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We induced placebo analgesia (PA), a phenomenon explicitly attenuating the self-pain feeling, to assess whether this resulted in reduced empathy pain when witnessing a confederate undergoing such pain experience. We recorded EEG and electrocardiogram during a painful Control and PA treatment in healthy adults who rated their experienced pain and empathy for pain. We derived HRV changes and, using wavelet analysis of non-phase-locked event-related EEG oscillations, EEG spectral power differences for self-pain and other-pain conditions. First-hand PA reduced self-pain and self-unpleasantness, whereas we observed only a slight decrease in other unpleasantness. We derived linear combinations of HRV and EEG band power changes significantly associated with self-pain and empathy for pain changes using PCAs. Lower Behavioral Inhibition System scores predicted self-pain reduction through the mediating effect of a relative HR-slowing and a decreased midline ϑ-band (4–8 Hz) power factor moderated by lower Fight-Flight-Freeze System trait scores. In the other-pain condition, we detected a direct positive influence of Total Empathic Ability on the other-pain decline with a mediating role of the midline β2-band (22–30 Hz) power reduction. These findings suggest that PA modulation of first-hand versus other pain relies on functionally different physiological processes involving different personality traits. [ABSTRACT FROM AUTHOR]

Background: Tactile maneuvers stimulating spontaneous respiratory activity in preterm infants are recommended since birth, but data on how and how often these maneuvers are applied in clinical practice are unknown. In the last years, most preterm newborns with respiratory failure are preferentially managed with non-invasive respiratory support and by stimulating spontaneous respiratory activity from the delivery room and in neonatal intensive care unit (NICU), in order to avoid the risks of intubation and prolonged mechanical ventilation.Methods: Preterm infants with gestational age < 31 weeks not intubated in the delivery room and requiring non-invasive respiratory support at birth will be eligible for the study. They will be randomized and allocated to one of two treatment groups: (1) the study group infants will be subject to the technique of respiratory facilitation within the first 24 h of life, according to the reflex stimulations, by the physiotherapist. The newborn is placed in supine decubitus and a slight digital pressure is exerted on a hemithorax. The respiratory facilitation technique will be performed for about three minutes and repeated for a total of 4/6 times in sequence, three times a day until spontaneous respiratory activity is achieved; thus, no respiratory support is required; (2) the control group infants will take part exclusively in the individualized postural care program. They will perform the technique of respiratory facilitation and autogenous drainage.Objective: To evaluate the efficacy of early respiratory physiotherapy in reducing the incidence of intubation and mechanical ventilation in the first week of life (primary outcome).Discussion: The technique of respiratory facilitation is based on reflex stimulations, applied early to preterm infant. Slight digital pressure is exerted on a "trigger point" of each hemithorax, to stimulate the respiratory activity with subsequent increase of the ipsilateral pulmonary minute ventilation and to facilitate the contralateral pulmonary expansion. This mechanism will determine the concatenation of input to all anatomical structures in relation to the area being treated, to promote spontaneous respiratory activity and reducing work of breathing, avoiding or minimizing the use of invasive respiratory support.Trial Registration: UMIN-CTR Clinical Trial UMIN000036066. Registered on March 1, 2019. Protocol 1. https://www.umin.ac.jp/ctr. [ABSTRACT FROM AUTHOR]

The Rorschach inkblot test allows access to psychological processes that usually do not emerge in self-report measures and it has been widely used in clinical psychological and psychiatric settings. Recordings of brain activity during the administration of the Rorschach inkblots test could provide information on neural correlates of the underlying perceptual-cognitive processing and potentially identify neuroimaging markers of psychopathology risk. The present paper offers a systematization of the available literature on the Rorschach inkblot test and neuroimaging research. The 13 selected studies had been conducted with healthy participants and using fMRI, EEG, and fNIRS to investigate the neural underpinnings of Rorschach inkblot test responses. The neural processes underlying the visual, social, and emotional processes described by the included papers are systematically summarized. Research on the neural correlates of the Rorschach inkblot test is promising and would further benefit from studies on clinical populations, broader samples, and younger age groups. • The Rorschach inkblot test is widely used in clinical psychological settings. • Brain activity during the test may shed light on the psychopathological conditions. • We describe the available literature on the Rorschach and neuroimaging research. • We summarize the neural activity underlying visual, social, and emotional processes. • Results show the need for studies on broader clinical samples and younger subjects. [ABSTRACT FROM AUTHOR]

