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Introduction. Anorexia nervosa severely impacts the physical body and mental body (i.e., body image). In this retrospective study, we investigated the relationship between the perceived body image and body composition in women with anorexia nervosa. Specifically, we aimed to verify what components (i.e., weight, body composition, and micronutrients) may predict a higher number of symptoms of negative body image in this clinical condition. Methods. Weight status and body composition, including the expressions of vitamins, and body image concerns were measured in a sample of 112 women with anorexia nervosa (age in years M = 26.78; SD = 12; range = 14–67). Results. According to the regression analysis, a higher skeletal muscle mass and a higher concentration of vitamin B6 seemed to predict a higher number of symptoms of negative body image in our sample. Conclusions. This study pointed out muscle mass and the concentration of vitamin B6 as involved in the psychological expression of body image concerns in anorexia nervosa, especially at the beginning of the disease. Thus, we may suggest including and monitoring these parameters in routine care for anorexia nervosa. [ABSTRACT FROM AUTHOR]

Background/Objectives: Although manual therapies can be used for pain alleviation in fibromyalgia, there is no clear evidence about the processing of gentle, affective touch in this clinical condition. In fact, persistent painful sensations and psychological factors may impact the hedonic experience of touch. Methods: This observational cross-sectional study compared the subjective experience of affective touch between 14 women with fibromyalgia (age range: 35–70; range of years of education: 5–13) and 14 pain-free women (age range: 18–30; range of years of education: 13–19). The participants rated the pleasantness of slow and fast touches delivered by a brush, the experimenter's hand, and a plastic stick. Tactile stimuli were either imagined or real to disentangle the contribution of top-down and bottom-up sensory components. Additionally, a self-report questionnaire explored the lifetime experiences of affective touch. Results: Akin to healthy counterparts, individuals with fibromyalgia rated slow touches delivered by the experimenter's hand or a brush as more pleasant than fast touches, regardless of whether they were imagined or real. However, the intensity of pain affects only the imagined pleasantness in our participants with fibromyalgia. Furthermore, despite the fibromyalgia patients reporting fewer experiences of affective touch in childhood and adolescence, this evidence was not associated with the experimental outcomes. Conclusions: The hedonic experience of affective touch seems preserved in fibromyalgia despite poor intimate bodily contact in youth. We confirmed that bottom-up and top-down factors contribute to the affective touch perception in fibromyalgia: bodily pain may impact even more the expected pleasure than the actual experience. Future investigations may introduce neurophysiological measures of the implicit autonomic responses to affective touch in fibromyalgia. To conclude, although preliminary, our evidence may be in favor of manual therapies for pain relief in fibromyalgia. [ABSTRACT FROM AUTHOR]

Impulsivity is known to influence food choices. We explored possible differences in its expression between individuals with or without an eco-sustainable diet and its relationship with cognitions and behaviours about eco-sustainable foods. Participants were categorised as having or not having an eco-sustainable diet. Impulsivity traits and cognitions and behaviours about sustainable food products were measured. Among the 332 participants, 92.78% showed an eco-sustainable diet, whereas only 7.22% had an eco-sustainable diet. No difference between groups emerged about impulsive traits, whereas significant differences emerged in cognitions and behaviours about sustainable foods, with the only exceptions of subjective norms and past behaviour. Impulsive traits were linked to cognitions and behaviours differently within groups. Impulsivity traits may be related to actions towards eco-sustainable foods, with the perception of their availability playing a crucial role. Increasing contextual opportunities may be fundamental for having eco-sustainable consumers [ABSTRACT FROM AUTHOR]

Objective Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity—a risk factor for suicidal ideation per se—could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation. Methods In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected. Results 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation. Discussion The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation. [ABSTRACT FROM AUTHOR]

Background: The evidence about facial emotion recognition in anorexia nervosa as the role of alexithymic traits on this emotional ability is conflicting and heterogeneous. Objective: We assessed the capability of recognizing facial expressions of two primary emotions, fear, and anger, in the context of anorexia nervosa. Methods: Women affected by anorexia nervosa were compared with healthy weight women in a well-established implicit facial emotion recognition task. Both reaction time and level of accuracy were computed. Moreover, the individual levels of alexithymia were assessed through a standard self-report questionnaire. Results: Participants with anorexia nervosa reported a significantly lower performance in terms of reaction time and accuracy when the emotion of fear— but not anger—was the target. Notably, such an alteration was linked to the levels of alexithymia reported in the self-report questionnaire. Conclusion: In anorexia nervosa, difficulties in processing facial fearful (but not angry) expressions may be observed as linked to higher expressions of alexithymic traits. We suggested future research in which emotional processing will be investigated taking into account the role of the bodily dimensions of emotional awareness. [ABSTRACT FROM AUTHOR]

