Pycnogenol® improves cognitive function in post-stroke patients: a 6 month-study

BACKGROUND

This pilot study in post-stroke patients evaluated the effects of supplementation with Pycnogenol® on alterations in cognitive functions (COFU) over a period of 6 months, starting 4 weeks after the stroke.

METHODS

The effects of supplementation - possibly acting on residual brain edema, on global cognitive function, attention and on mental performance - were studied. A control group used standard management (SM) and the other group added Pycnogenol®, 150 mg daily to SM.

RESULTS

38 post-stroke patients completed the 6-month-study, 20 in the Pycnogenol® group and 18 in the control group. No side effects were observed with the supplement. The tolerability was very good. The patients included into the two groups were comparable for age, sex and clinical distribution. There were 2 dropouts in the control group, due to non-medical problems. Main COFU parameters (assessed by a cognitive questionnaire) were significantly improved (all single items) with the supplement compared to controls (P<0.05). Additional observations indicate that Pycnogenol® patients experienced significantly less mini-accidents (including falls) than controls (P<0.05). The incidences of (minor) psychotic episodes or conflicts and distress and other problems including rare occurrence of minor hallucinations, were lower with the supplementation than in controls (P<0.05). Single observations concerning daily tasks indicated a better effect of Pycnogenol® compared to controls (P<0.05). Plasma free radicals also decreased significantly with the supplement in comparison to controls (P<0.05). Globally, supplemented subjects had a better recovery than controls.

CONCLUSIONS

In post-stroke subjects, Pycnogenol® supplementation resulted in better recovery outcome and faster COFU 'normalization' after the stroke in comparison with SM; it can be considered a safe, manageable post-stroke, adjuvant management possibly reducing local brain edema. Nevertheless, more patients and a longer period of evaluation are needed to confirm these results.

Prevention and control of jet lag symptoms and temporary impairment of cognitive function with Pycnogenol® in healthy individuals and in hypertensives

BACKGROUND

The aim of this registry study was to evaluate the efficacy of Pycnogenol® in controlling signs/symptoms and temporary impairment of cognitive function (COFU) associated with jet lag. Previous flight studies have shown a decrease in the level of jet lag symptoms with Pycnogenol®. The control of jet lag signs/symptoms appeared to be correlated with flight-related microangiopathy and peripheral edema. Pycnogenol® - a standardized extract from the bark of French maritime pine - has significant antiedema, anti-inflammatory and antioxidant properties.

METHODS

A group of subjects flying east in economy class for 10-12 hours used Pycnogenol® 150 mg/day and a similar group without supplementation served as controls. A subgroup of mild hypertensive subjects using a single ACE inhibitor was also included.

RESULTS

One hundred twenty-seven subjects completed the study. Of the participants, 48 were aviation professionals like pilots, flight attendants or air company staff - 24 of them took Pycnogenol® and 24 served as controls. Forty-seven study participants were frequent flyers and non-staff professionals, 25 of which took Pycnogenol® and 22 served as controls. In addition, a group of 32 subjects with mild hypertension was included, 16 took Pycnogenol® and 16 served as controls. No side effects and a good tolerability were observed. The registry groups were comparable for baseline characteristics. Eastbound flights' duration was 11.22±0.4 hours in supplemented subjects and 11.14±0.32 in controls. Dropouts were due to logistical problems. Post flight Visual Analogue Scale (VAS) scores were significantly lower in all Pycnogenol® groups, including hypertensives for all signs and symptoms of jet lag compared to controls, showing prevention and improvement of jet lag symptoms. The duration of any sign/symptom of jet lag with Pycnogenol® intake was significantly shorter (P<0.05) post-flight compared to controls (P<0.05). The number of nights of altered/disturbed sleep was also lower in the Pycnogenol® groups compared to controls. Leg edema was present in almost all subjects with different degrees especially in the hypertensive group. The increase in ankle circumference before and after flight was significantly lower with Pycnogenol® compared to controls (P<0.05). After the flight, average scores of the single COFU tasks were significantly higher in the Pycnogenol® groups compared to controls, showing preserved cognitive function.

CONCLUSIONS

In conclusion, in this registry study Pycnogenol® was effective in preventing jet lag-related symptoms and preserving cognitive functions without tolerability problems. These observations should be tested in a larger group of subjects including complex individuals prone to edema (i.e. diabetics, hypertensive or older patients).

The efficacy of telephone-delivered cognitive behavioral therapy in people with chronic illnesses and mental diseases: A meta-analysis

COVID-19 pandemic led to an increase of remote treatments, such as telephone-delivery cognitive behavioral therapy (T-CBT). To our knowledge, no meta-analyses studied the effect of T-CBT in chronic and/or mental illnesses on multiple psychological outcomes. Therefore, our study aims to evaluating the efficacy of T-CBT compared to other interventions (treatment as usual, TAU, or face-to-face CBT). Each effect size (ES) was calculated in Hedges' g and pooled together to produce a mean ES for each outcome (depression, anxiety, mental and physical QoL, worry, coping, and sleep disturbances). The meta-analysis included 33 studies with a randomized controlled trial design. A large ES was found when comparing the efficacy of T-CBT against TAU on depression (g = 0.84, p < 0.001), whereas a moderate ES was found on anxiety (g = 0.57; p < 0.001), and a small effect on mental quality of life (g = 0.33, p < 0.001), sleep disturbances (g = 0.37, p = 0.042), coping (g = 0.20, p = 0.016) and worry (g = 0.43, p = 0.001). The meta-analysis comparing the efficacy of T-CBT and CBT on depression revealed a not significant pooled ES (g = 0.06, p = 0.466). The results provided evidence that T-CBT could be to be more effective than TAU conditions in multiple psychological outcomes, and as efficient as face-to-face CBT in treating depression.

Psychometric properties of a new instrument for the measurement of the perceived quality of distance learning during the coronavirus disease 2019 (COVID-19) pandemic

Introduction

The lockdown restrictions due to the COVID-19 pandemic forced many students to use distance learning. Few studies have examined the psychological effects of distance learning during the pandemic on university or on non-university students using a specific psychometric tool. The principal aim of this study was the construction and validation of a new psychometric tool, the Perceived Quality of Distance Learning (PQDL), to measure students' appreciation and reaction to distance learning. The connection between anxiety, depression, perceived self-efficacy, and students' perception of distance learning was analyzed to assess the nomological validity of the new scale.

Method

The sample consists of 429 students who attended university or training courses. The factor structure of the new instrument was analyzed through Exploratory and Confirmatory Factor Analyses and its nomological validity was analyzed through regression analysis.

Conclusion

The results showed that PQDL consists of two subscales: Distance Learning Organization and Cognitive-Emotive Reaction to Distance Learning. Higher student's ability to organize and plan distance learning and higher student's positive cognitive-emotive reaction to distance learning, higher student's perceived quality of distance learning. Anxiety and depression scores were negatively correlated with students' perceived quality of distance learning. Furthermore, students' perceived emotional self-efficacy of negative emotions and perceived scholastic self-efficacy were positively correlated with students' perceived quality of distance learning. These data indicate that PQDL is a reliable questionnaire to assess student's perceived quality of distance learning.

The location of emotional intelligence measured by EQ-i in the personality and cognitive space: Are there gender differences?

