Search Results (27)

Background/Objectives: Impairment in self-awareness (ISA) is one of the common consequences of an acquired brain injury (ABI) and is associated with anosodiaphoria. Collectively, these co-occurring neuropsychological disorders pose significant obstacles in the neurorehabilitation of moderate-to-severe ABI patients. Individuals who recover from ISA may present with anxiety and/or depression as adaptive reactions to the ABI, along with related functional disabilities. The present study investigated whether the level of metacognitive self-awareness (SA) is associated with the presence of anxiety and depression, apathy, or anosodiaphoria in patients with moderate-to-severe ABI. It aimed also at investigating the possible relationship between the severity of disability and both psycho-emotional diseases and the presence of PTSD symptoms in patients with high metacognitive SA. Methods: Sixty patients with moderate-to-severe ABI and different levels of metacognitive SA completed a series of questionnaires, which assessed their self-reported metacognitive SA, anosodiaphoria, anxiety and depression, apathy, and PTSD symptoms. Results: Low-metacognitive-SA patients showed lower levels of anxiety and depression and higher anosodiaphoria than high-metacognitive-SA patients. Patients with high metacognitive SA and high levels of disability showed significant higher states of anxiety and PTSD symptoms than patients with high metacognitive SA and low levels of disability. Conclusions: The neurorehabilitation of individuals with moderate to severe ABI should address, in particular, the complex interaction between ISA and anxiety and depression in patients during the rehabilitation process. Full article

Background/Objectives: Depression, anxiety and apathy are often associated with subjective cognitive complaints (SCCs) in people with Parkinson’s disease (PwPD) without cognitive impairment. Cognitive reserve (CR) enhances emotional resilience, allowing people to better cope with stress and emotional challenges, factors affecting quality of life. We aimed to explore the relationship between CR and mood/anxiety in cognitively intact PwPD with and without SCCs. Methods: In this cross-sectional study we enrolled 133 PwPD and normal cognitive function (age 59.8 ± 6.7 years; disease duration 9.0 ± 5.5 years; male/female 84/49). We assessed cognitive reserve (CR scale), subjective cognitive complaints (with PD-CFRS), QoL (PDQ8), mood, anxiety and apathy (BDI-II; STAI, PAS, Apathy scales). We used a t-test to compare groups (with/without SCC; M/F); correlations and moderation analysis to evaluate the relation between CR and behavioral features and the interplay between CR, behavioral discomfort and QoL. Results: The group with SCCs had significantly (p < 0.05) higher scores in PDQ8, Apathy, STAI, PAS-C and BDI-II scales than those with no SCCs. Males with SCCs had higher scores in PDQ8, Apathy scale and BDI-II while females differed in PDQ8 and Apathy scale scores. In the SCC group, late-life CR was negatively correlated with PAS-C (avoidance behavior) and BDI-II; correlations were confirmed in the male group where CR also correlated with PDQ-8 and PAS persistent anxiety. Conclusions: PwPD and SCCs are more depressed and anxious compared to people without SCCs. Furthermore, we found a relationship between depressive symptoms, anxiety and CR: PwPD with SCCs may rely on cognitive reserve to better cope with the feeling of anxiety and depression, especially in male gender. Full article

The research analyzed the cognitive styles, sexist attitudes and social competencies that hinder gender equality in secondary education students. It identified sexist attitudes, cognitive styles and social skills that hinder change towards gender equality; explored significant differences in sexist attitudes and cognitive strategies and social attitudes by age; studied the relationship between sexist attitudes and cognitive and social strategies that perpetuate gender inequality; and analyzed how age may predict the use of these strategies. A total of 1034 students aged 11 to 18 participated in a cross-sectional study. The Ambivalent Sexism Inventory for Adolescents and the Questionnaire of Attitudes and Cognitive Social Strategies were administered. The results indicate that young people exhibit moderate levels of cognitive and social strategies that hinder the change in sexist behaviors. At ages 12–14, the acceptance of ambivalent and benevolent attitudes such as paternalism and heterosexual intimacy increases. We found greater aggressiveness–stubbornness, apathy–withdrawal, impulsivity, and rigidity of thought at ages 15–17. Age explains a small proportion of the variance in sexist attitudes, cognitive styles, and social competencies that hinder gender equality. The study highlights the need for coeducational measures that ensure equal cognitive and socio-emotional development in women and men. Full article

