SummaryApathy is a state of diminished goal-directed speech, motor activity and emotions. The prevalence of apathy in Parkinson's disease (PD) ranges from 16 to 62%. Several studies have investigated the relationships between apathy and other dimensions of PD, but little is known about possible discrepancies between self-evaluation (SE) and caregiver reporting (CR) of this symptom. The aim of this study is twofold: 1) to investigate the differences in apathy evaluations according to the point of view from which apathy is reported (SE vs CR); 2) to identify the possible relationships between each of the two evaluations (SE and CR) and cognitive and affective dimensions of PD. Forty-eight patients with PD were assessed using the Apathy Evaluation Scale (AES) in its SE and CR versions (AES-SE and AES-CR); cognitive, affective and behavioral symptoms were also assessed. AES-SE scores were significantly higher than AES-CR ones. Neither AES version correlated with depression, whereas both correlated with motor impairment, disease stage and behavioral symptoms. Mini-Mental State Examination and Frontal Assessment Battery scores showed significant negative correlations only with AES-SE scores. Our findings suggest that the point of view from which apathy is seen can lead to significant discrepancies, even when using the same tool. This should be taken into account in order to obtain correct assessment of this disabling and distressing symptom.
I pazienti con Disturbo Narcisistico di Personalità (DNP) possono provare senso di colpa e attuare specifiche strategie di fronteggiamento nel tentativo di gestire l'emozione. Le strategie più comunemente riscontrate nel funzionamento nel disturbo narcisistico di personalità sono l'espiazione, l'esternalizzazione della rabbia sugli altri e la rinuncia a perseguire i propri desideri, sostenuta dal blocco dell'azione. In questo lavoro descriviamo i sensi di colpa presenti in letteratura, in particolare la colpa altruistica e deontologica e, nella prospettiva della Terapia Metacognitiva Interpersonale, descriviamo la relazione tra colpa, funzionamento narcisistico e schemi maladattivi interpersonali. Questi ultimi guidano il paziente a partire da rappresentazioni negative, rigide e incarnate di sé e degli altri. Attraverso un caso clinico mostriamo come la concettualizzazione del caso possa permettere un inquadramento del funzionamento del paziente più preciso e, di conseguenza, un trattamento capace di ridurre il senso di colpa e di come questo abbia un effetto benefico sul disturbo narcisistico di personalità.
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