Novel metaphors comprehension in a child with High-Functioning Autism Spectrum Disorders. A study on assessment and treatment

Until the first decade of the current millennium, the literature on metaphor comprehension highlighted typical difficulties in children with high-functioning Autism Spectrum Disorder (ASD). More recently, some scholars have devised special programs for enhancing the capability of understanding metaphors in these children. This article presents a case study based on a treatment aiming at enhancing novel metaphor comprehension in a high-functioning child with ASD. M.M., a pseudoacronym for an 8;10 year-old boy, diagnosed with high-functioning ASD, was first assessed with a metaphor comprehension test. This testing (at time TO) highlighted a rigid refusal of metaphors and a marked tendency toward literal interpretation. A baseline treatment (8 sessions of 45-60 min each, twice a week) was implemented, based on a series of recognition, denomination and emotion comprehension activities. M. M.'s metaphor comprehension was assessed a second time (Ti), followed by the experimental treatment (same duration and frequency as the first one), specifically focused on metaphor comprehension. Finally, a third assessment of metaphor comprehension took place (T2), followed by a last assessment 4 months later (follow-up, T3). The comparison between the performances at the metaphor comprehension test across the four assessments, from TO to T3, showed that the baseline treatment produced no effect at all, whereas a significant improvement appeared at T2, just after the experimental treatment, later confirmed at the follow up. Both quantitative and qualitative results showed an evident improvement in the way M.M. handled the semantic issues posed by the metaphors of the test, in line with the strategies he was taught during the treatmen

Biomarkers proteici in pazienti con sintomi psicotici: dati preliminari

RIASSUNTO Introduzione: i disturbi psicotici come la schizofrenia, il disturbo bipolare e il disturbo schizoaffettivo sono malattie psichiatriche complesse ed invalidanti ad etiopatogenesi multifattoriale. Nonostante l’abbondante ricerca, la diagnosi e la classificazione di tali disturbi è esclusivamente basata su segni e sintomi o sulla descrizione del comportamento riportata dai pazienti stessi o valutata dagli operatori. Attualmente le conoscenze scientifiche non consentono ancora di migliorare la classificazione diagnostica stratificando i pazienti in gruppi più omogenei sulla base dei meccanismi neurobiologici che sottendono le entità cliniche. Il crescente interesse nella ricerca di biomarcatori proteici deriva dalla possibilità, con le attuali tecnologie, di studiare migliaia di proteine in un solo esperimento. Scopo dello studio oggetto di questa tesi è l'individuazione di biomarcatori proteici nei linfociti di pazienti con disturbi psicotici in fase acuta confrontati con pazienti psichiatrici senza anamnesi di episodi psicotici. Metodo: i due gruppi (psicosi in fase acuta e controlli psichiatrici non psicotici), sono stati valutati attraverso strumenti clinici (SCID-I, PANSS, YMRS, HAM-A, HAM-D, SCI-MOOD e SCI-PSY) e mediante un prelievo di sangue periferico. Dal sangue sono stati separati i linfociti e da questi sono stati preparati gli estratti proteici da sottoporre ad elettroforesi bidimensionale (2-DE). I pattern proteici ottenuti sono stati messi a confronto utilizzando il software Progenesis Same Spot ed è stata effettuata l’analisi statistica univariata (Anova) e multivariata (PCA). Risultati: i due gruppi hanno dimostato differenze statisticamente significative nel punteggio totale alla PANSS (p<0.001), nel punteggio paziale della PANSS per sintomi positivi (p<0.001); per sintomi negativi (p=0,05), e per la psicopatologia generale (p=0.002) confermando i criteri di inclusione e appartenenza ai gruppi. Anche i punteggi ottenuti alla YMRS differivano significativamente (p=0.001). Mentre i due gruppi non differiscono in modo statisticamente significativo per quanto riguarda i punteggi ottenuti alla HAM-A e alla HAM-D. L'elettroforesi bidimensionale ha messo in evidenza differenze significative nel profilo proteico linfocitario fra i due gruppi, in particolare per gli spots 1083, 1088 e 815. Dall’analisi multivariata si osserva una buona separazione tra le due classi analizzate, con un valore di t1 per la prima componente del 54%. Una separazione all’interno della classe è evidenziata dal valore della seconda componente t2=19.7% che sottolinea una leggera divergenza tra i pool della stessa classe. Questo fenomeno è visibile sia nel gruppo con psicosi acuta che all’interno del gruppo di controlli psichiatrici. Conclusioni: i risultati dell'elettroforesi bidimensionale evidenziano l'esistenza di differenze significative del proteoma linfocitario dei pazienti con psicosi acute rispetto ai controlli psichiatrici. Si tratta di uno studio esplorativo preliminare effettuato su un campione esiguo di pazienti e per questo motivo al momento non è possibile formulare delle ipotesi circa il significato di queste differenze. Inoltre i controlli psichiatrici, in questa fase del reclutamento non sono demograficamente e clinicamente accoppiati ai pazienti in fase acuta. Questi dati suggeriscono la necessità di analizzare singolarmente ogni soggetto e di estendere il campione in modo da rispettare la procedura caso-controllo. Tutti gli spot differenzialmente espressi verranno infine opportunamente trattati tramite spettrometria di massa per l’identificazione delle proteine che permetterà la formulazione di ipotesi circa l'origine e i meccanismi biologici alla base delle differenze tra classi