Introduction

Emotional Intelligence (EI) is first described by Salovey and Mayer as the ability to perceive and understand emotions and the ability to use them as supports for thoughts. Despite the great notoriety of EI, its definition remains not completely clear. An operative definition of EI can be achieved by studying its connection with other individual characteristics such as gender, personality traits, and fluid intelligence.

Methods

The sample was composed of 1,063 Italian subjects. A total of 330 participants were employed (31.0%; 57.9% men) and 702 were university students (66.0%; 38.7% men). The Emotional Quotient Inventory (EQ-i), one of the most used questionnaires in literature, was used to measure EI. The exploratory structural equation modeling (ESEM) was used to assess the role of personality traits (five-factor model of personality) and fluid intelligence in EI. Statistical analyses on differences between men and women means of total and subscale EQ-i scores were estimated to evaluate whether EI, measured by EQ-i, is influenced by gender. Furthermore, a Multigroup Confirmatory Factor Analysis was conducted to assess measurement invariance in relation to gender groups.

Results

Emotional Intelligence, measured by EQ-i, is prevalently connected with personality traits rather than fluid intelligence. Furthermore, men outperformed women in the Intrapersonal and Stress Management EI factors, and women outperformed men in the Interpersonal EI factor. No difference in the means of the EI total score and EI latent general factor did not differ between gender groups.

Conclusion

Emotional Intelligence, measured by EQ-i, can be conceptually considered as a Trait EI. Furthermore, men are more capable to cope with negative events and to control impulses, while women are more able to distinguish, recognize, and comprehend others' emotions.

Scholastic psychological well-being and irrational thoughts in students of primary and secondary school: An Italian study

The period of pre-adolescence is a period of age transition during which undesirable feelings such as anxiety, shyness, guilt, depression and anger are experienced accompanied by physical and hormonal changes experienced during puberty. Therefore, during early adolescence the psychological well-being is a critical issue. This period of transition coincides to the passage from the primary to the secondary school in Italy. This transition could have some effects on the psychological well-being on children, in particular on their scholastic well-being. In addition, during early adolescence children develop irrational thoughts. We tested, therefore, the variation of scholastic well-being and irrational thoughts in children of the primary (n = 50; mean age 10.5; 56 % females) and secondary school (n = 61; mean age 11.5; 49 % females). Results showed that children of the secondary school have lower scholastic well-being and higher level of irrational thoughts than children of primary school. In particular, during the transition from the primary to the secondary school, children showed a lower level of satisfaction with academic results and the perception of a low support from their teachers. In addition, there was also a stronger reduction of self-esteem and an increment of distrust in achieving scholastic success. A scholastic psychological support, with particular attention to the emotional development of early-adolescents, is suggested.

Telerehabilitation proposal of mind-body technique for physical and psychological outcomes in patients with fibromyalgia

Fibromyalgia (FM) syndrome is characterized by the close correlation of chronic widespread pain and other non-pain related symptoms. Aim of this study was to investigate whether telerehabilitation that provides physical and psychological support services of the mind-body techniques can affect the clinical profile and pain relief of FM patients. The study included twenty-eight female FM patients, mean aged 56.61 ± 8.56 years. All patients underwent a rehabilitation treatment (8 sessions, 1/week, 1 h/each) through Zoom platform, with the following principles of rehabilitation treatment: Anchoring to a positive emotion; listen and perceive your “own” body; conscious breathing; improve interoceptive awareness; relax. All patients then underwent clinical assessment of the physical distress and fear of movement for the Numeric Rating Scale (NRS); the Fatigue Assessment Scale (FAS); the Fear Avoidance Belief Questionnaire (FABQ); with measures of physical and mental disability for the Fibromyalgia Impact Questionnaire (FIQ); the 12-Items Short Form Survey; the Resilience Scale for Adults and the Coping Strategies Questionnaire-Revised. The evaluations were performed at T0 (baseline), T1 (after 8 weeks of treatment), and T2 (after 1 month of follow-up). The main finding was that telerehabilitation reduced physical and mental distress, fear, and disability (p < 0.001). Resilience and coping ability were less affected by the rehabilitative treatment. Our attempt of mind-body technique telerehabilitation has shown good results in the improvement of painful symptoms and quality of life for the FM patients but showed fewer positive impacts for the resilience and coping abilities aspects.

Intrinsic Shapes of Empathy: Functional Brain Network Topology Encodes Intersubjective Experience and Awareness Traits

Trait empathy is an essential personality feature in the intricacy of typical social inclinations of individuals. Empathy is likely supported by multilevel neuronal network functioning, whereas local topological properties determine network integrity. In the present functional MRI study (N = 116), we aimed to trace empathic traits to the intrinsic brain network architecture. Empathy was conceived as composed of two dimensions within the concept of pre-reflective, intersubjective understanding. Vicarious experience consists of the tendency to resonate with the feelings of other individuals, whereas intuitive understanding refers to a natural awareness of others’ emotional states. Analyses of graph theoretical measures of centrality showed a relationship between the fronto-parietal network and psychometric measures of vicarious experience, whereas intuitive understanding was associated with sensorimotor and subcortical networks. Salience network regions could constitute hubs for information processing underlying both dimensions. The network properties related to empathy dimensions mainly concern inter-network information flow. Moreover, interaction effects implied several sex differences in the relationship between functional network organization and trait empathy. These results reveal that distinct intrinsic topological network features explain individual differences in separate dimensions of intersubjective understanding. The findings could help understand the impact of brain damage or stimulation through alterations of empathy-related network integrity.

Fear of hypoglycemia in children with type 1 diabetes and their parents: Validation of the Italian version of the Hypoglycemia Fear Survey for Children and for Parents

BACKGROUND

Currently, Italian versions of the Hypoglycemia Fear Survey for Children (CHFS) and for Parents (PHFS) quantifying Fear of Hypoglycemia (FoH) in pediatric diabetes are not available.

OBJECTIVE

To validate the Italian version of the CHFS and PHFS.

SUBJECTS AND METHODS

One hundred and seventy-four children with type 1 diabetes aged 6-18 and 178 parents completed the CHFS and PHFS, the PedsQL 3.0 Diabetes module and the KIDSCREEN-10. Internal consistency was good (α = 0.85 for CHFS, α = 0.88 for PHFS); validity was supported by correlations of CHFS total score (CHFS-T r = -0.50; p < 0.001, CI = -0.62 to -0.35) and Worry subscale (CHFS-W r = -0.49; p < 0.001, CI = -0.62 to -0.32) with measures of health-related quality of life (QoL), which were not related to PHFS scores. Factor analyses justified the structure and the separate scoring of Behavior and Worry subscales. Children's age was negatively correlated with CHFS-T (r = -0.16; p = 0.03, CI = -0.36 to 0.00), CHFS-W (r = -0.29; p = 0.02, CI = -0.39 to -0.07), PHFS-T (r = -0.20; p = 0.006, CI = -0.35 to -0.04), PHFS-B (r = -0.30; p = 0.001, CI = -0.43 to -0.17). Mean (SD) item scores of CHFS-T (1.47 ± 0.56 vs. 1.27 ± 0.57; p < 0.05) and CHFS-W (1.20 ± 0.73 vs. 0.96 ± 0.68; p < 0.05) were higher in children with HbA1c ≥7.5%. Higher levels of distress for upsetting hypoglycemia were associated with lower child's QoL scores as perceived by children (Peds-QL: 72.6 ± 12.8 vs. 80.4 ± 11.9; p < 0.001) and parents (Peds-QL: 70.6 ± 13.8 vs. 75.8 ± 12.9; p < 0.05).