This study aimed to validate a recent conceptualization proposed by Coll and colleagues (2017a) that defines empathic response as a situational, cognitively complex process requiring emotion identification and affective sharing. Sixty right-handed women university students (18–29 years) voluntarily participated in the study. We measured ratings for empathy pain to assess the individual differences in empathy. At the same time, we collected peak amplitudes of the event-related potentials (ERPs) components to empathic stimulations of painful faces or hand stimuli and neutral images. Electrophysiological results proved that the P2, N170, N2, and P3 ERP components were associated with the modulation of empathic responses. Participants with low empathic responses (p < 0.05) disclosed a larger frontal central N2 for the painful hands than for painful faces (p <.05) and a reduced temporoparietal N170 for painful hands compared to neutral ones. Furthermore, our results highlighted higher frontal central P3a and P3b to painful stimuli than controls (p ≤ 0.01). We explained these findings assuming that in identifying the emotional value of a stimulus, the emotional content can modulate the reorientation of attention and the in-memory updating process associated with the empathic response. Results are in line with Coll and colleagues' conceptualization of the empathic response that includes two cognitive processes, the identification of emotions, and affective sharing, related to the recognition of the emotional state of the other in the self. [Display omitted] • Electrophysiological results proved that N170, N2, and P3 components are related to situational empathic response modulation. • Emotional content modulates attention re-orientation and in-memory updating processes related to the empathic pain response. • Empathic response can be defined in terms of two cognitive processes, the identification of emotions, and affective sharing. [ABSTRACT FROM AUTHOR]

Purpose: Psychosis is a symptom common to several mental illnesses and a defining feature of schizophrenia spectrum disorders, whose onset typically occurs in adolescence. Neuroradiological studies have reported evidence of brain structural abnormalities in patients with overt psychosis. However, early identification of brain structural changes in young subjects at risk for developing psychosis (such as those with Attenuated Psychosis Syndrome –APS) is currently lacking. Methods: Brain 3D T1-weighted and 64 directions diffusion-weighted images were acquired on 55 help-seeking adolescents (12–17 years old) with psychiatric disorders who referred to our Institute. Patients were divided into three groups: non-APS (n = 20), APS (n = 20), and Early-Onset Psychosis (n = 15). Cortical thickness was calculated from T1w images, and Tract-Based Spatial Statistics analysis was performed to study the distribution of white matter fractional anisotropy and all diffusivity metrics. A thorough neuropsychological test battery was adopted to investigate cognitive performance in several domains. Results: In patients with Attenuated Psychotic Syndrome, the left superior frontal gyrus was significantly thinner compared to patients with non-APS (p = 0.048), and their right medial orbitofrontal cortex thickness was associated with lower working memory scores (p = 0.0025, r = -0.668 for the working memory index and p = 0.001, r = -0.738 for the digit span). Early-Onset Psychosis patients showed thinner left pars triangularis compared to non-APS individuals (p = 0.024), and their left pars orbitalis was associated with impaired performance at the symbol search test (p = 0.005, r = -0.726). No differences in diffusivity along main tracts were found between sub-groups (p > 0.05). Conclusion: This study showed specific associations between structural imaging features and cognitive performance in patients with APS. Characterizing this disorder using neuroimaging could reveal useful information that may aid in the development and evaluation of preventive strategies in these individuals. [ABSTRACT FROM AUTHOR]

This study evaluates the modulation of phasic pain and empathy for pain induced by placebo analgesia during pain and empathy for pain tasks. Because pain can be conceptualized as a dangerous stimulus that generates avoidance, we evaluated how approach and avoidance personality traits modulate pain and empathy for pain responses. We induced placebo analgesia to test whether this also reduces self-pain and other pain. Amplitude measures of the N1, P2, and P3 ERPs components, elicited by electric stimulations, were obtained during a painful control, as well as during a placebo treatment expected to induce placebo analgesia. The placebo treatment produced a reduction in pain and unpleasantness perceived, whereas we observed a decrease in the empathy unpleasantness alone during the empathy pain condition. The moderator effects of the fight-flight-freeze system (FFFS) in the relationships linking P2 and P3 amplitude changes with pain reduction were both significant among low to moderate FFFS values. These observations are consistent with the idea that lower FFFS (active avoidance) scores can predict placebo-induced pain reduction. Finally, in line with the revised Reinforcement Sensitivity Theory (r-RST), we can assume that phasic pain is an aversive stimulus activating the active-avoidance behavior to bring the system back to homeostasis. [ABSTRACT FROM AUTHOR]