Background/Objectives: Virtual reality (VR) is increasingly being explored as a non-pharmacological therapy to enhance the well-being of people with cognitive impairment (PwCI). Studies suggest that VR-based interventions improve mood, reduce apathy, and enhance emotional engagement, making VR a valuable tool for cognitive and emotional support. This scoping review synthesizes evidence on VR-based reminiscence therapy (VRRT) for PwCI. It aims to map existing knowledge, highlight implementation challenges, and offer practical, technical design, and evidence-informed recommendations for clinical integration—building on prior reviews that have touched on these aspects, but placing a stronger and more structured emphasis on real-world applicability and translational insights. This review draws extensively on qualitative findings across the included studies to better capture contextual factors, user experiences, facilitator roles, and barriers to usability. Moreover, unlike previous research, we included only studies involving individuals—either directly or via proxies—with an age-related cognitive impairment, formally diagnosed by a qualified authority. Methods: A systematic search based on the PRISMA-ScR guideline identified 310 studies, of which 11 met the inclusion criteria. These studies assessed the effectiveness and feasibility of immersive VRRT. Research methodologies included longitudinal (n = 2), cross-sectional (n = 2), mixed-methods (n = 4), and randomized controlled trials (n = 3)—with most studies focusing on feasibility—with a cumulative sample size of approximately 287 participants. The quality of the included studies was generally moderate; common limitations included small sample sizes, short intervention periods, and limited control conditions. Results: The findings highlight VRRT’s potential to enhance engagement, emotional well-being, and cognitive function. However, usability challenges and technical limitations persist. While VR offers promising benefits, further research is needed to refine interventions, address personalization barriers, and assess long-term effects. Conclusions: This review underscores the importance of integrating VRRT into care programs and improving accessibility. Future research should enhance methodological rigor to ensure reliable outcomes and maximize VR’s impact on PwCI well-being. The scoping review protocol is registered a priori with the Center for Open Science (OSF) (registration type: OSF Preregistration, data registered: 15 November 2024, associated project: osf.io/r7jha, identifier: DOI 10.17605/OSF.IO/R7JHA). Full article

Background/Objectives: Parkinson’s disease (PD) is a complex neurodegenerative disorder responsible for both motor and non-motor disturbances impairing motor behavior. This complexity necessitates integrated, multidisciplinary, and comprehensive models of care. A new and interesting complementary approach is represented by “Dance Well”, i.e., an artistic, multisensory dance intervention based on art and music. This pilot study aims to evaluate the efficacy, feasibility, and safety of a 4-week Dance Well (DW) program in PD patients in early–medium disease stages. Methods: Twenty-four PD patients (H&Y ≤ 3; MoCA score ≥ 13.8) were enrolled and randomly allocated into two groups, both with a twice-per-week frequency and lasting 4 weeks: one group underwent the DW program, while the other underwent conventional physiotherapy (CPT). Demographic, biometric, and clinical data were collected. To study the treatment effect, motor (Unified PD Rating Scale-III, Timed Up and Go Test, Berg Balance Scale, 6-Minute Walk Test, and Falls Efficacy Scale), cognitive (Corsi Supra Span Test, Trail Making Test A and B-A), and emotional–motivational (Beck Depression Inventory, State-Trait Anxiety Inventory, Apathy Evaluation Scale) outcome measures were assessed, before and after the rehabilitation program. To study treatment compliance and safety, the number of dropouts and any adverse events (such as injuries and falls) were recorded. Results: All outcome measures improved in both groups. The percentage of improvement in outcome measures assessing attention and motivation was greater in the DW group. No dropouts, falls, or injuries occurred. Conclusions: In the early–medium stages of PD, DW could be considered a feasible and safe complementary treatment, useful in improving motor, cognitive, and emotional–motivational symptoms. Full article

