Dissociative symptoms in female patients with mood and anxiety disorders: a psychopathological and temperamental investigation.

Abstract OBJECTIVE: Dissociative symptoms are frequent among psychiatric patients and may considerably affect patients' psychopathological condition and treatment outcomes. The objectives of the study are to assess the presence of dissociative symptoms in female patients with mood and anxiety disorders, to investigate their correlation with the clinical severity of the disorders and to investigate those personality traits that are more frequent in patients with high levels of dissociation. PATIENTS AND METHODS: 50 Caucasian females were enrolled in the study. Patients were assessed through the Self-Report Symptom Check-List, the Dissociative Experiences Scale (DES) and rating scales for Depression and Anxiety. RESULTS: The mean DES score in the overall sample was 16.6. 32% of patients had a DES score > 20. Depressive symptoms positively correlated with the DES total scores. Dissociator patients presented some significantly different temperamental characteristics in comparison with non dissociator patients. CONCLUSIONS: Dissociative symptoms are highly present in patients with mood and anxiety disorders and correlate with the severity of depressive symptoms. Specific personality traits more frequently observed in dissociator people may represent predisposing factors; their early identification could be clinically relevant

An LTL Semantics of Business Workflows with Recovery

We describe a business workflow case study with abnormal behavior management (i.e. recovery) and demonstrate how temporal logics and model checking can provide a methodology to iteratively revise the design and obtain a correct-by construction system. To do so we define a formal semantics by giving a compilation of generic workflow patterns into LTL and we use the bound model checker Zot to prove specific properties and requirements validity. The working assumption is that such a lightweight approach would easily fit into processes that are already in place without the need for a radical change of procedures, tools and people's attitudes. The complexity of formalisms and invasiveness of methods have been demonstrated to be one of the major drawback and obstacle for deployment of formal engineering techniques into mundane projects

A phenotype of resiliency? cross-sectional psychobiological differences between caregivers who are vulnerable vs. resilient to depression, and controls

Introduction: Being a caregiver of chronically ill children is a source of chronic-psychological stress affecting general physical and mental health. However, there is tremendous variance among caregivers: some may develop stress-related depression, whereas others are more “resilient”. The objective of the study was to phenotypically differentiate on psychobiology caregivers who developed depressive symptoms (“vulnerable”) vs. those who did not (“resilient”) from each other and from age-matched controls. Methods: Forty-five mothers of chronically-ill children and 18 controls have been examined. Caregivers were divided via a median split of Center for Epidemiological Studies Depression Scale scores in “resilient” (RCs) and “vulnerable” (VCs). We assessed cognitive, affective, metabolic, neuroendocrine and oxidative markers at rest and in response to a laboratory social stressor. ANCOVAs and Bonferroni post-hoc tests were used to examine between-group differences. Results: Although RCs compared to VCs had similar levels of objective parenting-related burden (P = 0.51), they had lower subjective distress (P < 0.01) and higher levels of positive affect (P = 0.04). Although RCs compared to controls had higher levels of objective parenting-related burden (P = 0.04), they had greater cortisol suppression post-dexamethasone (P = 0.05), lower F2-isoprostanes/vitamin E ratio (P < 0.01) and lower fasting insulin levels (P = 0.06). Discussion: Our results suggest that caregivers with higher resiliency demonstrate more salutary stress-related functioning in comparison with less resilient caregivers and, more surprisingly, non-caregiver controls. These findings might be interpreted in the spirit of Nietzsche's quote “What does not kill me, makes me stronger” and of the idea that successfully overcoming adversity may be more psychobiologically beneficial than not having been exposed to any adversity

Euthanasia and physician-assisted suicide for patients with depression. Thought-provoking remarks

Euthanasia and medical assistance in dying entail daunting ethical and moral challenges, in addition to a host of medical and clinical issues, which are further complicated in cases of patients whose decision-making skills have been negatively affected or even impaired by psychiatric disorders. The authors closely focus on clinical depression and relevant European laws that have over the years set firm standards in such a complex field. Pertaining to the mental health realm specifically, patients are required to undergo a mental competence assessment in order to request aid in dying. The way psychiatrists deal and interact with decisionally capable patients who have decided to end their own lives, on account of sufferings which they find to be unbearable, may be influenced by subjective elements such as ethical and cultural biases on the part of the doctors involved. Moreover, critics of medical aid in dying claim that acceptance of such practices might gradually lead to the acceptance or practice of involuntary euthanasia for those deemed to be nothing more than a burden to society, a concept currently unacceptable to the vast majority of observers. Ultimately, the authors conclude, the key role of clinicians should be to provide alternatives to those who feel so hopeless as to request assistance in dying, through palliative care and effective social and health care policies for the weakest among patients: lonely, depressed or ill-advised people

Integrated Modeling and Verification of Real-Time Systems through Multiple Paradigms

