Ludovica Zanini

Interpersonal synchrony is increasingly being studied in the context of psychotherapy. The Interpersonal Synchrony (In-Sync) model proposes that patient-therapist synchrony enhances working alliance by promoting emotion regulation (ER). While the link between synchrony and working alliance has been extensively described, its relation to ER in the clinical setting remains underexplored. The present systematic review, therefore, aimed to address this gap by providing a qualitative synthesis of the methods employed and the results reported by studies investigating the relationship between patient-therapist synchrony and ER. A comprehensive search yielded seven studies (out of an initial 2,094), published between 2007 and 2024, encompassing 828 participants (563 patients and 265 therapists). Despite finding highly heterogeneous conceptual frameworks and methodologies employed to assess both synchrony (e.g., motion energy analysis [MEA], electrocardiogram, skin conductance) and ER (e.g., self-report questionnaires and behavioral coding systems), the studies’ results revealed a predominantly positive association between synchrony and ER, with in-phase synchrony linked to improved emotional stability and positive emotional experiences. Nonetheless, two studies presented contrasting results, either suggesting a more complex dynamic of co-regulation or finding no direct relationship between nonverbal synchrony and emotional self-regulation. Additionally, a notable research gap was revealed regarding older adults, as no studies included participants over 61 years. Overall, this systematic review highlights the lack of standardized methods and conceptual ambiguity surrounding ER, ultimately limiting cross-study comparability, as well as emphasizing the multiple roles of synchrony in psychotherapy and the need for further research to establish methodological coherence and theoretical consensus in this field.

Background: C-tactile (CT) afferents preferentially activate in response to slow caress-like touch, evoking a diffuse pleasant sensation and promoting autonomic regulation. According to Braak's classic model, the neurodegenerative process in Alzheimer's disease (AD) only affects somatosensory cortices in advanced disease stages; however, the processing of complex sensory stimuli, such as CT-mediated Affective Touch, may be impacted in earlier phases. Objective: The present study aimed to assess the behavioral and psychophysiological response to CT-targeted touch in a group of biomarker-tested patients with mild cognitive impairment (MCI) due to AD, compared to a group of age, sex, and education matched controls. Methods: The preference for CT-optimal stimulations (3 cm/s) over non-CT-optimal stimulations (30 cm/s), in terms of perceived pleasantness, was first assessed in both groups. The behavioral (i.e., perceived pleasantness) and psychophysiological (i.e., heart rate and heart rate variability) responses to 16 min of continuous CT-targeted stimulations were then evaluated. All participants also underwent quantitative sensory testing for the screening of tactile sensitivity, tactile acuity, nociception, and interoception. Results: Despite both groups rating CT-optimal stimulations as more pleasant than non-CT-optimal ones, MCI patients specifically exhibited an altered response to prolonged CT-targeted stimulations, characterized by a progressive reduction of their perceived pleasantness and by an unvaried Heart Rate Variability. No group-differences emerged in other somatosensory-related functions. Conclusions: A specific multi-level alteration of the pleasant and soothing features of CT-optimal touch was identified as a prodromal marker of AD, providing the first indications of how the CT system degrades in conditions of pathological aging.

Despite its well-established importance in psychoanalytic theory, there is a scarcity of empirical evidence on the relationship between a therapist’s transference interpretation (TI) and therapeutic outcome. The current scientific literature shows no consensus on the existence and nature of such an association. Therefore, the present study aimed to systematically review the literature on the link between TI and outcomes in psychodynamic psychotherapies. The American Psychological Association PsycInfo, MEDLINE, and the Web of Science Core Collection were selected as the primary databases for the literature search. Studies were included if they measured the frequency/ concentration of TI in psychodynamic psychotherapy [e.g., transference focused psychotherapy (TFP), supportive-expressive therapy] or compared a treatment group (e.g., high in TI and TFP) with a control group (e.g., low in TI supportive therapy) in an adult population with psychiatric symptoms. Out of 825 retrieved abstracts, 25 articles (21 studies) were included in the final synthesis. 13 out of 21 (62%) studies showed a significant improvement in at least one therapy outcome measure following the use of TI. The present systematic review also revealed high heterogeneity across studies in terms of TI measurement, outcome assessment (e.g., psychiatric symptoms, dynamic change, interpersonal functioning, therapeutic alliance), study design (e.g., experimental, quasi-experimental, naturalistic), patient population (e.g., anxiety disorders, personality disorders), and types of treatment (e.g., TFP, supportive-expressive therapy), preventing researchers from asserting solid conclusions. The results strongly highlight the urgent need for highquality research to understand which types of patients, how, and when TIs could be effective throughout the therapy process.

The Iowa Gambling Task (IGT) was designed to assess decision-making under conditions of complexity and uncertainty; it is currently one of the most widely used tests to assess decision-making in both experimental and clinical settings. In the original version of the task, participants are given a loan of play money and four decks of cards and are asked to maximize profits. Although any single card unpredictably yields wins/losses, variations in frequency and size of gains/losses ultimately make two decks more advantageous in the long term. Several studies have previously suggested that there may be a sex-related difference in IGT performance. Thus, the present study aimed to explore and quantify sex differences in IGT performance by pooling the results of 110 studies. The meta-analysis revealed that males tend to perform better than females on the classic 100-trial IGT (UMD = 3.381; p < 0.001). Furthermore, the significant heterogeneity observed suggests high variability in the results obtained by individual studies. Results were not affected by publication bias or other moderators. Factors that may contribute to differences in male and female performance are discussed, such as functional sex-related asymmetries in the ventromedial prefrontal cortex and amygdala, as well as differences in sensitivity to wins/losses.

Ageism is a social issue of growing concern; ageist beliefs can shape the individual and collective experience of aging. The present study aimed to explore positive and negative ageism in young adults (YA) (18-30 years) and adults (AD) (31-60 years) and their relationship with epistemic trust, psychological distress, and psychological well-being. 301 Italian adult participants completed an online survey that included the following self-report questionnaires: attitudes towards older people scale, epistemic trust, mistrust and credulity questionnaire, depression anxiety stress scale-21, and Warwick-Edinburgh mental wellbeing scale. Negative ageism was significantly higher in YA compared to AD; on the contrary, AD presented more positive ageism than YA. When considering the entire sample, negative ageism was correlated with various dimensions of psychological distress and epistemic trust. A mediation model revealed that epistemic mistrust fully mediated the relationship between age and negative ageism, suggesting that changes in ageist beliefs that seem to occur with age are mediated by a mistrustful epistemic stance. Future research should focus on further exploring the link between epistemic trust, mental health, and holding ageist beliefs. The results are also discussed in terms of their implications for the treatment of older patients.