Alfonso Troisi

Alfonso Troisi
University of Rome Tor Vergata | UNIROMA2 · Dipartimento di Medicina dei Sistemi

MD

About

214
Publications
33,169
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6,232
Citations
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December 2010 - present
University of Rome Tor Vergata
Position
  • Professor (Associate)

Publications

Publications (214)
Article
Full-text available
Since the pioneering work by Panksepp et al, the neurobiological bases of attachment behavior have been closely linked with opioid neurotransmission. Candidate gene studies of adult individuals have shown that variation in the mu-opioid receptor gene (OPRM1) influences attachment behavior. Early maternal care and the A/A genotype of the A118G polym...
Article
Studies of the activation of the behavioral immune system triggered by the coronavirus disease-2019 pandemic have demonstrated that evolutionary explanations of individual differences in self-protection should not be based only on parental investment and sexual selection theory. An evolutionary model must also incorporate individual differences tha...
Article
Full-text available
Purpose Evidence that social difficulties promote the development and the maintenance of eating disorders (EDs) derive from self-reported data and only partially from experimental tasks. This study objectively assessed non-verbal behaviors of individuals with EDs in a psycho-social stress scenario. Methods Thirty-one women suffering from EDs (13 w...
Article
Full-text available
In the present study, we recruited a large sample (N = 595) of highly educated participants to assess which causal variables they considered as more important in the etiology of two diagnostically unlabeled cases of psychiatric disorders. The first clinical case described a patient with early schizophrenia whereas the second clinical case described...
Article
Free access to my latest article published in Physiology & Behavior (till June 15 2022)
Article
The behavioral immune system includes a set of proactive mechanisms that inhibit contact with pathogens in the first place. These mechanisms offer a sort of psychological and behavioral prophylaxis against infection. The aim of this study was to assess the functionality of the behavioral immune system under conditions of strong ecological validity....
Article
In recent decades, psychiatry and the neurosciences have made little progress in terms of preventing, diagnosing, classifying, or treating mental disorders. Here we argue that the dilemma of psychiatry and the neurosciences is, in part, based on fundamental misconceptions about the human mind, including misdirected nature-nurture debates, the lack...
Poster
Full-text available
This is a flyer for an upcoming meeting open to all students of evolutionary medicine. You can choose to attend the meeting either in presence (beautiful location!) or online.
Article
Full-text available
Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose weight. The implementation of surgical treatment of obesity is growing at an impressive rate. As expected, the expanding implementation of bariatric procedures has progressively revealed critical issues that were not evident when the number of obese patients trea...
Article
Full-text available
Fear of becoming infected is an important factor of the complex suite of emotional reactions triggered by the COVID-19 pandemic. Among healthcare workers (HWs), fear of infection can put at risk their psychological well-being and occupational efficiency. The aim of this study was to analyze the role of personality (i.e., the big five traits) and ad...
Article
Full-text available
Psoriasis is a multisystemic inflammatory disease with a significant burden in terms of disability and reduced quality of life. The interrelations between disease severity, psychological well-being, and disability and/or health-related quality of life (HRQOL) of psoriatic patients are not fully understood. The aim of the study was to assess the rel...
Article
Full-text available
The aim of this study was to estimate the contribution of adult attachment style and alexithymia to cutaneous body image in patients with psoriasis while controlling for the confounding effects of disease severity and depressive symptoms. Participants were 107 consecutive patients (60% women) with a diagnosis of plaque-type psoriasis. Cutaneous bod...
Article
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This is a commentary addressing possible explanations for the data on long-term use of psychiatric drugs reported by Peter Goetzche in a twin article. Questions related to efficacy of psychiatric drugs, diagnostic validity, and undue prescription are discussed.
Article
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The existence of a proportional relationship between the number of early-life stress (ELS) events experienced and the impoverishment of child mental health has been hypothesized. However, different types of ELS experiences may be associated with different neuro-psycho-biological impacts, due to differences in the intrinsic nature of the stress. DNA...
Article
Background The syndromic diagnosis of major depressive disorder (MDD) is associated with individual differences in prognosis, course, treatment response, and outcome. There is evidence that patients with a history to adverse childhood experiences (ACEs) may belong to a distinct clinical subgroup. The combination of data on ACEs and blood biomarkers...