Background. Fall represents one of the highest concerns in the healthcare system, especially in medical rehabilitation settings. However, there is a lack of instruments for the assessment of risk falls in the context of musculoskeletal rehabilitation. Methods. This retrospective multisite study aimed to assess the sensitivity and specificity of four fall risk assessment tools (the Functional Independence Measure, the Fall Risk Assessment, the Schmid Fall Risk Assessment Tool, and the ePA-AC) in predicting falls in patients admitted to musculoskeletal rehabilitation in Swiss inpatient facilities. Results. The data relative to 6970 individuals (61.5% females) were analyzed and 685 (9.83% of patients) fall events were registered. The area under the curve (AUC) relative to the Functional Independence Measure was 0.689, 0.66 for the Fall Risk Assessment, 0.641 for the Schmid Fall Risk Assessment Tool, and 0.675 for the ePA-AC. Among the four tools, the Functional Independence Measure had an acceptable discriminatory power in distinguishing between significant events (i.e., patients' falls) and non-events (no falls). Conclusion. None of the assessed tools showed highly satisfying levels of statistical sensitivity or sensibility. However, the Functional Independence Measure could be used to assess the fall risk assessment in musculoskeletal rehabilitation settings, although with some caution, since this questionnaire was not designed for this diagnostic purpose. We strongly suggest urgently designing a tool for risk assessment that is specific to this population and the rehabilitative setting. [ABSTRACT FROM AUTHOR]

Introduction: Pleasant and comforting bodily contacts characterized intimate and affective interactions. Affective touch informs us about others’ emotions and intentions, sustains intimacy and closeness, protecting from loneliness and psychological distress. Previous evidence points to an altered experience of affective touch in clinical populations reporting interpersonal difficulties. However, there is no investigation of affective touch in obesity, which is often associated with negative affective-relational experiences since childhood. Methods: This study aimed to provide the first evidence about the experience of affective touch in obesity by comparing 14 women with obesity with 14 women with healthy weight. Participants rated the pleasantness of both imagined and actual tactile stimuli, which consisted of (i) soft-brush strokes, (ii) touches of the experimenter’s hand, and (iii) of a plastic stick (as control, non-affective, stimulation). Participants should report the pleasantness of each kind of touch. Moreover, we explored lifespan experiences of affective touch and interpersonal pleasure in social contexts through self-report questionnaires. Results: No differences emerged for the pleasantness of affective touch (in both the real and imagery task) between the two groups. However, participants with obesity reported less frequent and less satisfying early experiences of affective touch when compared with the controls. Discussion: Our results spoke in favor of a preserved experience of affective touch when experimentally probed in obesity, despite a limited early exposure to bodily affective contacts. We interpreted our results in the light of the social reconnection hypothesis. Nevertheless, we provided crucial methodological considerations for future research, considering that both the experimenter’s and the brush touch may not resemble adequately real-life experiences, in which affective touch involves intimate people. [ABSTRACT FROM AUTHOR]

Executive attention as a frontal domain ability that is effective in potentially blocking distracting information, reconciling conflicts among simultaneous attentional demands, and regulating impulsive behavior may be impaired in individuals with obesity and cardiovascular disease (CVD). This study aimed (i) to explore the presence of selected cognitive (global cognitive impairment, sensitivity to interference, and attention) and psychological (quality of life, depression, anxiety, and impulsivity) dimensions and (ii) to examine the interactive relationship between attentional dyscontrol—both as a psychological and as a cognitive measure—and the above-mentioned variables in a sample of patients with CVD attending a cardiac rehabilitation program across different body mass index (BMI) levels. Clinical information of 104 patients with CVD was retrospectively collected. Participants were classified into three groups according to their BMI as follows: normal weight (NW = 30), overweight (OW = 19), and obese (OB = 55). Individuals with CVD and a higher BMI showed problems in controlling executive attention—through both neuropsychological and behavioral measures. Specifically, OB patients demonstrated reduced sensitivity to cognitive interference, lower capabilities in divided attention during visual-tracking tasks, and greater impulsivity compared to NW patients. This behavioral characteristic was also found to be correlated with higher levels of anxiety and depression and a lower quality of life. Implications for cognitive rehabilitation were discussed to offer directions for better management of patients with CVD and obesity. [ABSTRACT FROM AUTHOR]

