Adesione al trattamento, sostegno familiare e rapporto con il medico in pazienti affetti da ipertensione essenziale

La non aderenza al trattamento rappresenta un comportamento frequentemente osservato nella pratica medica, soprattutto in quelle patologie caratterizzate dall\u2019assenza di sintomi come l\u2019ipertensione. Scopo del presente studio \ue8 stato quello di indagare l\u2019aderenza al trattamento farmacologico in un campione di 61 pazienti affetti da ipertensione essenziale, cercando di evidenziare l\u2019eventuale ruolo svolto rispetto a tale collaborazione dal sostegno percepito da parte della famiglia, dalla soddisfazione rispetto al rapporto con il proprio medico e dell\u2019eventuale presenza di sintomi psicopatologici. I risultati del presente studio non hanno mostrato alcuna correlazione significativa tra le variabili esaminate e l\u2019adesione al trattamento nel campione esaminato. Gli autori sottolineano come i presenti risultati siano coerenti con studi precedenti che non hanno finora individuato chiare correlazioni tra l\u2019aderenza al trattamento dell\u2019ipertensione e diversi fattori individuali, affettivi, sociali,e sanitari

To Fear is to Gain? The Role of Fear Recognition in Risky Decision Making in TBI Patients and Healthy Controls

Fear is an important emotional reaction that guides decision making in situations of ambiguity or uncertainty. Both recognition of facial expressions of fear and decision making ability can be impaired after traumatic brain injury (TBI), in particular when the frontal lobe is damaged. So far, it has not been investigated how recognition of fear influences risk behavior in healthy subjects and TBI patients. The ability to recognize fear is thought to be related to the ability to experience fear and to use it as a warning signal to guide decision making. We hypothesized that a better ability to recognize fear would be related to a better regulation of risk behavior, with healthy controls outperforming TBI patients. To investigate this, 59 healthy subjects and 49 TBI patients were assessed with a test for emotion recognition (Facial Expression of Emotion: Stimuli and Tests) and a gambling task (Iowa Gambling Task (IGT)). The results showed that, regardless of post traumatic amnesia duration or the presence of frontal lesions, patients were more impaired than healthy controls on both fear recognition and decision making. In both groups, a significant relationship was found between better fear recognition, the development of an advantageous strategy across the IGT and less risk behavior in the last blocks of the IGT. Educational level moderated this relationship in the final block of the IGT. This study has important clinical implications, indicating that impaired decision making and risk behavior after TBI can be preceded by deficits in the processing of fear

WHAT HAPPENS TO HEART RATE DURING THE VIEWING OF LONG LASTING PLEASANT STIMULI?

Previous studies have shown larger heart rate deceleration during the viewing of unpleasant pictures compared to neutral and pleasant stimuli. More recently it has also been shown that high arousing pleasant pictures determine greater heart rate deceleration than neutral pictures. Less is known on heart rate changes during longer lasting pleasant stimuli. Particularly few studies have compared heart rate changes during high arousing pleasant and unpleasant film clips. The present study investigated the effects of high arousing pleasant (erotic film) and unpleasant (surgery film) film clips (120 sec) on heart rate, respiratory sinus arrhythmia (RSA), skin conductance level and corrugator EMG activity. As expected, arousal ratings of the pleasant and the unpleasant film clips did not differ from one another and were evaluated as more arousing compared to the neutral film. Results indicated a greater heart rate deceleration to the surgery and the erotic film clips compared to the neutral film. Particularly no differences were found between the two emotional films during the first 60 seconds fromthe onset of the stimuli, while during the last 60 seconds a greater deceleration for the surgery film compared to the erotic film was observed. No differences were found among the three films in RSA. A higher skin conductance level was found for the arousing film clips compared to the neutral. These results suggest that high arousing pleasant and unpleasant stimuli elicit a different pattern of heart rate changes across time

Adult Attachment Styles and Psychological Disease: Examining the Mediating Role of Personality Traits

ABSTRACT. The aim of the present study was to examine differences in anxiety and depression related to differences in attachment models of the self and of others and whether personality traits mediate this relationship. The authors assessed attachment styles, anxiety, depression, and personality traits among 274 adult volunteers. Participants were classified into 4 attachment groups (secure, preoccupied, fearful, and dismissing\u2013avoidant) according to K. Bartholomew\u2019s (1990) model. The present authors found significant differences among attachment groups on anxiety and depressive symptoms with attachment styles involving a negative self-model showing higher scores than attachment styles characterized by a positive self-model. The authors also found that differences between attachment styles in anxiety and depression remained significant when personality factors related to attachment prototypes were entered as covariates. Results indicate that secure attachment in adults was associated with better mental health, while insecure attachment styles characterized by negative thinking about the self were associated with higher depression and anxiety scores. Our findings seem to evidence that attachment and personality are only partly overlapping and that attachment cannot be considered as redundant with personality in the explanation of psychological disease

Un confronto tra Relationship Questionnaire (RQ) e Attachment Style Questionnaire (ASQ)

