Lo Buono Viviana, Culicetto Laura, Berenati Matteo, Stroscio Giuseppe, Sorbera Chiara, Brigandì Amelia, Marino Silvia, Di Lorenzo Giuseppe, Quartarone Angelo, De Cola Maria Cristina
IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy.
J Clin Med. 2024 Aug 7;13(16):4625. doi: 10.3390/jcm13164625.
: Assertiveness, defined as the positive affirmation of oneself, encompasses the ability to refuse requests, express anger, disagree or oppose others, show affection, and uphold personal beliefs without causing conflict. Deficits in assertive behavior are often linked to pathological changes in the basal ganglia and prefrontal dopaminergic systems, commonly observed in Parkinson's disease (PD), and are predictive of poor clinical outcomes. Psychological factors such as mood alterations and cognitive dysfunction may also impact assertiveness. This study investigated the psychological factors influencing assertiveness in individuals with PD. : A cross-sectional study was conducted, involving 160 patients with PD attending a movement disorders outpatient clinic. The participants underwent assessment using a battery of standardized neuropsychological tests to evaluate cognitive function, assertiveness, mood, dysarthria, and quality of life (QoL). All dimensions of assertiveness correlated with depression and anxiety. Individuals experiencing mood disturbances may struggle to express themselves assertively. Similarly, some dimensions of assertiveness correlated also with the QoL, indicating that, overall, well-being affects assertive behavior. Gender emerged as a significant influencer of assertiveness across all dimensions. Specifically, in subjects with PD, the male gender was associated with lower scores in assertiveness compared to women. No significant correlations were found between assertiveness and dysarthria. : The findings highlight the importance of adopting a holistic approach to PD management, addressing not only motor symptoms but also psychological challenges which patients may encounter in their daily lives.
自信被定义为对自我的积极肯定，包括拒绝请求、表达愤怒、不同意或反对他人、表达情感以及坚持个人信念而不引发冲突的能力。自信行为的缺陷通常与基底神经节和前额叶多巴胺能系统的病理变化有关，这在帕金森病（PD）中很常见，并且预示着临床预后不良。情绪改变和认知功能障碍等心理因素也可能影响自信。本研究调查了影响PD患者自信的心理因素。
进行了一项横断面研究，纳入了160名在运动障碍门诊就诊的PD患者。参与者接受了一系列标准化神经心理测试，以评估认知功能、自信、情绪、构音障碍和生活质量（QoL）。自信的所有维度都与抑郁和焦虑相关。经历情绪困扰的个体可能难以自信地表达自己。同样，自信的一些维度也与生活质量相关，这表明总体而言，幸福感会影响自信行为。性别是所有维度自信的一个重要影响因素。具体而言，在PD患者中，男性与女性相比，自信得分较低。未发现自信与构音障碍之间存在显著相关性。
研究结果强调了采用整体方法管理PD的重要性，不仅要解决运动症状，还要应对患者在日常生活中可能遇到的心理挑战。