Article
The literature on social stress and psychiatric disorders is biased toward proximate explanations. While it is important to know how the mechanisms implicated in social stress operate, we also need to learn why selection has retained those mechanisms. This review analyzes debated questions from the perspective of Darwinian psychiatry: What is a str...
Preprint
In the last two decades, hundreds of studies have converged on the same conclusion: children who experience severe chronic stressors are vulnerable to a plethora of medical and psychiatric problems across the life span. In this chapter, the relationship between childhood trauma and psychopathology will be analyzed from the vantage point of two inte...
Chapter
One of the tasks of mental health professionals who take care of bariatric patients is to analyze the motivations that lead the patient to seek surgery treatment for obesity, the entire spectrum of changes the patient expects to see as a result of undergoing surgery, and the patient’s long-term experiences after bariatric surgery. Patients’ motivat...
Chapter
An increasing degree of severity of obesity is accompanied by a rising prevalence of personality disorders, reaching 23.4% for obesity class III. Yet, there are few studies that have focused on the relationship between bariatric surgery and personality disorders. Preliminary data show that personality disorders do not impact weight loss but weight...
Chapter
Studies of pathological anxiety in bariatric patients often combine data on anxiety disorders with data on obsessive-compulsive disorder (OCD) or post-traumatic stress disorder (PTSD). Among bariatric patients, the prevalence rate of anxiety disorders is high. According to the majority of prospective studies, when successful outcome is measured in...
Chapter
As bariatric surgery procedures continue to grow, it is critical that clinicians acknowledge the unsolved issues that need to be addressed by practice and research. Many of these issues pertain to the emerging fields of bariatric psychology and psychiatry. An open question concerns the outcome measures to assess the success of bariatric surgery. Cu...
Chapter
Unlike eating and mood disorders, psychotic disorders have been scarcely investigated by studies focusing on the relationship between psychopathology and bariatric surgery. That is unfortunate because the prevalence of severe obesity and metabolic disorders is high among patients with psychotic syndromes and bariatric surgery may be a viable treatm...
Chapter
There is much evidence that bariatric surgery can worsen the course of a preexistent substance use disorder or even cause its new onset post-operatively. Factors associated with new onset or increased substance use include the type of surgery, a personal history of substance use disorder, a family history of substance use disorder, a history of ear...
Chapter
The popularity of bariatric surgery is growing at an impressive rate among both clinicians and patients with obesity. No other branch of surgery is so strictly intertwined with psychology and psychiatry as bariatric surgery. The study of mental health in bariatric patients has now reached a notable level of complexity as shown by the emergence of t...
Chapter
Eating disorders are probably the area of psychopathology most relevant to bariatric surgery. Obese patients seeking bariatric surgery have a high prevalence of eating disordered behavior, and binge eating disorder is frequently diagnosed in bariatric candidates. A small, but significant, number of bariatric patients develop eating disorders after...
Chapter
There is a growing concern that post-bariatric surgery patients may have an increased risk for completed suicide, attempted suicide, and self-harm compared to age-, sex-, and BMI-matched controls. Although the pathogenic mechanisms increasing the risk are not fully understood, there is evidence that various pre- and post-surgical psychosocial, phar...
Chapter
Body image is the perception that individuals have of their physical self and the thoughts and feelings that result from that perception. Body dissatisfaction consists of a negative subjective evaluation of one’s physical body such as figure, weight, stomach, and hips. Body dissatisfaction is greater in persons with obesity than in normal-weight pe...
Chapter
The assessment of personality traits is an important component of the psychosocial evaluation of bariatric patients for at least two different reasons. First, personality traits exert a major influence on a wide range of behaviors that make a difference between poor and good outcomes of surgery treatment for obesity. Second, compared to psychiatric...
Chapter
Depression is one of the most common pre-operative psychiatric conditions among bariatric surgery candidates. In some studies, pre-surgical assessment showed that the percentage of patients suffering from depression is around 40%. There is evidence for short- and medium-term improvement in depressive symptoms after surgery. However, a subgroup of p...
Chapter
Bariatric candidates presenting with depressive symptoms represent a challenge for differential diagnosis. A patient may present with the classic symptoms of depression but may actually be suffering from bipolar disorder. It is very important to avoid the trap of diagnosing depressive disorder too quickly and to consider all the clinical aspects th...