Purpose: In this study, we evaluated changes in attentional capabilities and reasoning among early abstinent alcohol-dependent individuals after a 28-day residential rehabilitation program (not including cognitive treatment). Furthermore, we explored the role of individual characteristics and disease-related factors (i.e., length of alcohol use, history of polysubstance dependence, severity of alcohol use) on spontaneous cognitive recovery. Patients and Methods: Fifty-five patients with a diagnosis of Alcohol Use Disorder (AUD) were consecutively recruited from a residential rehabilitation hospital in Northern Italy. The majority were male (67.3%) with a mean age of 47.83 years (SD = 8.21). The computerized Psychology Experiment Building Language Test Battery was used to assess the performance at the Posner Cueing Test, Go/no-go Task, Trail Making Test (TMT), Tower of London (TOL), and Balloon Analog Risk Scale. The evaluation was performed twice: at the beginning (T0) and at its end (T1, before the hospital discharge). Results: We observed statistically improvements over time in the performance at the: 1) TOL in the time amount required to solve the task (p < 0.001); and 2) TMT in the indexes relative to the number of errors (p = 0.003) and the total time required to solve the task (p < 0.001). Age played a significant role on the changes observed in the score relative to the time amount used by participants to solve the task in TMT (test (p = 0.03) and in TOL (p = 0.02). Moreover, the length of alcohol dependence had an effect on the change observed for the time amount to solve the TMT (time) (p = 0.01). Conclusion: We found spontaneous recovery after alcohol detoxification on some, but not all, cognitive functions assessed in our study. The neuropsychological assessment and the identification of patients with cognitive impairment and specific risk factors (e.g., older age and longer history of alcohol use) is important to orient cognitive rehabilitation and increase the efficacy of AUD treatments. [ABSTRACT FROM AUTHOR]

The Obstructive Sleep Apnea Syndrome (OSAS) significantly impacts cognitive functioning. The prolonged use (more than 3 months) of ventilotherapy with continuous positive airway pressure (CPAP) seems to have positive effects in restoring cognitive difficulties. However, there is poor evidence about its possible short-term effect. We investigated whether the short use (less than 15 days at testing) of CPAP improved the cognitive functioning in fifty individuals with OSAS by collecting retrospective neuropsychological measures about verbal memory and learning, information processing speed, attention (i.e., alerting, orienting, and executive system), and executive functions (i.e., strategic reasoning, problem-solving, and mental planning). The predictive role of days of CPAP use on the neuropsychological scores was assessed by hierarchical multiple linear regression analyses, over and above the possible role of demographics, body mass index, level of OSAS severity, and the level of anxiety and depression. The average number of days since CPAP adaptation was 4.70 (SD = 3.90; range = 0–15). As the days of CPAP adaptation increased, verbal learning and long-term memory significantly improved, contrary to the other assessed domains. Our results show a significant improvement in some cognitive functions even after a short treatment with CPAP, pointing to the importance of the early use of ventilotherapy to rapidly improve cognitive functioning. Identifying which cognitive functions can or cannot be restored with CPAP use may enable the design of complementary neuropsychological interventions focused on those residual difficulties, possibly enhancing patients' compliance to the treatment. [ABSTRACT FROM AUTHOR]

Obesity is a clinical condition that impacts severely the physical body. However, evidence related to the mental representation of the body in action is scarce. The few available studies only focus on avoiding obstacles, rather than participants imagining their own body. To advance knowledge in this field, we assessed the performance of 22 individuals with obesity compared with 30 individuals with a healthy weight in two tasks that implied different motor (more implicit vs. more explicit) imagery strategies. Two tasks were also administered to control for visual imagery skills, to rule out confounding factors. Moreover, we measured body uneasiness, through a standard questionnaire, as body image negativity could impact on other body representation components. Our findings do not show differences in the motor imagery tasks between individuals with obesity and individuals with healthy weight. On the other hand, some differences emerge in visual imagery skills. Crucially, individuals with obesity did report a higher level of body uneasiness. Despite a negative body image and visual imagery differences, obesity per se does not impact on the representation of the body in action. Importantly, this result is independent from the level of awareness required to access the mental representation of the body. [ABSTRACT FROM AUTHOR]

Body ownership (i.e., the conscious belief of owning a body) and sense of agency (i.e., being the agent of one's own movements) are part of a pre-reflective experience of bodily self, which grounds on low-level complex sensory–motor processes. Although previous literature had already investigated body ownership in obesity, sense of agency was never explored. Here, we exploited the sensory attenuation effect (i.e., an implicit marker of the sense of agency; SA effect) to investigate whether the sense of agency was altered in a sample of 18 individuals affected by obesity as compared with 18 healthy-weight individuals. In our experiment, participants were asked to rate the perceived intensity of self-generated and other-generated tactile stimuli. Healthy-weight individuals showed a significantly greater SA effect than participants affected by obesity. Indeed, while healthy-weight participants perceived self-generated stimuli as significantly less intense as compared to externally generated ones, this difference between stimuli was not reported by affected participants. Our results relative to the SA effect pinpointed an altered sense of agency in obesity. We discussed this finding within the motor control framework with reference to obesity. We encouraged future research to further explore such effect and its role in shaping the clinical features of obesity. [ABSTRACT FROM AUTHOR]

