Sergio Paradiso

Hemispheric lateralization of hedonic evaluation (‘liking’) and incentive motivation (‘wanting’) in neural networks connecting the basal ganglia and insula (BG-I) in humans was examined. Participants with brain damage restricted to the BG-I of the right (n = 5) or left (n = 5) hemisphere, and 26 healthy participants matched on age, sex and intelligence quotient were tested on positively and negatively valenced pictures drawn from varied stimulus categories (Vijayaraghavan et al., 2008). Liking was assessed with explicit ratings of pleasantness using a nine-point Likert scale. Wanting was quantified as the amount of work (via repeated keypresses) that participants expended to increase (approach) or decrease (withdraw) viewing time. Right-lesion patients showed abnormally low viewing times and liking ratings for positive images. For a subset of positive images depicting sexual content, right-lesion patients exhibited active withdrawal, while the other two groups approached such stimuli. These results suggest that the right basal ganglia–insula complex plays a greater role than the left in supporting hedonic evaluation and motivational approach to positively valenced stimuli. The finding that active avoidance of stimuli that were not ‘liked’ was spared in both right- and left-sided lesion subjects suggests that unilateral damage to insula/basal ganglia circuits may not be sufficient to affect general incentive motivation independent of preference.

In the following article we present a view that social cognition and social neuroscience, as shaped by the current research paradigms, are not sufficient to improve our understanding of psychopathological phenomena. We hold that the self, self-awareness, and inter-subjectivity are integral to social …

Loneliness has been shown to be inversely correlated with empathy in younger adults. The present study extends previous research by investigating the association between empathy and loneliness across the adult lifespan and examining the role of relevant demographic and personality factors. 110 community-dwelling adults (18 to 81 years old) completed the UCLA Loneliness Scale and the Empathy Quotient. Empathy scores were inversely associated with rated loneliness and predicted 8.7% of variance in loneliness scores after accounting for sex, age, relationship status, education, and neuroticism. The Social Skills factor of the Empathy Quotient was the strongest predictor of the association between perceived empathy and loneliness. Previous research is extended by the finding that rated loneliness was inversely associated with empathy scores across the adult lifespan. Underlying this relationship may be negative perceptions of personal social proclivity as a function of difficulty in understanding the mental states of others and high trait neuroticism.

Background: Measuring social adjustment (including attachment style and current social adaptation) in late‐life depression may support planning secondary prevention, rehabilitation, and treatment. Insecure attachment style is a risk factor for developing new depression, and social adjustment may constitute a problem after symptoms abatement. Few studies have examined attachment style and social adjustment in late‐onset depression.Design: Subjects 50 years of age and older with early‐onset (n = 35), late‐onset DSM‐IV unipolar depression (n = 38), and never‐depressed volunteers (n = 47) were assessed with a widely used measure of attachment style (the Experiences in Close Relationship Scale). Social adjustment was measured using the Social Adjustment Scale.Results: Both early‐onset and late‐onset patients with depression showed greater insecure attachment and poorer social adaptation compared with never‐depressed volunteers. No difference was found between early‐onset and late‐onset patients with depression on attachment style or social adjustment. There were no significant differences between late‐life depression in remission or current on attachment or social adaptation.Conclusion: Insecure attachment style may be a risk factor for late‐life depression irrespective of the age of onset. Social maladaptation may persist among individuals with late‐life depression in remission. Copyright © 2011 John Wiley & Sons, Ltd.

Objective: To determine rates of psychotic symptoms and associated modifiable and non-modifiable factors among elderly long term nursing home residents without prior history of psychiatric illness. Method: A cross-sectional design using the Scale for the Assessment of Positive Symptoms (SAPS) to measure psychotic symptoms, the Folstein's Mini-Mental State Exam (MMSE), and Mattis Dementia Rating Scale (DRS) to evaluate cognitive impairment. Frequency and rates of global psychotic symptoms and hallucinations, delusions, formal thought disorder, and bizarre behavior were calculated. Logistic regression was used to examine modifiable (e.g., medication use) and non-modifiable clinical characteristics (e.g., older age) associated with late-life psychosis. Results: There were 15.9% of subjects reporting delusions and 7.3% reporting hallucinations. History of stroke, poorer cognition, and receiving multiple medications showed significant association with late-life psychosis. Only stroke (OR=9.12; 95% CI: 1.58–52.74) and receiving different classes of medications (benzodiazepines, neuroleptics, and antidepressants) (OR=13.17; 95% CI: 2.10–85.82) remained significantly associated with psychosis after adjusting for Mattis DRS total score. Further analyses excluding subjects with MMSE scores of 24 or lower ( n = 24) showed essentially the same results but subjects with better cognitive function suffered a less severe form of psychosis, essentially constituted by one symptom type (i.e., visual hallucinations). Conclusions: Rates of late-life psychosis in this sample of nursing home residents without previous psychiatric history were high. Simultaneous use of medications including antidepressants, sedatives, and stimulants may be a clinically relevant modifiable factor to be targeted in prevention studies. Severity and type of psychosis is dependent on the severity of cognitive impairment.

The literature suggests that alexithymia is the result of individual differences and/or biological mechanisms. Both individual differences and disease mechanisms may play a role among individuals with medical or surgical conditions. The relative weight of clinical and individual differences factors related to alexithymia has not been studied in patients with cancer. The purpose of this study was to examine the extent to which individual differences in perceived stress and biological markers of illness severity are associated with alexithymia among patients with cancer. Treated oncologic outpatients (N = 37) were assessed using the 20-item Toronto Alexithymia Scale and Perceived Stress Scale. Alexithymia was examined in relation to perceived stress, tumor staging, and hemoglobin levels. Among the patients studied, 34.2% endorsed the established cutoff score (≥61) for alexithymia. Higher alexithymia scores were found in patients with more advanced stages of cancer invasion. Alexithymia correlated directly with perceived stress and indirectly with hemoglobin levels. Hemoglobin levels and cancer invasion significantly correlated with alexithymia when controlling for perceived stress. A significant component of alexithymia in cancer patients may be construed as acquired. But awareness of health status influencing perceived stress might partially mediate the role of cancer invasion and hemoglobin on alexithymia.