CONCLUSION

The Italian version of CHFS and PHFS appears to be a valid measure to assess FoH in clinical practice and factor analysis supports separate scoring for the Worry and Behavior subscales.

Connections between Children's Eating Habits, Mental Health, and Parental Stress

BACKGROUND

Obesity and eating disorders are increasing in occidental countries and can undermine physical and psychological health. Therefore, preventing the insurgency of unhealthy eating habits in childhood is fundamental. Parents can play an important role in assisting pediatricians, psychiatrists, and clinical psychologists in the diagnosis of eating disorders because they have an active role in observing and assessing the quality of their children's eating habits.

METHODS

In our study, we collected data from a sample of children (n = 125) and their parents (n = 161) without symptoms related to eating disorders. Parents assessed the eating habits, behavior problems, and mental health of their children and parental stress. In addition, we measured body mass index, anxiety, and lifestyle in children. Data were analyzed with bivariate correlation and MIMIC models.

RESULTS

Both mothers' and fathers' assessments of children's eating habits are reliable. Unhealthy eating habits are connected with children's behavioral problems and parental stress. We did not find significant differences in feeding styles and ways of assessing the quality of eating habits between mothers and fathers. Our study showed greater sensitivity of mothers toward the physical fitness of their children rather than fathers.

CONCLUSIONS

Mothers and fathers both proved to be good observers of their children's eating behavior, and they could cooperate with medical and psychological operators in preventing the risk of obesity.

Association of COMT, BDNF and 5-HTT functional polymorphisms with personality characteristics

Background: The real impact of genetic factors on personality is still unknown, even if in literature about 50% of variance in personality traits are considered genetically determined. The determination of the genetic variance in personality traits could promote psychological well-being and the prevention of psychopathologies, because there are many experimental evidences showing that mental illness is associated to personality. Numerous studies have showed that Catechol-O-methyltransferase (COMT), brain derived neurotrophic factor (BDNF) and serotonin transporter (5-HTT) are genes whose variants are associated with personality traits. This aim of this study is the investigation of the association between personality traits and 5-HTTLPR/rs255315-HTT promoter variant, COMT Val158Met and BDNF Val66Met gene polymorphisms. Methods: The sample was composed by 132 healthy female students. Genomic DNA was extracted from buccal swab, while personality was assessed with Cloninger's Temperament and Character Inventory-Revised (TCI-R). Linear discriminant analysis was used to analyze how personality characteristics can differentiate individuals in relation to their genetic polymorphisms. Results: Data showed that the temperament trait Reward Dependence discriminated individuals with different BDNF variants; Novelty Seeking and Harm Avoidance discriminated individuals with different 5HTTLPR variants; Persistence discriminated individuals with different COMT variants. Conclusions: Since these traits are connected to psychological diseases as depression, social anxiety, anorexia and obsessive-compulsive disorders of personality, the study of their genetic component can be used as intermediary issue to better define the connection between genes and predisposition toward maladaptive behavior and mental illness.

The Role of Gender in the Association Among the Emotional Intelligence, Anxiety and Depression

Recent epidemiological data show an increase of depression and anxiety that cause a loss of about 3-4% of the gross domestic product in Europe, as a consequence of a reduced productivity and a premature death of people. Gender differences in both psychopathologies were found from mid-to-late adolescence until 55 years, and data indicate an increase of depression in women. Considering these data, new interventions focused on promoting psychological well-being were designed. A predictive factor of psychological disorders is Emotional Intelligence (EI), the ability to understand and regulate our own emotions, as well as those of others. EI is associated with psychological well-being, as well as with the treatment of mental illness, but gender differences in the association among EI, anxiety and depression remains unclear. The present study aims at analyzing the nomological associations among EI, anxiety and depression. Furthermore, the possible moderating role of gender in the relation between EI, depression and anxiety is investigated in a sample of 1725 healthy participants. Our results show that the ability to recognize and to control emotions in the social context helps us to reduce the risk to be affected by depression and anxiety. Moreover, our study shows that the association of EI with anxiety and depression wasn't gender moderated. In conclusion, the findings highlight that EI can help people to manage emotions linked to negative events and to successfully understand emotions in others. In addition, we found no moderation role of gender in the association between EI, anxiety and depression.

Prevention of work-related stress, fatigue, loss of cognitive function, attention and recovery of stamina with Robuvit® in professionals with increased oxidative stress

AIM

The aim of this open, pilot supplement registry study was to evaluate the protective, preventive effects of Robuvit® on professional-related fatigue symptoms and on aspects of cognitive functions, professional attitudes and decision-making in healthy nurses under professional stress and with increased oxidative stress.

RESULTS

In total, 40 subjects, aged 30 - 37, completed the 4-week registry study. A control group of 20 subjects used only the standard management (SM) and one group of 20 subjects took 300 mg Robuvit®. Safety and tolerability of Robuvit® were optimal. The two registry groups were comparable at inclusion. The overall scores of the real daily life & tasks questionnaire after 4 weeks were significantly higher in the Robuvit® group (p<0.05) as compared to controls. It increased from 4.3±0.4 at baseline to 6.78±0.8 after 4 weeks of Robuvit® intake and from 4.2±0.5 to 5.12±1.0 in the control group. The supplementation significantly improved the objective perception of fatigue in comparison with controls (p<0.05). A practical professional score evaluation provided an indication of professional attitude and stamina, in difficult, stressful working conditions under continuous pressure. The results showed that after 4-week supplementation all assessed parameters improved significantly and the difference with controls was statistically significant (p<0.05). Furthermore,oxidative stress as plasma free radicals decreased significant in the Robuvit® group (p<0.05) but not in the control group.

CONCLUSIONS

Robuvit® supplementation appears to improve most symptoms related to work-induced fatigue, stress and cognitive function and supports stamina. Further evaluations need to be planned according to the concept of this pilot registry in a field that requires more attention.

On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis

In recent years a large array of treatment protocols conceptualized as transdiagnostic have been developed with clinical and practical advantages compared to traditional single-disorder protocols. Within this panorama, the Transdiagnostic Unified Protocol (UP) of Emotional Disorders was developed aimed at treating the negative affective processes underlying several diagnostic categories, and accounting for the covariance of different emotional disorders. The UP has been found to efficiently target the roots of these disorders leading to a reduction in symptoms of co-occurring disorders. However, several questions have marginally addressed in the previous studies, and some UP features still remain unexplored. The present meta-analysis aims at evaluating whether the UP results to significant changes in anxiety and depression symptoms severity in children, adolescents, and adults. 19 RCTs and 13 uncontrolled pre-post trials comprising 2183 patients/clients met inclusion criteria for meta-analysis. Large to moderate combined overall effect size for both depression plus anxiety were detected in the uncontrolled pre-post studies (g = 0.756) and in RTCs studies (g = 0.452), respectively. Large effect size at pre-treatment to 3-6-month follow-up was observed for combined depression plus anxiety (g = 1.113). Subgroup analysis suggested that UP treatment does not differ across the anxiety and depression self-report measures. Moreover, UP intervention outperformed both passive and active control conditions to treat negative affective syndromes. Meta-regression confirmed the moderate effects of therapist level of experience, the sample characteristics, and the UP-protocol adaptations. The findings indicate that the manualized UP treatment has potential to contribute to improving mental health outcomes, particularly of anxiety and depression.