The microbiota–gut–brain axis extends beyond visceral perception, influencing higher-order brain structures, and ultimately psychological functions, such as fear processing. In this exploratory pilot study, we attempted to provide novel experimental evidence of a relationship between gut microbiota composition and diversity, and fear-processing in obesity, through a behavioral approach. Women affected by obesity were enrolled and profiled for gut microbiota, through 16S rRNA amplicon sequencing. Moreover, we tested their ability to recognize facial fearful expressions through an implicit-facial-emotion-recognition task. Finally, a traditional self-report questionnaire was used to assess their temperamental traits. The participants exhibited an unbalanced gut microbiota profile, along with impaired recognition of fearful expressions. Interestingly, dysbiosis was more severe in those participants with altered behavioral performance, with a decrease in typically health-associated microbes, and an increase in the potential pathobiont, Collinsella. Moreover, Collinsella was related to a lower expression of the persistence temperamental trait, while a higher expression of the harm-avoidance temperament, related to fear-driven anxiety symptoms, was linked to Lactobacillus. Once confirmed, our findings could pave the way for the design of innovative microbiome-based strategies for the treatment of psychological and emotional difficulties by mitigating obesity-related consequences and behaviors. [ABSTRACT FROM AUTHOR]

The Tower of London (ToL) test is traditionally used to assess strategical reasoning, problem-solving, and mental planning in clinical populations. Here, we provide the Italian standardization norms for the original, 12-problem version of the ToL test. The performance of 216 Italian individuals ranging 18 to 89 in age was scored in terms of both Time (Speed) and Accuracy —the time, and the number of attempts, necessary to find a solution. We performed univariate analyses on separate Time and Accuracy scores, using Age in years, Education in years, and Sex (male vs. female) as predictors. z scores and equivalent scores were provided. Moreover, we performed a bivariate analysis for the assessment of individuals' performance in terms of Time and Accuracy simultaneously. This standardization allows clinicians to use the original, most widespread version of ToL with the Italian population, thus optimizing comparability with other clinical and experimental research worldwide. Critically, this article offers a new statistical perspective on how Time and Accuracy scores, which are typically related to each other, can be combined to obtain a single, consistent clinical categorization that captures most of the information contained in the patient's performance. [ABSTRACT FROM AUTHOR]

Previous research about body size estimation in obesity reported heterogeneous results. This might be related to the fact that the tasks adopted explored different body representations. Classifying the previous studies according to the specific body representation probed (i.e. implicit, explicit or both) might clarify discordant findings. A systematic review and meta-analysis of research articles assessing body size estimation in individuals affected by obesity compared with healthy weight individuals were performed in PubMed and Web of Science. Additional records were identified by reference lists inspection. The last search was run in May 2021. Two independent authors performed data extraction according to predefined criteria. Both groups either overestimated or underestimated the implicit body representation depending on the task used and the body part considered. Conversely, the explicit representation of the body was mainly overestimated by both individuals with obesity and healthy weight. In tasks relying on both these representations, overestimation and underestimation were reported in both groups, possibly depending on the degree of which each procedure relied on the explicit and/or implicit representation of the body. According to the meta-analysis, individuals with obesity tended to be significantly less accurate in body size estimations than participants with healthy weight. We confirmed that heterogeneous findings in body size estimation in obesity are related to the adoption of different tasks, which likely involve different body representations. We discussed the role of body dissatisfaction and altered somatosensation in the lower accuracy observed in obesity. [ABSTRACT FROM AUTHOR]

Purpose: The main aim of the present study was to identify the long-term effects of continuous positive airway pressure (CPAP) treatment in patients co-affected by obstructive sleep apnea syndrome (OSAS) and mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (ADD). Methods: This retrospective multicentre study included patients affected by MCI or ADD, diagnosed according to the core clinical and biomarkers criteria, and presenting comorbid OSAS. Only patients performing at least a 1-year visit during their follow-up to monitor cognitive deterioration and adherence with CPAP treatment were included. Both Mini-Mental State Examination (MMSE) and clinical dementia rating scale (CDR) were conducted during the baseline and the follow-up visits. Results: Twenty-four patients were included in the study and were distributed according to the diagnosis in MCI (n = 8) or ADD (n = 16). There were no significant differences in the variables analysed at baseline between the CPAP non-adherent and CPAP adherent patients. In the whole group, a significant decrease was found in MMSE scores, and a significant increase was found in CDR scores between baseline and follow-up. No longitudinal changes in ESS scores were statistically significant from baseline to follow-up. A significant difference was found for the mean score change of the CDR since CPAP non-adherent patients showed a higher mean change of CDR compared to CPAP adherent patients. No significant differences were found for the mean change of MMSE. Conclusion: These findings highlight the clinical potential of treating OSAS with CPAP to delay cognitive deterioration in patients with MCI or ADD. [ABSTRACT FROM AUTHOR]

