Therapeutic Lying as a Non-Pharmacological and Person-Centered Approach in Dementia for Behavioral and Psychological Symptoms of Dementia.

The acceptance and ethics behind therapeutic lying (TL) as a non-pharmacological intervention for behavioral and psychological symptoms of dementia (BPSD) among persons with dementia continues to generate heated debates. This article presents a discussion of the ethical and cultural challenges on the perception of TL by people with dementia, their families, and health care professionals. Additionally, decision-making before TL was analyzed, including the types of TL, its efficacy and implications, alternatives to TL, and the ethical principles behind it. The results from this analysis show that TL is a common practice for BPSD. Its benefits include the reduction of these symptoms as well as the use of physical or chemical restraints. However, there is no consensus on its suitability as an approach, nor on the appropriate way it should be used. More experimental studies are needed to create legal and clinical intervention protocols that respect the fundamental rights of people with dementia promoting coherence, good ethical practices, and guidelines for person-centered care.

[Emotion and recognition memory: the discrimination of negative information as an adaptive process]. / Emoción y memoria de reconocimiento: la discriminación de la información negativa como un proceso adaptativo.

We studied the effect of emotion generated by IAPS (International Affective Picture System) pictures on incidental recognition of these pictures for short retention periods (15 min). Memorization distraction tasks and reaction time tasks were used together with short exposure times (2 seconds per picture) in order to prevent a high recognition rate that would impede testing for the effect of emotion on discrimination parameters (A´) and response bias (B´´D) (ceiling effect). We used 80 pictures representing the medium and high levels of two-dimensional emotional space. The results showed greater discrimination and a more conservative response style to unpleasant and medium arousal level pictures. These pictures produced higher confidence and lower response times in the recognition phase. The results can be explained by the negative content of the pictures and activation level effects on attentional processing and memory, and can be interpreted as a phenomenon that is evolutionarily adaptive.

[Design and validation of two scales about attitudes and knowledge regarding doll therapy in dementia]. / Diseño y validación de dos escalas sobre actitudes y conocimientos ante la terapia con muñecas en demencias.

INTRODUCTION: Non-pharmacological interventions are often the subject of debate in the scientific field. Therefore, it is essential to know the attitudes that health professionals have towards the novel Doll Therapy in Dementia (DTD). The objective of this study was to design and validate two questionnaires to find out the attitudes and knowledge on DTD in health professionals. MATERIAL AND METHODS: A total of 120 Spanish-speaking Geriatrics and Gerontology professionals, with a mean age of 38.3 years (DT = 10.99), participated, mostly women (88.3%). A questionnaire (TCM_DEMCO) on knowledge about the DTD and a questionnaire (TCM_DEMAC) on attitudes towards the DTD were designed and applied. The construct validity was assessed by exploratory factor analysis, and reliability was calculated using Cronbach's α. RESULTS: The exploratory factor analysis of the TCM_DEMCO questionnaire retained 10 items in 5 factors ("environment and dementia", "therapeutic application", "activities", "methodology" and "benefits and implications") that explained 70.1% of the total variability, giving a Cronbach α coefficient value > 0.50. The exploratory factor analysis of the TCM_DEMAC questionnaire retained 10 items in two factors ("positive attitudes" and "negative attitudes") that explained 61.2% of the total variability, giving a Cronbach α value > 0.85. CONCLUSIONS: Both questionnaires are a brief tool to learn about the attitudes and knowledge of Spanish-speaking Geriatrics and Gerontology professionals in matters of DTD. The reliability and validity analyses performed showed good psychometric properties of these tools.

Evolución de la tendencia de búsqueda en España de los términos “Ansiedad”, “Depresión” y “Suicidio” entre 2019 y 2022: Antes, durante y después de la pandemia por COVID-19 / Evolution of the search trend in Spain for the terms “Anxiety”, “Depression” and “Suicide” between 2019 and 2022: Before, during and after the COVID-19 pandemic