Does a Fundamentalist Mindset Predict a State or Trait Anxiety? The Covariate Role of Dogmatism

Recent neuropsychological studies reported that fundamentalism beliefs and its cognitive mindset provoke sense of coherency and protection against the ambiguity as well as a rapid doubt resolution and thus offer relief from distress and uncertainty. In this study, we examined whether the need for closure dimensions predicted religious fundamentalism. Further, we tested if pronounced religious beliefs (also controlled for dogmatism) would be associated with a state or trait anxiety, in a sample of 388 Roman Catholics (females = 53.9%). Path analysis (SEM), with observed variables, was used to determine the pathways by which religious fundamentalism, need for closure dimensions, and dogmatism interacted to influence anxiety. The results revealed that religious fundamentalism was predicted by intolerance to ambiguity, preference for order, and closed-mindedness; in turn, high fundamentalism scores predicted state anxiety exclusively. Additionally, when controlling for dogmatism, the fundamentalism-anxiety path became nonsignificant. Although it seemed that fundamentalism beliefs "per se" have played no direct anxiolytic effect, they partially perform a function of avoiding chaos and disorder in order to maintain cognitive integrity.

Physical and Psychological Impact of the Phase One Lockdown for COVID-19 on Italians

The exceptional pandemic due to the 2019 coronavirus disease (COVID-19) has obliged all Italians to stay at home. In the literature, there are evidences that traumatic global events, such as natural catastrophes and pandemic, have negative effects on the physical and psychological health of the population. We carried out a survey to analyze the physical and psychological conditions of Italians during the pandemic. Due to the severe limitations in moving during the phase one lockdown, the survey was administered by internet. Results show that Italians followed the provisions established by the Italian government to avoid contamination, but 43% of them declared to have suffered from physical symptoms, in particular migraine, sleep disorders, persistent exhaustion, and difficulty of concentration. They have great fear to be contaminated or that relatives or friends can be contaminated, and they actively take actions to avoid contamination. Participants declared that they had suffered a lot of inconveniences due to restrictions in their movements, and that their life habits were strongly changed. They spent their time at home in different activities, but their psychological well-being was strongly impaired by the lockdown. The level of anxiety tripled, in relation to the prepandemic period, and 30% of males and 41% of females declared to have severe levels of depression. Participants with high levels of optimism and hopefulness show a stronger resilience against anxiety and depression. In addition, there is a negative correlation between anxiety and depression and the five factors of personality. These results show that psychological diseases must not be neglected, and that people in lockdown do need support for their psychological health, also with the help of internet and communication technologies.

The WeReha Project for an Innovative Home-Based Exercise Training in Chronic Stroke Patients: A Clinical Study

Background

Telerehabilitation (TR) in chronic stroke patients has emerged as a promising modality to deliver rehabilitative treatment-at-home. The primary objective of our methodical clinical study was to determine the efficacy of a novel rehabilitative device in terms of recovery of function in daily activities and patient satisfaction and acceptance of the medical device provided.

Methods

A 12-week physiotherapy program (balance exercises, upper and lower limb exercises with specific motor tasks using a biofeedback system and exergaming) was administered using the WeReha device. Twenty-five (N = 25) chronic stroke outpatients were enrolled, and the data of 22 patients was analyzed. Clinical data and functional parameters were collected by Berg Balance scale (BBS), Barthel Index (BI), Fugl-Meyer scale (FM), Modified Rankin scale (mRS), and Technology Acceptance Model (TAM) questionnaire at baseline (T0), after treatment (T1), and at the 12-week follow-up (T2). Statistical tests were used to detect significant differences (P < .05), and Cohen's (Co) value was calculated.

Results

BI scores improved significantly after treatment (P = .036; Co 0.776, medium), as well as BBS scores (P = .008; Co 1.260, high). The results in FM scale (P = .003) and mRS scores (P = .047) were significant post treatment. Follow-up scores remained stable across all scales, except the BI. The A and C sub-scales of the TAM correlated significantly to only a T2 to T1 difference for BI scores with P = .021 and P = .042.

Conclusion

Currently, the WeReha program is not the conventional therapy for stroke patients, but it could be an integrative telerehabilitative resource for such patients as a conventional exercise program-at-home.ClinicalTrials.gov identifier: NCT03964662.

Improving the psychometric properties of the dissociative experiences scale (DES-II): a Rasch validation study

BACKGROUND

The Dissociative Experiences Scale-II (DES-II) is a self-report questionnaire that measures dissociative experiences such as derealization, depersonalization, absorption and amnesia. The DES-II has been prevalently used as a screening tool in patients suffering from psychotic disorders or schizophrenia. However, dissociative experiences can also be part of normal psychological life. Despite its popularity, the most problematic aspect of the DES-II is the inconsistency in its factor structure, which is probably due to the tendency to treat ordinal responses as responses on an interval scale, as it is assumed in the Classical Test Theory approach. In order to address issues related to the inconsistency of previous results, the aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis, i.e. analyzing the functioning of the response scale.

METHODS

Data were obtained on a sample composed by 320 Italian participants (122 inmates and 198 community-dwelling individuals) and were analyzed with the Rasch model. This model allows the estimation of participants' level of dissociation, the degree of misfit of each item, the reliability of each item, and their measurement invariance. Moreover, Rasch estimation allows to determine the best response scale, in terms of response modalities number and their discriminant power.

RESULTS

Three items of the scale had strong misfit. After their deletion, the resulting scale was composed by 25 items, which had low levels of misfit and high reliability, and showed measurement invariance. Participants tended to select more often lower categories of the response scale.

CONCLUSIONS

Results provided new knowledge on the DES-II structure and its psychometric properties, contributing to the understanding and measurement of the dissociation construct.

Tailored Screening for Late-Life Depression: A Short Version of the Teate Depression Inventory (TDI-E)

A number of assessment instruments have been developed as efficacy measures of geriatric depression in clinical trials but most showed several weaknesses, such as time-consuming administration, development and validation in younger populations, and lack of discrimination between anxiety and depression. Among the extant self-report measures of depression, the 21-item Teate Depression Inventory (TDI; Balsamo and Saggino, 2013), developed via Rasch analysis, showed a satisfactory level of diagnostic accuracy, and allowed the reduction of false positives in test scoring in adult population. The present study explored the potential improvement in the psychometric performance of the TDI in the elderly by item refinement through Rasch analysis in a sample of 836 elderly people (49.5% males; mean age = 73.28; SD = 6.56). A resulting shorter version was composed of the best-fitting and discriminative nine items from the full form. The Teate Depression Inventory (TDI-E) (E for elderly) presented good internal construct validity, with unidimensional structure, local dependency, good reliability (person separation index and Cronbach’s alpha), and no signs of differential item functioning or measurement bias due to gender and age (65 vs. 75+ years). Cut-off points and normative data provided could enhance the clinical usefulness of the TDI-E, which seems to be a promising valid and reliable tool for the screening of geriatric depression, with less risk of finding false positives due to overlapping of depression in elderly with other comorbid conditions.

