Purpose: The aim of this paper is to present current views on the meaning of trauma and its treatment by the use of Open Dialogue Approach (ODA). Authors broadly define trauma as mental crisis that urges an immediate and comprehensive care. Views: Open Dialogue Approach with its demand on development of professional mental health structures not only meet the requirements imposed on community mental health centre (CMHC) as a core of the National Mental Health Program, but it seems to be exceptionally useful in the context of therapeutic work with traumatized patients and with people in a mental crisis. One of the main aspect of currently carried out mental health reform is the liberalization of hospital beds for those who are in severe mental crisis, substantially the raise od hospital standard for patients admitted to psychiatric hospital and to offer an ambulatory, easily accessible (local) ways of dealing with mental health problems. Conclusions: At the core of the ODA lies a broad understanding of traumatic experience and broad perception of its symptomatic and processual consequences issuing mental crisis, which requires a fast, diverse and coordinated care. ODA may be defined as an integrative and community-oriented model of mental health service that follows constantly changing patients’ needs. Available mental health structural frame – if well-coordinated – seems sufficient and could adequately respond to patient needs in the recovery process. Further prospective and methodologically well designed studies measuring method’s treatment outcomes and cost-effectiveness should be conducted.
{"title":"A model of treating posttraumatic disorders in the Open Dialogue Approach (ODA) exemplified by the Community Mental Health Centre (CMHC)","authors":"Renata Wallner, Michał Kłapciński","doi":"10.5114/PPN.2018.77210","DOIUrl":"https://doi.org/10.5114/PPN.2018.77210","url":null,"abstract":"Purpose: The aim of this paper is to present current views on the meaning of trauma and its treatment by the use of Open Dialogue Approach (ODA). Authors broadly define trauma as mental crisis that urges an immediate and comprehensive care. Views: Open Dialogue Approach with its demand on development of professional mental health structures not only meet the requirements imposed on community mental health centre (CMHC) as a core of the National Mental Health Program, but it seems to be exceptionally useful in the context of therapeutic work with traumatized patients and with people in a mental crisis. One of the main aspect of currently carried out mental health reform is the liberalization of hospital beds for those who are in severe mental crisis, substantially the raise od hospital standard for patients admitted to psychiatric hospital and to offer an ambulatory, easily accessible (local) ways of dealing with mental health problems. Conclusions: At the core of the ODA lies a broad understanding of traumatic experience and broad perception of its symptomatic and processual consequences issuing mental crisis, which requires a fast, diverse and coordinated care. ODA may be defined as an integrative and community-oriented model of mental health service that follows constantly changing patients’ needs. Available mental health structural frame – if well-coordinated – seems sufficient and could adequately respond to patient needs in the recovery process. Further prospective and methodologically well designed studies measuring method’s treatment outcomes and cost-effectiveness should be conducted.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.77210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The process of adaptation to trauma requires readiness to assess the distortion of basic beliefs related to an experienced life event. The adapted Core Beliefs Inventory, developed by Cann et al., measures readiness to revise distorted as a result of the trauma the basic beliefs. Method: The basis for the evaluation of the psychometric properties of the Inventory is the results of surveys of several groups of people (N = 415), who experienced a traumatic event (domestic violence, illness, transport accident). Except the Core Beliefs Inventory (CBI) the following tests have been applied: the Impact of Event Scale – Revised, Posttraumatic Stress Disorder Checklist, Posttraumatic Growth Inventory, Posttraumatic Cognitions Inventory, Cognitive Processing of Trauma Scale and Event Related Rumination Inventory. Results: Study of structural relevancy confirmed the heterogeneity of the construct of basic beliefs. The best features are a 3-factor model that explains 74.9% variance. Reliability: Cronbach α is 0.90 for the whole scale and 0.57 to 0.70 for the 3 factors; test-retest stability is from 0.52 to 0.77. External validity was confirmed by correlating CBI with the results of other tools, including PTCI, CPOTS and ERRI. Sten standards were established for the general belief indicator. A stronger association of disruptions of core beliefs with PTSD (r = 0.55) than PTG (r = 0.40) was confirmed. Conclusions: Polish version of CBI seems to be a useful tool for assessing disruptions of core beliefs and can be applied both in research and in practice.