Introducción: La pandemia por COVID-19 ha incrementado la prevalencia de la ansiedad, la depresión y el suicidio en la mayoría de los países. La utilización de herramientas como Google Trends ha mostrado su eficacia en el seguimiento de diferentes enfermedades y trastornos mentales, con la posibilidad de mejorar la respuesta sanitaria. En esta investigación se analizó la evolución de las tendencias de búsqueda de los términos “Ansiedad”, “Depresión” y “Suicidio” en las comunidades autónomas españolas entre 2019 y 2022. Método: Se utilizó la herramienta Google Trends para la obtención del Volumen Relativo de Búsqueda (VRB). Resultados: El VRB para “Ansiedad” se incrementó en 2020 y se mantuvo estable y moderado hasta 2022, mientras que para “Depresión” se mostró un incremento solo en 2022. Por otro lado, el VRB para “Suicidio” se redujo progresivamente de 2019 a 2022. Las comunidades que mostraron mayores niveles en VRB para “Ansiedad” y “Depresión” fueron Asturias y Aragón, que partían en 2019 con niveles altos que mantuvieron en los años posteriores. Mientras que Extremadura fue la comunidad que mayor progresión mostró, llegando a 2022 con niveles altos en ansiedad y depresión. Respecto al “Suicidio”, Castilla y León, Cantabria, Murcia y Andalucía, fueron las comunidades que tuvieron mayor VRB, si bien todas las comunidades mostraron disminuciones progresivas de 2019 a 2022. Conclusiones: Estudios que analicen las tendencias de búsqueda podrían ser útiles en determinadas situaciones de emergencia, facilitando la implementación de intervenciones preventivas y adaptadas a cada comunidad, que podrían atenuar el impacto sobre la salud mental.(AU)

Introduction: The COVID-19 pandemic has increased the prevalence of anxiety, depression and suicide in most countries. The use of tools such as Google Trends has shown to be effective in monitoring different mental illnesses and disorders, with the potential to improve the health response. In this research we analyse the evolution of search trends for the terms “Anxiety”, “Depression” and “Suicide” in the Spanish autonomous communities between 2019 and 2022. Method: We used the Google Trends tool to obtain the Relative Search Volume (RSV). Results: The RSV of “Anxiety” increased in 2020 and remained stable and moderate until 2022, while “Depression” showed an increase only in 2022. On the other hand, the RSV of “Suicide” decreased progressively from 2019 to 2022. The communities that showed the highest levels of RSV for “Anxiety” and “Depression” were Asturias and Aragon, which started in 2019 with high levels that they maintained in the following years. While Extremadura was the community that showed the greatest progression, arriving in 2022 with high levels of anxiety and depression. Regarding “Suicide”, Castilla and León, Cantabria, Murcia and Andalusia, were the Communities with the highest RSV, although all communities showed progressive decreases from 2019 to 2022. Conclusions: Studies that analyse search trends could be useful in certain emergency situations, facilitating the implementation of preventive interventions adapted to each community, which could mitigate the impact on mental health.(AU)

Can the Acoustic Analysis of Expressive Prosody Discriminate Schizophrenia?

Emotional states, attitudes and intentions are often conveyed by modulations in the tone of voice. Impaired recognition of emotions from a tone of voice (receptive prosody) has been described as characteristic symptoms of schizophrenia. However, the ability to express non-verbal information in speech (expressive prosody) has been understudied. This paper describes a useful technique for quantifying the degree of expressive prosody deficits in schizophrenia, using a semi-automatic method, and evaluates this method's ability to discriminate between patient and control groups. Forty-five medicated patients with a diagnosis of schizophrenia were matched with thirty-five healthy comparison subjects. Production of expressive prosodic speech was analyzed using variation in fundamental frequency (F0) measures on an emotionally neutral reading task. Results revealed that patients with schizophrenia exhibited significantly more pauses (p < .001), were slower (p < .001), and showed less pitch variability in speech (p < .05) and fewer variations in syllable timing (p < .001) than control subjects. These features have been associated with «flat¼ speech prosody. Signal processing algorithms applied to speech were shown to be capable of discriminating between patients and controls with an accuracy of 93.8%. These speech parameters may have a diagnostic and prognosis value and therefore could be used as a dependent measure in clinical trials.

[Expressive prosodic patterns in individuals with Alzheimer's disease]. / Patrones de prosodia expresiva en pacientes con enfermedad de Alzheimer.

This paper describes a useful technique for quantifying the degree of speech deficits in dementia of GDS 4 Alzheimer's type (DAT). Production of prosodic speech in DAT patients and healthy older controls was analysed using variation in fundamental frequency (F0) measures on a reading task. The prosogram computational model was used to analyze the prosodic contours of the speech samples, using melodic styling of F0 based on perceptual principles and prominence detection of spectral and amplitude fluctuations in the speech signal. Results revealed significant differences in most of these prosodic parameters among the DAT group. Normal pitch variation in speech and variations in syllable timing were reduced in the DAT group, these features cause "flat" speech prosody in these patients. These speech parameters may have diagnostic and prognostic value for Alzheimer's disease and therefore could be a useful aid in clinical trials.

