Giampaolo Nicolais

Neurobiological Correlates of EMDR Monitoring - An EEG Study

Background Eye Movement Desensitization and Reprocessing (EMDR) is a recognized first-line treatment for psychological trauma. However its neurobiological bases have yet to be fully disclosed. Methods Electroencephalography (EEG) was used to fully monitor neuronal activation throughout EMDR sessions including the autobiographical script. Ten patients with major psychological trauma were investigated during their first EMDR session (T0) and during the last one performed after processing the index trauma (T1). Neuropsychological tests were administered at the same time. Comparisons were performed between EEGs of patients at T0 and T1 and between EEGs of patients and 10 controls who underwent the same EMDR procedure at T0. Connectivity analyses were carried out by lagged phase synchronization. Results During bilateral ocular stimulation (BS) of EMDR sessions EEG showed a significantly higher activity on the orbito-frontal, prefrontal and anterior cingulate cortex in patients at T0 shifting towards left temporo-occipital regions at T1. A similar trend was found for autobiographical script with a higher firing in fronto-temporal limbic regions at T0 moving to right temporo-occipital cortex at T1. The comparisons between patients and controls confirmed the maximal activation in the limbic cortex of patients occurring before trauma processing. Connectivity analysis showed decreased pair-wise interactions between prefrontal and cingulate cortex during BS in patients as compared to controls and between fusiform gyrus and visual cortex during script listening in patients at T1 as compared to T0. These changes correlated significantly with those occurring in neuropsychological tests. Conclusions The ground-breaking methodology enabled our study to image for the first time the specific activations associated with the therapeutic actions typical of EMDR protocol. The findings suggest that traumatic events are processed at cognitive level following successful EMDR therapy, thus supporting the evidence of distinct neurobiological patterns of brain activations during BS associated with a significant relief from negative emotional experiences.

Pretreatment, Intratreatment, and Posttreatment EEG Imaging of EMDR: Methodology and Preliminary Results From a Single Case

Electroencephalography (EEG), due to its peculiar time and spatial resolution, was used for the first time to fully monitor neuronal activation during the whole eye movement desensitization and reprocessing (EMDR) session, including the autobiographical script. The present case report describes the dominant cortical activations (Z-score >1.5) during the first EMDR session and in the last session after the client processed the index trauma. During the first EMDR session, prefrontal limbic cortex was essentially activated during script listening and during lateral eye movements in the desensitization phase of EMDR. In the last EMDR session, the prevalent electrical activity was recorded in temporal, parietal, and occipital cortical regions, with a clear leftward lateralization. These findings suggest a cognitive processing of the traumatic event following successful EMDR therapy and support evidence of distinct neurobiological patterns of brain activations during lateral eye movements in the desensitization phase of EMDR.

Neural processing of emotions in traumatized children treated with Eye Movement Desensitization and Reprocessing therapy: A hdEEG study

Eye Movement Desensitization and Reprocessing (EMDR) therapy has been proven efficacious in restoring affective regulation in post-traumatic stress disorder (PTSD) patients. However, its effectiveness on emotion processing in children with complex trauma has yet to be explored. High density electroencephalography (hdEEG) was used to investigate the effects of EMDR on brain responses to adults’ emotions on children with histories of early maltreatment. Ten school-aged children were examined before (T0) and within one month after the conclusion of EMDR (T1). hdEEGs were recorded while children passively viewed angry, afraid, happy, and neutral faces. Clinical scales were administered at the same time. Correlation analyses were performed to detect brain regions whose activity was linked to children’s traumatic symptom-related and emotional-adaptive problem scores. In all four conditions, hdEEG showed similar significantly higher activity on the right medial prefrontal and fronto-temporal limbic regions at T0, shifting toward the left medial and superior temporal regions at T1. Moreover, significant correlations were found between clinical scales and the same regions whose activity significantly differed between pre- and post-treatment. These preliminary results demonstrate that, after EMDR, children suffering from complex trauma show increased activity in areas implicated in high-order cognitive processing when passively viewing pictures of emotional expressions. These changes are associated with the decrease of depressive and traumatic symptoms, and with the improvement of emotional-adaptive functioning over time.

Assessment of Adolescent Personality Disorders Through the Interview of Personality Organization Processes in Adolescence (IPOP-A): Clinical and Theoretical Implications #

In the field of developmental research, there is a pressing need to develop clinically sounded and empirically grounded tools for the assessment of personality development in adolescence. After a review of the relevant literature on adolescent personality disorders we present through empirical data and clinical material the IPOP-A, a semi-structured interview for adolescents ranging from 13 years old to 21 years old. The IPOP-A seems to be promising to gather information about processes that constitute the building blocks of adolescent personality organization.

Borderline Personality Disorder in Adolescence Through the Lens of the Interview of Personality Organization Processes in Adolescence (IPOP-A): Clinical Use and Implications

Borderline personality disorder can be assessed in adolescence mainly through a dimensional approach that takes into account strengths and weaknesses of emerging personality patterns. Clinical interviews could help clinicians to gather information about adolescent’s functioning, fostering therapeutic alliance and promoting a mentalizing stance during the assessment of borderline adolescents. In this article, the Interview of Personality Organization Processes in Adolescence (IPOP-A) is presented through clinical case material to show its usefulness in clinical and research settings. The IPOP-A assesses an adolescent’s emerging personality along three dimensions: identity, quality of object relations and affect regulation. These dimensions are the core of borderline personality in adolescence.