Chapter
Childhood trauma is a powerful risk factor for the adult onset of a variety of medical and psychiatric disorders including obesity and metabolic syndrome. Among patients seeking surgical treatment for obesity, a history of childhood trauma is relatively common and is associated with higher prevalence rates of psychiatric symptoms and mental disorde...
Chapter
Until recently, a diagnosis of intellectual disability was an absolute contraindication to bariatric surgery. Such a conservative approach reflects a series of worries concerning the capacity of patients to understand the risks and benefits related to surgical procedures and their capacity and willingness to adhere to post-operative treatment guide...
Article
Full-text available
Open Access Fear of infectious disease is substantially different from that evoked by other medical conditions. Such a difference depends on psychological and behavioral adaptations shaped by natural selection throughout the evolutionary history of Homo sapiens. Selective pressures have favored the evolution of a behavioral immune system that is se...
Article
Full-text available
Fear of infectious disease is substantially different from that evoked by other medical conditions. Such a difference depends on psychological and behavioral adaptations shaped by natural selection throughout the evolutionary history of Homo sapiens. Selective pressures have favored the evolution of a behavioral immune system that is separate from,...
Cover Page
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Hardcover Ca. 119,99 € | Ca. £109.99 | Ca. $149.99 Ca. 128,39 € (D) | Ca. 131,99 € (A) [1] | Ca. CHF 141,50 eBook Available from your library or springer.com/shop MyCopy [3] Printed eBook for just € | $ 24.99 springer.com/mycopy Alfonso Troisi Bariatric Psychology and Psychiatry Provides step-by-step guidelines on selecting bariatric surgery candid...
Article
Full-text available
Patients with psoriasis are at increased risk for psychiatric comorbidities, including suicidal ideation and behavior. For this reason, a careful assessment of patients, in particular for those reporting history of psychiatric symptoms is needed. We herein report a case series of 3 patients affected by major psychiatric disorders and moderate-to-se...
Book
This book offers a step-by-step guide to mental health assessment for bariatric surgery patients. A general introduction explains the concepts of bariatric psychology and psychiatry, their relevance in contemporary bariatric surgery, and reasons to include psychologists and psychiatrists in multidisciplinary teams taking care of bariatric patients....
Chapter
My view of the current and future status of Darwinian Psychiatry.
Article
Stress related to parenting a child with autism spectrum disorder can differently affect caregiver's physiological reactivity to acute stress. Here, parental stress levels, psychological characteristics and coping strategies were assessed alongside measures of heart rate, heart rate variability, and cortisol during a psychosocial stress test in mot...
Article
After the Darwinian revolution, biology is not only the study of the operation of structural elements (functional biology), but also the study of adaption and phylogenetic history (evolutionary biology). From an evolutionary perspective, the biology of mental disorders is not just “neurobiology and genetic constitution” but also adaptive reactions...
Article
The primary purpose of this study was to assess the relationship between prenatal exposure to sex hormones, as measured by digit ratio (2D:4D), and psychopathic personality traits while controlling for the confounding effect of life history strategy. The secondary purpose was to confirm the hypothesis that primary and secondary psychopathy reflect...
Article
We aimed to ascertain if cholesterol levels within the reference standards for healthy non-pregnant women are a risk factor for depressive and anxiety symptoms in the immediate postpartum period. During the first week after delivery, total cholesterol levels of 120 new mothers were measured and their mood state was assessed with the Profile of Mood...
Article
Full-text available
Background: Sleeve gastrectomy (SG) has grown into the most popular bariatric operation. Nevertheless, a scarcity of long-term outcomes are available. Objectives: This study aims at evaluating the long-term percent weight loss (%WL), excess weight loss (%EWL), weight regain (WR), and co-morbidity resolution rates in a single-center cohort underg...
Article
Full-text available
Background: Experiencing traumatic childhood is a risk factor for developing substance use disorder, but the mechanisms that underlie this relationship have not been determined. Adverse childhood experiences affect the immune system, and the immune system mediates the effects of psychostimulants. However, whether this system is involved in the eti...
Article
This review outlines the contribution of evolutionary science to experimental and clinical psychotraumatology. From an evolutionary perspective, traumatic and psychosocial stressors are conceived of as events or circumstances that thwart the achievement of biological goals. The more important is the adaptive value of the goal, the more painful is t...