Le tecniche di misurazione dello stile d\u2019attaccamento adulto si sono sviluppate secondo due approcci divergenti: Il primo ha come scopo principale la discriminazione fra gli stili di attaccamento mentre il secondo si pone come fine ultimo la descrizione dettagliata delle diverse sfumature dell\u2019attaccamento. In ambito clinico questa discrepanza negli obiettivi comporta notevoli difficolt\ue0 quando occorre paragonare informazioni ottenute dai diversi questionari, ciascuno dei quali offre una misura dell\u2019attaccamento utilizzando una propria singolare prospettiva. Obiettivo di questa ricerca \ue8 mettere a confronto queste due modalit\ue0 di misura dell\u2019attaccamento attraverso l\u2019analisi della relazione fra un questionario a scelta forzata a pochi items, l\u2019RQ di Bartolomew e Horowitz (1990), e un questionario a scala multi-items, l\u2019ASQ di Feeney, Noller e Callan (1994). Questo studio ha coinvolto 293 donne e 177 uomini con un\u2019et\ue0 media di 32.9 anni (range 14-68). Tutti i soggetti sono stati analizzati sia per quando riguarda il loro stile di attaccamento che rispetto al livello di ansia e di depressione. Lo stile di attaccamento \ue8 stato esaminato tramite il Relationship Questionnaire (RQ, Bartolomew and Horowitz, 1990, Bartolomew and Horowitz, 1991) e l\u2019Attachment Style Questionnaire (ASQ, Feeney, Noller and Hanrahan, 1994). A tutti i soggetti sono inoltre stati somministrati lo STAI di Spielberger, Gorsuch e Leschne (1968), per misurare l\u2019ansia di tratto e di stato e il BDI di Beck e Steer (1986) per valutare la depressione. Dai risultati emerge uno spostamento significativo verso uno stile sicuro all\u2019aumentare dell\u2019et\ue0. Dall\u2019analisi dell\u2019Alpha di Cronbach si rilevano degli indici di affidabilit\ue0 discreti per entrambi i questionari. Per quanto riguarda l\u2019RQ, l\u2019analisi della correlazione fra i diversi stili di attaccamento ha individuato una buona correlazione fra gli stili non sicuri anche se la distinzione fra questi e lo stile sicuro non risulta cos\uec netta come postulano Bartolomew e Horowitz (1991). Il Multidimensional Scaling e l\u2019Analisi Fattoriale forniscono una descrizione dei dati e permettono il confronto con i modelli teorici di riferimento. I risultati confermano che l\u2019ASQ e L\u2019RQ individuano due dimensioni importanti che si potrebbero associare alla divisione fra modello di s\ue9 e modello dell\u2019altro cos\uec come postulata dagli stessi modelli teorici di riferimento. Riprendendo l\u2019analisi di Feeney, Noller e Hanrahan (1994), questi fattori possono essere spiegati come ansia per le relazioni (legata alle scale preoccupazione per le relazioni, bisogno di approvazione e mancanza di fiducia) e disagio per l\u2019intimit\ue0 (legata alle scale disagio per l\u2019intimit\ue0 e secondariet\ue0 delle relazioni). La concordanza fra i due tipi di questionari studiata tramite l\u2019analisi della correlazione e l\u2019analisi della varianza multivariata fa pensare che nonostante le diversit\ue0 di costrutto e struttura gi\ue0 menzionate si pu\uf2 pensare a una base teorica comune molto forte, come gi\ue0 evidenziato dalle analisi descrittive. Infine, dall\u2019analisi della relazione fra gli stili di attaccamento ottenuti all\u2019RQ e all\u2019ASQ e i punteggi di ansia e depressione evidenziano che c\u2019\ue8 una relazione fra gli stili individuati dall\u2019RQ e i livelli di ansia e depressione mentre non tutte le scale determinate dall\u2019ASQ sono correlate all\u2019ansia e alla depressione

Alexithymia, Verbal Ability and Emotion Recognition

Although previous studies seem to indicate that alexithymic individuals have a deficit in their ability to recognize emotional stimuli, none had studied the relationship between alexithymia and verbal and non verbal abilities and their possible role in emotion recognition. The aim of the present study is to further investigate the relationship between alexithymia and emotion recognition ability. In particular we studied whether this relationship is mediated by verbal ability. Thirty-five students were selected from a group of 91 University students previously screened for alexithymia (Toronto Alexithymia Scale;TAS-20). Participants were shown black and white slides depicting facial expression of the following emotions: anger, sadness, disgust, surprise, happiness and fear. Compared to low alexithymic participants, and, more importantly, taking verbal IQ into account, high alexithymic and low alexithymic participants did not differ in emotion recognition

Facial emotion recognition in trait anxiety

The study investigated the relationship between recognition of emotional facial expressions and trait anxiety. A nonclinical sample of 19 participants with high-trait anxiety was selected, using the trait version of the State-Trait Anxiety Inventory, and compared with a sample of 20 participants with low-trait anxiety on a facial expression recognition task. Visual stimuli were 42 faces, representing seven emotional expressions: anger, sadness, happiness, fear, surprise, disgust and neutral. Participants had to identify the emotion portrayed by each face. Results showed that participants with high-trait anxiety recognized fear faces significantly better while the two groups did not differ in recognition of other facial expression