Objective: The Psychology Experiment Building Language (PEBL) Test Battery is a recent computerized software for the assessment of cognitive functioning in clinical and healthy populations. However, its applicability for the assessment of old adults and the role of level of familiarity with technology on performance have not been tested. Method: To verify if PEBL Test Battery is sensitive to aging cognitive decline, we assessed young and older adults' performance on the neuropsychological tests relative to the following domains: verbal and visuospatial short-term memory, selective attention, inhibition to interference, planning and problem-solving, set-shifting, and cognitive flexibility. The difference between the two groups was studied taking into account the self-reported level of familiarity with technology, measured through the Attitudes Toward Computers Questionnaire. Results: Old participants showed a lower level of cognitive performance compared with the younger group, in line with the traditional literature about cognitive function decline in aging. However, this difference was not related to the level of familiarity with technology. Conclusion: Our descriptive study seemed to support the applicability of PEBL Test Battery for testing old adults' cognitive functioning. However, some criticisms and future improvements about this computerized battery were discussed for its applicability in clinical, rehabilitative and research contexts. [ABSTRACT FROM AUTHOR]

Continuous positive airway pressure (CPAP) therapy is the standard treatment for obstructive sleep apnea (OSA) syndrome. However, optimizing adherence to CPAP therapy of individuals remains very challenging for clinicians because of the role played by the psychological components. In this study, we verified the changes in cognitions and beliefs of individuals after a four-week multidisciplinary residential rehabilitation program targeting the adaptation to CPAP therapy for OSA syndrome. We assessed the components of perceived risks, confidence toward the treatment, and self-efficacy through the self-report questionnaire, namely the Self-Efficacy Measure for Sleep Apnea (SEMSA) questionnaire. We also explored the role played by the temperamental traits on the changes registered in these components after the treatment. Forty-five participants completed the rehabilitation program, showing a higher level of adherence to the treatment. Significant changes were observed in terms of confidence toward the treatment, although no change was reported in terms of perceived risks and self-efficacy. Moreover, those individuals with a higher persistent temperamental trait reported a significant improvement in perceived risks, in the absence of other significant results. After the rehabilitation treatment, our participants were more prone to consider the effect of CPAP treatment on health outcomes. This was in line with the educational aim of the rehabilitation treatment. The temperament seemed to play only a marginal role in the global changes reported by our participants. We discussed the need for behavioral interventions, in addition to education, in improving self-efficacy. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aims to provide an accessible summary of available evidence on the efficacy of motivational interventions to increase adherence to Continuous Positive Airway Pressure (CPAP) among patients with Obstructive Sleep Apnea Syndrome (OSAS) and of their specific aspects and strategies by assessing adherence measures. Methods: A literature search was performed in PubMed, Scopus, Medline, PsycINFO, and Web of Science databases using the concepts of "obstructive sleep apnea syndrome," "continuous positive airway pressure," "motivational intervention," and "adherence." Rigorous inclusion criteria and screening by at least two reviewers were applied. Data were extracted to address the review aims and were presented as a narrative synthesis. Results: Search for databases produced 11 randomized controlled trials, all including naïve CPAP users. Findings showed that motivational interventions were more effective than usual care and educational programs in increasing adherence to CPAP, despite results were not always maintained over time across studies. Discussion: To our knowledge, this is the first scoping review of the literature aimed to explore the characteristics and impact of motivational interventions to promote adherence to CPAP in patients with OSAS. More research providing a detailed description of motivational strategies, and testing of their association with positive treatment outcomes via both direct and indirect measures are needed to increase awareness on active mechanisms of change. [ABSTRACT FROM AUTHOR]

Evidence about the psychological functioning in individuals who survived the COVID-19 infectious is still rare in the literature. In this paper, we investigated fearful facial expressions recognition, as a behavioural means to assess psychological functioning. From May 15th, 2020 to January 30th, 2021, we enrolled sixty Italian individuals admitted in multiple Italian COVID-19 post-intensive care units. The detection and recognition of fearful facial expressions were assessed through an experimental task grounded on an attentional mechanism (i.e., the redundant target effect). According to the results, our participants showed an altered behaviour in detecting and recognizing fearful expressions. Specifically, their performance was in disagreement with the expected behavioural effect. Our study suggested altered processing of fearful expressions in individuals who survived the COVID-19 infectious. Such a difficulty might represent a crucial sign of psychological distress and it should be addressed in tailored psychological interventions in rehabilitative settings and after discharge. [ABSTRACT FROM AUTHOR]