A bidimensional measure of empathy: Empathic Experience Scale

Empathy is a key notion in the study of sociality. A phenomenological perspective on empathy as intersubjective understanding offers a common ground for multiple dimensions. Corresponding to the dichotomy between perceptual and cognitive levels, two constructs can be distinguished: vicariously experiencing and intuitively understanding others’ emotions. We developed and validated a new questionnaire for the assessment of individual differences in empathy. In a first study (N = 921), we created a questionnaire measuring empathy consisting of a pool of 75 items. Exploratory factor analysis suggested to retain two factors (“Intuitive Understanding” and “Vicarious Experience”), whereas a 30-item version of the questionnaire had satisfactory psychometric properties. In a second study (N = 504), we administered the 30-items questionnaire and several concurrent/divergent measures. Confirmatory factor analysis indicated that a two-factor structure best represented its latent factor structure. The results show that our questionnaire could be considered a reliable and valid measure of empathy with internal consistencies of 0.93 and 0.95 for Vicarious Experience and Intuitive Intuitive Understanding, respectively. Whereas our questionnaire mostly showed the expected convergence with existing scales of empathy, the correlations also suggest that it adds valuable new information to the assessment of empathy. The two-factor structure suggests that the perceptual (vicarious) experience and the basic (non-effortful) cognitive awareness of others’ emotions can be assessed as distinct constructs. This bidimensional structure that distinguishes between the perceptual experience and the basic cognitive awareness of others’ emotional states connects theoretical, empirical, and clinical data from psychology and neuroscience.

EEG microstates distinguish between cognitive components of fluid reasoning

Fluid reasoning is considered central to general intelligence. How its psychometric structure relates to brain function remains poorly understood. For instance, what is the dynamic composition of ability-specific processes underlying fluid reasoning? We investigated whether distinct fluid reasoning abilities could be differentiated by electroencephalography (EEG) microstate profiles. EEG microstates specifically capture rapidly altering activity of distributed cortical networks with a high temporal resolution as scalp potential topographies that dynamically vary over time in an organized manner. EEG was recorded simultaneously with functional magnetic resonance imaging (fMRI) in twenty healthy adult participants during cognitively distinct fluid reasoning tasks: induction, spatial relationships and visualization. Microstate parameters successfully discriminated between fluid reasoning and visuomotor control tasks as well as between the fluid reasoning tasks. Mainly, microstate B coverage was significantly higher during spatial relationships and visualization, compared to induction, while microstate C coverage was significantly decreased during spatial relationships and visualization, compared to induction. Additionally, microstate D coverage was highest during spatial relationships and microstate A coverage was most strongly reduced during the same condition. Consistently, multivariate analysis with a leave-one-out cross-validation procedure accurately classified the fluid reasoning tasks based on the coverage parameter. These EEG data and their correlation with fMRI data suggest that especially the tasks most strongly relying on visuospatial processing modulated visual and default mode network activity. We propose that EEG microstates can provide valuable information about neural activity patterns with a dynamic and complex temporal structure during fluid reasoning, suggesting cognitive ability-specific interplays between multiple brain networks.

Dimensions of Anxiety, Age, and Gender: Assessing Dimensionality and Measurement Invariance of the State-Trait for Cognitive and Somatic Anxiety (STICSA) in an Italian Sample

The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a widely used measure of state and trait anxiety that permits a specific assessment of cognitive and somatic anxiety. Previous research provided inconsistent findings about its factor structure in non-clinical samples (e.g., hierarchical or bi-factor structure). To date, no psychometric validation of the Italian version of the STICSA has been conducted. Our study aimed to determine the psychometric functioning of the Italian version of the STICSA, including its dimensionality, gender and age measurement equivalence, and convergent/divergent validity in a large sample of community-dwelling participants (N = 2,938; 55.9% female). Through confirmatory factor analysis, the multidimensional structure of both State and Trait STICSA scales, with each including Cognitive and Somatic dimensions, was supported. Factor structure invariance was tested and established at configural, metric, and scalar levels for males and females. Additionally, full factorial measurement invariance was supported for the State scale across young, middle age, and old adult groups whereas the Trait scale was partially invariant across age groups. The STICSA also showed good convergent validity with concurrent anxiety measures (State-Trait Anxiety Inventory and Beck Anxiety Inventory), and satisfactory internal discriminant validity with two depression measures (Teate Depression Inventory and Beck Depression Inventory-II). Results provided support for the multidimensionality of the STICSA, as well as the generalizability of the State and Trait scales as independent measures of Cognitive and Somatic symptomatology across gender in the general population. Implications for research and personality and clinical assessment are discussed.

Improvement in mood, oxidative stress, fatigue, and insomnia following supplementary management with Robuvit®

BACKGROUND

Oxidative stress (OS) plays a substantial role in inflammatory and neurodegenerative diseases, causing cellular damage and mitochondrial dysfunction. OS also contributes to aging and severe neural disorders such as Alzheimer's and Parkinson's diseases. Previous registries have documented a reduction in OS levels with Robuvit® (Horphag Research, Ltd.), an extract from wood of the French oak (Quercus robur) that provides a decrease of OS as well as relief from chronic fatigue syndrome. The aim of the present registry was to investigate the influence of Robuvit® on a group of subjects presenting with mood disorders, oxidative stress, fatigue, and insomnia.

METHODS

Forty patients were recruited from a selection of patients with high OS levels as assessed with the d-ROMs test. Twenty-two subjects formed the control group following the standard management plan. The remaining 18 subjects formed the Robuvit® supplementation group. They received three capsules of Robuvit® 100 mg per day, for 8 weeks.

RESULTS

Tolerability to the supplementation with Robuvit® was overall good, and no safety concerns were raised. Mood tests showed a significant general improvement in 13 out of 16 items of the BMIS (P<0.05) in the active treatment group. Oxidative stress levels decreased significantly with Robuvit® supplementation after 4 and 8 weeks. Fatigue and insomnia score were also significantly better in supplemented subjects (P<0.05). No changes were observed in controls.

CONCLUSIONS

The observed decrease in OS levels in our patients is probably the result of the antioxidative activity of Robuvit®, and, more precisely, of its active metabolites, the urolithins and ellagic acid.

Pycnogenol® supplementation in minimal cognitive dysfunction

BACKGROUND

Impairments in cognitive function are difficult to evaluate and measure. In most cases, subjects do not perceive any alteration in their own status, particularly in case of mild cognitive impairment. In case of minimal alterations of cognitive function, no real treatment exists at the moment. Functional and/or temporary alterations in the cerebral microcirculation may be involved in cognitive impairment, and some aspects of MCI may be theoretically caused by perfusional problems. Metabolic problems and sleep disturbances can also be associated to cognitive impairment. Pycnogenol® (Horphag) is a natural compound extracted from the bark of French maritime pine, and it is a highly standardized supplement. The aim of this registry was to evaluate the effects of supplementation with Pycnogenol® over a two-month-period in otherwise healthy individuals with minimal cognitive impairment and initial cognitive dysfunction selected on the basis of their MMSE score.