Complex systems typically have many different parts and facets, with different characteristics. In a multi-paradigm approach to modeling, formalisms with different natures are used in combination to describe complementary parts and aspects of the system. This can have a beneficial impact on the modeling activity, as different paradigms an be better suited to describe different aspects of the system. While each paradigm provides a different view on the many facets of the system, it is of paramount importance that a coherent comprehensive model emerges from the combination of the various partial descriptions. In this paper we present a technique to model different aspects of the same system with different formalisms, while keeping the various models tightly integrated with one another. In addition, our approach leverages the flexibility provided by a bounded satisfiability checker to encode the verification problem of the integrated model in the propositional satisfiability (SAT) problem; this allows users to carry out formal verification activities both on the whole model and on parts thereof. The effectiveness of the approach is illustrated through the example of a monitoring system.Comment: 27 page

SMT-based Verification of LTL Specifications with Integer Constraints and its Application to Runtime Checking of Service Substitutability

An important problem that arises during the execution of service-based applications concerns the ability to determine whether a running service can be substituted with one with a different interface, for example if the former is no longer available. Standard Bounded Model Checking techniques can be used to perform this check, but they must be able to provide answers very quickly, lest the check hampers the operativeness of the application, instead of aiding it. The problem becomes even more complex when conversational services are considered, i.e., services that expose operations that have Input/Output data dependencies among them. In this paper we introduce a formal verification technique for an extension of Linear Temporal Logic that allows users to include in formulae constraints on integer variables. This technique applied to the substitutability problem for conversational services is shown to be considerably faster and with smaller memory footprint than existing ones

Capgras-like syndrome in a patient with an acute urinary tract infection.

Delusional misidentification syndromes are a group of delusional phenomena in which patients misidentify familiar persons, objects, or themselves, believing that they have been replaced or transformed. In 25%-40% of cases, misidentification syndromes have been reported in association with organic illness. We report an acute episode of Capgras-like delusion lasting 8 days, focused on the idea that people were robots with human bodies, in association with an acute urinary infection. To our knowledge, this is the first case report associating urinary tract infection with Capgras-like syndrome. Awareness of the prevalence of delusional misidentification syndromes associated with acute medical illness should promote diligence on the part of clinicians in recognizing this disorder

Trait mindfulness at baseline predicts increases in telomerase activity over time

Introduction Preliminary investigations of cross-sectional samples have linked trait mindfulness with measures related to the hypothalamic–pituitary–adrenal (HPA)-mediated stress response and to the inflammatory system, suggesting that this is one potential pathway linking mindfulness based interventions and health. However, no previous studies explored the association between the trait mindfulness construct and markers of cellular ageing. Methods In the current study we examined in a sample of healthy mothers (n = 92) of a child with Autism Spectrum Disorder (i.e. women showing high levels of chronic psychological stress) the prospective associations between a multidimensional scale of trait mindfulness, the Five Facet Mindfulness Questionnaire (FFMQ), and telomerase activity (TA), a marker of cellular ageing and telomere homeostasis. Participants’ trait mindfulness and TA were assessed at baseline as well as 9 and 18 month follow-up. Results Analysis showed that higher levels of baseline mindfulness on FFMQ observation and describe subscales were related to increase in TA from baseline to 9 month (r = 0.27, P = 0.03 and r = 0.24, P = .04, respectively). Additionally, the FFMQ Describe subscale was related to increase in TA from baseline to 18 month (r = .30, P = .02). Results are reported following covariate adjustment of age, BMI, ethnicity, and education. Discussion Our results showed that higher levels of baseline mindfulness are associated with higher increases in TA after 9 months and 18 months, with increased TA reportedly being associated with decreased oxidative damage, increased telomere length and overall more functional cellular physiology. These findings support a role of mindfulness-related interventions to increase general and mental health

A Model-Driven Approach for the Formal Verification of Storm-Based Streaming Applications

Data-intensive applications (DIAs) based on so-called Big Data technologies are nowadays a common solution adopted by IT companies to face their growing computational needs. The need for highly reliable applications able to handle huge amounts of data and the availability of infrastructures for distributed computing rapidly led industries to develop frameworks for streaming and big-data processing, like Apache Storm and Spark. The definition of methodologies and principles for good software design is, therefore, fundamental to support the development of DIAs. This paper presents an approach for non-functional analysis of DIAs through D-VerT, a tool for the architectural assessment of Storm applications. The verification is based on a translation of Storm topologies into the CLTLoc metric temporal logic. It allows the designer of a Storm application to check for the existence of components that cannot process their workload in a timely manner, typically due to an incorrect design of the topology

Bounded Reachability for Temporal Logic over Constraint Systems

We present CLTLB(D), an extension of PLTLB (PLTL with both past and future operators) augmented with atomic formulae built over a constraint system D. Even for decidable constraint systems, satisfiability and Model Checking problem of such logic can be undecidable. We introduce suitable restrictions and assumptions that are shown to make the satisfiability problem for the extended logic decidable. Moreover for a large class of constraint systems we propose an encoding that realize an effective decision procedure for the Bounded Reachability problem