{"title":"The importance of core beliefs in the process of posttraumatic adaptation – the Polish adaptation of the Core Beliefs Inventory","authors":"Z. Juczyński, N. Ogińska-Bulik","doi":"10.5114/ppn.2018.77211","DOIUrl":"https://doi.org/10.5114/ppn.2018.77211","url":null,"abstract":"Purpose: The process of adaptation to trauma requires readiness to assess the distortion of basic beliefs related to an experienced life event. The adapted Core Beliefs Inventory, developed by Cann et al., measures readiness to revise distorted as a result of the trauma the basic beliefs. Method: The basis for the evaluation of the psychometric properties of the Inventory is the results of surveys of several groups of people (N = 415), who experienced a traumatic event (domestic violence, illness, transport accident). Except the Core Beliefs Inventory (CBI) the following tests have been applied: the Impact of Event Scale – Revised, Posttraumatic Stress Disorder Checklist, Posttraumatic Growth Inventory, Posttraumatic Cognitions Inventory, Cognitive Processing of Trauma Scale and Event Related Rumination Inventory. Results: Study of structural relevancy confirmed the heterogeneity of the construct of basic beliefs. The best features are a 3-factor model that explains 74.9% variance. Reliability: Cronbach α is 0.90 for the whole scale and 0.57 to 0.70 for the 3 factors; test-retest stability is from 0.52 to 0.77. External validity was confirmed by correlating CBI with the results of other tools, including PTCI, CPOTS and ERRI. Sten standards were established for the general belief indicator. A stronger association of disruptions of core beliefs with PTSD (r = 0.55) than PTG (r = 0.40) was confirmed. Conclusions: Polish version of CBI seems to be a useful tool for assessing disruptions of core beliefs and can be applied both in research and in practice.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2018.77211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The aim of the study was to examine the strength of association between posttraumatic stress disorder (PTSD) as well as alexithymia and dissociation relative to persons, who have experienced one of the following types of trauma: trauma associated with rape or sexual violence (ST), other kinds of trauma associated with being a victim of a fire or an accident (NST). Method: The total number of participants amounted to 117 women, among whom 39 fell victims to sexual abuse (ST), 39 experienced non-sexual trauma (NST), and 39 denied ever having come through a traumatic situation (NT). Seventy five women (64.1%) admitted that they suffered from PTSD. Three standardised instrument were used to assess alexithymia (TAS-26), dissociation (CES) and Posttraumatic Stress Disorder (PDS). Results: The ST group is characterised by significantly higher levels of alexithymia, but only in the form of identifying and describing one’s own emotions. The surprising finding was that ST and NT groups reported slightly different levels on the general scale of dissociation, which can be explained by the fact that NST group showed significantly more intensive dissociative tendencies in the form of self-absorption, while ST showed it in the form of depersonalisation and amnesia. In the ST group, significantly more serious PTSD-symptoms were confirmed, particularly regarding the avoidance of stimuli related with trauma. These findings suggest that trauma-type (sexual/non-sexual) might be a key factor determining the extent, kind and intensity of trauma-related disorders. Conclusions: Dissociation and alexithymia are very important to the development and maintenance of the symptoms of PTSD. The high levels of alexithymia were associated with more serious problems of affective arousal and regulation of affect after trauma.