Beyond the literal meaning of words in children with klinefelter syndrome: two case studies

Literature on children with Klinefelter Syndrome (KS) points to general linguistic difficulties in both comprehension and production among other cognitive functions, and in the majority of cases, these coexist with an intellectual level within the norms. In these conditions, children having language delay generally engage in language therapy and are systematically monitored across ages. In this article, we present the profiles of two children with KS (47, XXY), aged 9.1 (Child S) and 13 (Child D), whose language development was assessed as adequate at age 3, and for this reason, did not receive any language treatment. At the present stage, their IQ, as measured by Wechsler Scales (Child S: 92; Child D: 101), is within the norm, but they both present marked weaknesses in pragmatic skills such as figurative language comprehension. The analysis of these two cases points to the need to go beyond global indexes of verbal abilities, as the same global index may mask a wide diversification of individual profiles. In addition, this study underlines the importance of monitoring the developmental trajectories of children like Child D and Child S, because weaknesses in pragmatic skills that are relevant for both academic achievement and social adaptation could emerge at later stages

Poor written and oral text comprehension in third grade children. A multiple case study

In this multiple case study we analyzed oral text comprehension, reading profiles and underlying cognitive abilities (attention, executive functions, working memory, narrative memory, rapid automatized naming and vocabulary) of 9 children identified as poor written text comprehenders after a school screening on 75 third grade children. Four out of the 9 children were named Language-Minority (L-M) children, since they had immigrant parents. The remaining 5 children were born in Italy from Italian parents. The comparisons of the two subgroups suggested that the lexical route of reading was particularly impaired in the L-M subgroup and that written text comprehension was weakened by restricted vocabulary which, in turn, was not supported by efficient phonological short-term memory. In a second type of data analysis we examined the individual profiles of the 9 children, irrespective of their belonging to the L-M or Italian subgroups, and identified different patterns of associations among reading performance, written text comprehension and oral text comprehension. The findings showed that poor text comprehension always co-occurred with word and/or text reading difficulties which, in turn, were associated to slow naming and weak verbal working memory. Moreover, when children had both written and oral text comprehension difficulties, not only verbal working memory was impaired but also narrative memory, suggesting a weakness in the episodic buffer (Baddeley 2000; 2010). The implications of poor working memory associated to slow naming and/or weak episodic buffer for text comprehension are discusse

Herbal highs: review on psychoactive effects and neuropharmacology

Background: A new trend among users of new psychoactive substances’ the consumption of “herbal highs”: plant parts containing psychoactive substances. Most of the substances extracted from herbs, in old centuries were at the centre of religious ceremonies of ancient civilizations. Currently, these herbal products are mainly sold by internet web sites and easily obtained since some of them have no legal restriction. Objective: We reviewed psychoactive effects and neuropharmacology of the most used “herbal highs” with characterized active principles, with studies reporting mechanisms of action, pharmacological and subjective effects, eventual secondary effects including intoxications and/or fatalities Method: The PubMed database was searched using the following key.words: herbal highs, Argyreia nervosa, Ipomoea violacea and Rivea corymbosa; Catha edulis; Datura stramonium; Piper methysticum; Mitragyna speciosa. Results: Psychoactive plants here reviewed have been known and used from ancient times, even if for some of them limited information still exist regarding subjective and neuropharmacological effects and consequent eventual toxicity when plants are used alone or in combination with “classical” drugs of abuse. Conclusion: Some “herbal highs” should be classified as harmful drugs since chronic administration has been linked with addiction and cognitive impairment; for some others taking into consideration only the recent trends of abuse, studies investigating these aspects are lacking

Impact of the major SSWs of February 2018 and January 2019 on the middle atmospheric nitric oxide abundance