• The influence of personality traits on acute pain and placebo analgesia is reviewed. • Personality and situational variables can modulate placebo analgesia responses. • Reward is a homoeostatic process serving to interrupt the ongoing pain sensation. • Acute pain is associated with the BIS and related to passive avoidance. • Placebo analgesia is associated with the BAS and related to approach behaviour. Pain is an unpleasant sensory and emotional experience associated with actual or potential damage to the body. The experience of acute pain reflects the continuous processing of a complex hierarchical system of motivations to act that incorporates expectations and beliefs serving to limit the impact of adverse events. Research on placebo analgesia highlights that placebo analgesia can be modulated by dispositional characteristics that interact with environmental and personality-state variables. Generally, acute pain relief, and particularly placebo analgesia, is conceptualized as a self-regulated homoeostatic process associated with the achievement of a reward that serves to interrupt the ongoing pain sensation. Motivational states that drive the behaviour of aversion to acute pain and the attainment of pain relief or placebo analgesia can be conceptualized in terms of behavioural inhibition, behavioural approach, and the fight-flight-freeze system. It is desirable to conduct more research on placebo analgesia to evaluate the role of individual approach/avoidance behaviour to allow the planning of individual treatments to reduce pain. [ABSTRACT FROM AUTHOR]

Background: Brain cortical activity in resting electroencephalogram (EEG) recordings can be considered as measures of latent individual disposition to approach/avoidance behavior. This systematic review aims to provide an updated overview of the relationship between resting EEG cortical activity and approach/avoidance motivation personality traits. Methods: The review process was conducted according to the PRISMA-Statement, using PsycArticles, MEDLINE, Scopus, Science Citation Index, and Research Gate database. Restrictions were made by selecting EEG studies conducted in resting idling conditions, which included approach/avoidance personality traits or parallel measures, and an index of EEG brain activity. In the review 50 studies were selected, wherein 7120 healthy adult individuals participated. Results: The study of the relationship between resting EEG cortical activity and approach/avoidance personality traits provides controversial and unclear results. Therefore, the validity of resting asymmetry or frequency oscillations as a potential marker for approach/avoidance personality traits is not supported. Conclusions: There are important contextual and interactional factors not taken into account by researchers that could mediate or moderate this relationship or prove it scarcely replicable. Further, it would be necessary to conduct more sessions of EEG recordings in different seasons of the year to test the validity and the reliability of the neurobiological measures. [ABSTRACT FROM AUTHOR]

• Cross-frequency coupling of resting EEG oscillations in Anxiety and Relaxation groups. • Examined the association of RST-PQ traits with within-S EEG cross-frequency coupling. • The anxiogenic situation showed a significant between-subject delta-beta coupling. • BIS trait associated with higher within-subject delta-beta coupling in Anxiety group. • BIS was positively associated with higher delta-theta coupling in Relaxation group. Research has shown that the coupling between slow and fast EEG frequency oscillations reflects cortico-subcortical interaction. Specifically, the between-subject delta-beta amplitude-amplitude correlation is found to increase in some hypothetically anxiogenic conditions. We tested whether cortical-subcortical coupling would increase as a function of decreased delta (theta) or higher beta (gamma) activity. EEG recording was obtained from a group of 59 students during a resting anxiogenic situation (Anxiety) and from another group of 66 during a relaxation situation (Relaxation). Participants filled out the State Anxiety and the Reinforcement Sensitivity Theory Personality Questionnaire. Between-subjects cross-frequency correlations were calculated between power values in the delta (theta) and beta (gamma) frequency bands and compared between Anxiety and Relaxation groups. A significant positive between-subject delta-beta correlation was observed in the resting Anxiety, and this association was significantly higher than that observed in the Relaxation group. In the Anxiety, but not Relaxation group, we observed a delta-beta coupling for the low delta activity. In the Anxiety group, BIS trait was significantly associated with higher strength of within-subject delta-beta coupling, while in the Relaxation group BIS was positively associated with delta-theta coupling. Interesting, in both resting Anxiety and Relaxation groups, BAS-GDP was positively associated with higher delta-gamma coupling. [ABSTRACT FROM AUTHOR]

A previous study showed that about 80% of Italian adolescents reported isolated symptoms of acute or post-traumatic stress during the first lockdown in Italy. We proposed a new questionnaire to investigate the presence of symptoms related to anxiety, panic, depression, eating disorders, sleep disorders, social withdrawal, stress disorders, psychotic symptoms, anti-conservative thoughts, and self-harming acts aggravated by COVID-19 restrictions and possible differences between males and females. 500 adolescents (12–18 years) completed an online survey created using validated scales. 41% of the respondents felt more stress than during the first lockdown. 1.85% showed suprathreshold symptoms for post-traumatic stress disorder and 21% showed isolated symptoms of acute or post-traumatic stress due to the pandemic. In addition, we found psychotic symptoms (16%), panic (25% suprathreshold), anxiety (46.8% suprathreshold), depression (18.7% suprathreshold), eating-related symptoms (51%), sleep difficulties (57%), a tendency to social withdrawal after the pandemic (15%), suicidal ideation (30%), and self-harming behavior (9%). Furthermore, girls showed a more severe level of distress. The results show a high prevalence of symptoms because of the COVID-19 pandemic and confirm the need for easy access to support and treatment service to help contain the bio-psycho-social risk factors prompted by the current pandemic and promptly and effectively manage the consequences. [ABSTRACT FROM AUTHOR]