{"title":"Sexual trauma type and its relation to alexithymia, dissociation and posttraumatic stress disorder symptoms among women survivors","authors":"E. Zdankiewicz-Ścigała, M. Szczepaniak","doi":"10.5114/ppn.2018.78714","DOIUrl":"https://doi.org/10.5114/ppn.2018.78714","url":null,"abstract":"Purpose: The aim of the study was to examine the strength of association between posttraumatic stress disorder (PTSD) as well as alexithymia and dissociation relative to persons, who have experienced one of the following types of trauma: trauma associated with rape or sexual violence (ST), other kinds of trauma associated with being a victim of a fire or an accident (NST). Method: The total number of participants amounted to 117 women, among whom 39 fell victims to sexual abuse (ST), 39 experienced non-sexual trauma (NST), and 39 denied ever having come through a traumatic situation (NT). Seventy five women (64.1%) admitted that they suffered from PTSD. Three standardised instrument were used to assess alexithymia (TAS-26), dissociation (CES) and Posttraumatic Stress Disorder (PDS). Results: The ST group is characterised by significantly higher levels of alexithymia, but only in the form of identifying and describing one’s own emotions. The surprising finding was that ST and NT groups reported slightly different levels on the general scale of dissociation, which can be explained by the fact that NST group showed significantly more intensive dissociative tendencies in the form of self-absorption, while ST showed it in the form of depersonalisation and amnesia. In the ST group, significantly more serious PTSD-symptoms were confirmed, particularly regarding the avoidance of stimuli related with trauma. These findings suggest that trauma-type (sexual/non-sexual) might be a key factor determining the extent, kind and intensity of trauma-related disorders. Conclusions: Dissociation and alexithymia are very important to the development and maintenance of the symptoms of PTSD. The high levels of alexithymia were associated with more serious problems of affective arousal and regulation of affect after trauma.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/ppn.2018.78714","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Małgorzata Figlus, Magdalena Obrembska, E. Miller, A. Głąbiński
Purpose: Cognitive dysfunction occurs in more than half of patients with multiple sclerosis (MS). The evaluation of the level of cognitive functioning in MS patients is important for the assessment of the disease course and deciding on appropriate therapeutic interventions. The purpose of the study was to analyse the suitability of the Addenbrooke’s Cognitive Examination-III (ACE-III) as a screening tool for detecting cognitive dysfunctions in MS. Methods: The study included 28 MS patients and 24 ageand gender-matched controls. The evaluation of cognitive functioning was conducted with ACE-III. The results were subjected to statistical analysis expanded by determining the optimal cut-off points for individual subscales of the test. Results: The level of all cognitive functions was lower in MS patients. Statistically significant differences (p < 0.005) were demonstrated for the results of the ACE-III total score, memory, Mini-ACE (M-ACE) and fluency. The highest AUC values were obtained for total score, memory, M-ACE and fluency. With the cut-off level of 97 points, the test was characterised by sensitivity of 75% and specificity of over 95%. In terms of memory and fluency, the test was characterised by sensitivity close to 60% and specificity over 90%. Conclusions: The ACE-III presents high diagnostic accuracy, good sensitivity and diagnostic specificity in the assessment of cognitive dysfunctions in MS. The results of the study concerning the deteriorated functioning of MS patients in terms of memory and fluency coincide with the conclusions from the literature and are an attempt to characterise the profile of cognitive dysfunctions in MS patients.
目的:超过一半的多发性硬化症(MS)患者发生认知功能障碍。评价多发性硬化症患者的认知功能水平对于评估病程和决定适当的治疗干预措施具有重要意义。本研究的目的是分析阿登布鲁克认知检查- iii (ACE-III)作为检测MS认知功能障碍的筛查工具的适用性。方法:研究包括28例MS患者和24例年龄和性别匹配的对照组。认知功能评估采用ACE-III。结果通过确定测试的各个子量表的最佳截止点进行统计分析。结果:MS患者各项认知功能水平均降低。ACE-III总分、记忆、Mini-ACE (M-ACE)和流畅性的差异有统计学意义(p < 0.005)。总分、记忆、M-ACE和流畅性的AUC值最高。截断水平为97点，灵敏度75%，特异度95%以上。在记忆和流畅性方面，该测试的特点是灵敏度接近60%，特异性超过90%。结论:ACE-III在评估MS认知功能障碍方面具有较高的诊断准确性、良好的敏感性和诊断特异性，关于MS患者在记忆和流畅性方面功能恶化的研究结果与文献结论相吻合，是表征MS患者认知功能障碍特征的一种尝试。
{"title":"Addenbrooke’s Cognitive Examination-III (ACE-III) test as a new potential tool for screening of cognitive dysfunctions in the course of multiple sclerosis","authors":"Małgorzata Figlus, Magdalena Obrembska, E. Miller, A. Głąbiński","doi":"10.5114/PPN.2018.79556","DOIUrl":"https://doi.org/10.5114/PPN.2018.79556","url":null,"abstract":"Purpose: Cognitive dysfunction occurs in more than half of patients with multiple sclerosis (MS). The evaluation of the level of cognitive functioning in MS patients is important for the assessment of the disease course and deciding on appropriate therapeutic interventions. The purpose of the study was to analyse the suitability of the Addenbrooke’s Cognitive Examination-III (ACE-III) as a screening tool for detecting cognitive dysfunctions in MS. Methods: The study included 28 MS patients and 24 ageand gender-matched controls. The evaluation of cognitive functioning was conducted with ACE-III. The results were subjected to statistical analysis expanded by determining the optimal cut-off points for individual subscales of the test. Results: The level of all cognitive functions was lower in MS patients. Statistically significant differences (p < 0.005) were demonstrated for the results of the ACE-III total score, memory, Mini-ACE (M-ACE) and fluency. The highest AUC values were obtained for total score, memory, M-ACE and fluency. With the cut-off level of 97 points, the test was characterised by sensitivity of 75% and specificity of over 95%. In terms of memory and fluency, the test was characterised by sensitivity close to 60% and specificity over 90%. Conclusions: The ACE-III presents high diagnostic accuracy, good sensitivity and diagnostic specificity in the assessment of cognitive dysfunctions in MS. The results of the study concerning the deteriorated functioning of MS patients in terms of memory and fluency coincide with the conclusions from the literature and are an attempt to characterise the profile of cognitive dysfunctions in MS patients.