Metacognition, mental disorders and aggressive behaviour: a longitudinal study

Metacognitive functions play a key role in understanding which elements might lead a person with severe mental disorder to commit violent acts against others. Indeed, understanding internal states such as thoughts, emotions, desires, fears and goals, both their own and those of others and differentiating between them, is needed in order to guide behaviour towards the resolution of interpersonal conflict. This is a fundamental aspect of affronting the risk of committing aggressive acts. The aims of the study were the following: (a) to investigate the differences between patients with a poor metacognitive functioning and patients with a good metacognitive functioning in relation to history of violence; (b) to explore the differences between patients with a poor metacognitive functioning and patients with a good metacognitive functioning in relation to other important aspects potentially involved in aggressive behaviour such as personality traits, anger, impulsiveness, hostility and emotion recognition; (c) to investigate the differences between patients with a poor metacognitive functioning and patients with a good metacognitive functioning in relation to aggressive behaviour displayed by patients during the one year follow-up; (d) to analyse the predictors of aggressive behaviour and evaluate if the metacognitive functions associated with other investigated aspects are related to aggressive behaviour during the one-year follow-up. The sample included 180 patients: 56% outpatients and 44% inpatients, the majority were male (75%) with a mean age of 44 (+9,8) years and half of them had a history of violence. The sample was split into two groups: Poor Metacognition (PM) group and Good Metacognition (GM) group, according to MAI evaluation scores. The PM patients reported a history of violence more frequently than GM patients (considering MAI total score), and in particular patients with poor monitoring, differentiating and decentering. Furthermore, PM patients showed less ability in emotion recognition and more frequently paranoid and narcissistic personality traits compared to GM patients. Concerning hostility, impulsivity and anger, no significant differences were found, except for ‘Negativism’ (i.e., BDHI subscale) that was higher in PM patients. During the 1-year follow-up, no differences between the PM group and the GM group in aggressive behaviours (verbal, against objects, self-aggression, against people) were found. The strongest predictors of aggressive behavoiur were: Borderline and Passive-Aggressive personality traits, history of violence, anger and hostility. The metacognitive functions alone did not predict aggressive behaviour, but metacognitive functions interacted with hostility manifested through direct and indirect aggression (two BDHI subscales) and with angry reaction through aggressive behaviour (one STAXI-2 subscale) in predicting aggressive behaviour. Indeed, these aspects predicted aggressive behaviour only in PM patients and not in GM patients. This study leads to important conclusions: (a) certain aspects closely related with violence (e.g., hostility, anger) are predictive of aggressive behaviour only in patients with poor metacognition, thus good metacognition is a protective factors; (b) poor metacognition is associated with history of violence, which in turn increases the risk of committing aggressive behaviour. For this reason and considering that research in this field is still very limited, further studies are needed to deepen the role of metacognitive functions in relation to aggressive behaviour and to investigate whether psychotherapy focused on metacognitive functions is effective to prevent and/or reduce interpersonal violence

Antiferromagnetic coupling of TbPc2 molecules to ultrathin Ni and Co films

The magnetic and electronic properties of single-molecule magnets are studied by X-ray absorption spectroscopy and X-ray magnetic circular dichroism. We study the magnetic coupling of ultrathin Co and Ni films that are epitaxially grown onto a Cu(100) substrate, to an in situ deposited submonolayer of TbPc2 molecules. Because of the element specificity of the X-ray absorption spectroscopy we are able to individually determine the field dependence of the magnetization of the Tb ions and the Ni or Co film. On both substrates the TbPc2 moleculescouple antiferromagnetically to the ferromagnetic films, which is possibly due to a superexchange interaction via the phthalocyanine ligand that contacts the magnetic surface

Cardiac Functional and Structural Abnormalities in a Mouse Model of CDKL5 Deficiency Disorder

CDKL5 (cyclin-dependent kinase-like 5) deficiency disorder (CDD) is a severe neurodevelopmental disease that mostly affects girls, who are heterozygous for mutations in the X-linked CDKL5 gene. Mutations in the CDKL5 gene lead to a lack of CDKL5 protein expression or function and cause numerous clinical features, including early-onset seizures, marked hypotonia, autistic features, gastrointestinal problems, and severe neurodevelopmental impairment. Mouse models of CDD recapitulate several aspects of CDD symptomology, including cognitive impairments, motor deficits, and autistic-like features, and have been useful to dissect the role of CDKL5 in brain development and function. However, our current knowledge of the function of CDKL5 in other organs/tissues besides the brain is still quite limited, reducing the possibility of broad-spectrum interventions. Here, for the first time, we report the presence of cardiac function/structure alterations in heterozygous Cdkl5 +/- female mice. We found a prolonged QT interval (corrected for the heart rate, QTc) and increased heart rate in Cdkl5 +/- mice. These changes correlate with a marked decrease in parasympathetic activity to the heart and in the expression of the Scn5a and Hcn4 voltage-gated channels. Interestingly, Cdkl5 +/- hearts showed increased fibrosis, altered gap junction organization and connexin-43 expression, mitochondrial dysfunction, and increased ROS production. Together, these findings not only contribute to our understanding of the role of CDKL5 in heart structure/function but also document a novel preclinical phenotype for future therapeutic investigation

Mesoscopic 3D Charge Transport in Solution-Processed Graphene-Based Thin Films: A Multiscale Analysis

Graphene and related 2D material (GRM) thin films consist of 3D assembly of billions of 2D nanosheets randomly distributed and interacting via van der Waals forces. Their complexity and the multiscale nature yield a wide variety of electrical characteristics ranging from doped semiconductor to glassy metals depending on the crystalline quality of the nanosheets, their specific structural organization ant the operating temperature. Here, the charge transport (CT) mechanisms are studied that are occurring in GRM thin films near the metal-insulator transition (MIT) highlighting the role of defect density and local arrangement of the nanosheets. Two prototypical nanosheet types are compared, i.e., 2D reduced graphene oxide and few-layer-thick electrochemically exfoliated graphene flakes, forming thin films with comparable composition, morphology and room temperature conductivity, but different defect density and crystallinity. By investigating their structure, morphology, and the dependence of their electrical conductivity on temperature, noise and magnetic-field, a general model is developed describing the multiscale nature of CT in GRM thin films in terms of hopping among mesoscopic bricks, i.e., grains. The results suggest a general approach to describe disordered van der Waals thin films

Spin-communication channels between Ln(III) bis-phthalocyanines molecular nanomagnets and a magnetic substrate

Learning the art of exploiting the interplay between different units at the atomic scale is a fundamental step in the realization of functional nano-architectures and interfaces. In this context, understanding and controlling the magnetic coupling between molecular centers and their environment is still a challenging task. Here we present a combined experimental-theoretical work on the prototypical case of the bis(phthalocyaninato)-lanthanide(III) (LnPc 2) molecular nanomagnets magnetically coupled to a Ni substrate. By means of X-ray magnetic circular dichroism we show how the coupling strength can be tuned by changing the Ln ion. The microscopic parameters of the system are determined by ab-initio calculations and then used in a spin Hamiltonian approach to interpret the experimental data. By this combined approach we identify the features of the spin communication channel: the spin path is first realized by the mediation of the external (5d) electrons of the Ln ion, keeping the characteristic features of the inner 4 f orbitals unaffected, then through the organic ligand, acting as a bridge to the external world

Human Adipose Mesenchymal Stromal/Stem Cells Improve Fat Transplantation Performance

The resorption rate of autologous fat transfer (AFT) is 40-60% of the implanted tissue, requiring new surgical strategies for tissue reconstruction. We previously demonstrated in a rabbit model that AFT may be empowered by adipose-derived mesenchymal stromal/stem cells (AD-MSCs), which improve graft persistence by exerting proangiogenic/anti-inflammatory effects. However, their fate after implantation requires more investigation. We report a xenograft model of adipose tissue engineering in which NOD/SCID mice underwent AFT with/without human autologous AD-MSCs and were monitored for 180 days (d). The effect of AD-MSCs on AFT grafting was also monitored by evaluating the expression of CD31 and F4/80 markers. Green fluorescent protein-positive AD-MSCs (AD-MSC-GFP) were detected in fibroblastoid cells 7 days after transplantation and in mature adipocytes at 60 days, indicating both persistence and differentiation of the implanted cells. This evidence also correlated with the persistence of a higher graft weight in AFT-AD-MSC compared to AFT alone treated mice. An observation up to 180 d revealed a lower resorption rate and reduced lipidic cyst formation in the AFT-AD-MSC group, suggesting a long-term action of AD-MSCs in support of AFT performance and an anti-inflammatory/proangiogenic activity. Together, these data indicate the protective role of adipose progenitors in autologous AFT tissue resorption

Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence

none34noopende Girolamo, Giovanni; Buizza, Chiara; Sisti, Davide; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Cristiano, Giuseppe; De Francesco, Alessandra; Giobbio, Gian Marco; Maggi, Paolo; Rossi, Giuseppe; Segalini, Beatrice; Candini, Valentina; Andreose, Suor; Basso, Pasquale; Beneduce, Rossella; Bertolotti, Pietro; Braida, Vanda; Bonelli, Marina; Bongiorno, Fanny; Bussi, Riccardo; Castagno, Elisa; Dominicis, Fabio; Ghersi, Loredana; Greppo, Stefania; Sodano, Alessandro Jaretti; Leporatti, Massimo; Presti, Eleonora Lo; Milone, Valeria; Panigada, Fausto; Pasquadibisceglie, Livia; Rigamonti, Danilo; Rillosi, Lucianade Girolamo, Giovanni; Buizza, Chiara; Sisti, Davide; Ferrari, Clarissa; Bulgari, Viola; Iozzino, Laura; Boero, Maria Elena; Cristiano, Giuseppe; De Francesco, Alessandra; Giobbio, Gian Marco; Maggi, Paolo; Rossi, Giuseppe; Segalini, Beatrice; Candini, Valentina; Andreose, Suor; Basso, Pasquale; Beneduce, Rossella; Bertolotti, Pietro; Braida, Vanda; Bonelli, Marina; Bongiorno, Fanny; Bussi, Riccardo; Castagno, Elisa; Dominicis, Fabio; Ghersi, Loredana; Greppo, Stefania; Sodano, Alessandro Jaretti; Leporatti, Massimo; Presti, Eleonora Lo; Milone, Valeria; Panigada, Fausto; Pasquadibisceglie, Livia; Rigamonti, Danilo; Rillosi, Lucian

Self-Assembled Monolayer of Cr7Ni Molecular Nanomagnets by Sublimation

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Metacognition, mental disorders and aggressive behaviour: a longitudinal study

Metacognitive functions play a key role in understanding which elements might lead a person with severe mental disorder to commit violent acts against others. Indeed, understanding internal states such as thoughts, emotions, desires, fears and goals, both their own and those of others and differentiating between them, is needed in order to guide behaviour towards the resolution of interpersonal conflict. This is a fundamental aspect of affronting the risk of committing aggressive acts. The aims of the study were the following: (a) to investigate the differences between patients with a poor metacognitive functioning and patients with a good metacognitive functioning in relation to history of violence; (b) to explore the differences between patients with a poor metacognitive functioning and patients with a good metacognitive functioning in relation to other important aspects potentially involved in aggressive behaviour such as personality traits, anger, impulsiveness, hostility and emotion recognition; (c) to investigate the differences between patients with a poor metacognitive functioning and patients with a good metacognitive functioning in relation to aggressive behaviour displayed by patients during the one year follow-up; (d) to analyse the predictors of aggressive behaviour and evaluate if the metacognitive functions associated with other investigated aspects are related to aggressive behaviour during the one-year follow-up. The sample included 180 patients: 56% outpatients and 44% inpatients, the majority were male (75%) with a mean age of 44 (+9,8) years and half of them had a history of violence. The sample was split into two groups: Poor Metacognition (PM) group and Good Metacognition (GM) group, according to MAI evaluation scores. The PM patients reported a history of violence more frequently than GM patients (considering MAI total score), and in particular patients with poor monitoring, differentiating and decentering. Furthermore, PM patients showed less ability in emotion recognition and more frequently paranoid and narcissistic personality traits compared to GM patients. Concerning hostility, impulsivity and anger, no significant differences were found, except for ‘Negativism’ (i.e., BDHI subscale) that was higher in PM patients. During the 1-year follow-up, no differences between the PM group and the GM group in aggressive behaviours (verbal, against objects, self-aggression, against people) were found. The strongest predictors of aggressive behavoiur were: Borderline and Passive-Aggressive personality traits, history of violence, anger and hostility. The metacognitive functions alone did not predict aggressive behaviour, but metacognitive functions interacted with hostility manifested through direct and indirect aggression (two BDHI subscales) and with angry reaction through aggressive behaviour (one STAXI-2 subscale) in predicting aggressive behaviour. Indeed, these aspects predicted aggressive behaviour only in PM patients and not in GM patients. This study leads to important conclusions: (a) certain aspects closely related with violence (e.g., hostility, anger) are predictive of aggressive behaviour only in patients with poor metacognition, thus good metacognition is a protective factors; (b) poor metacognition is associated with history of violence, which in turn increases the risk of committing aggressive behaviour. For this reason and considering that research in this field is still very limited, further studies are needed to deepen the role of metacognitive functions in relation to aggressive behaviour and to investigate whether psychotherapy focused on metacognitive functions is effective to prevent and/or reduce interpersonal violence.Le funzioni metacognitive svolgono un ruolo chiave nella comprensione di quali elementi potrebbero indurre una persona con gravi disturbi mentali a commettere atti violenti contro altre persone. Risulta, infatti, essenziale comprendere gli stati interni quali pensieri, emozioni, desideri, paure e obiettivi, sia propri che altrui, ed essere capaci di differenziarli tra loro, per poter guidare il proprio comportamento verso la risoluzione dei conflitti interpersonali. Per tale ragione, questo aspetto diviene fondamentale nell'affrontare il tema del rischio di violenza, cercando di comprendere ciò che discrimina persone con disturbi mentali che commettono agiti aggressivi e pazienti con gli stessi disturbi che non commettono tali atti. Gli obiettivi dello studio erano i seguenti: (a) indagare le differenze tra pazienti con uno scarso funzionamento metacognitivo e pazienti con un buon funzionamento metacognitivo in relazione alla storia di violenza; (b) esplorare le differenze tra pazienti con uno scarso funzionamento metacognitivo e pazienti con un buon funzionamento metacognitivo in relazione ad altri importanti aspetti potenzialmente coinvolti in comportamenti aggressivi come i tratti della personalità, la rabbia, l'impulsività, l'ostilità e il riconoscimento delle emozioni; (c) investigare le differenze tra pazienti con uno scarso funzionamento metacognitivo e pazienti con un buon funzionamento metacognitivo in relazione al comportamento aggressivo manifestato durante l’anno di follow-up; (d) analizzare i fattori predittivi del comportamento aggressivo e valutare se le funzioni metacognitive associate ad altri aspetti indagati sono correlate al comportamento aggressivo agito durante il follow-up. Il campione è costituito da 180 pazienti: 56% ambulatoriali e 44% residenziali, la maggior parte erano maschi (75%) con un'età media di 44 anni (+9,8) e metà di essi aveva una storia di violenza. Il campione è stato diviso in due gruppi: il gruppo Scarsa Metacognizione (PM) e il gruppo Buona Metacognizione (GM), in base ai punteggi ottenuti nella valutazione dell’intervista metacognitiva (MAI). I pazienti con scarsa metacognizione hanno riportato più frequentemente una storia di violenza rispetto ai pazienti con buona metacognizione (considerando il punteggio totale MAI), e in particolare i pazienti con scarsa metacognizione nelle specifiche funzioni di monitoraggio, differenziazione e decentramento. Inoltre, i pazienti con scarsa metacognizione presentavano meno abilità nel riconoscimento delle emozioni e più frequentemente tratti di personalità paranoidi e narcisistici rispetto ai pazienti con buona metacognizione. Per quanto concerne l'ostilità, l'impulsività e la rabbia, non sono state riscontrate differenze significative tra i due gruppi, ad eccezione del "Negativismo" (sottoscala del BDHI), che era più alto nei pazienti con scarsa metacognizione. Anche nel caso dei comportamenti aggressivi (verbali, contro oggetti, auto-aggressivi, contro le persone) manifestati durante l’anno di follow-up, non sono emerse differenze significative tra i due gruppi. I dati rivelano che i predittori del comportamento aggressivo sono i seguenti: tratti di personalità borderline e passivo-aggressivi, storia di violenza, rabbia e ostilità. Le funzioni metacognitive da sole non predivano il comportamento aggressivo, ma esse interagivano con le seguenti dimensioni in tale predizione: l'ostilità manifestata attraverso aggressioni dirette e indirette (due sottoscale del BDHI) e le reazioni rabbiose agite tramite il comportamento aggressivo (una sottoscala della STAXI-2). Infatti, questi aspetti emergevano come predittori dei comportamenti aggressivi solo nei pazienti con scarsa metacognizione e al contrario, non risultavano più predittori nei pazienti con buona metacognizione. Questo studio porta a importanti riflessioni: (a) alcuni aspetti strettamente correlati alla violenza (ad esempio, ostilità, rabbia) sono predittivi di comportamenti aggressivi solo in pazienti con scarsa metacognizione, facendo risutare la buona metacognizione come fattore protettivo; (b) la scarsa metacognizione è associata alla storia di violenza, la quale a sua volta aumenta il rischio di commettere comportamenti aggressivi. Per tale ragione e considerando che la ricerca in questo campo è ancora molto limitata, sono necessari ulteriori studi al fine di approfondire il ruolo delle funzioni metacognitive in relazione al comportamento aggressivo, e per indagare se la psicoterapia orientata al miglioramento delle funzioni metacognitive può rivelarsi efficace nel prevenire e/o ridurre la violenza interpersonale

Clinical and neuropsychological features of violence in schizophrenia: A prospective cohort study

The increased risk of violence in schizophrenia has been linked to several environmental, clinical and neuropsychological factors, including executive dysfunction. However, data about the nature of these effects are mixed and controversial. The main aim of this study was to investigate the relationship between clinical and neuropsychological factors with violence risk in patients with schizophrenia, taking into account current psychopathology and lifetime alcohol use. We compared a sample of patients living in Residential Facilities (RFs) with schizophrenia and a past history of interpersonal violence (vSZ, N=50) to patients with schizophrenia matched on age, gender and alcohol abuse/dependence but with no violence history (nvSZ, N=37). We then established the association between the clinical and neuropsychological factors that predicted violence over a 1year follow-up period. The results revealed that vSZ patients living in RFs were characterized by greater compulsory hospital admissions, higher anger and less negative symptoms as compared to nvSZ patients. vSZ patients performed better on executive and motor tasks than nvSZ; however, these differences appeared to be explained by the lower negative psychotic symptom in the vSZ group. Both groups were involved in episodes of violence during the follow-up period; among the two, the vSZ patients were more likely to be violent. Negative symptoms predicted less verbal aggression at 1year follow-up. Overall, these findings support a key role of negative rather than positive symptoms in driving violence risk among SZ patients living in RFs, in a manner that negative symptoms are linked to a lower risk of violence