Background: A growing body of research provides evidence for social and behavioral problems observed among adolescents with psychosis and also as precursors of vulnerability to psychosis, long before the illness onset, especially in females patients. As such, the main aim of the current study was to investigate from a patient perspective the presence of differences in the behavioral problems self-disclosed by psychotic, clinically high-risk, and non-psychotic adolescents. Moreover, since adolescent girls may present higher risk of internalizing problems, we explored the additional role of sex in interaction with psychotic risk or clinical condition in altering the self-disclosed severity of behavioral problems among the three groups of adolescents. Methods: One-hundred and fifty-eight adolescent patients were interviewed by a trained child neuropsychiatrist applying the Comprehensive Assessment of At Risk Mental States in order to identify a quantitative index of risk for full-blown and attenuated psychosis. All patients self-reported on their behavioral problems filing in the well-validated Italian version of the Youth Self-Report, which quantifies internalizing, externalizing, and total behavioral problems. Results: Regarding Youth Self-Report's scores, non-psychotic adolescents had reported lower total and internalizing scores compared to clinically high-risk and psychotic counterparts. Additionally, in our sample a significant group × sex interaction effect emerged for total and internalizing scores: females reported greater risk of total and internalizing behavioral problems, only in the clinically high-risk group. Conclusions: Higher variability should be expected in the behavioral profile of high-risk adolescents in comparison to psychotic ones. Elevations of internalizing behavioral symptoms, thus, might be considered as a much more relevant risk factor in girls during adolescence. [ABSTRACT FROM AUTHOR]

Previously published models of frontal activity linked high relative left frontal activity to the behavioral approach system (BAS) and impulsivity. Additionally, these models did not account for BAS facets encompassing the anticipation of reward, i.e., goal-driven persistence (BAS–GDP) and reward interest (BAS–RI), from those that deal with the actual hedonic experience of reward, i.e., reward reactivity (BAS–RR) and impulsivity (BAS–I). Using resting electroencephalographic (EEG) recordings, the source localization (LORETA) method allowed us to calculate the hemispheric asymmetry of the current density within the alpha band (7.5–13 Hz) in ten regions of interest. Compared to low BAS subtrait scorers, high BAS subtrait scorers (except for BAS–I) were correlated with greater relative left-sided activity in the superior frontal gyrus (BA10). Further, an isolated effective coherence (iCOH) analysis of the beta activity (21 Hz) disclosed that high impulsive scorers as compared to low impulsive ones had higher connectivity between the superior frontal gyrus and middle temporal gyrus, which was not compensated for by enhanced inhibitory alpha (11 Hz) connectivity between these regions. For the beta frequency, we also found in highly impulsive individuals that (i) both left and right middle temporal lobes directly influenced the activity of the left and right superior frontal lobes, and (ii) a clear decoupling between left and right superior frontal lobes. These findings could indicate reduced control by the supervisory system in more impulsive individuals. [ABSTRACT FROM AUTHOR]

This study explored the electrocortical correlates of conscious and nonconscious perceptions of emotionally laden faces in neurotypical adult women with varying levels of autistic-like traits (Autism Spectrum Quotient—AQ). Event-related potentials (ERPs) were recorded during the viewing of backward-masked images for happy, neutral, and sad faces presented either below (16 ms—subliminal) or above the level of visual conscious awareness (167 ms—supraliminal). Sad compared to happy faces elicited larger frontal-central N1, N2, and occipital P3 waves. We observed larger N1 amplitudes to sad faces than to happy and neutral faces in High-AQ (but not Low-AQ) scorers. Additionally, High-AQ scorers had a relatively larger P3 at the occipital region to sad faces. Regardless of the AQ score, subliminal perceived emotional faces elicited shorter N1, N2, and P3 latencies than supraliminal faces. Happy and sad faces had shorter N170 latency in the supraliminal than subliminal condition. High-AQ participants had a longer N1 latency over the occipital region than Low-AQ ones. In Low-AQ individuals (but not in High-AQ ones), emotional recognition with female faces produced a longer N170 latency than with male faces. N4 latency was shorter to female faces than male faces. These findings are discussed in view of their clinical implications and extension to autism. [ABSTRACT FROM AUTHOR]