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.79556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The assessment of subjectively experienced and perceived stigma by people suffering from schizophrenia. Methods: The study included 64 people diagnosed with schizophrenia from the Masovia Province. The study used Angermeyer’s Questionnaire. Results: The respondents definitely expect negative social attitudes towards people who are mentally ill. The sense of anticipated stigma among respondents is high in every area (contacts with people, employment, relationships, social perceptions of mentally ill people, structural discrimination). The results show that some respondents experienced both rejection due to illness and also positive acceptance in their immediate environment. Respondents believed that it is better to keep the illness to themselves to avoid being exposed to rejection (72%) and that people respond negatively to people with mental illness (70%). They also believed that the majority of healthy people avoid contact with sick people (70%), and that employers are reluctant to hire them (72%). The majority of respondents believed that other people do not want to have mentally ill partners (77%), 59% of respondents had experienced rejection due to mental illness, 53% had the experience of all social contacts being broken with them for the same reason. In the area of employment, 39% of respondents declared that they had failed to be recruited because of the illness. Conclusions: Respondents definitely expect negative social attitudes in various areas of their lives. Most often they experience stigma in the area of contacts with other people.
{"title":"Experienced and perceived stigma among people suffering from schizophrenia","authors":"Katarzyna Chotkowska","doi":"10.5114/PPN.2018.80883","DOIUrl":"https://doi.org/10.5114/PPN.2018.80883","url":null,"abstract":"Purpose: The assessment of subjectively experienced and perceived stigma by people suffering from schizophrenia. Methods: The study included 64 people diagnosed with schizophrenia from the Masovia Province. The study used Angermeyer’s Questionnaire. Results: The respondents definitely expect negative social attitudes towards people who are mentally ill. The sense of anticipated stigma among respondents is high in every area (contacts with people, employment, relationships, social perceptions of mentally ill people, structural discrimination). The results show that some respondents experienced both rejection due to illness and also positive acceptance in their immediate environment. Respondents believed that it is better to keep the illness to themselves to avoid being exposed to rejection (72%) and that people respond negatively to people with mental illness (70%). They also believed that the majority of healthy people avoid contact with sick people (70%), and that employers are reluctant to hire them (72%). The majority of respondents believed that other people do not want to have mentally ill partners (77%), 59% of respondents had experienced rejection due to mental illness, 53% had the experience of all social contacts being broken with them for the same reason. In the area of employment, 39% of respondents declared that they had failed to be recruited because of the illness. Conclusions: Respondents definitely expect negative social attitudes in various areas of their lives. Most often they experience stigma in the area of contacts with other people.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.80883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70510002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Fijałkowski, Karolina Jędrzejczak-Pospiech, J. Błaszczyk
Purpose: Catalase (cat) and glutathione peroxidase (GSH-Px) activities and thiobarbituric acid reactive substances (TBARS) concentration in blood platelets were determined in patients with multiple sclerosis (MS). Methods: The study was carried out in a group of 36 patients, men and women, aged 21-50 years old. They were divided into groups dependently on the degree of motor disability and duration of the disease. The control group included 15 healthy individuals of similar age to the study group. The activity of catalase was estimated according to the method by Beers and Sizer. Glutathione peroxidase activity was determined by the method of Sedlak and Lindsay, modified by Little and O’Brien. The concentration of thiobarbituric acid reactive substances in blood platelets was carried out using the method by Placer et al. Results: We observed a lower level of TBARS concentration in platelets of MS patients than in control group with an enhanced activities of both antioxidative enzymes on the basis of disability degree and duration of the disease. Conclusions: Catalase and glutathione peroxidase protect blood platelets from lipid peroxidation process in multiple sclerosis patients and may play a role in the course of the disease. It may also suggest involvement of lipid peroxidation in the activity of multiple sclerosis.