To locate our body in the space, we rely on an implicit representation of body size and shape: the body model. Evidence about the implicit representation of bodily dimensions in obesity is rare. Nevertheless, it seems to suggest that such representation is not altered in obesity compared to healthy weight individuals. To probe further this hypothesis, we investigated the implicit representation of hand dimensions with a landmark localisation task, comparing individuals with obesity and healthy weight individuals. Furthermore, as body model distortions may be related to tactile acuity, the tactile acuity threshold was measured using a two-point discrimination task. In accordance with the previous evidence, we observed that healthy weight participants showed a significant under estimation of finger length and over estimation of hand width. Interestingly, comparable body model distortions were shown also in participants with obesity. No differences in tactile acuity emerged between the two groups; also, when considering the whole sample, as tactile acuity decreases hand width overestimation increases. Thus, obesity seems to have no effect on the characteristics of the body model relative to the hand. Accordingly, the physiological mechanisms supporting the development of the implicit representation of hand dimensions in the healthy weight population may be preserved in obesity. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) syndrome severely affects psychological well-being. This syndrome frequently occurs in obesity; however, no previous study has investigated the level of psychological well-being in the case of OSA syndrome associated with obesity. In this work, we assessed the level of psychological well-being in fifty-two individuals affected by OSA syndrome and obesity through the Psychological General Well-Being Index. Moreover, we investigated the role of personality, cognitive functioning and attentional capabilities, subjective perception and objective measurement about sleeping, on the subjective perception of psychological well-being. Our sample reported a lower level of psychological well-being; the participants' scores were below the normative cut-off in all components, except for depression symptoms. A lower expression of harm avoidance temperament and a lower level of daily sleepiness predicted a higher level of psychological well-being. Psychological well-being seemed to be severely affected in individuals affected by OSA syndrome and obesity. The temperament and subjective perception of daily alertness and sleepiness, rather than the syndrome severity, seemed to play a crucial role in the individual perception of the psychological well-being. [ABSTRACT FROM AUTHOR]

Preliminary evidence showed a reduced temporal sensitivity (i.e., larger temporal binding window) to audiovisual asynchrony in obesity. Our aim was to extend this investigation to visuotactile stimuli, comparing individuals of healthy weight and with obesity in a simultaneity judgment task. We verified that individuals with obesity had a larger temporal binding window than healthy-weight individuals, meaning that they tend to integrate visuotactile stimuli over an extended range of stimulus onset asynchronies. We point out that our finding gives evidence in support of a more pervasive impairment of the temporal discrimination of co-occurrent stimuli, which might affect multisensory integration in obesity. We discuss our results referring to the possible role of atypical oscillatory neural activity and structural anomalies in affecting the perception of simultaneity between multisensory stimuli in obesity. Finally, we highlight the urgency of a deeper understanding of multisensory integration in obesity at least for two reasons. First, multisensory bodily illusions might be used to manipulate body dissatisfaction in obesity. Second, multisensory integration anomalies in obesity might lead to a dissimilar perception of food, encouraging overeating behaviours. [ABSTRACT FROM AUTHOR]

The Rubber Hand Illusion (RHI) is used widely to investigate the multisensory integration mechanisms that support bodily self-consciousness and, more specifically, body ownership and self-location. It has been reported that individuals affected by obesity show anomalous multisensory integration processes. We propose that these obesity-induced changes could lead to an unusual susceptibility to the RHI and anomalous bodily self-experience. To test this hypothesis, we administered a modified version of the RHI (using a picture of the participant's hand) to individuals affected by obesity and participants with a healthy weight. During synchronous and asynchronous stimulation, we compared the subjective experience of the illusion (using a questionnaire) and the effect of the illusion on self-location (i.e., proprioceptive drift). In accordance with the illusion phenomenology, both groups had a comparable subjective illusory experience after the synchronous stimulation. Nevertheless, individuals affected by obesity showed less recalibration of self-location than healthy weight participants. In light of a recent interpretation of the multisensory integration mechanisms that underpin the RHI, our findings suggest that in obesity visuo-tactile integration supporting the subjective experience of the illusion is preserved, whereas visuo-proprioceptive integration for self-location is reduced. [ABSTRACT FROM AUTHOR]

A growing body of evidence demonstrated that it is feasible to induce ownership over an artificial body to alter bodily experience. However, several uncharted aspects about full-body illusion applications need to be tackled before a complete exploitation of these methods in clinical practice. This work is devoted to explore possible individual age-related differences in shaping changes in body representations induced with a full-body illusion. A total of 40 women were divided into two different age groups according to the median of the variable age. Participants estimated the width of three different body parts (i.e., shoulders, abdomen, and hips) before the entire illusion was induced (baseline), and after the synchronous and the asynchronous conditions. Results revealed that 26-to-55-year-old participants were more resistant to changes induced by the bodily illusion, whereas 19-to-25-year-old participants underestimated their bodies after both conditions. The findings were discussed in terms of the literature exploring age differences in responses to bodily illusion, which could suggest a Bayesian mechanism underlying these individual differences. [ABSTRACT FROM AUTHOR]

Non-organic vision loss (NOVL), a functional partial or global vision loss, might be considered a manifestation of conversion disorder. The few previous studies focused on investigating the relationship between cerebral activity and subjective symptoms in NOVL; however, the emotional processing is still neglected. In the present case-controls study, we investigated the capability of two individuals diagnosed with NOVL to recognize implicitly the emotions of fear and anger; this was assessed through a facial emotion recognition task based on the redundant target effect. In addition, the level of alexithymia was measured by asking them to judge explicitly their ability to identify and describe emotions. Both individuals showed selective difficulties in recognizing the emotion of fear when their performance was contrasted with a matched control sample; they also mislabeled other emotional stimuli, judging them as fearful, when they were not. However, they did not report alexithymia when measured using a standard questionnaire. This preliminary investigation reports a mismatch between the implicit (i.e., the behavior in the experimental paradigm) and the explicit (i.e., the subjective evaluation of one's own emotional capability) components of the emotional processing in NOVL. Moreover, fear seems to represent a critical emotion in this condition, as has been reported in other psychiatric disorders. However, possible difficulties in the emotional processing of fear would emerge only when they are inferred from an implicit behavior, instead of a subjective evaluation of one's own emotional processing capability. [ABSTRACT FROM AUTHOR]

