research aiming to tailor novel rehabilitation strategies and assess their functional outcomes.
Alcohol Use Disorder (AUD) is a chronic relapsing condition characterized by excessive alcohol consumption despite its multifaceted adverse consequences, associated with impaired performance in ...several cognitive domains including decision-making. While choice deficits represent a core component of addictive behavior, possibly consecutive to brain changes preceding the onset of the addiction cycle, the evidence on grey-matter and white-matter damage underlying abnormal choices in AUD is still limited. To fill this gap, we assessed the neurostructural bases of decision-making performance in 22 early-abstinent alcoholic patients and 18 controls, by coupling the Cambridge Gambling Task (CGT) with quantitative magnetic resonance imaging metrics of grey-matter density and white-matter integrity. Regardless of group, voxel based morphometry highlighted an inverse relationship between deliberation time and grey-matter density, with alcoholics displaying slower choices related to grey-matter atrophy in key nodes of the motor control network. In particular, grey-matter density in the supplementary motor area, reduced in alcoholic patients, explained a significant amount of variability in their increased deliberation time. Tract-based spatial statistics revealed a significant relationship between CGT deliberation time and all white-matter indices, involving the most relevant commissural, projection and associative tracts. The lack of choice impairments other than increased deliberation time highlights reduced processing speed, mediated both by grey-matter and white-matter alterations, as a possible marker of a generalized executive impairment extending to the output stages of decision-making. These results pave the way to further studies aiming to tailor novel rehabilitation strategies and assess their functional outcomes.
First-person experience of stressful life events can change individuals' risk attitudes, driving to increased or decreased risk perception. This shift to more risk-averse or risk-loving behaviors may ...find a correlate in the individual psycho-socio-emotional profile. To this purpose, we aimed to estimate the relationship between differences in risk-taking attitudes toward possible negative health outcomes and psycho-socio-emotional dimensions modulating the experience of life-threatening situations, in the context of the Covid-19 pandemic. In March 2020, we launched the PsyCovid Study (
https://wprn.org/item/428452
) to assess psycho-socio-emotional changes due to Covid-19 pandemic in the Italian population. Additionally, we distributed to 130 participants the Covid-19 Risk Task, including monetary and health-related stimuli, estimating a measure of risk-aversion toward health and classifying participants on the basis of their risk-attitude profiles. The set of psycho-socio-emotional variables was reduced to three PCA components:
Proactivity, Isolation, Inactivity
. The individual degree of risk-aversion toward negative health outcomes was directly related to
Proactivity
, encasing empathic, social support and positive coping strategies, which may prompt individuals to put in place self-protection strategies toward possible negative health consequences. These findings indicate that a risk-averse profile toward possible negative health outcomes may be associated to higher levels of individual prosocial and proactive dispositions, possibly making individuals' more compliant with the social and hygienic guidelines and, thus, reducing their exposure to the SARS-CoV-2 infection.
The early identification of fragile populations in the Covid-19 era would help governments to allocate resources and plan strategies to contain consequences of the pandemic. Beyond frailty, social ...vulnerability to environmental stressors, such as the social distancing enforced to reduce the SARS-CoV2 contagion, can modify long-term disease risk and induce health status changes in the general population. We assessed frailty and social vulnerability indices in 1,258 Italian residents during the first lockdown phase
via
an on-line survey. We compared indices taking into account age categories and gender. While frailty showed a linear increase with age and was greater in females than in males, social vulnerability was higher in young adults and elders compared to middle aged and older adults, and in males than females. Both frailty and social vulnerability contributed in explaining the individual perception of the impact of Covid-19 emergency on health, which was further influenced by proactive attitudes/behaviors and social isolation. Social isolation and loneliness following the Covid-19 outbreak may exert dramatic psychosocial effects in the general population. The early detection of vulnerable categories, at risk to become ill and develop long-lasting health status changes, would help to prevent consequences on general well-being by allocating resources to targeted interventions managing psychosocial distress and increasing young adults and elderly resilience toward the post-Covid-19 crisis.
Increasing attention is being devoted to cognitive-behavioural measures to improve interventions for chronic pain.
To develop an Italian version of the Coping Strategies Questionnaire - Revised ...(CSQ-R), and to validate it in a study involving 345 Italian subjects with chronic pain.
The questionnaire was developed following international recommendations. The psychometric analyses included confirmatory factor analysis; reliability, assessed by internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficients); and construct validity, assessed by calculating the correlations between the subscales of the CSQ-R and measures of pain (numerical rating scale), disability (Sickness Impact Profile - Roland Scale), depression (Center for Epidemiological Studies - Depression Scale) and coping (Chronic Pain Coping Inventory) (Pearson's correlation).
Confirmatory factor analysis revealed that the CSQ-R model had an acceptable data-model fit (comparative fit index and normed fit index ≥0.90, root mean square error of approximation ≤0.08). Cronbach's alpha was satisfactory (CSQ-R 0.914 to 0.961), and the intraclass correlation coefficients were good⁄excellent (CSQ-R 0.850 to 0.918). As expected, the correlations with the numerical rating scale, Sickness Impact Profile - Roland Scale, Center for Epidemiological Studies - Depression Scale and Chronic Pain Coping Inventory highlighted the adaptive and maladaptive properties of most of the CSQ-R subscales.
The CSQ-R was successfully translated into Italian. The translation proved to have good factorial structure, and its psychometric properties are similar to those of the original and other adapted versions. Its use is recommended for clinical and research purposes in Italy and abroad.
Summary Opiates and/or nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most effective therapies for chronic pain, but their prolonged time of use can affect health conditions through ...physical and psychological side effects. They include the very common gastrointestinal effects and changes that can induce osteoporosis, depression, impaired cognition and a generally poor quality of life, which per se can induce and maintain a chronic painful condition. For this reason it is becoming imperative to expand our knowledge of the interaction of these substances with body functions apparently not directly involved in nociception and pain, such as neuroendocrine functions. The purpose of this study was to determine, in male and female patients suffering from chronic pain, the effect of conventional pain therapy (opiates, NSAIDs) on hypothalamic-pituitary-adrenal (HPA) axis function. This was assessed by measuring the blood levels of adrenal-related hormones (adrenocorticotrophin hormone, ACTH; cortisol; dehydroepiandrosterone, DHEA and dehydroepiandrosterone sulfate, DHEAS). The second purpose of the study was to test the hypothesis that these hormones are associated with the psychological profile shown by the chronic pain patients. The results showed significant changes induced by pain therapy on the HPA axis: ACTH, cortisol, DHEA and DHEAS blood levels decreased in all subjects taking opiates or NSAIDs to treat pain. Moreover these changes showed significant correlations with psychological features of the subjects depending on age and sex.
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