Diseño y validación de dos escalas sobre actitudes y conocimientos ante la terapia con muñecas en demencias / Design and validation of two scales about attitudes and knowledge regarding doll therapy in dementia

INTRODUCCIÓN: Las intervenciones no farmacológicas suelen ser objeto de debate en el ámbito científico. Por ello, resulta fundamental conocer qué actitudes tienen los profesionales de la salud hacia la novedosa terapia con muñecas en demencias (TCMD). El objetivo de este estudio fue diseñar y validar dos cuestionarios para conocer las actitudes y conocimientos ante la TCMD en profesionales de la salud. MATERIAL Y MÉTODOS: Participaron 120 profesionales de la Geriatría y Gerontología hispanohablantes con una media de edad de 38,3 años (DT = 10,99), en su mayoría mujeres (88,3%). Se diseñó y aplicó un cuestionario (TCM_DEMCO) de conocimientos sobre la TCMD y un cuestionario (TCM_DEMAC) de actitudes hacia la TCMD. La validez de constructo se valoró mediante análisis factorial exploratorio y se calculó la fiabilidad por medio del alfa de Cronbach. RESULTADOS: El análisis factorial exploratorio del cuestionario TCM_DEMCO retuvo 10 ítems en 5 factores («entorno y demencia», «aplicación terapéutica», «actividades», «metodología» y «beneficios e implicaciones») que explicaron el 70,1% de la variabilidad total, para el que se obtuvo un valor de coeficiente alfa de Cronbach > 0,50. El análisis factorial exploratorio del cuestionario TCM_DEMAC retuvo 10 ítems en dos factores («actitudes positivas» y «actitudes negativas») que explicaron un 61,2% de la variabilidad total, para el que se obtuvo un valor alfa de Cronbach > 0,85. CONCLUSIONES: Ambos cuestionarios suponen una herramienta breve para conocer las actitudes y conocimientos de los profesionales de la Geriatría y Gerontología hispanohablantes en materia de TCMD. Los análisis de fiabilidad y validez realizados han mostrado buenas propiedades psicométricas de estos instrumentos

INTRODUCTION: Non-pharmacological interventions are often the subject of debate in the scientific field. Therefore, it is essential to know the attitudes that health professionals have towards the novel Doll Therapy in Dementia (DTD). The objective of this study was to design and validate two questionnaires to find out the attitudes and knowledge on DTD in health professionals. MATERIAL AND METHODS: A total of 120 Spanish-speaking Geriatrics and Gerontology professionals, with a mean age of 38.3 years (DT = 10.99), participated, mostly women (88.3%). A questionnaire (TCM_DEMCO) on knowledge about the DTD and a questionnaire (TCM_DEMAC) on attitudes towards the DTD were designed and applied. The construct validity was assessed by exploratory factor analysis, and reliability was calculated using Cronbach's alpha. RESULTS: The exploratory factor analysis of the TCM_DEMCO questionnaire retained 10 items in 5 factors ("environment and dementia", "therapeutic application", "activities", "methodology" and "benefits and implications") that explained 70.1% of the total variability, giving a Cronbach alpha coefficient value > 0.50. The exploratory factor analysis of the TCM_DEMAC questionnaire retained 10 items in two factors ("positive attitudes" and "negative attitudes") that explained 61.2% of the total variability, giving a Cronbach alpha value > 0.85. CONCLUSIONS: Both questionnaires are a brief tool to learn about the attitudes and knowledge of Spanish-speaking Geriatrics and Gerontology professionals in matters of DTD. The reliability and validity analyses performed showed good psychometric properties of these tools

Can the acoustic analysis of expressive prosody discriminate schizophrenia?