Objective: The Cognitive Estimation Test (CET) is widely used in clinical and research settings to assess the ability to produce reasonable estimates to items that individuals would not know that the exact answer (e.g., "How fast do race horses run?"). We examined the performance of non-demented Parkinson's disease (PD) patients on the CET, because previous studies reported heterogeneous results about possible cognitive estimation impairments in PD. We also examined whether PD patients improve their performance if given the chance to reconsider their initial CET responses. Methods: Thirty non-demented idiopathic PD patients and 30 healthy controls matched in age, gender and years of education performed the two parallel forms of Italian CET. The estimation scores for initial and final responses as well as the number of times individuals changed their answers were examined. Additional neuropsychological tests, evaluating intellectual, frontal executive, speed of processing, naming and arithmetical abilities, were also administered. Results: The PD group were not significantly poorer than healthy controls at estimating the answers to items on either CET versions. Moreover, PD patients did not significantly differ in their initial and final responses or number of response changes. Performance on the CET was significantly related to performance on a global measure of executive function, processing speed and arithmetic. However, PD patients were impaired compared to controls on the component involving mainly, but not exclusively, length-related estimations. Conclusions: Non-demented PD patients have mild impairments in cognitive estimation ability, which may depend on the estimations they are required to provide. [ABSTRACT FROM AUTHOR]

The Stroop Color and Word Test (SCWT) is a neuropsychological test extensively used to assess the ability to inhibit cognitive interference that occurs when the processing of a specific stimulus feature impedes the simultaneous processing of a second stimulus attribute, well-known as the Stroop Effect. The aim of the present work is to verify the theoretical adequacy of the various scoring methods used to measure the Stroop effect. We present a systematic review of studies that have provided normative data for the SCWT. We referred to both electronic databases (i.e., PubMed, Scopus, Google Scholar) and citations. Our findings show that while several scoring methods have been reported in literature, none of the reviewed methods enables us to fully assess the Stroop effect. Furthermore, we discuss several normative scoring methods from the Italian panorama as reported in literature. We claim for an alternative scoring method which takes into consideration both speed and accuracy of the response. Finally, we underline the importance of assessing the performance in all Stroop Test conditions (word reading, color naming, named color-word). [ABSTRACT FROM AUTHOR]

Aim: The relationship between dizziness and falls in the obese population is a relatively unexplored issue. The aims of the present study were to define the 1-year prevalence of dizziness in an obese inpatient population undergoing metabolic rehabilitation and to investigate possible correlations with fall events. Materials and Methods: We recruited 329 obese subjects: 203 female (BMI 43,74 kg/m2 ± 0.5 SE; age 17–83 years, 58.33 ± 0.9 SE) and 126 male (BMI 44,27kg/m2 ± 0.7 DE age 27–79 years, 58.84 ± 1 SE). To assess dizziness we used the validated Italian version (38) of the Dizziness Handicap Inventory (DHI). Results: Out of the experimental sample, 100 subjects did not complain of dizziness and felt confident about their balance control, while 69.6% reported some degree of dizziness. Their mean DHI score was 22.3, which corresponds to mild dizziness. Twenty-one percent reported more severe dizziness (DHI score > 40). The majority of our sample reported minor dizziness and its perception appears to be independent from BMI: DHI scores were consistent across classes of obesity. Discussion: The rate of dizziness and falls (30.1%) in this obese population was higher than that previously reported in a general matched population. However, obese subjects, in our sample, seem to underestimate their risk of fall and DHI score does not appear a reliable predictor of falls. Since complications associated with falls in obese persons generally require longer treatments than in lean individuals, our findings should be taken into account in order to identify other predictors, including cognitive and perceptual, of risk of fall and to implement fall prevention programs. [ABSTRACT FROM AUTHOR]

