Trust or Distrust Toward Healthcare Services: Breast Screening in the North and South of Italy

This article follows a previous study that has recently been published in Narrare I Gruppi and explored the reasons for the large numeric gap between the regions of the North and South of Italy, referring to the breast cancer screening program adherence rate sponsored by the Italian Healthcare System, that addresses all women living in Italy ranging in age between 48 and 69 years, and proposes a free mammogram every two years. The effectiveness of cancer early detections has been widely demonstrated by medical research; this kind of diagnosis is particularly important in the case of breast cancer. A diagnosis of this form of cancer at its early phases in 97% of cases allows women to survive at least five years after it. However, the different level of trust women feel for healthcare structures is the discriminating element between the North and South of Italy for their access to the screening program. This topic will be thoroughly analyzed by presenting the results of research aimed at evaluating the meaning given to the outcomes of a first exploratory study, this second study also offers the opportunity to share our results within the social context that has generated them. The outcomes of the present research have been presented to a group of “privileged witnesses” living in the South (Naples and its surroundings): 12 women aging from 49 to 65, and 5 healthcare workers (one doctor, 25 two nurses, and two Local Health Authority supervisors); they took part in three Focus Groups for an in-depth look of the theme in question. The analyses of the groups' debates, carried out by means of a software for text analysis (T-LAB), confirmed the results of the previous research: the diffidence and lack of synergy between institutions and healthcare workers are the causes of southern women's lack of participation to the breast cancer screening program. In particular, the comparison between women's and workers' viewpoints shows a different emotional connotation about the possibility to improve participation to the screening: the workers' optimism countervails women's distrust and pessimism.     

Mental rotation training: transfer and maintenance effects on spatial abilities

One of the aims of research in spatial cognition is to examine whether spatial skills can be enhanced. The goal of the present study was thus to assess the benefit and maintenance effects of mental rotation training in young adults. Forty-eight females took part in the study: 16 were randomly assigned to receive the mental rotation training (based on comparing pairs of 2D or 3D objects and rotation games), 16 served as active controls (performing parallel non-spatial activities), and 16 as passive controls. Transfer effects to both untrained spatial tasks (testing both object rotation and perspective taking) and visual and verbal tasks were examined. Across the training sessions, the group given mental rotation training revealed benefits in the time it took to make judgments when comparing 3D and 2D objects, but their mental rotation speed did not improve. When compared with the other groups, the mental rotation training group did show transfer effects, however, in tasks other than those practiced (i.e., in object rotation and perspective-taking tasks), and these benefits persisted after 1 month. The training had no effect on visual or verbal tasks. These findings are discussed from the spatial cognition standpoint and with reference to the (rotation) training literature.     

Exploring the associations shared by mood,pain-related attention and pain outcomes related to sleep disturbance in a chronic pain sample

Objective: Sleep disturbance in chronic pain is common, occurring in two-thirds of patients. There is a complex relationship between chronic pain and sleep; pain can disrupt sleep and poor sleep can exaggerate pain intensity. This may have an impact on both depressive symptoms and attention to pain. This study aims to evaluate the relationship between chronic pain and sleep, and the role of mood and attention.

Methods: Chronic pain patients, recruited from a secondary care outpatient clinic, completed self-report measures of pain, sleep, depressive symptoms and attention to pain. Hierarchical regression and structural equation modelling were used to explore the relationships between these measures. Participants (n = 221) were aged between 20 and 84 (mean = 52) years.

Results: The majority of participants were found to be ‘poor sleepers’ (86%) with increased pain severity, depressive symptoms and attention to pain. Both analytical approaches indicated that sleep disturbance is indirectly associated with increased pain severity Instead the relationship shared by sleep disturbance and pain severity was further associated with depressive symptoms and attention to pain.

Conclusions: Our results indicate that sleep disturbance may contribute to clinical pain severity indirectly though changes in mood and attention. Prospective studies exploring lagged associations between these constructs could have critical information relevant to the treatment of chronic pain.     