METHODS

Eighty-seven healthy subjects with a MMSE score ranging from 18 to 23 (mild impairment) were included. Their BMI was <26 kg/m2, and no metabolic disorders were present. Participants were divided into two groups: one group was treated with standard management (SM) only (N.=44), whereas the other group received Pycnogenol® supplementation (150 mg/day) in addition to SM (N.=43).

RESULTS

In the Pycnogenol® group MMSE score at inclusion was on average 21.64±1.5; after 8 weeks of supplementation, the average MMSE score increased significantly to 25.64±1.4 (P<0.05). In controls, the initial MMSE score was 22.43±1.2, comparable to the supplement group; however, in these subjects it did not show significant improvement after 8 weeks (average after treatment: 23.00±1.3). The median increase was 18% with Pycnogenol® vs. 2.48% in the SM group (P<0.05).

CONCLUSIONS

Pycnogenol® has shown a large number of positive effects in subjects with initial cognitive impairment, due to its effects on oxidative stress levels. The safety and tolerability of Pycnogenol® are good, and thus the supplementation regimen should be tested in larger studies with a longer follow-up.

Application of Bayes' Theorem in Valuating Depression Tests Performance

The validity of clinical diagnoses is a fundamental topic in clinical psychology, because now there are some political administrations, as the IOM or the U.K. government, which are focusing on best evidence-based practice in clinical psychology. The most problematic issue in clinical psychology is to avoid wrong diagnoses which can have negative consequences on individual life and on the utility of clinical treatments. In the case of diagnoses based on self-report tests, the diagnostic decision about individual health is based on the comparison between its score and the cutoff, according to the frequentist approach to probability. However, the frequentist approach underestimates the possible risks of incorrect diagnoses based on cutoffs only. The Bayesian approach is a valid alternative to make diagnoses on the basis of the scores from psychological tests. The Bayes' theorem estimates the posterior probability of the presence of a pathology on the basis of the knowledge about the diffusion of this pathology (prior probability) and of the knowledge of sensitivity and specificity values of the test. With all this information, it is possible to estimate the diagnostic accuracy of some self-report tests used for assessing depression. We analyzed the diagnostic accuracy of the most used psychological tests of depression (Zung's Self-Rating Depression Scale, Hamilton Rating Scale for Depression, Center for Epidemiological Studies for Depression and the Beck Depression Inventory), together with a new scale (Teate Depression Inventory) developed with the IRT procedure, by analyzing the published works in which data about sensitivity and specificity of these scales are reported. Except the TDI, none of these scales can reach a satisfactory level of diagnostic accuracy, probably for the absence of an optimal procedure to select test items and subjects with clearly defined pathological symptoms which could allow the reduction of false positives in test scoring.

Using Overt and Covert Items in Self-Report Personality Tests: Susceptibility to Faking and Identifiability of Possible Fakers

Self-report personality tests widely used in clinical, medical, forensic, and organizational areas of psychological assessment are susceptible to faking. Several approaches have been developed to prevent or detect faking, which are based on the use of faking warnings, ipsative items, social desirability scales, and validity scales. The approach proposed in this work deals with the use of overt items (the construct is clear to test-takers) and covert items (the construct is obscure to test-takers). Covert items are expected to be more resistant to faking than overt items. Two hundred sixty-seven individuals were presented with an alexithymia scale. Two experimental conditions were considered. Respondents in the faking condition were asked to reproduce the profile of an alexithymic individual, whereas those in the sincere condition were not asked to exhibit a particular alexithymia profile. The items of the scale were categorized as overt or covert by expert psychotherapists and analyzed through Rasch models. Respondents in the faking condition were able to exhibit measures of alexithymia in the required direction. This occurred for both overt and covert items, but to a greater extent for overt items. Differently from overt items, covert items defined a latent variable whose meaning was shared between respondents in the sincere and faking condition, and resistant to deliberate distortion. Rasch fit statistics indicated unexpected responses more often for respondents in the faking condition than for those in the sincere condition and, in particular, for the responses to overt items by individuals in the faking condition. More than half of the respondents in the faking condition showed a drift rate (difference between the alexithymia levels estimated on the responses to overt and covert items) significantly larger than that observed in the respondents in the sincere condition.

Co-rumination, anxiety, and maladaptive cognitive schemas: when friendship can hurt

Background

This study investigated maladaptive cognitive schemas as mediators of the relationship between co-rumination and anxiety.

Methods

Self-report measures of co-rumination, trait cognitive and somatic anxiety, and early maladaptive cognitive schemas were provided to a nonclinical sample of 461 young adults. Mediation of co-rumination and trait somatic and cognitive anxiety by each early maladaptive schema domain was tested using nonparametric, bootstrap-based resampling.

Results

Significant associations between co-rumination and trait and cognitive anxiety were mediated by schema domains related to Rejection and Disconnection, Overvigilance and Inhibition, and Impaired Autonomy. The association between co-rumination and somatic anxiety was mediated by domains related to Rejection and Disconnection and Impaired Autonomy.

Conclusion

The results of this study showed that those who engage in co-rumination, potentially resulting in clinical levels of anxiety, might benefit from treatment that focuses on themes of rejection sensitivity and belonging, beliefs about autonomy, and when the anxiety is more cognitive, treatment that focuses on hypercriticalness and emotional inhibition too.

Psychometric Properties of the Italian Version of the Young Schema Questionnaire L-3: Preliminary Results

Schema Therapy (ST) is a well-known approach for the treatment of personality disorders. This therapy integrates different theories and techniques into an original and systematic treatment model. The Young Schema Questionnaire L-3 (YSQ-L3) is a self-report instrument, based on the ST model, designed to assess 18 Early Maladaptive Schemas (EMSs). During the last decade, it has been translated and validated in different countries and languages. This study aims to establish the psychometric properties of the Italian Version of the YSQ-L3. We enrolled two groups: a clinical (n = 148) and a non-clinical one (n = 918). We investigated the factor structure, reliability and convergent validity with anxiety and depression between clinical and non-clinical groups. The results highlighted a few relevant findings. Cronbach's alpha showed significant values for all the schemas. All of the factor models do not seem highly adequate, even if the hierarchical model has proven to be the most significant one. Furthermore, the questionnaire confirms the ability to discriminate between clinical and non-clinical groups and could represent a useful tool in the clinical practice. Limitations and future directions are discussed.

Correlations Between Personality, Affective and Filial Self-Efficacy Beliefs, and Psychological Well-Being in a Sample of Italian Adolescents

Adolescence is a critical period for the emergence of a balanced personality in adults. Extraversion, neuroticism, and affective self-efficacy beliefs in emotion regulation showed to be good predictors of psychological well-being in adolescents. We analyzed the association between affective self-efficacy beliefs, personality traits, and psychological well-being of 179 Italian adolescents. We also analyzed the connection between adolescents' filial self-efficacy beliefs and psychological well-being and possible moderating effects of self-efficacy beliefs on personality traits. Results show that extraversion, neuroticism, and self-efficacy beliefs in emotion regulation are correlated with psychological well-being, while filial self-efficacy does not. Self-efficacy beliefs do not show significant moderating effects on personality traits, even if self-efficacy beliefs in expressing positive emotions reduce negative characteristics of individuals with high level of psychoticism.

