The Self in the Alzheimer's Patient as Revealed through Psycholinguistic-story Based Analysis☆

AbstractThe World Alzheimer Report (2014) stated that 44 million people worldwide suffer from AD. Perhaps the worst effect of the disease is the loss of Self, which is based on the loss of identity and memory (Caddell & Clare, 2010). Research into the initial stages of the disease with the scope of developing some sort of 'salvage therapy' is rather scarce. This work reports research done from a psycho-linguistic point of view with the goal of identifying how Alzheimer's patients maintain the Self through narrative. Self-narrative may be effective in maintaining the Self in AD patients if begun in the preliminary stages of AD .The purpose of this study was to extend knowledge about how subjects with a probable AD diagnosis or in a medium-low phase maintain the continuity of Self. The use of narration with linguistic analysis was used. Various authors have considered the use of narrative therapy (England, 2010; Ramanthan, 1997; Hyman, 2011). The study was conducted on a group of 10 patients /7 females and 3 males) with ages ranging between 67-82 (average=73.70; DS=4.76), a medium-low education level (between 1 and 11 years of education) and a probable diagnosis of AD. Three interviews were conducted including neuropsychological tests. Interviews were recorded, transcribed according to Mergenthaler (1992) and analysed following the GT approach and using the textual analysis software of Atlas.ti. This research showed that the emotional aspects which give continuity to the patients' Self seem to be well conserved in their implicit memory. The analysis of the beginning phase of the disease and the way in which it progresses seems to be useful in the effort to understand the patient's psychic reaction to the diagnosis as well as how he or she reorganizes self-representation. It is also useful in observing how the subject's identity weave or self concept begins to deteriorate. Intervention protocols could be developed as well as a subsequent model to promote psychological health and efficacy of available traditional treatments. More research needs to be done in this area internationally, in order to test the universality of these results

Can cognitive reserve protect frail individuals from dementia

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Defense mechanisms and alexithymia in Inflammatory bowel disease and Irritable bowel disease

Objectives: This study aimed to examine the differential contribution of demographic and medical characteristics on severity of gastrointestinal symptoms in a sample of patients with IBS or IBD. In a sample of outpatients with gastrointestinal disorders. In addition this study aimed to explore the role of alexithymia and defense style on gastrointestinal symptoms. Methods: The participants consisted of 65 outpatients with an IBS or IBD diagnosis who completed a demographic questionnaire, the Toronto Alexithymia Scale – 20 (TAS-20), the Defense Style Questionnaire (DSQ), and the Gastrointestinal Symptom Rating Scale (GSR). Results: ANOVA showed no significant effect of specific diagnosis on the severity of gastrointestinal symptoms. Results of MANCOVA showed that there was a significant multivariate effect of gender with female scoring significantly higher than males on severity of intestinal symptoms. Other variables such as age, level of education, years since diagnosis did not reach a significance on the dependent variables. In addition the defense style defined “maladaptive” had a significant effect on dyspeptic symptoms. Conclusions: Our results have shown the influence of the maladaptive defense style on the severity of symptoms with no differences for the three considered diagnosis. Moreover they are coherent with past studies highlighting the risk for the female gender to develop a somatic disease

The Role of Metacognitions in Predicting Anxiety and Depression Levels in Cancer Patients Ongoing Chemotherapy