Moral attitudes predict cheating and gamesmanship behaviors among competitive tennis players

Background: The present study tested Lee et al.’s (2008) model of moral attitudes and cheating behavior in sports in an Italian sample of young tennis players and extended it to predict behavior in actual match play. In the first phase of the study we proposed that moral, competence and status values would predict prosocial and antisocial moral attitudes directly, and indirectly through athletes’ goal orientations. In the second phase, we hypothesized that moral attitudes would directly predict actual cheating behavior observed during match play. Method: Adolescent competitive tennis players (N = 314, 76.75% males, M age = 14.36 years, SD = 1.50) completed measures of values, goal orientations, and moral attitudes. A sub-sample (n = 90) was observed in 45 competitive tennis matches by trained observers who recorded their cheating and gamesmanship behaviors on a validated checklist. Results: Consistent with hypotheses, athletes’ values predicted their moral attitudes through the effects of goal orientations. Anti-social attitudes directly predicted cheating behavior in actual match play providing support for a direct link between moral attitude and actual behavior. Conclusion: The present study findings support key propositions of Lee and colleagues’ model, and extended its application to competitive athletes in actual match play.

Emerging criteria for the low-coherence cannot classify category

ABSTRACT As suggested by Main et al., to respond to the need for an adaptation of the existing Adult Attachment Interview (AAI) coding system, especially regarding the application to nonnormative samples, this study presents additional criteria that characterize the low-coherence cannot classify (CC) category. Three AAIs were selected from a sample of parents of maltreated children. All transcripts indicated a very low coherence, with no evidence of contradictory insecure discourse strategies. Moreover, global category descriptors were identified, together with specific indices of discourse characteristics and features that highlight the breakdown in reasoning and discourse experienced by the speakers. The aim of the study is to illustrate new criteria to identify and rate a low-coherence CC profile toward the operationalization of this pervasively unintegrated state of mind. Through the definition of additional criteria for low-coherence CC category, our study helps the AAI and its coding system be more flexible and effective when dealing with clinical samples.

Neurobiological correlates of EMDR therapy

The EEGs in a group of ten subjects with major psychological trauma treated with EMDR and in ten controls have been registered both during the listening of the autobiographical narrative of the index trauma (script) and during a whole EMDR session. The EEGs have been performed again during the last EMDR session when patients were free of symptoms. During script listening a prevalent activation of the limbic regions corresponding to prefrontal and orbitofrontal cortex has been registered, being explained as the emotional arousal during trauma reliving at the symptomatic phase. The significant decrease of such activations during the late asymptomatic phase represents the neurobiological correlate of recovery. Moreover, the evidence of significant cortical activation in the parietal-temporo-occipital areas, during the last session, suggests a switch of the dominant electrical signal towards cortical areas with a prevalent cognitive function.The EEGs in a group of ten subjects with major psychological trauma treated with EMDR and in ten controls have been registered both during the listening of the autobiographical narrative of the index trauma (script) and during a whole EMDR session. The EEGs have been performed again during the last EMDR session when patients were free of symptoms. During script listening a prevalent activation of the limbic regions corresponding to prefrontal and orbitofrontal cortex has been registered, being explained as the emotional arousal during trauma reliving at the symptomatic phase. The significant decrease of such activations during the late asymptomatic phase represents the neurobiological correlate of recovery. Moreover, the evidence of significant cortical activation in the parietal-temporo-occipital areas, during the last session, suggests a switch of the dominant electrical signal towards cortical areas with a prevalent cognitive function.

Rappresentazioni mentali materne e qualità degli scambi diadici in un gruppo di bambini a rischio di maltrattamento

Maternal representations and quality of dyadic interactions in children at risk of maltreatment - Problem: maltreatment impacts on the quality of interactive exchanges, precociously putting the infant at risk for maladaptive outcomes. Method: research involved 37 mother-infant dyads at risk for maltreatment and 37 non-referred dyads. AAI has been administered to the mothers; furthermore, dyadic interactive exchanges were observed and video-recorded. Results: in comparison with the control group, the at-risk group shows a prevalence of disorganized models (X2= 12,2; p < 0,01). Additionally, in the at-risk group an influence of maternal mental state on the interactive quality has been evidenced: dismissing mothers present lower sensitivity (F = 4,87; p < 0,01), whereas disorganized mothers express more negative affective states (F = 5,65; p < 0,01). Conclusions: early traumatic relational experiences influence maternal state of mind with respect to attachment, thus compromising the process of dyadic affective regulation. Key words: child maltreatment, traumatic experiences, attachment, dyadic interaction. Parole chiave: maltrattamento infantile, esperienze traumatiche, attaccamento, interazione diadica.

EARLY MORAL CONSCIENCE: THE DEVELOPMENT OF A MORAL SHORT PLAYED STORIES PROCEDURE

We set up a cross-sectional study to investigate how moral core selfs mental representations develop from age 3 to 6 years. An ad hoc instrument (Moral Short Played Stories Procedure; MSPSP) was developed to tap into how moral emotions, conducts, and cognitions referred to moral and nonmoral characters. A total of 143 preschoolers completed the MSPSP and moral dilemmas procedures, together with attachment and behavioral inhibition assessment. The main results confirm the hypothesis of a mild developmental trend characterized by the prominence of moral conduct over moral emotion and cognition. In addition, our results stress the emergence of a developmental turning point at around age 4 when procedural moral activation in children predicts the declarative feature of moral conscience.