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.

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

Clinical Efficacy and Therapeutic Alliance in a Time-Limited Group Therapy for Young Adults

This study evaluated the clinical efficacy of a time limited psychodynamic therapy for a group of young adult patients in terms of outcome and process. The results register a favourable outcome concerning not only the gravity of patients' initial symp-toms but also the structural personality changes and attachment style. In an exploratory perspective this study investigated the connection between the outcome of the tre-atment and therapeutic alliance measured by CALPAS-G in three different time intervals of therapy. A correlational analysis highlighted a strong connection between the Patient Commitment scale assessed at the beginning and the final outcome of the therapy. Work-ing Strategy Consensus and Group Understanding and Involvement assessed in the middle of the therapy course, show significant correlations with the final outcome of therapy

Reflective functioning and dissociative experiences: A comparison study between adolescents at “high-risk” of psychosis and healthy controls

# Background Despite the established contribution to psychological well-being in young subjects, the investigation of reflective functioning and dissociative experiences in help-seekers adolescents still appears an unmet need. # Objective The study aimed to assess reflective functioning and dissociative symptoms in help-seekers adolescents, and compare them to gender-matched healthy controls. # Methods The Reflecting Functioning Questionnaire (RFQ) was used to investigate mentalizing; the Adolescent Dissociative Experience Scale (A-DES) was used to explore dissociative symptoms. # Results The study involved 102 adolescents (mean age 18.06 ± 1.78 years), split into "help-seekers" (N= 51; mean age 19 ± 1.98 years) and healthy controls (N= 51; mean age 17.12 ± 0.84). "Help-seekers" adolescents showed lower RFQ-certainty scores (mean 3.39 ± 2.47), compared to healthy controls (mean 6.73 ± 5.01). Furthermore, "help-seekers" adolescents reported higher scores on RFQ-uncertainty (mean 7.73 ± 4.38), compared to healthy controls (mean 5.14 ± 4.17), which indicates a greater lack of knowledge about mental states (hypomentalizing). Eventually, "help-seekers" adolescents showed significantly worse dissociative symptoms (A-DES total mean score 3.49 ± 2.04), compared to healthy controls (A-DES total mean score 2.06 ± 1.43). # Conclusion The importance of an assessment in early adolescence denotes a topic of increasing concern, in order to identify failures in reflective functioning and the onset of dissociative experiences among help-seekers adolescents, toward the implementation of tailored psychological interventions

Dreams and Nightmares during the First and Second Wave of the COVID-19 Infection: A Longitudinal Study

Recent literature shows that the Coronovirus-19 (COVID-19) pandemic has provoked significant changes in dreaming. The current study intends to provide an update about dream variable changes during the second wave of COVID-19. A total of 611 participants completed a web survey from December 2020 to January 2021. Statistical comparisons showed that subjects had lower dream-recall frequency, nightmare frequency, lucid-dream frequency, emotional intensity, and nightmare distress during the second than the first wave of the pandemic. Dreams had a higher negative tone during the second than first wave. We revealed significant differences concerning post-traumatic growth, sleep-related post-traumatic stress disorder (PTSD) symptoms and sleep measures between groups obtained as a function of the changes in the oneiric frequency between the first and second waves. We also found significant correlations between qualitative/emotional dream features and COVID-19-related factors (job change, forced quarantine, having COVID-19 infected relatives/friends, or asking for mental health help). Overall, we found that the second wave affected fewer quantitative features of dream activity and there was less emotional intensity. Moreover, we confirmed the relationship between nightmares and the high risk of PTSD when subjects were grouped as a function of the increasing/decreasing frequency. Finally, our findings are partly coherent with the continuity hypothesis between oneiric and waking experiences

THE ROLE OF METACOGNITION IN MULTIPLE SCLEROSIS: A CLINICAL STUDY AND ASSESSMENT OF POSSIBLE CORRELATION WITH ANXIETY, DEPRESSION AND COPING STRATEGIES.

The current study aimed to explore the relationships between metacognition and anxiety, depression, and coping strategies in MS patients, compared to healthy subjects. The study was conducted on a group of 50 MS patients and a control group of 50 healthy volunteers matched for gender, age, level of education and social status. Metacognitions were assessed with the Metacognitions Questionnaire-30, while anxiety and depression were assessed with the Hospital Anxiety and Depression Scale, and coping strategies were assessed with the Brief COPE. Results did not show significant differences between metacognitive factors for MS patients and healthy subjects. However, we found specific, contrasting correlations between the MS group and the control group. The results of this study could have some implications for clinical practice. Given the relationship between metacognitions and negative emotions, “psychological intervention”, based on the metacognitive approach, could have positive effects on MS patients

Suppl.1 B Poster

Suppl. 1 B Poster proceedings AIP Milazzo 2015 Milazzo 25,26,27 Sept. 201