Emotional states, attitudes and intentions are often conveyed by modulations in the tone of voice. Impaired recognition of emotions from a tone of voice (receptive prosody) has been described as characteristic symptoms of schizophrenia. However, the ability to express non-verbal information in speech (expressive prosody) has been understudied. This paper describes a useful technique for quantifying the degree of expressive prosody deficits in schizophrenia, using a semi-automatic method, and evaluates this method’s ability to discriminate between patient and control groups. Forty-five medicated patients with a diagnosis of schizophrenia were matched with thirty-five healthy comparison subjects. Production of expressive prosodic speech was analyzed using variation in fundamental frequency (F0) measures on an emotionally neutral reading task. Results revealed that patients with schizophrenia exhibited significantly more pauses (p < .001), were slower (p < .001), and showed less pitch variability in speech (p < .05) and fewer variations in syllable timing (p < .001) than control subjects. These features have been associated with «flat» speech prosody. Signal processing algorithms applied to speech were shown to be capable of discriminating between patients and controls with an accuracy of 93.8%. These speech parameters may have a diagnostic and prognosis value and therefore could be used as a dependent measure in clinical trials (AU)

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Patrones de prosodia expresiva en pacientes con enfermedad de Alzheimer / Expressive prosodic patterns in individuals with Alzheimer’s Disease

En este trabajo se describe una técnica útil para cuantificar el grado de déficits en el habla de los pacientes con Enfermedad de Alzheimer (EdA). Se comparan las características prosódicas del habla de un grupo de pacientes con EdA con GDS 4 y un grupo de control, midiendo las variaciones de la frecuencia fundamental (F0) en una tarea de lectura. Se utiliza el modelo computacional denominado Prosogram para analizar los contornos prosódicos de las muestras de voz, utilizando estilizaciones melódicas de la F0 basadas en la detección de sus prominencias y de las fluctuaciones de la amplitud de la señal espectral del habla. Los resultados muestran diferencias significativas en la mayoría de los parámetros prosódicos analizados en el grupo con EdA GDS 4. Las variaciones normales del tono, así como en la estructura silábica, están reducidas en el grupo de EdA, lo que provoca un habla prosódicamente plana. Estos parámetros del habla pueden tener valor diagnóstico y pronóstico en la EdA y pueden ser útiles en ensayos clínicos (AU)

This paper describes a useful technique for quantifying the degree of speech deficits in dementia of GDS 4 Alzheimer’s type (DAT). Production of prosodic speech in DAT patients and healthy older controls was analysed using variation in fundamental frequency (F0) measures on a reading task. The prosogram computational model was used to analyze the prosodic contours of the speech samples, using melodic styling of F0 based on perceptual principles and prominence detection of spectral and amplitude fluctuations in the speech signal. Results revealed significant differences in most of these prosodic parameters among the DAT group. Normal pitch variation in speech and variations in syllable timing were reduced in the DAT group, these features cause «flat» speech prosody in these patients. These speech parameters may have diagnostic and prognostic value for Alzheimer’s disease and therefore could be a useful aid in clinical trials (AU)

Emoción y memoria de reconocimiento: la discriminación de la información negativa como un proceso adaptativo / Emotion and recognition memory: The discrimination of negative information as an adaptive process

Se estudió el efecto de la emoción generada a través de fotografías del IAPS (International Affective Picture System) sobre el reconocimiento incidental de dichas fotografías con períodos de retención cortos (15 min). Se utilizaron tareas distractoras de memorización y tiempo de reacción, junto a tiempos de exposición breves (2 segundos por fotografía), con el fin de evitar que la elevada tasa de reconocimiento presente en este tipo de trabajos impida comprobar el efecto de la emoción sobre los parámetros de discriminación (A´) y sesgo de respuesta (B´´D) (efecto techo). Para este fin se utilizaron 80 fotografías representativas de los niveles medio y alto del espacio afectivo bidimensional. Los resultados informan de una mayor discriminación y un estilo de respuesta más conservador para las fotografías desagradables y las de arousal medio. Para este tipo de fotografías se obtuvo una mayor confianza y menores tiempos de respuesta en la fase de reconocimiento. Los resultados pueden explicarse por los efectos que el contenido negativo y el nivel de activación de las fotografías tienen sobre el procesamiento atencional y la memoria, e interpretarse como un fenómeno que resulta adaptativo evolutivamente (AU)

We studied the effect of emotion generated by IAPS (International Affective Picture System) pictures on incidental recognition of these pictures for short retention periods (15 min). Memorization distraction tasks and reaction time tasks were used together with short exposure times (2 seconds per picture) in order to prevent a high recognition rate that would impede testing for the effect of emotion on discrimination parameters (A´) and response bias (B´´D) (ceiling effect). We used 80 pictures representing the medium and high levels of two-dimensional emotional space. The results showed greater discrimination and a more conservative response style to unpleasant and medium arousal level pictures. These pictures produced higher confidence and lower response times in the recognition phase. The results can be explained by the negative content of the pictures and activation level effects on attentional processing and memory, and can be interpreted as a phenomenon that is evolutionarily adaptive (AU)