Marco Garzitto

Linguistic production and syntactic comprehension in schizophrenia and bipolar disorder

Perlini C, Marini A, Garzitto M, Isola M, Cerruti S, Marinelli V, Rambaldelli G, Ferro A, Tomelleri L, Dusi N, Bellani M, Tansella M, Fabbro F, Brambilla P. Linguistic production and syntactic comprehension in schizophrenia and bipolar disorder.

Functional MRI studies in disruptive behaviour disorders

Aggressive or antisocial behaviours with violations of social rules are the main features of disruptive behaviour disorders (DBDs), which are developmental diseases and include conduct disorder and oppositional defiant disorder. In the last decade, several efforts have been made to shed light on the biological underpinnings of DBDs. In this context, the main findings of functional magnetic resonance imaging studies in DBD are reported here. There are indications of neural dysfunctions in response to affective stimuli, especially regarding medial and orbitofrontal prefrontal cortex and connected subcortical structures.

Twelve months of TEACCH-oriented habilitation on an Italian population of children with autism

Abstract Autism is a severe disorder and it is important to implement targeted interventions designed on the strengths and needs of affected children in order to improve their daily life. In this sense, the TEACCH program (Treatment and Education of Autistic and related Communication handicapped CHildren) may be useful in autism. A longitudinal study was conducted in Italy to evaluate the effectiveness of our treatment and the best age to start a low-intensive TEACCH-oriented intervention. Twenty-eight children with autism were treated twice a week following the guidelines inspired by the TEACCH intervention. Developmental abilities were rated at baseline and after six and 12 months with the Psychoeducational Profile-Revised (PEP-R) scale. Developmental abilities significantly improved during the first 6 months with progressive amelioration throughout the 12-month follow-up period, particularly for children under 40 months of age. Specifically perception, motor skills, and cognition improved only in patients who begun the program before 60 months of age. This study shows that early low-intensive TEACCH habilitation is effective in improving developmental abilities in autism even after 6 months, particularly in patients at the very early stages of the disease. It is therefore crucial to begin the habilitation program in autism at the very early stage of the illness in order to maximize the effectiveness of the treatment.

Attempts at memory control induce dysfunctional brain activation profiles in Generalized Anxiety Disorder: An exploratory fMRI study

Suppression of aversive memories through memory control has historically been proposed as a central psychological defense mechanism. Inability to suppress memories is considered a central psychological trait in several psychiatric disorders, including Generalized Anxiety Disorder (GAD). Yet, few studies have attempted the focused identification of dysfunctional brain activation profiles when patients with Generalized Anxiety Disorders attempt memory control. Using a well-characterized behavioral paradigm we studied brain activation profiles in a group of adult GAD patients and well-matched healthy controls (HC). Participants learned word-association pairs before imaging. During fMRI when presented with one word of the pair, they were instructed to either suppress memory of, or retrieve the paired word. Subsequent behavioral testing indicated both GAD and HC were able to engage in the task, but attempts at memory control (suppression or retrieval) during fMRI revealed vastly different activation profiles. GAD were characterized by substantive hypo-activation signatures during both types of memory control, with effects particularly strong during suppression in brain regions including the dorsal anterior cingulate and the ventral prefrontal cortex. Attempts at memory control in GAD fail to engage brain regions to the same extent HC, providing a putative neuronal signature for a well-established psychological characteristic of the illness.

Normative data and effects of age and gender on temperament and character dimensions across the lifespan in an Italian population: A cross-sectional validation study

BACKGROUND The short version of the Temperament and Character Inventory (TCI-125) has been employed for the study of personality traits in both clinical and normal populations. However, to the best of our knowledge, no studies explored the psychometric properties of this instrument in healthy individuals across the lifespan. We here provide the Italian normative data and present the personality features according to age and gender in a sample of healthy individuals. METHODS A cross-sectional study was carried out in a total of 1430 Italian healthy individuals ranging from 13 to 67 years (59.3% females). We evaluated the factorial model of the TCI-125, explored the internal consistency of the scales and carried out univariate analyses of variance for the investigation of age and gender differences in temperament and character dimensions. RESULTS Confirmatory factor analysis only partially confirmed the factor structure, with some Reward Dependence, Self-Directedness, and Cooperativeness items showing poor fit. Overall we found acceptable internal consistencies for all the dimensions of the TCI-125 across all age groups, except for Reward Dependence, Persistence, and Novelty Seeking, which showed unsatisfactory internal consistency in younger age groups. Furthermore, we found significant age differences in most temperament and all character dimensions. Finally, in specific age groups we also observed significantly lower scores in males compared to females in Harm Avoidance, Reward Dependence and all character dimensions except for Self-Directedness, on which males scored higher than females. CONCLUSIONS Although this study only partially confirmed the factor structure of the TCI-125 and suggested limited homogeneity for some temperament scales, overall our results supported the reliability of the TCI-125, which can therefore be considered a useful tool for exploring personality traits in both clinical and normal samples. Moreover, this study suggested the need of using this instrument with caution in adolescents.