Background: Pediatric illnesses not only impose physical challenges on affected children, but also profoundly impact their emotional well-being. Understanding how parents respond to their children’s psychological distress during medical experiences is crucial for enhancing the overall support provided to these families. Aim: This study evaluated the internal structure of the Parental Response Styles Questionnaire (PRSQ), designed to differentiate parental responses to psychological distress in children with pediatric illnesses. Methods: A sample of 701 parents of children with medical issues responded to the PRSQ, reporting their different emotional expressions and responses to their children’s expressions of distress during the medical experience. Results: Factor analysis confirmed, in three of the five subsamples, an internal scale structure consisting of four factors: apathy and dysphoria, irritability and rejection, overprotectiveness, and perceived maladjustment. The invariance analyses revealed that congenital heart disease and neurological disorders are more similar in function to each other than pediatric cancer. Parents of children with neurological disorders exhibited a notably insecure pattern of parental responsiveness. Conclusions: In pediatric contexts, parental responses to their children’s emotional distress are significant factors in the process of adaptation. These responses can be measured, differentiated, and, ideally, managed by nurses and other healthcare professionals. The Parental Response Styles Questionnaire (PRSQ) is a promising tool for assessing parental reactions during their children’s treatment, and its structure appears to be particularly robust across diagnoses such as pediatric cancer, congenital heart disease, and neurological disorders. Full article

Background/Objectives: Elder abuse, and more specifically financial exploitation, is expected to be a major problem in modern societies as the worldwide population is getting older. Neuropsychological protocols regarding financial capacity assessment are the only available window allowing us to view the cognitive–emotional–behavioral strengths/deficits and vulnerabilities of individuals. Given the paucity of relevant research in Greece in the most vulnerable individuals such as older adults suffering from neurocognitive disorders (NCDs), this systematic review attempts to investigate whether NCDs impair financial capacity and to highlight the most important factors that can predict financial incapacity in Greek older patients and the likelihood of financial abuse. Methods: A systematic search was conducted in Embase, PsycINFO, and PubMed. Results: The search identified n = 21 relevant research articles. The synthesis of available evidence supports that financial incapacity is clearly demonstrated in the group of Greek older adults suffering from NCDs of different severity and etiology; thus, such changes can assist diagnosis, treatment, and care of these individuals, but the implications for elder abuse in the Greek cultural context have not been examined in detail so far. Conclusions: Given the unique source of information that neuropsychological assessments represent by revealing the importance of factors such as arithmetic cognition and relevant brain volume changes in the left angular gyrus, depressive mood, apathy, frailty, vascular risk factors, and financial illiteracy, forensic neuropsychology can play a vital role in protecting older individuals from financial abuse. Full article

Background/Objectives: Degenerative cerebellar ataxias (DCA) present a group of complex neurological disorders primarily affecting the cerebellum and its pathways. Classic manifestations include motor symptoms of cerebellar ataxia. However, emerging evidence suggests that the cerebellum also plays a crucial role in various cognitive and emotional processes. The objective was to assess the psychiatric profile of a heterogeneous group of patients with degenerative cerebellar ataxia. Methods: Our sample comprised 107 participants diagnosed with cerebellar degenerative ataxia. All patients were clinically evaluated using SARA, INAS, and different neuropsychiatric scales (ACE-R, HAMA, HAMD, AS, and GAF). Results: The majority of patients had autosomal dominant ataxia (38.3%) followed by sporadic ataxia (32.7%) with an average age at the moment of diagnosis of 35.3 ± 16.23 years, while the mean duration of disease at the study beginning was 12.1 ± 9.9 years. Psychiatric disorders were present in 40 patients (37.4%), with dysthymia (14.2%), major depressive disorder (9.4%), and MDD with melancholic features (7.6%). The presence of MDD with melancholic features was statistically significantly correlated with a lower ACE-R total score (r = −0.223; p = 0.022), while dysthymia was statistically significantly associated with a shorter duration of the disease (r = −0.226; p = 0.020) and older age (r = 0.197; p = 0.043). Statistically significant differences were observed between MSA-C patients and those with sporadic ataxia (HDRS p < 0.001, HARS p < 0.001, Apathy Scale p = 0.003, and GAF p = 0.004). Conclusions: Based on our findings, we can conclude that the degree of motor deficit has a significant impact on the development of psychiatric disorders, including depression, anxiety, and apathy. However, it is not the only factor, and the impact also depends on the type of DCA. Full article