Introduction: The available clinical guidelines for super-super obese patients (i.e., with body mass index (BMI) > 60 kg/m²) that are not suitable for bariatric surgery mandate a palliative multidisciplinary treatment (i.e., production and maintenance of weight loss) provided in a center of excellence. However, the modality and the impact of this approach are still controversial. Moreover, it is not able to address the high level of body dissatisfaction and body distortions that are common among these patients. Clinical Presentation: We report the case of a non-operable super- super obesity - a 37 year old woman with a BMI of 62 kg/m² - receiving a specialized treatment for her obstructive sleep apnea. She entered a multidisciplinary program that promoted healthy behaviors, including physical activities and psychological intervention. To improve body dissatisfaction, which was linked to a significant multisensory impairment of body perception, she also entered a virtual reality (VR) body-swapping illusion protocol. At the end of the current investigation, the patient continued her multidisciplinary program, reporting an increase in the motivation for undertaking healthy behavior and a decrease in the anxiety feelings associated with her clinical condition. Conclusion: This case provides preliminary evidence that both body dissatisfaction and body-size distortions of non-operable super-super obesity patients could be addressed by a VR body-swapping protocol, which is important because the palliative multidisciplinary treatment recommended for these patients is not able to address them. Interestingly, the use of a VR body-swapping illusion protocol seems to be able to improve not only the experience of the body in these patients but their motivation for change, too. [ABSTRACT FROM AUTHOR]

The cognitive estimation test (CET) measures cognitive estimation abilities: it assesses the ability to apply reasoning strategies to answer questions that usually cannot lead to a clear and exact reply. Since it requires the activation of an intricate ensemble of cognitive functions, there is an ongoing debate in the literature regarding whether the CET represents a measurement of global cognitive abilities or a pure measure of executive functions. In the present study, CET together with a neuropsychological assessment focused on executive functions was administered in thirty patients with Parkinson's disease without signs of dementia. The CET correlated with measures of verbal working memory and semantic knowledge, but not with other dimensions of executive domains, such as verbal phonemic fluency, ability to manage real-world interferences, or visuospatial reasoning. According to our results, cognitive estimation abilities appeared to trigger a defined cognitive path that includes executive functions, namely, working memory and semantic knowledge. [ABSTRACT FROM AUTHOR]

Prism adaptation involves a proprioceptive, a visual and a motor component. As the existing paradigms are not able to distinguish between these three components, the contribution of the proprioceptive component remains unclear. In the current study, a proprioceptive judgement task, in the absence of motor responses, was used to investigate how prism adaptation would specifically influences the felt position of the hands in healthy participants. The task was administered before and after adaptation to left and right displacing prisms using either the left or the right hand during the adaptation procedure. The results appeared to suggest that the prisms induced a drift in the felt position of the hands, although the after-effect depended on the combination of the pointing hand and the visual deviation induced by prisms. The results are interpreted as in line with the hypothesis of an asymmetrical neural architecture of somatosensory processing. Moreover, the passive proprioception of the hand position revealed different effects of proprioceptive re-alignment compared to active pointing straight ahead: different mechanisms about how visuo-proprioceptive discrepancy is resolved were hypothesized. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is frequently characterized by cognitive and affective dysfunctions. The 'Parkinson Neuropsychometric Dementia Assessment' (PANDA) is a screening tool designed for the early detection of mild cognitive impairment as well as dementia in PD. The PANDA is already validated in German and in French. Objective: The aim of the present work was to provide normative data for the Italian-speaking population, Swiss regions included; moreover, the effectiveness of the PANDA compared to the Mini Mental State Examination (MMSE) was tested. Methods: One-hundred and eleven PD patients with and without cognitive impairment and one-hundred and three matched healthy subjects participated at this study; all patients underwent an extensive neuropsychological evaluation. Results: A PANDA total score of 13 appeared to be the most fitting cut-off with a sensitivity of 96.6% and a specificity of 82.2%; with the MMSE, the same value of sensitivity but with a specificity of 72,4% was reached only by adopting a cut-off of 28. Moreover, a PANDA range of 13-17 appeared to be suggestive for possible cognitive disturbance. Conclusions: The present work provides evidence for the effectiveness of the PANDA in evaluating cognitive deficits also in PD Italian-speaking patients, even when their pathological degree is still initial or very mild. [ABSTRACT FROM AUTHOR]

Abstract: Background and purpose: Anxiety and depression are common psychological conditions in post-stroke patients. In the present study, their relation with perceived quality of life and psychophysical well-being was investigated. Methods: In the present cross-sectional study, chronic post-stroke patients (n =81; average years from stroke=4±4.6) were assessed with the Hospital Anxiety and Depression Scale (HADS), the 36-item Short-Form Healthy Survey (SF-36) and the Psychological General Well-Being Index (PGWBI), as well as a brief neuropsychological assessment focused on the thinking ability and executive functions. Results: Higher levels of anxiety compared to depressive symptoms were found. Hierarchical multiple regressions indicated that SF-36 predicts neither anxiety nor depression, and PGWBI subscales only partially. Conclusion: Post-stroke anxiety can be a largely observed psychological distress in chronic patients: this pattern would be interpreted in relation to patients' expectations about their health status during a rehabilitation follow-up. SF-36 and PGWBI questionnaires did not provide satisfactory and reliable indexes: the relation between anxiety and both quality of life and psychological well-being needs further exploration. [Copyright &y& Elsevier]

Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.

Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive—Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post—Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper.