Hedonicity in functional motor disorders: a chemosensory study assessing taste

The aim of this study was to explore hedonicity to basic tastes in patients with functional motor disorders (FMDs) that are often associated with impairment in emotional processing. We recruited 20 FMD patients and 24 healthy subjects, matched for age and sex. Subjects were asked to rate the hedonic sensation (i.e., pleasant, neutral, and unpleasant) on a\u2009-\u200910 to +10 scale to the four basic tastes (sweet, sour, salty, and bitter) at different concentrations, and neutral stimuli (i.e., no taste stimulation) by means of the Taste Strips Test. Anxiety, depression, and alexithymia were assessed. FMD patients rated the highest concentration of sweet taste (6.7\u2009\ub1\u20092.6) as significantly more pleasant than controls (4.7\u2009\ub1\u20092.5, p\u2009=\u20090.03), and the neutral stimuli significantly more unpleasant (patients:\u2009-\u20090.7\u2009\ub1\u20090.4, controls: 0.1\u2009\ub1\u20090.4, p\u2009=\u20090.013). Hedonic ratings were not correlated to anxiety, depression, or alexithymia scores. Hedonic response to taste is altered in FMD patients. This preliminary finding might result from abnormal interaction between sensory processing and emotional valence

A physical therapy programme for functional motor symptoms: A telemedicine pilot study

INTRODUCTION: for a proportion of patients with functional motor symptoms (FMS), specific physiotherapy has recently emerged as a promising treatment. Aim of the present study was to assess in a sample of patients with FMS the efficacy of a physical therapy-based telemedicine programme on the motor symptoms themselves and on some psychological variables such as anxiety, depression, alexithymia and quality of life. MATERIALS AND METHODS: eighteen patients were recruited. The programme consisted of 24 sessions: three face-to-face sessions (at week 0 (T0), 12 (T1) and 24 (T2)) and 21 tele-sessions. Each session included education, movement retraining exercises and development of a management plan. All patients underwent the following assessment at T0, T1 and T2: Psychogenic movement disorders rating scale (PMDRS), assessment of depression, anxiety, alexithymia and quality of life. Self-assessment of outcome (CGI) was recorded at T1 and T2. RESULTS: On the CGI improvement was reported by 66,7% of patients at T1 and 77,8% at T2. A significant improvement over the three time points was shown for PMDRS and for the following domains of the SF-36: general health, vitality, social functioning and mental health. CONCLUSION: the use of two innovative approaches for FMS (physiotherapy and telemedicine), combined together, might have a valuable role in the treatment of this neuropsychiatric condition

Belief updating about Interoception and Body Size Estimation in Anorexia Nervosa

Anorexia Nervosa (AN) is an eating disorder with high mortality and morbidity rates, partly due to treatment resistance and high relapse rates. Treatment adherence and recovery has been found to be hindered by insight deficits, a lack of appreciation of one’s illness, or its consequences, most frequent in restrictive AN. However, to date, insight disturbances in AN have mainly been studied in relation to treatment outcomes rather than explanatory mechanisms. One possibility is that interoception (the sensing, awareness and interpretation of physiological signals) and particularly its metacognitive aspects such as prospective (self-efficacy) and retrospective (insight) beliefs about one’s interoceptive abilities may be affected in AN. To our knowledge however such aspects of global metacognition, and their relation to key interoceptive and body perception impairments, have not been assessed in AN. Here in two experiments (nAN=51 and 28, nAN-WR=47 and 21, nHC=63 and 34, respectively), we tested, (a) how women with and weight-restored from AN (AN-WR), in comparison to healthy controls (HCs), formulate explicit interoceptive self-efficacy beliefs (i.e., estimates of performance in a cardiac perception task) prospectively and then update them following performance and then following explicit feedback and (b) how they formulate prospectively and then update following feedback two types of body-size beliefs (estimates about the envisioned body, ‘How thin it looks' vs the emotional body, ‘How thin it feels’). Results of Experiment 1 confirmed our hypotheses that the AN (but not the AN-WR) group formulated more pessimistic interoceptive self-efficacy beliefs in comparison to HCs both before and after otherwise comparable performance. In Experiment 2 we found that the AN group envisioned and felt (also the AN-WR group) their body size to be bigger than it really is in comparison to controls. Post-feedback, the AN but not AN-WR group significantly overestimated both their envisioned and emotional body and they also updated their emotional body size estimates at a slower rate than the HCs. These observed group differences in belief updating about interoceptive self-efficacy and body size estimates warrant further studies in interoceptive metacognition and belief updating in AN, and their relation with insight deficits, particularly at the acute stages of the disease

Interoceptive Belief Updating in Women With and Weight-Restored from Anorexia Nervosa

This experiment is based on our pilot study in interoception, wherein we investigated how individuals with and weight-restored from AN form and update beliefs in the cardiac interoception modality. In our pilot study, we found that individuals with AN hold negative performance-related beliefs, i.e., when asked to estimate how well they think they will perform in a heartbeat counting task (HCT; Schandry, 1981; see more in Note 7; referred to as Prior Prospective Self-Efficacy Beliefs; see more in Section 3), the AN group’s estimates were lower than those of the HC group. In our pilot study we found no significant differences in IAcc (see Section 3) between our three groups, but we found that the AN group had lower Retrospective Self-Efficacy Beliefs even after a successful Performance (i.e., high IAcc). However, across all groups we found that individuals who received positive feedback following their performance in the HCT gave significantly higher Post-Feedback Retrospective Estimates than those who received negative feedback. The hypotheses and power calculations in the present Pre-registration are based on the findings from our pilot study and relevant literature

Belief Updating in Anorexia Nervosa

Belief Updating about Interoceptive States and Body Size Estimates in Anorexia Nervos