The benefits of exercise have been widely explored among people with Parkinson’s (PwP). Exercise can improve non-motor (fatigue, pain, sleep, etc.) and motor features (balance, muscle strength, gait speed, etc.), maintain function, as well as prevent disease progression. Although the benefits are well known, PwP continue to show difficulty adhering to physical activity and exercise. This study aims to explore motivation to exercise, support, and self-management needs among people with Parkinson’s, their family members, and physiotherapists. Purposeful and maximum-variation sampling methods (age, sex, geographical setting, and disease severity) were employed. PwP and family members were recruited through physiotherapy services and local support groups. Twelve semi-structured interviews with PwP and two group interviews, one with family members (n = 4) and one with physiotherapists (n = 5), were conducted. Interview guides were informed by patient–public input and a recent systematic review. Interviews were recorded, transcribed, and analysed using thematic analysis informed by the Grounded Theory methodology. Four common themes emerged: (1) The value of an intrinsic connection with exercise, for which there are challenges. A greater connection to exercise led to long-term adherence. (2) Adapting exercise to the needs and preferences of a person is essential. Preferred exercises and environments were mixed, with differences emerging between sexes. (3) Physiotherapists’ aim to only maintain physical function led to frustration. Limited self-management opportunities, stigma, and dehumanisation were discussed. (4) Non-motor symptoms, stigma, fear, and determination as well as apathy, pain, and low mood were discussed. Exercise provided physical, emotional, and social rewards. Supports are necessary; however, challenges arise when PwP’s motivations are mismatched to family members’ and physiotherapists’ goals. Co-created goals, tailored to their preferences, and exercise plans with supported self-management are recommended. Full article

Correct classification of irritability is extremely important to assess prognosis and treatment indications of juvenile mood disorders. We assessed factors associated with low versus high parent- and self-rated irritability using the affective reactivity index (ARI) in a sample of 289 adolescents diagnosed with a bipolar or a major depressive disorder. Bivariate analyses were followed by multilinear logistic regression model. Factors significantly and independently associated with high versus low parent-rated ARI score were: more severe emotional dysregulation and bipolar disorders diagnosis. Factors significantly and independently associated with high versus low self-rated ARI score were: lower children depression rating scale (CDRS-R) difficulty of having fun item score, greater children depression inventory (CDI-2) self-report score, more severe emotional dysregulation, and greater CDRS-R appetite disturbance item score. High parent-rated irritability was strictly related with a bipolar disorder diagnosis, whereas high youth-rated irritability was related to depressive phenotype characterized by appetite/food-intake dysregulation, mood lability, and less anhedonia and apathy. Full article

Rolando Toro’s Biodanza (SRT) is a therapeutic strategy that uses movement, music, and emotions to induce integrative living experiences. The present study aims to explore the efficacy of a three-month SRT intervention on motor, cognitive, and behavioral symptoms in patients with Parkinson’s disease (PD). This study employed a randomized between-group design. Twenty-eight non-demented PD patients were enrolled in this study. Out of these, fourteen patients were assigned to the active treatment group using the Biodanza SRT system and fourteen to the untreated control group. The study group attended 2 h SRT classes once a week, completing twelve lessons in twelve weeks. All patients underwent: (i) a neurological examination to measure the severity of motor symptoms, balance, mobility, and risk of falls, and (ii) a neuropsychological battery to assess cognitive status, apathy, depressive symptomatology, and perceived quality of life (QoL), at study entry (T0) and at twelve weeks (T1, end of dance training). At T1, we observed a significant improvement in motor (i.e., severity of motor symptoms and balance) and cognitive parameters (i.e., working memory and delayed verbal memory) in all treated patients compared with the controls. Furthermore, a significant improvement in the social support dimension was found in all treated patients compared to the controls. A trend toward increased apathy was found in untreated patients at T1. The three-month Biodanza intervention significantly ameliorated the motor parameters of PD patients, with a parallel improvement in cognitive and QoL status. Hence, Biodanza intervention can, in the short term, represent a useful personalized medical intervention for the management of Parkinson’s disease. Full article

Background: Previous investigations on healthy humans showed conflicting evidence regarding the impact of mood on working memory performance. A systematic investigation of how mood affects apathy levels in healthy participants is currently missing. Methods: We administered a visuospatial (VS) and a numerical (N) n-back task to a sample of 120 healthy individuals. In these participants, using a series of questionnaires, we also evaluated apathy, mood, working memory, perceived stress, PTSD symptoms caused by the COVID-19 pandemic outbreak, and general psychiatric symptoms. Successively, we investigated their performance in the n-back task as a function of scores to these questionnaires. Results: Participants performed better in the N block than in the VS one. Their accuracy decreased as a function of the n-back difficulty. We reported no differences in working memory performance or apathy as a function of mood, stress, or PTSD symptoms. We found that phobic anxiety negatively predicted accuracy to the numerical n-back task and that subjects with greater anxiety and difficulty in regulating emotions also showed higher levels of withdrawal from the task. Conclusion: The study’s results suggest that while mood did not significantly affect working memory performance, strong associations were found between WMQ scores and working memory capabilities. Full article

Apathy is commonly defined as a loss of motivation leading to a reduction in goal-directed behaviors. This multidimensional syndrome, which includes cognitive, emotional and behavioral components, is one of the most prevalent neuropsychiatric features of Parkinson’s disease (PD). It has been established that the prevalence of apathy increases as PD progresses. However, the pathophysiology and anatomic substrate of this syndrome remain unclear. Apathy seems to be underpinned by impaired anatomical structures that link the prefrontal cortex with the limbic system. It can be encountered in the prodromal stage of the disease and in fluctuating PD patients receiving bilateral chronic subthalamic nucleus stimulation. In these stages, apathy may be considered as a disorder of motivation that embodies amotivational behavioral syndrome, is underpinned by combined dopaminergic and serotonergic denervation and is dopa-responsive. In contrast, in advanced PD patients, apathy may be considered as cognitive apathy that announces cognitive decline and PD dementia, is underpinned by diffuse neurotransmitter system dysfunction and Lewy pathology spreading and is no longer dopa-responsive. In this review, we discuss the clinical patterns of apathy and their treatment, the neurobiological basis of apathy, the potential role of the anatomical structures involved and the pathways in motivational and cognitive apathy. Full article

The objective of the present work was to compare the levels of executive, emotional, and initiation apathy in individuals with mild cognitive impairment (MCI), mild Alzheimer’s disease dementia (ADD), and cognitively intact healthy controls (HCs). Fifty-two patients with mild ADD, 40 individuals with MCI, and 37 cognitively intact individuals were included in the current study. The participants were consecutive visitors to the Outpatient Memory Clinic of “Nestor” Alzheimer’s Center. The symptoms of apathy were measured with the dimensional apathy scale. Analyses showed that ADD patients had significantly higher degrees of executive, emotional, initiation, and overall apathy compared with both the MCI group and the HCs. Additionally, a significant difference was observed in the dimension of executive apathy between individuals with MCI and the HCs. In conclusion, the dimension of executive apathy was the most sensitive measure regarding the differentiation of individuals with mild ADD or MCI and HCs. Hence, detailed evaluation of executive apathy in older individuals referred to a memory clinic may provide useful information contributing to their diagnostic categorization and to the differentiation between neurocognitive disorders and healthy cognitive ageing. Full article

With planetary health gaining traction as a global movement and problem-solving approach, this trans-disciplinary field is well-placed to provide an exciting and dynamic platform to promote engagement with young people. Previous studies have shown that although there is great energy and passion from youth, the global planetary health community struggles in sustaining young people’s motivations and engagement in today’s crowded physical and online environments. Planetary health advocates are also dealing with an increase in climate anxiety that has taken a toll on the emotional and mental wellbeing of young people. Here, we review our experience in engaging youth groups and networks in Malaysia through a four-pronged approach (consultation, facilitation, capacity-sharing, and evidence-building), as well as challenges commonly faced by the planetary health community in educating and building a youth movement. After a year of engagement, we found that mobilising the next generation of planetary health leaders requires a change in existing power dynamics to a capacity-sharing model, an emphasis on clear, simplified, and effective communications that utilise the mainstream youth spaces (e.g., social media), and hopeful messages to counter apathy and anxiety into action. Full article