Reliability and normative data of the Perceptual Aberration Scale in an Italian juvenile general population sample.

Psychometric tools, such as the Perceptual Aberration Scale (PAS), have been developed to identify people at risk to develop psychosis. This paper aims at providing an Italian version of the Perceptual Aberration Scale and its normative data for the general juvenile Italian population. The Italian version of the PAS was produced using three independent translators. It was administered to 1089 non-clinical participants, stratified into three age-groups, i.e., 8-13, 14-17 and 18-24. The Italian version of the PAS displayed good internal consistency in each age-group evaluated (i.e. Alpha Coefficients: 0.90 for the 8-13 age-group, 0.84 for the 14-17 age-group, and 0.87 for the 18-24 age-group) and the assumption of unidimensionality was corraborate. Furthermore, normative data for the three groups were collected (i.e. cut-offs: 25 for the 8-13 age-group, 21 for the 14-17 age-group and 20 for the 18-24 age-group) and an age-related difference, as the 18-24 group scored lower than the younger groups, was found. The Italian version of the PAS proved to be a reliable psychometric tool to investigate perceptual aberration during childhood, adolescence and young adulthood.

Temperament and character effects on late adolescents’ well-being and emotional-behavioural difficulties

Background Research on adults points to personality as a crucial determinant of well-being. The present study investigates the question of personality’s relation to well-being and psychosocial adjustment in adolescence. Methods We assessed the role of temperament and character (Temperament and Character Inventory, TCI-125), on psychological well-being (PWB; Psychological Well-Being scales), subjective well-being (SWB; Positive and Negative Affect, PA and NA, respectively), and psychosocial adjustment (emotional-behavioural problems measured by the Strengths and Difficulties Questionnaire for Adolescents, SDQ-A), in 72 Italian late adolescents (aged 17.5 ± 0.75). Multiple regressions were conducted to predict PWB, SWB, and SDQ-A scores using TCI-125 scales as predictors. Results Character maturity, and in particular Self-Directedness, had a widespread protective effect on well-being and psychosocial adjustment, while different strengths and emotional-behavioural difficulties were associated to specific temperamental and character traits. For example, Harm-Avoidance and Novelty-Seeking positively predicted internalized and externalized problems, respectively. Discussion The present results suggest the usefulness of continuing to evaluate temperament and, in particular, character dimensions in investigations focused on adolescents’ well-being and psychosocial functioning, especially in the contexts of potential interventions aimed at enhancing development of adolescents’ character dimensions at the intrapersonal, interpersonal, and transpersonal levels.

The mental simulation of state/psychological verbs in the adolescent brain: An fMRI study

&NA; This fMRI study investigated mental simulation of state/psychological and action verbs during adolescence. Sixteen healthy subjects silently read verbs describing a motor scene or not (STIMULUS: motor, state/psychological verbs) and they were explicitly asked to imagine the situation or they performed letter detection preventing them from using simulation (TASK: imagery vs. letter detection). A significant task by stimuli interaction showed that imagery of state/psychological verbs, as compared to action stimuli (controlled by the letter detection) selectively increased activation in the right supramarginal gyrus/rolandic operculum and in the right insula, and decreased activation in the right intraparietal sulcus. We compared these data to those from a group of older participants (Tomasino et al. 2014a). Activation in the left supramarginal gyrus decreased for the latter group (as compared to the present group) for imagery of state/psychological verbs. By contrast, activation in the right superior frontal gyrus decreased for the former group (as compared to the older group) for imagery of state/psychological verbs.