Article
Full-text available
Objective: To ascertain if the 5-HTLPR short allele was associated with an insecure style of attachment in a mixed sample of healthy subjects and psychiatric patients. Method: Three hundred and thirty five adults (222 healthy subjects and 113 psychiatric patients) were genotyped for the 5-HTTLPR serotonin transporter polymorphism. Adult attachment...
Article
Full-text available
Objective: The aim of this investigation was to evaluate defence mechanisms and attachment styles in paranoid ideation through a cross-sectional design with sequential recruitment of subjects. Methods: Five hundred and fifty non-clinical subjects were recruited from university students. A psychometric protocol comprising paranoid ideation scale...
Chapter
Full-text available
The evolutionary study of orgasm in primates investigates the origin of human orgasm by cross-species comparison and mainly focuses on female orgasm, a controversial topic in human sexual behavior. The female orgasm was once believed to be exclusive to human females and a vestigial by-product of the male orgasm. Based on genital homology, the capac...
Article
Background: There is evidence that both a past history of psychiatric illness and insecure attachment put women at risk for mood disturbances in the postpartum period. The aim of this study was to ascertain whether maternal insecure attachment is a risk factor for mood symptoms in the immediate postpartum period independently of the confounding ef...
Article
The relationships of personal resources with symptom severity and psychosocial functioning have never been tested systematically in a large sample of people with schizophrenia. We applied structural equation models to a sample of 921 patients with schizophrenia collected in a nationwide Italian study, with the aim to identify, among a large set of...
Article
Full-text available
Experiencing an adverse childhood and parental neglect is a risk factor for depression in the adult population. Patients with a history of traumatic childhood develop a subtype of depression that is characterized by earlier onset, poor treatment response and more severe symptoms. The long-lasting molecular mechanisms that are engaged during early t...
Article
Full-text available
Psychopathology of Theory of Mind: Evolutionary Reflections - In medicine, the study of pathology can often help to get a better understanding of physiology. Based on this premise and adopting an evolutionary perspective, the present commentary analyzes some conditions characterized by an abnormal functioning of the Theory of Mind (ToM). It has bee...
Article
Medicalization of human behavioral diversity is a recurrent theme in the history of psychiatry, and the problem of defining what is a genuine mental disorder is an unresolved question since the origins of clinical psychopathology. Darwinian psychiatry can formulate a definition of mental disorder that is value free and based on factual criteria. Fr...
Article
Epidemiological studies indicate that separation anxiety disorder occurs more frequently in adults than children. It is unclear whether the presence of adult separation anxiety disorder (ASAD) is a manifestation of anxious attachment, or a form of agoraphobia, or a specific condition with clinically significant consequences. We conducted a study to...
Article
Full-text available
In people suffering from schizophrenia, major areas of everyday life are impaired, including independent living, productive activities and social relationships. Enhanced understanding of factors that hinder real-life functioning is vital for treatments to translate into more positive outcomes. The goal of the present study was to identify predictor...
Article
Indirect evidence suggests partially common pathogenetic mechanisms for Neurological Soft Signs (NSS), neurocognition, and social cognition in schizophrenia. However, the possible association between NSS and mentalizing impairments has not yet been examined. In the present study, we assessed the ability to attribute mental states to others in patie...
Article
Full-text available
Social anhedonia, or the diminished capacity to experience pleasure and reward from social affiliation, is a major symptom of different psychiatric disorders, including some forms of infantile autism and schizophrenia spectrum disorders. The brain opioid hypothesis of social attachment is a promising model for achieving insights into how neurobiolo...
Article
This chapter deals with those activities that clinicians exert in their everyday practice and that people suffering from mental disorders expect to progress at a fast pace: diagnosis, therapy, and prevention. Each of these clinical tasks is analyzed from the perspective of Darwinian psychiatry. When refocused from an evolutionary perspective, diagn...
Article
Introduction Most of us find social encounters rewarding, especially when we encounter those with whom we are familiar and have built up a relationship. From an evolutionary point of view, this is not surprising considering that human beings are fundamentally social organisms. Considering that endogenous opioids mediate hedonic responses to a varie...