The Arctic middle atmosphere was affected by major sudden stratospheric warmings (SSW) in February 2018 and January 2019, respectively. In this article, we report for the first time the impact of these two events on the middle atmospheric nitric oxide (NO) abundance. The study is based on measurements obtained during two dedicated observation campaigns, using the Sub-Millimetre Radiometer (SMR) aboard the Odin satellite, measuring NO globally since 2003. The SSW of February 2018 was similar to other, more dynamically quiet, Arctic winters in term of NO downward transport from the upper mesosphere–lower thermosphere to lower altitudes (referred to as energetic particle precipitation indirect effect EPP-IE). On the contrary, the event of January 2019 led to one of the strongest EPP-IE cases observed within the Odin operational period. Important positive NO anomalies were indeed observed in the lower mesosphere–upper stratosphere during the three months following the SSW onset, corresponding to NO volume mixing ratios more than 50 times higher than the climatological values. These different consequences on the middle atmospheric composition are explained by very different dynamical characteristics of these two SSW events

Training verbal working memory in children with mild intellectual disabilities: effects on problem-solving

This multiple case study explores the effects of a cognitive training program in children with mild to borderline intellectual disability. Experimental training effects were evaluated comparing pre-post-test changes after (a) a baseline phase versus a training phase in the same participant, (b) an experimental training versus either a no intervention phase or a control training in two pairs of children matched for cognitive profile. Key elements of the training program included (1) exercises and card games targeting inhibition, switching, and verbal working memory, (2) guided practice emphasizing concrete strategies to engage in exercises, and (3) a variable amount of adult support. The results show that both verbal working memory analyzed with the listening span test and problem-solving tested with the Raven’s matrices were significantly enhanced after the experimental trainin

The bridge between classical and ‘synthetic’/chemical psychoses: towards a clinical, psychopathological and therapeutic perspective

© 2019 Orsolini, Chiappini, Papanti, De Berardis, Corkery and Schifano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.The critical spread and dissemination of novel psychoactive substances (NPS), particularly among the most vulnerable youngsters, may pose a further concern about the psychotic trajectories related to the intake of new synthetic drugs. The psychopathological pattern of the “new psychoses” appears to be extremely different from the classical presentation. Therefore, clinicians need more data on these new synthetic psychoses and recommendations on how to manage them. The present mini-review aims at deepening both the clinical, psychopathological features of synthetic/chemical NPS-induced psychoses and their therapeutic strategies, according to the different NPS classes implicated, by underlining the main differences with the “classical” psychoses. A comprehensive review was conducted using the PubMed/Medline database by combining the search strategy of free-text terms and exploding a range of MESH headings relating to the topics of novel psychoactive substances and synthetic/chemical psychoses as follows: {(Novel Psychoactive Substances[Title/Abstract]) AND Psychosis[Title/Abstract])} and for each NPS categories as well, focusing on synthetic cannabinoids and cathinones, without time and/or language restrictions. Finally, an overview of the main clinical and psychopathological features between classical versus NPS-induced chemical/synthetic psychoses is provided for clinicians working with dual disorders and addiction psychiatry. Further insight is given here on therapeutic strategies and practical guidelines for managing patients affected with synthetic/chemical NPS-induced psychoses.Peer reviewedFinal Published versio

Use of Medicinal Cannabis and Synthetic Cannabinoids in Posttraumatic Stress Disorder (PTSD): a systematic review

Background and Objectives: Post-traumatic stress disorder (PTSD) is a common psychiatric disorder resulting from a traumatic event, is manifested through hyperarousal, anxiety, depressive symptoms, and sleep disturbances. Despite several therapeutic approaches being available, both pharmacological and psychological, recently a growing interest has developed in using cannabis and synthetic cannabinoids stems from their consideration as more efficient and better tolerated alternatives for the treatment of this condition. The present paper aims to evaluate the clinical and therapeutic potentials of medical cannabis and synthetic cannabinoids in treating PTSD patients. Methods: A systematic electronic search was performed, including all papers published up to May 2019, using the following keywords (((cannabis[Title/Abstract]) OR (synthetic cannabinoids [Title/Abstract])) AND ((PTSD[Title/Abstract]) OR (Posttraumatic stress disorder[Title/Abstract]))) for the topics ‘Cannabis’, ‘Synthetic Cannabinoids’, ‘PTSD’, and MESH terms, on the PubMed, Cochrane Library, and Web of Science online databases. For data gathering purposes, PRISMA guidelines were followed. Results were organized into two groups, considering cannabis and synthetic cannabinoids as different therapeutic approaches for PTSD. Results: Present data show that cannabis and synthetic cannabinoids, both acting on the endocannabinoids system, may have a potential therapeutic use for improving PTSD symptoms, e.g., reducing anxiety, modulating memory-related processes, and improving sleep. Conclusions: Even though the current literature suggests that cannabis and synthetic cannabinoids may have a role in the treatment of PTSD, there is currently limited evidence regarding their safety and efficacy. Therefore, additional research is needed in order to better understand the effectiveness and therapeutic usage of these drug classes and monitor their safety.Peer reviewe