{"title":"Do catalase and glutathione peroxidase protect blood platelets from lipid peroxidation in multiple sclerosis","authors":"P. Fijałkowski, Karolina Jędrzejczak-Pospiech, J. Błaszczyk","doi":"10.5114/PPN.2018.74323","DOIUrl":"https://doi.org/10.5114/PPN.2018.74323","url":null,"abstract":"Purpose: Catalase (cat) and glutathione peroxidase (GSH-Px) activities and thiobarbituric acid reactive substances (TBARS) concentration in blood platelets were determined in patients with multiple sclerosis (MS). Methods: The study was carried out in a group of 36 patients, men and women, aged 21-50 years old. They were divided into groups dependently on the degree of motor disability and duration of the disease. The control group included 15 healthy individuals of similar age to the study group. The activity of catalase was estimated according to the method by Beers and Sizer. Glutathione peroxidase activity was determined by the method of Sedlak and Lindsay, modified by Little and O’Brien. The concentration of thiobarbituric acid reactive substances in blood platelets was carried out using the method by Placer et al. Results: We observed a lower level of TBARS concentration in platelets of MS patients than in control group with an enhanced activities of both antioxidative enzymes on the basis of disability degree and duration of the disease. Conclusions: Catalase and glutathione peroxidase protect blood platelets from lipid peroxidation process in multiple sclerosis patients and may play a role in the course of the disease. It may also suggest involvement of lipid peroxidation in the activity of multiple sclerosis.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.74323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70508174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Psychiatry as a discipline of medicine and science is subject to constant social assessment. Psychiatrists – its key representatives – often share discriminating experiences with mentally-ill patients. The aim of the paper is to analyse the attitude of Polish psychiatrists towards psychiatry and their own professional role. Methods: The studied group consisted of Polish psychiatrists. A diagnostic survey in the form of a questionnaire to be filled-in individually was used and 232 questionnaires underwent the final analysis. Results: According to the majority of psychiatrists (62.9%), the greater part of the society is aware of the fact that psychiatry is a discipline of medicine; 47% of psychiatrists believe that an average citizen considers psychiatric treatment to be either only slightly effective or ineffective at all. According to 53.8% of the respondents, 40 to 100% of the society associates psychiatric therapy with violence. In the opinion of the majority of respondents (84.1%), a small part of the society (up to 40%) believes that psychiatry is a field of magical influences. A small part of the studied doctors (8.6%) claim that most of the society (60% and more) thinks that psychiatry is used to protect individuals who break the law. According to 46.5% of the respondents, a smaller part of the society (up to 40%) claims that psychiatrists become similar to their patients. Most of them (56.9%) think that the prestige of psychiatry in the eyes of doctors of other specialisations is low or very low. According to 62.5% of the studied psychiatrists, doctors of other specialisations think that the effectiveness of psychiatric treatment is average, although most of their colleagues (76.2%) are satisfied with the choice of this specialisation. A vast majority (96.1%) expressed satisfaction with their own choice of medical specialisation. According to the great majority (76.8%), the level of emotional burden related to the work of a psychiatrist is high or very high. Most of the respondents (64.3%) estimate that the level of legal responsibility related to the work of a psychiatrist is more than average. A vast majority of the studied persons (86.6%) claim that financial outlays designated to psychiatry are lower as compared to other disciplines of medicine. Most of the respondents (87.5%) believe that doctors of other specialisations often or very often treat men- tally-ill patients in a discriminating manner. Conclusions: Polish psychiatrists believe that psychiatry is an undervalued and discriminated discipline of medicine. At the same time, they express high level of satisfaction with their choice of this medical specialisation.