Dissociative Experiences and Psychopathology Among Inmates in Italian and Portuguese Prisons

The association between dissociation and psychopathological symptoms is well established, yet studies with inmates are lacking. If higher rates of dissociation and psychiatric symptoms are reported in inmate samples, it is not clear whether they represent two separate, albeit related, characteristics. We examined the association between dissociation and psychopathological symptoms among 320 Italian subjects (122 inmates and 198 community participants) and a Portuguese inmate sample ( n = 67). Then, we tested whether dissociation and psychopathology levels were higher among inmates. Both hypotheses were supported, confirming the relevance of dissociative, paranoid, and psychotic symptoms among inmates, as well as their interrelations. Notably, the group difference in dissociation remained significant after partialing out the variance associated with other psychopathological symptoms. Conversely, only the difference in paranoid symptoms remained-marginally-significant when controlling for the influence of dissociation. This finding suggests that dissociation may have unique relevance for the psychological functioning of inmates.

Alcohol drinking patterns in young people: A survey-based study

Binge drinking represents a major clinical and public health concern. Here, we investigated the prevalence of binge drinking and its related consequences, in a population of young adults. A questionnaire was administered to a sample of 4275 healthy subjects. In the overall sample, the percentage of binge drinkers was 67.6 per cent; among regular alcohol users, 79.5 per cent reported episodes of binge drinking. Among binge drinkers, several serious consequences were identified (staggering and stuttering, amnesia, loss of control, aggressiveness, sexual disinhibition). Raising awareness about the seriousness of binge drinking may help health care providers to identify cases early on and provide appropriate treatments.

Corsi's Block-Tapping Task: Standardization and Location in Factor Space with the Wais–R for Two Normal Samples of Older Adults

Corsi's block-tapping task and WAIS–R were administered to two Italian samples of 200 normal older adults (aged 65–74 years and 75–100 years). Corsi's reliabilities and standardization data are shown. Additionally, Corsi's location in the factor space of cognitive abilities represented by the 11 WAIS–R subtests is presented. Corsi's test seems to be a reliable one for older Italians. It seems also to be a measure of general intelligence in those 65–74 years of age and a measure of the Freedom from Distractibility factor in subjects 75 years and older.

Integrative Processing of Touch and Affect in Social Perception: An fMRI Study

Social perception commonly employs multiple sources of information. The present study aimed at investigating the integrative processing of affective social signals. Task-related and task-free functional magnetic resonance imaging was performed in 26 healthy adult participants during a social perception task concerning dynamic visual stimuli simultaneously depicting facial expressions of emotion and tactile sensations that could be either congruent or incongruent. Confounding effects due to affective valence, inhibitory top-down influences, cross-modal integration, and conflict processing were minimized. The results showed that the perception of congruent, compared to incongruent stimuli, elicited enhanced neural activity in a set of brain regions including left amygdala, bilateral posterior cingulate cortex (PCC), and left superior parietal cortex. These congruency effects did not differ as a function of emotion or sensation. A complementary task-related functional interaction analysis preliminarily suggested that amygdala activity depended on previous processing stages in fusiform gyrus and PCC. The findings provide support for the integrative processing of social information about others' feelings from manifold bodily sources (sensory-affective information) in amygdala and PCC. Given that the congruent stimuli were also judged as being more self-related and more familiar in terms of personal experience in an independent sample of participants, we speculate that such integrative processing might be mediated by the linking of external stimuli with self-experience. Finally, the prediction of task-related responses in amygdala by intrinsic functional connectivity between amygdala and PCC during a task-free state implies a neuro-functional basis for an individual predisposition for the integrative processing of social stimulus content.

The COFU3 Study. Improvement in cognitive function, attention, mental performance with Pycnogenol® in healthy subjects (55-70) with high oxidative stress

AIM

This 12-month product registry study evaluated the effects of supplementation with French pine bark extract (Pycnogenol(®)) on cognitive function, attention, and mental performance in healthy subjects with high oxidative stress.

METHODS

Healthy subjects (age range 55-70) were screened - within a cardiovascular screening program - for oxidative stress. Out of 150 subjects, high oxidative stress was present in 44; the use of the supplement Pycnogenol(®) was suggested (100 mg/day). These subjects decided to use Pycnogenol(®) and accepted to be evaluated by assessing cognitive functions. A group of subjects with comparable oxidative stress was followed as a reference. IQ Code (Informant Questionnaire on Cognitive Decline in the Elderly), daily tasks, cognitive function, oxidative stress and the short Blessed tests (SBT) were used (in defined scales) to evaluate cognitive functions (COFU).

RESULTS

As for the IQ Code, at 12 months there was a significantlty total lower score in Pycnogenol(®) patients and also a lower value (P<0.05) for 14 out of 16 items in the questionnaire. Daily tasks: all items were improved (P<0.05) with supplementation in comparison with controls. The improvement was seen for all 12 items (P<0.05) with the supplement. Cognitive function values (visual scale line) indicated a significant improvement (P<0.05) in all elements present in the questionnaire with the 12-month supplementation (no significant variations in controls). Oxidative stress was comparable in both groups at inclusion. It was significantly decreased with Pycnogenol(®) (-28.07%; P<0.05) at 12 months; there was no decrease in controls. The short blessed test (SBT) value was significantly increased in controls (P<0.05); but significantly decreased in the Pycnogenol(®) group (P<0.05). Values for supplemented patients at 12 months were almost within the normal range (21 out or 38 were below the normal value of 4). Tolerability and compliance for Pycnogenol(®) were optimal with >97% of the doses of the supplement correctly used. No side effects were observed, recorded or described.

CONCLUSION

Pycnogenol(®) supplementation for 12 months appears to improve cognitive function and oxidative stress in normal subjects between 55 and 70 years of age.

Robuvit® (Quercus robur extract) supplementation in subjects with chronic fatigue syndrome and increased oxidative stress. A pilot registry study

AIM

The aim of this registry study was to evaluate the effects of supplementation with Robuvit® (French Quercus robur extract) capsules in subjects with Chronic Fatigue Syndrome (CFS) associated with an increased oxidative stress. Robuvit is a wood extract from Quercus robur (Horphag Research) used to improve liver dysfunction and chronic fatigue. After excluding any disease, subjects observed a defined management plan to improve CFS. Signs/symptoms had been present for more than 6 months in association with an increase in oxidative stress (measured as plasma free radicals). Blood tests were within normal values.

METHODS

The registry study included 38 CFS subjects and 42 comparable controls. There were no dropouts in the 4 weeks of follow-up; the subjects were evaluated for a further period of 6 months. The management plan included: improved/increased sleep; reduction/abolition in smoking and alcohol or any other agent that may have affected them; control of diet, increase in dietary proteins; good hydration; rest (1/2-1 h/day) and exercise (at least 30 min/day); planned relaxation time; increased time in open spaces. In the Robuvit® supplementation group 300 mg/day of Robuvit® was used.

RESULTS

Symptoms improved in both groups with a significantly more important improvement in the supplement group (P<0.05). The single items in the Multidimensional Assessment of Fatigue (MAF) questionnaire were statistically better improved (P<0.05) in the supplement group. A parallel improvement in oxidative stress was observed in the supplemented subjects. In the follow up, at 6 months no organic disease was discovered or disease markers found.