Abstract Cancer patients often have to deal with numerous side effects and psychological distress during chemotherapy. Research has shown that dysfunctional metacognitive beliefs are the basis for the development and maintenance of emotional disorders. The present research is a first attempt to explore how metacognitions influence anxiety and depression in cancer patients undergoing chemotherapy. A sample of 175 cancer patients undergoing chemotherapy completed a demographic questionnaire, the Metacognitions Questionnaire-30 (MCQ-30)and the Hospital Anxiety and Depression Scale (HADS). Medical information about the stage of disease and the history of treatment was obtained. Linguistic analysis (Stansfield et al., 1992) was employed to ensure that the form had been correctly translated because the Italian form of the MCQ-30 was utilized (Quattropani, et.al, 2014) Negative beliefs, the need to control thoughts, and positive beliefs explained up to 89% of variance of anxiety in cancer patients during chemotherapy. The negative beliefs about worry and the gender explained up to 81% of variance of depression in cancer patients during chemotherapy. In fact, female gender was positively correlated with depression level of patients. The negative beliefs about worry and the need to control thoughts explained the 81% variance for the overall distress of patients during chemotherapy. In conclusion, some metacognitive factors have a crucial role both for anxiety and depression in cancer patients ongoing chemotherapy. It is suggested that the psychological intervention for cancer patients should assess such factors and try to address them in clinical practice. Statistical analysis was conducted by Massimo Mucciardi. Mary Ellen Toffle wrote the abstract, re-werote entire article, assisted in translation and wrote section 3.3.

Failures in Reflective Functioning and Reported Symptoms of Anxiety and Depression in Bereaved Individuals: A Study on a Sample of Family Caregivers of Palliative Care Patients

Introduction. This study aims at examining the role of failures in reflective functioning in predicting anxiety and depression among family caregivers of palliative care patients deceased for at least one year. Methods. A sample of 157 bereaved participants (77.1% females, mean age = 43.50 ± 14.04 years) completed the Hospital Anxiety and Depression Scale (HADS) and the Reflective Functioning Questionnaire (RFQ). Results. Results of the correlational analysis showed that anxiety was positively correlated with uncertainty about mental states, indicating one type of impairment in reflective functioning. Anxiety was also negatively correlated with the certainty about mental states. Depression was negatively correlated with certainty but not with uncertainty about mental states. The results of regression analysis indicated that gender and certainty about mental states were statistically significant predictors of anxiety, with the final model explaining 23% of the variance. The results also showed that gender, the condition of being the main caregiver, and the certainty about mental states were significant predictors of depression, with the final model predicting 14% of the variance. Conclusions. Overall, the results of this study point out that the bereaved individuals who scored low on certainty about mental states reported more symptoms of anxiety and depression. Psychological interventions to prevent mental disorders and to promote psychological health in the context of palliative care should carefully consider these findings

Gender and Psychosocial Differences in Psychological Resilience among a Community of Older Adults during the COVID-19 Pandemic

The study aimed at exploring gender and additional sociodemographic differences in psychological resilience, as well as the association between resilience and psychological distress in older adults, during the first lockdown in Italy, due to the COVID-19 pandemic. Participants attended an online survey during the first lockdown in May 2020. Psychological distress was assessed through the Depression Anxiety Stress Scale-21, the Resilience Scale (RS) was administered to evaluate psychological resilience, and sociodemographic variables were also collected. The study involved 108 community older adults (mean age 70.02 ± 3.5 years). Comparisons revealed that women reported significantly lower total scores of RS (p = 0.027), as well as lower levels of resilience-related domains, namely Meaningfulness (p = 0.049), Self-Reliance (p = 0.011), Perseverance (p = 0.035), and Existential Aloneness (p = 0.014), compared to men. Significantly higher RS scores were found in older adults being involved in a relationship, compared to those not involved in relationships (p = 0.026), and in older adults with children (p = 0.015), compared to those without offspring, suggesting the importance for older adults of not dealing alone with such a dramatic and stressful event, such as the pandemic. Negative correlations were found between psychological resilience and stress, depression, and anxiety. Linear regressions revealed that lower RS total scores, as well as lower scores in the majority of the RS scales, were associated with greater levels of stress, greater levels of anxiety, and greater levels of depressive symptoms. This study suggested that older women might appear more vulnerable in facing the pandemic, compared to men; having not lived alone through the lockdown period might also be considered as a factor of resilience for older adults

The burnout syndrome in palliative home care workers: the role of coping strategies and metacognitive beliefs