{"title":"Opinions of Polish psychiatrists on psychiatry and their own professional role","authors":"Artur Kochański, A. Cechnicki","doi":"10.5114/PPN.2018.74325","DOIUrl":"https://doi.org/10.5114/PPN.2018.74325","url":null,"abstract":"Purpose: Psychiatry as a discipline of medicine and science is subject to constant social assessment. Psychiatrists – its key representatives – often share discriminating experiences with mentally-ill patients. The aim of the paper is to analyse the attitude of Polish psychiatrists towards psychiatry and their own professional role. Methods: The studied group consisted of Polish psychiatrists. A diagnostic survey in the form of a questionnaire to be filled-in individually was used and 232 questionnaires underwent the final analysis. Results: According to the majority of psychiatrists (62.9%), the greater part of the society is aware of the fact that psychiatry is a discipline of medicine; 47% of psychiatrists believe that an average citizen considers psychiatric treatment to be either only slightly effective or ineffective at all. According to 53.8% of the respondents, 40 to 100% of the society associates psychiatric therapy with violence. In the opinion of the majority of respondents (84.1%), a small part of the society (up to 40%) believes that psychiatry is a field of magical influences. A small part of the studied doctors (8.6%) claim that most of the society (60% and more) thinks that psychiatry is used to protect individuals who break the law. According to 46.5% of the respondents, a smaller part of the society (up to 40%) claims that psychiatrists become similar to their patients. Most of them (56.9%) think that the prestige of psychiatry in the eyes of doctors of other specialisations is low or very low. According to 62.5% of the studied psychiatrists, doctors of other specialisations think that the effectiveness of psychiatric treatment is average, although most of their colleagues (76.2%) are satisfied with the choice of this specialisation. A vast majority (96.1%) expressed satisfaction with their own choice of medical specialisation. According to the great majority (76.8%), the level of emotional burden related to the work of a psychiatrist is high or very high. Most of the respondents (64.3%) estimate that the level of legal responsibility related to the work of a psychiatrist is more than average. A vast majority of the studied persons (86.6%) claim that financial outlays designated to psychiatry are lower as compared to other disciplines of medicine. Most of the respondents (87.5%) believe that doctors of other specialisations often or very often treat men- tally-ill patients in a discriminating manner. Conclusions: Polish psychiatrists believe that psychiatry is an undervalued and discriminated discipline of medicine. At the same time, they express high level of satisfaction with their choice of this medical specialisation.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.74325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70508262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Secondary traumatic stress and vicarious posttraumatic growth in nurses working in palliative care – the role of psychological resilience","authors":"N. Ogińska-Bulik","doi":"10.5114/PPN.2018.78713","DOIUrl":"https://doi.org/10.5114/PPN.2018.78713","url":null,"abstract":"","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.78713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70508810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Cognitive activity, including event-related ruminations and personality features play an essential role in the occurrence of negative outcomes of experienced traumatic events. The study investigated the role of ruminations, treated both in terms of stable disposition (trait-like rumination) and about the event in the relationship between personality dimensions and posttraumatic stress disorder (PTSD). Methods: Sixty people, aged 18–78 years (M = 50.4, SD = 17.74), who had experienced malignant tumours in the craniofacial area were examined. The majority of respondents (68.3%) were women. The Impact of Event Scale-Revised, the NEO Five-Factor Inventory (NEO-FFI), the Rumination-Reflection Questionnaire (RRQ) and the Event Related Rumination Inventory (ERRI) were used in the study. Results: The majority of respondents, i.e. 76.7%, reported moderate or severe PTSD symptoms. Low levels of these symptoms were observed only in 23.3% of the subjects. The only dimension of personality associated with the severity of PTSD symptoms was neuroticism. It plays a predictive role for dispositional ruminating and for the intrusive ruminations of an experienced event. In turn, this type of ruminations is conducive to the occurrence of PTSD symptoms. The conducted multiple mediation analysis (double mediation model) indicated the significance of intrusive ruminations as a factor favouring the intensity of the PTSD symptoms. Conclusions: Ruminations seem to play a more important role in the occurrence of PTSD symptoms than personality traits. Ruminations about the experienced situation are more significant than trait-like rumination for the occurrence of these symptoms.