Altered Cortico-Limbic Functional Connectivity During an Empathy Task in Subjects with Post-Traumatic Stress Disorder

Empathy is a multidimensional construct consisting of cognitive (inferring mental states) and emotional (empathic concern) components. Emotional empathy is severely impaired in individuals affected by Post-Traumatic Stress Disorder (PTSD). Here, we investigated the neural correlates of such an emotional empathy dysfunction to shed light on the neural circuitry responsible for the social and emotional dysfunction in PTSD. We asked a group of PTSD and a group of healthy controls to solve a Multifaceted Empathy Test, measuring both cognitive and emotional empathy, and investigated the functional connectivity of the cortical areas involved in solving the test. The results revealed that, in healthy individuals, increased neural activity in the frontal cortex modulates activity in the insula while subjects perform the emotional empathy task; whereas, in individuals affected by PTSD, increased activity in limbic regions such the insula and the amygdala modulates activity in the frontal cortex while performing the emotional empathy task. These findings suggest that the lack of cortical top-down control of the frontal cortex on the limbic system in PTSD during empathic processing may explain the emotional and social difficulties experienced by individuals suffering from PTSD.     

Interfering with activity in the dorsomedial prefrontal cortex via TMS affects social impressions updating

In our everyday social interactions we often need to deal with others’ unpredictable behaviors. Integrating unexpected information in a consistent representation of another agent is a cognitively demanding process. Several neuroimaging studies point to the medial prefrontal cortex (mPFC) as a critical structure in mediating social evaluations. Our aim here was to shed light on the possible causal role of the mPFC in the dynamic process of forming and updating social impressions about others. We addressed this issue by suppressing activity in the mPFC by means of 1 Hz offline transcranial magnetic stimulation (TMS) prior to a task requiring participants to evaluate other agents’ trustworthiness after reading about their social behavior. In two different experiments, we found that inhibiting activity in the mPFC increased perceived trustworthiness when inconsistent information about one agent’s behavior was provided. In turn, when only negative or positive behaviors of a person were described, TMS over the mPFC did not affect judgments. Our results indicate that the mPFC is causally involved in mediating social impressions updating—at least in cases in which judgment is uncertain due to conflicting information to be processed.     

Linguistic and prosodic aspects of child-directed speech: The role of maternal child-rearing experiences

This study explored if the quality of mothers’ reported child-rearing experiences influences the prosodic and linguistic features of maternal child-directed speech. Lexical, syntactic, functional and prosodic aspects of maternal speech directed towards their 24-month-old children were examined. Results showed that mothers with different child-rearing histories differed in the ways they talked to their children. Mothers who recalled the caregiving they received during childhood as characterized by high levels of care and low levels of control, used a lexically and syntactically more complex speech and expressed more positive emotions. This kind of input seems to be more attuned with the typical growing skills of two-year-old children. Implications for the study of mother–infant relationship as well as for the study of child language development are addressed.     

Aging and the intrusion superiority effect in visuo-spatial working memory

This study investigated the active component of visuo-spatial working memory (VSWM) in younger and older adults testing the hypotheses that elderly individuals have a poorer performance than younger ones and that errors in active VSWM tasks depend, at least partially, on difficulties in avoiding intrusions (i.e., avoiding already activated information). In two experiments, participants were presented with sequences of matrices on which three positions were pointed out sequentially: their task was to process all the positions but indicate only the final position of each sequence. Results showed a poorer performance in the elderly compared to the younger group and a higher number of intrusion (errors due to activated but irrelevant positions) rather than invention (errors consisting of pointing out a position never indicated by the experiementer) errors. The number of errors increased when a concurrent task was introduced (Experiment 1) and it was affected by different patterns of matrices (Experiment 2). In general, results show that elderly people have an impaired VSWM and produce a large number of errors due to inhibition failures. However, both the younger and the older adults' visuo-spatial working memory was affected by the presence of activated irrelevant information, the reduction of the available resources, and task constraints.     

Gender Differences in Self-Serving Attributions About Sexual Experiences1

Two studies investigated sex differences in attributions about sexual experiences. Subjects were asked to provide causal explanations for satisfying and unsatisfying past experiences. Men were expected to display a greater self-serving bias than women. This hypothesis was supported for unsatisfying but not for satisfying experiences. In both experiments, males were found to blame their partners more for unsatisfying experiences than females. Males used self-serving attributions, assigning more responsibility to the partner than to themselves (Experiment I), whereas women displayed self-derogatory attributions, attributing negative outcomes more to themselves than to their partners (Experiment II). Furthermore, self-derogatory attribution patterns were correlated with unsatisfactory sexual histories in women but not in men. Implications for the treatment of sexual dysfunctions via reattribution training are discussed.