Healthcare professionals are daily confronted with events involving the suffering of others, which are likely to generate highly negative and stressful emotions. In palliative care the emotional commitment is exacerbated by the constant confrontation with the theme of suffering and death. The failure to successfully down-regulate negative emotions is a key risk factor for a severe form of discomfort, known as burnout syndrome. Burnout is a psychological state of exhaustion, related to stress at work. Maslach (1996) describes it as a psychological syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. Recent studies have shown that healthcare worker coping strategies may function either as a risk or aprotective factor for the development of distress and emotional problems. Furthermore, other studies highlighted the role of the dimensions of metacognition as vulnerability factors in predicting the development of psychological symptoms. The aim of this study is to examine and assess the relationships between burnout, coping strategies and metacognitive beliefs in workers involved in home palliative care. The hypothesis of the present work is that the appropriate use of positive and flexible coping strategies and functional metacognitive beliefs may relate to the management of distress and emotional problems. A group of operators working in a team of Integrated Home Palliative Care participated in the research.The study was based on a protocol including the Italian version of MCQ-30, used to assess a range of metacognitive beliefs and processes relevant to vulnerability and maintenance of emotional disorders; the Brief Cope (BC) to survey coping strategies; Maslach Burnout Inventory (MBI) to measure burnout. The questionnaire includes a socio-demographical section. The results show the presence of a statistically significant correlation between the variables investigated

Alexithymia and psychological distress affect perceived quality of life in patients with type 2 diabetes mellitus

Backgrounds: Psychological factors may affect patients' ability to cope with chronic illness, which occur with a high incidence as they represent age related disorder. Anxiety, depression and alexithymia could specifically interfere with compliance and adherence leading to predictable consequences and predicting morbidity and mortality independently of several confounders. The present work aims at investigating the relationship between alexithymia and affective dimension such as anxiety and depression levels, and health related quality of life in T2DM patients. Particularly, alexithymia was analyzed in its three main facets and time since diagnosis was considered with also metabolic control. Methods: Forty seven patients with T2DM were consecutively enrolled and assessed with a gold standard interview and with a psycho-diagnostic evaluation. Clinical psychological exploration consisted of HAM-A, BECK-II, SF-36 and TAS-20 administration. Statistical analysis was performed using IBM SPSS statistical version 25. Data were analyzed anonymously. Results: 47 participants showed moderate depressive symptoms as confirmed by the mean BDI-II and HAMA-A score (15.14 ± 8.95 and 24.31 ± 6.95, respectively), suggesting a high prevalence of anxiety in the enrolled subjects. It was observed a lower perceived QoL as resulted by the MCS and PCS mean values (37.68 ± 9.41 and 39.31 ± 12.29, respectively) and TAS-20 highlighted considerable mean values of 60.53 ± 7.93 in the recruited participants with a prevalence in EOT values (27.51± 4.27), in comparison with mean DID and DDF values (17.26 ± 5.52 and 15.48 ± 3.84, respectively). Conclusions: Our study may suggest a predictive role of alexithymia in patients with T2DM. Moreover, lower PCS and MCS, revealing worst perceived QoL were associated to both higher anxiety and disease duration

Generation of Entangled N-Photon States in a Two-Mode Jaynes-Cummings Model

We describe a mathematical solution for the generation of entangled N-photon states in two field modes. A simple and compact solution is presented for a two-mode Jaynes-Cummings model by combining the two field modes in a way that only one of the two resulting quasi-modes enters in the interaction term. The formalism developed is then applied to calculate various generation probabilities analytically. We show that entanglement, starting from an initial field and an atom in one defined state may be obtained in a single step. We also show that entanglement may be built up in the case of an empty cavity and excited atoms whose final states are detected, as well as in the case when the final states of the initially excited atoms are not detected.Comment: v2: 5 pages, RevTeX4, minor text changes + 1 figure added, revised version to be published in PRA, May 200