Article
The "hijacking" and "drug instrumentalization" models of psychoactive drug use predict opposite outcomes in terms of adaptive behavior and fitness benefits. Which is the range of applicability of each model? To answer this question, we need more data than those reported by studies focusing on medical, psychiatric, and legal problems in addicted use...
Article
Full-text available
There is evidence that both early experience and genetic variation play a role in influencing sensitivity to social rejection. In this study, we aimed at ascertaining if the A118G polymorphism of the μ-opioid receptor gene (OPRM1) moderates the impact of early maternal care on fearful attachment, a personality trait strongly related to rejection se...
Article
Full-text available
A large body of evidence links altered opioid signaling with changes in social behavior in animals. However, few studies have attempted to determine whether similar links exist in humans. Here we investigate whether a common polymorphism (A118G) in the mu-opioid receptor gene (OPRM1) is associated with alterations in personality traits linked to af...
Article
Patients with physical symptoms for which no organic cause can be found are distributed along a continuum of disease simulation that ranges from a sincere belief of having a serious disease to intentional presentation of false symptoms. The evolutionary hypothesis that self-deception improves the deception of others can explain such a combination o...
Article
This study examined the relationship between cholesterol levels and impulsivity in a large sample of patients with mood symptoms. Three hundred and one patients with mood, anxiety, and personality disorders completed a battery of psychometric scales including the Barratt Impulsiveness Scale-Version 11 (BIS-11) and the Profile of Mood States (POMS)....
Article
Several studies that have explored associations between attachment measures and interpersonal dispositions have found that people with avoidant attachment consistently express a preference for being alone rather than affiliating with others. These findings suggest that the lack of sociability of avoidant individuals reflects high levels of social a...
Article
Several studies have shown that physical and/or sexual abuse during childhood may lead to the development of obesity later in life. Despite these consistent findings, the mechanism for the increased risk of obesity following developmental trauma is unknown. It has been suggested that psychological dysfunction, including the presence of disordered e...
Article
To evaluate the frequency and clinical correlates of adult separation anxiety disorder in a large cohort of patients with mood and anxiety disorders. Overall, 508 outpatients with anxiety and mood disorders were assessed by the structured clinical interview for diagnostic and statistical manual (IV edition) axis I disorders for principal diagnosis...
Article
Full-text available
Medication overuse headache (MOH) can be considered a clinical condition at the boundaries between drug addiction and chronic pain disorder. The common 196G > A single-nucleotide polymorphism of BDNF gene, resulting in a valine 66 to methionine (Val66Met), is related with behaviour disorders and substance abuse. With the aim of identifying a worsen...
Article
The goal of this article is to review the studies that have linked low cholesterol levels with psychiatric symptoms or behavioral disorders in order to clarify which cholesterol fractions may influence psychological well being and mental health. The distinction between “bad” (i.e., pro-atherogenic) and “good” (i.e., anti-atherogenic) cholesterol is...
Article
Background: Impairment of social functioning is one of the worst consequences of psychiatric disorders. Deficits in sociat cognition domains, like the "Theory of Mind" (ToM) [i.e., the ability to decipher others' mental states to account for (or make inference on) their behavior], are supposed to take part in social impairment of psychiatric patien...
Article
Social cognition is a broad term, incorporating all aspects of social functioning from perceiving emotional stimuli to attributional style and theory of mind. Not distinguishing between these different capacities may confound the interpretation of the data deriving from studies of the relationship between psychiatric disorders and the social brain....
Article
Several studies have consistently shown that patients with schizophrenia or schizophrenia spectrum disorders (SSD) can be distinguished from normal controls on the basis of their nonverbal behavior during standardized interviews, with considerable interactions between negative symptoms and poor facial expressivity. However, most studies have examin...
Article
Homozygosis for wolframin (WFS1) mutations determines Wolfram syndrome (WS), and common polymorphisms of WFS1 are associated with psychiatric illnesses and dependence behaviour. To test the influence of WFS1 polymorphisms on medication overuse headache (MOH), a chronic headache condition related to symptomatic drugs overuse, we analyzed 82 MOH pati...
Article
The epidemiology of personality disorders confirms the importance of the evolutionary approach to a better understanding of individual differences in personality traits and adds credibility to the evolutionary genetic model. A full appreciation of the potential of the evolutionary genetic framework requires a critical revision of current measures o...