A Multimodal Adaptive Dialogue Manager for Depressive and Anxiety Disorder Screening: A Wizard-of-Oz Experiment

In this paper, we present an Adaptive Multimodal Dialogue System for Depressive and Anxiety Disorders Screening (DADS). The system interacts with the user through verbal and non-verbal communication to elicit the information needed to make referrals and recommendations for depressive and anxiety disorders while encouraging the user and keeping them calm. We designed the problem using interconnected Markov Decision Processes using sub-goals to deal with the large state space. We present the problem formulation and the experimental procedure for the training data collection and the system training following the methodology of Wizard-of-Oz experiments

Cross validation of bi-modal health-related stress assessment

This study explores the feasibility of objective and ubiquitous stress assessment. 25 post-traumatic stress disorder patients participated in a controlled storytelling (ST) study and an ecologically valid reliving (RL) study. The two studies were meant to represent an early and a late therapy session, and each consisted of a "happy" and a "stress triggering" part. Two instruments were chosen to assess the stress level of the patients at various point in time during therapy: (i) speech, used as an objective and ubiquitous stress indicator and (ii) the subjective unit of distress (SUD), a clinically validated Likert scale. In total, 13 statistical parameters were derived from each of five speech features: amplitude, zero-crossings, power, high-frequency power, and pitch. To model the emotional state of the patients, 28 parameters were selected from this set by means of a linear regression model and, subsequently, compressed into 11 principal components. The SUD and speech model were cross-validated, using 3 machine learning algorithms. Between 90% (2 SUD levels) and 39% (10 SUD levels) correct classification was achieved. The two sessions could be discriminated in 89% (for ST) and 77% (for RL) of the cases. This report fills a gap between laboratory and clinical studies, and its results emphasize the usefulness of Computer Aided Diagnostics (CAD) for mental health care

Dissociation and interpersonal autonomic physiology in psychotherapy research: an integrative view encompassing psychodynamic and neuroscience theoretical frameworks

Interpersonal autonomic physiology is an interdisciplinary research field, assessing the relational interdependence of two (or more) interacting individual both at the behavioral and psychophysiological levels. Despite its quite long tradition, only eight studies since 1955 have focused on the interaction of psychotherapy dyads, and none of them have focused on the shared processual level, assessing dynamic phenomena such as dissociation. We longitudinally observed two brief psychodynamic psychotherapies, entirely audio and video-recorded (16 sessions, weekly frequency, 45 min.). Autonomic nervous system measures were continuously collected during each session. Personality, empathy, dissociative features and clinical progress measures were collected prior and post therapy, and after each clinical session. Two-independent judges, trained psychotherapist, codified the interactions\u2019 micro-processes. Time-series based analyses were performed to assess interpersonal synchronization and de-synchronization in patient\u2019s and therapist\u2019s physiological activity. Psychophysiological synchrony revealed a clear association with empathic attunement, while desynchronization phases (range of length 30-150 sec.) showed a linkage with dissociative processes, usually associated to the patient\u2019s narrative core relational trauma. Our findings are discussed under the perspective of psychodynamic models of Stern (\u201cpresent moment\u201d), Sander, Beebe and Lachmann (dyad system model of interaction), Lanius (Trauma model), and the neuroscientific frameworks proposed by Thayer (neurovisceral integration model), and Porges (polyvagal theory). The collected data allows to attempt an integration of these theoretical approaches under the light of Complex Dynamic Systems. The rich theoretical work and the encouraging clinical results might represents a new fascinating frontier of research in psychotherapy