CONCLUSION

This preliminary registry indicates that supplementation with Robuvit® improves CFS in otherwise healthy subjects with no presence of clinical disease or risk conditions. The effects of Robuvit® in CFS may be partially mediated by a clear reduction of plasma free radicals and oxidative stress.

Pycnogenol® improves cognitive function, attention, mental performance and specific professional skills in healthy professionals aged 35-55

AIM

This 12-week, product-evaluation registry study aimed to compare the effects of supplementation with French Pine Bark Extract (Pycnogenol®) on cognitive function, attention, and mental performance in healthy professionals with increased oxidative stress in a professional context.

METHODS

Professionals were screened for increased oxidative stress: 60 subjects (range 35-55 years, no risk conditions, no addictions) voluntarily decided to be followed-up. Diet, alcohol and lifestyle patterns, including exercise, were controlled. Pycnogenol® (150 mg/day) was used in combination with a health plan to enhance mental performance and control oxidative stress.

RESULTS

A group of 30 professionals used Pycnogenol®, and 29 acted as comparable controls for a period of 12 weeks. The two registry groups were comparable. Cognitive function, attention, mental performance, sustained attention, memory, executive functions, mood and oxidative stress values were comparable at inclusion. At 12 weeks the improvement in Pycnogenol® subjects was more significant than in controls. Plasma-free radicals (oxidative stress) were significantly decreased (median -30.4%) at 12 weeks in Pycnogenol® subjects in comparison with a non-significant variation observed in controls (+0.9%; difference between groups). Considering the cognitive test battery (PASAT, pattern recognition memory, spatial recognition memory, spatial working memory), Pycnogenol® subjects showed a small but significant improvement with spatial recognition memory unchanged. Mood parameters (alertness, anxiety, contentedness) also improved in professionals using the supplement. In the evaluation of 12 professional daily tasks all items were improved with Pycnogenol® supplementation. The score relative to semi-professional minitasks was improved more in Pycnogenol® subjects. Tolerability and compliance were optimal with >94% of the doses of supplement correctly used.

CONCLUSION

Pycnogenol® supplementation for 12 weeks appears to improve cognitive function and oxidative stress in healthy professionals.

Measurement of external shame: an inside view

The aims of this study were to investigate the construct validity of the Other as Shamer scale (OAS) using confirmatory factor analysis (CFA) and to examine the psychometric properties of its Italian version in a sample of 687 nonclinical individuals. The CFA results indicated that the hypothesized hierarchical model (with 1 higher order factor and 3 first-order factors) was the best fitting solution. Cronbach's alpha indexes, as well as test-retest stability, provided satisfactory results. Correlations of the OAS total score and its subscales with the Beck Depression Inventory-II (rs = .30-.48) and the Teate Depression Inventory (rs = .32-.45) were both substantial and significant (p < .01). Receiver operating characteristic curves were constructed to indicate sensitivity and specificity of the OAS and its subscales when determining those nonclinical subjects who met clinical thresholds for depression symptoms. A series of cutoff scores for the OAS scale and its subscales was developed, with sensitivity values between .70 and .62, and specificity values between .71 and .62, indicating good to fair discrimination between the 2 groups (depressed vs. nondepressed). The theoretical and practical implications of these results were discussed.

Building a new Rasch-based self-report inventory of depression

This paper illustrates a sequential item development process to create a new self-report instrument of depression refined with Rasch analysis from a larger pool of potential diagnostic items elicited through a consensus approach by clinical experts according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders criteria for major depression. A 51-item pool was administered to a sample of 529 subjects (300 healthy community-dwelling adults and 229 psychiatric outpatients). Item selection resulted in a 21-item set, named the Teate Depression Inventory, with an excellent Person Separation Index and no evidence of bias due to an item-trait interaction (χ (2)=147.71; df =168; P=0.48). Additional support for the unidimensionality, local independence, appropriateness of the response format, and discrimination ability between clinical and nonclinical subjects was provided. No substantial differential item functioning by sex was observed. The Teate Depression Inventory shows considerable promise as a unidimensional tool for the screening of depression. Finally, advantages and disadvantages of this methodology will be discussed in terms of subsequent possible mathematical analyses, statistical tests, and implications for clinical investigations.

Determining a diagnostic cut-off on the Teate Depression Inventory

A small but growing body of literature suggests that the Teate Depression Inventory (TDI) may be an "objective" measure of depression compared with other commonly used scales. Furthermore, the TDI has strong psychometric properties in both clinical and nonclinical samples. The present study aimed to extend the use of TDI by identifying cut-off scores that could differentiate varying levels of depression severity in a group of clinically diagnosed depression disorder patients (N=125). Three receiver operating characteristic curve analyses indicated cut-off scores of 21 (sensitivity =0.86, specificity =0.94, and classification accuracy =0.90); 36 (sensitivity =0.84, specificity =0.96, and classification accuracy =0.92); and 50 (sensitivity =0.81, specificity =0.93, and classification accuracy =0.90), for minimal, mild, moderate, and severe depression, respectively. Results suggest that the TDI measures depression severity across a broad range with high test accuracy and may be appropriately used to screen for depression.

Acute effects of modafinil on brain resting state networks in young healthy subjects

Background

There is growing debate on the use of drugs that promote cognitive enhancement. Amphetamine-like drugs have been employed as cognitive enhancers, but they show important side effects and induce addiction. In this study, we investigated the use of modafinil which appears to have less side effects compared to other amphetamine-like drugs. We analyzed effects on cognitive performances and brain resting state network activity of 26 healthy young subjects.

Methodology

A single dose (100 mg) of modafinil was administered in a double-blind and placebo-controlled study. Both groups were tested for neuropsychological performances with the Raven’s Advanced Progressive Matrices II set (APM) before and three hours after administration of drug or placebo. Resting state functional magnetic resonance (rs-FMRI) was also used, before and after three hours, to investigate changes in the activity of resting state brain networks. Diffusion Tensor Imaging (DTI) was employed to evaluate differences in structural connectivity between the two groups. Protocol ID: Modrest_2011; NCT01684306; http://clinicaltrials.gov/ct2/show/NCT01684306.

Principal Findings

Results indicate that a single dose of modafinil improves cognitive performance as assessed by APM. Rs-fMRI showed that the drug produces a statistically significant increased activation of Frontal Parietal Control (FPC; p<0.04) and Dorsal Attention (DAN; p<0.04) networks. No modifications in structural connectivity were observed.

Conclusions and Significance

Overall, our findings support the notion that modafinil has cognitive enhancing properties and provide functional connectivity data to support these effects.

Trial Registration

ClinicalTrials.gov NCT01684306 http://clinicaltrials.gov/ct2/show/NCT01684306.

Factor Structure of the Italian Version of the Religious Fundamentalism Scale

The Religious Fundamentalism Scale was applied to an Italian group, composed of 250 participants, to assess if it could be considered a reliable measure of fundamentalism. All participants professed to be believers of the Catholic religion. The overall group was split randomly into two smaller groups. The data of the first group were analyzed with an exploratory factor analysis (EFA) to test the factor structure of the Italian version of the scale. The data of the second sample were analyzed with a confirmatory factor analysis, to test the factor structure that emerged from EFA. Results indicated a two-dimensional structure, composed of two correlated factors apparently representing believing and skeptical attitudes.