T85. PRELIMINARY ANALYSES OF THE NEUROCOGNITIVE DATABASE OF PRONIA USING UNIVARIATE STATISTICS: CLINICAL GROUP DIFFERENCES

Abstract Background Neuro-cognitive deficits are a core feature of psychosis. In the clinical high risk stages of psychosis, neuro-cognitive deficits qualitatively affect the same functions while being quantitatively less marked compared to those in full-blown disorder. Therefore, cognitive impairments are considered to be an important intermediate phenotype for transition to psychosis. Partially overlapping deficits were also reported in depressive disorders, so it is important to identify deficits specifically associated to psychotic symptoms from those common to other conditions. We aimed to identify and differentiate cognitive deficits specifically associated to [i] psychopathology in general (i.e., presence of clinical diagnosis); [ii] psychotic symptoms; [iii] sub- and threshold levels of psychotic symptoms. Methods We compared four groups of participants within the project Personalised Prognostic Tools for Early Psychosis Management (PRONIA; www.pronia.eu). The PRONIA Cognitive Battery (PCB) includes 10 tests selected as reliable measures of neuropsychological difficulties in patients at high-risk of psychosis. The scores were obtained from the PRONIA Discovery Sample, which included 707 participants: 278 healthy controls (HC); 138 recent-onset depression (ROD); 139 clinical high-risk (CHR); 152 recent-onset psychosis (ROP), tested in seven sites across Europe. At first the norms were calculated correcting the HC’s raw scores by sex, age, cognitive level, education, and mother language (English, Finnish, German, Italian, or other). Then, univariate analyses of variance with a priori contrasts were used for directly comparing [i] HC vs ROD/CHR/ROP; [ii] ROD vs CHR/ROP; [iii] CHR vs ROP. Results The difference in cognitive performance between the clinical groups (ROD, CHR, ROP) as compared to the HC [i], was shown in measures of: speed of execution (ωP2 range 0.016–0.123; all p≤0.035); sustained attention (ωP2: 0.024–0.080; p≤0.022); verbal fluency (ωP2: 0.020–0.031; p≤0.002); emotion recognition (ωP2=0.026; p=0.001); visuo-spatial (ωP2: 0.018–0.049; p≤0.006) and verbal (ωP2: 0.038–0.075; p<0.001) both short- and long-term memory. Three clinical groups did not show significant difference in salience measures when compared with HC (p≥0.053), beyond a main effect of group (ωP2=0.015). Differences between ROD and CHR/ROP groups [ii] were detected in: speed of execution (all p≤0.001); sustained attention (p≤0.011); short-term and working memory (p≤0.004); long-term memory (p≤0.001); semantic verbal fluency (p=0.024); emotion recognition (p=0.005); and estimation of adaptive salience (p=0.021). When compared with ROP, CHR [iii] performed significantly better in the same domains that differentiated ROD from CHR/ROP, with the important exception of long-term memory measures (p≥0.094). Discussion These results are consistent with the expectations drawn from previous literature on the neuropsychological impairments in psychotic disorders and CHR participants. Furthermore, PCB showed to be useful in [i] psychopathology in general, [ii] differentiating between recent-onset depression and psychotic symptoms, and [iii] between threshold and sub-threshold psychotic symptoms. Interestingly, long-term memory deficits contributed more in differentiating psychotic symptoms from other psychopathological entities (ROD vs CHR/ROP comparison) than along the spectrum of attenuated psychotic symptoms, resulting in full clinical picture of psychosis (CHR vs ROP). Finally, salience attribution difficulties were confirmed to be associated with (sub-)threshold psychotic symptoms, more than to general psychopathology.

Reduced cortical thickness and increased gyrification in generalized anxiety disorder: a 3 T MRI study

BACKGROUND Although the study of the neuroanatomical correlates of generalized anxiety disorder (GAD) is gaining increasing interest, up to now the cortical anatomy of GAD patients has been poorly investigated and still no data on cortical gyrification are available. The aim of the present study is to quantitatively examine the cortical morphology in patients with GAD compared with healthy controls (HC) using magnetic resonance imaging (MRI). To the best of our knowledge, this is the first study analyzing the gyrification patterns in GAD. METHODS A total of 31 GAD patients and 31 HC underwent 3 T structural MRI. For each subject, cortical surface area (CSA), cortical thickness (CT), gray matter volume (GMV), and local gyrification index (LGI) were estimated in 19 regions of interest using the Freesurfer software. These parameters were then compared between the two groups using General Linear Model designs. RESULTS Compared with HC, GAD patients showed: (1) reduced CT in right caudal middle frontal gyrus (p < 0.05, Bonferroni corrected), (2) hyper-gyrification in right fusiform, inferior temporal, superior parietal and supramarginal gyri and in left supramarginal and superior frontal gyri (p < 0.05, Bonferroni corrected). No significant alterations in CSA and GMV were observed. CONCLUSIONS Our findings support the hypothesis of a neuroanatomical basis for GAD, highlighting a possible key role of the right hemisphere. The alterations of CT and gyrification in GAD suggest a neurodevelopmental origin of the disorder. Further studies on GAD are needed to understand the evolution of the cerebral morphology with age and during the clinical course of the illness.