Arts, Health and Well-Being across the Military Continuum

Is there an active, meaningful role for the arts and creative arts therapies in addressing this vast array of critical human readiness issues across the military continuum? In general, "readiness" is the #1 issue for the military at all times. The connection of the arts to the human dimension of readiness is key. Military leaders say we need every weapon in our arsenal to meet the many challenges we face today. However, one of the most powerful tools we have in our arsenal -- the arts -- is often under-utilized and not well understood within the military and the healthcare system. The arts and creative arts therapists are -- and have been -- a part of military tradition and missions across all branches, supporting military health services, wellness, and mission readiness, including family support. For example, the War Department ordered the use of music in rehabilitation for the war wounded in World War II. In June 1945, the Department of War issued "Technical Bulletin 187: Music in Reconditioning in American Service Convalescent and General Hospitals." This bulletin was a catalyst for the growth and development of music therapy being used as a rehabilitative service for active duty service members and veterans alike during and after WWII. Although many gaps exist in our knowledge regarding the arts in military settings, what we do know to date holds great promise for powerful outcomes for our service members, veterans, their families, and the individuals who care for them. Today, a growing number of members of the public and private sectors are eager to collaborate with military leaders to help make these outcomes a reality.Nowhere was the momentum for greater collaboration more evident than in October 2011, when the first National Summit: Arts in Healing for Warriors was held at Walter Reed National Military Medical Center (now referred to as Walter Reed Bethesda) and the National Intrepid Center of Excellence (NICoE). Rear Admiral Alton L. Stocks, Commander of Walter Reed Bethesda, hosted the National Summit, in partnership with a national planning group of military, government, and nonprofit leaders. The 2011 Summit marked the first time various branches of the military collaborated with civilian agencies to discuss how engaging with the arts provides opportunities to meet the key health issues our military faces -- from pre-deployment to deployment to homecoming.Building upon its success, a multi-year National Initiative for Arts & Health in the Military was established in 2012, with the advice and guidance of federal agency, military, nonprofit, and private sector partners (see Figure 2). The National Initiative for Arts & Health in the Military (National Initiative) represents an unprecedented military/civilian collaborative effort whose mission is to "advance the arts in health, healing, and healthcare for military service members, veterans, their families, and caregivers."Members of the National Initiative share a commitment to optimize health and wellness, with a deep understanding and awareness that the arts offer a unique and powerful doorway into healing in ways that many conventional medical approaches do not. The Initiative's goals include working across military, government, private, and nonprofit sectors to: 1. Advance the policy, practice, and quality use of arts and creativity as tools for health in the military; 2. Raise visibility, understanding, and support of arts and health in the military; and 3. Make the arts as tools for health available to all active duty military, medical staff, family members, and veterans

Changes in narrative quality pre- and post-emotion focused therapy for childhood abuse trauma

The present study sought to test a theory that the quality of narratives written by adult survivors of childhood abuse would improve after undergoing Emotion Focused Therapy for Trauma (EFTT; Paivio et al., 2008), and that improvement in quality would be associated with trauma resolution. Pre- and post-therapy narratives of 37 subjects participating in EFTT were analyzed for incoherence, positive and negative emotion words, temporal orientation, and depth of experiencing. Results showed a significant increase in positive emotion words, present/future orientation, and depth of experiencing, but the improvement in quality was not associated with trauma-related therapy outcome. Pre-therapy negative emotion words and depth of experiencing were associated with degree of abuse resolution, and pre-therapy incoherence was associated with post-therapy PTSD symptoms. These results support a theory that unresolved trauma disrupts narrative quality, and further suggest that trauma narrative quality provides useful information about client capacity for change in EFTT

Responding sensitively to survivors of child sexual abuse: an evidence review

This report summarises what the evidence tells us about the characteristics of adults who were sexually abused as children and how to most effectively support them.

Security and the performative politics of resilience : critical infrastructure protection and humanitarian emergency preparedness

This article critically examines the performative politics of resilience in the context of the current UK Civil Contingencies (UKCC) agenda. It places resilience within a wider politics of (in)security that seeks to govern risk by folding uncertainty into everyday practices that plan for, pre-empt, and imagine extreme events. Moving beyond existing diagnoses of resilience based either on ecological adaptation or neoliberal governmentality, we develop a performative approach that highlights the instability, contingency, and ambiguity within attempts to govern uncertainties. This performative politics of resilience is investigated via two case studies that explore 1) Critical National Infrastructure protection and 2) Humanitarian Emergency Preparedness. By drawing attention to the particularities of how resilient knowledge is performed and what it does in diverse contexts, we repoliticise resilience as an ongoing, incomplete, and potentially self-undermining discourse