{"title":"Personality and posttraumatic stress symptoms in oncological patients – the mediating role of ruminations","authors":"N. Ogińska-Bulik","doi":"10.5114/PPN.2018.77209","DOIUrl":"https://doi.org/10.5114/PPN.2018.77209","url":null,"abstract":"Purpose: Cognitive activity, including event-related ruminations and personality features play an essential role in the occurrence of negative outcomes of experienced traumatic events. The study investigated the role of ruminations, treated both in terms of stable disposition (trait-like rumination) and about the event in the relationship between personality dimensions and posttraumatic stress disorder (PTSD). Methods: Sixty people, aged 18–78 years (M = 50.4, SD = 17.74), who had experienced malignant tumours in the craniofacial area were examined. The majority of respondents (68.3%) were women. The Impact of Event Scale-Revised, the NEO Five-Factor Inventory (NEO-FFI), the Rumination-Reflection Questionnaire (RRQ) and the Event Related Rumination Inventory (ERRI) were used in the study. Results: The majority of respondents, i.e. 76.7%, reported moderate or severe PTSD symptoms. Low levels of these symptoms were observed only in 23.3% of the subjects. The only dimension of personality associated with the severity of PTSD symptoms was neuroticism. It plays a predictive role for dispositional ruminating and for the intrusive ruminations of an experienced event. In turn, this type of ruminations is conducive to the occurrence of PTSD symptoms. The conducted multiple mediation analysis (double mediation model) indicated the significance of intrusive ruminations as a factor favouring the intensity of the PTSD symptoms. Conclusions: Ruminations seem to play a more important role in the occurrence of PTSD symptoms than personality traits. Ruminations about the experienced situation are more significant than trait-like rumination for the occurrence of these symptoms.","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.77209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70508869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Wciórka, M. Anczewska, Piotr Jahołkowski, P. Świtaj
Purpose: The Mini-ICF-APP is a simple, practical tool measuring activity limitations and participation restrictions in mental disorders according to the principles and categories of the International Classification of Functioning, Disability and Health (ICF). The aim of the study was to determine the basic psychometric properties of the Polish language version of the Mini-ICF-APP. Method: A total of 58 patients in the early stages of recovery were included. Each of them was independently assessed by three clinicians with varied professional backgrounds (psychiatrists, psychologists and other therapists) using the Mini-ICF-APP and measures of psychopathology (Brief Psychiatric Rating Scale – BPRS) and level of psychosocial functioning (Global Assessment of Functioning Scale – GAF; Personal and Social Performance Scale – PSP). Feasibility, reliability (internal consistency and inter-rater agreement), and validity (content, criterion and construct) were analysed. Results: Feasibility was concluded on the basis of positive feedback from clinicians, diversity of distribution and good item performance. Internal consistency was high, both when analysed jointly and separately for particular groups of clinicians. Measures of inter-rater agreement reached high values for the scale and were significant for each item. Criterion validity was indicated by high correlations with the GAF and the PSP, and slightly weaker with the BPRS. The construct validity of the Mini-ICF-APP was inferred ISSN: 1230-2813 volume 26 / Issue 1 2017 ADVANCES IN PSYCHIATRY & NEUROLOGY
{"title":"Psychometric evaluation of the polish version of the MINI-ICF-APP – a concise measure of limitations on activity and restrictions on participation according to the international classification of functioning, disability and health (ICF) – in people with mental disorders","authors":"J. Wciórka, M. Anczewska, Piotr Jahołkowski, P. Świtaj","doi":"10.5114/PPN.2018.78715","DOIUrl":"https://doi.org/10.5114/PPN.2018.78715","url":null,"abstract":"Purpose: The Mini-ICF-APP is a simple, practical tool measuring activity limitations and participation restrictions in mental disorders according to the principles and categories of the International Classification of Functioning, Disability and Health (ICF). The aim of the study was to determine the basic psychometric properties of the Polish language version of the Mini-ICF-APP. Method: A total of 58 patients in the early stages of recovery were included. Each of them was independently assessed by three clinicians with varied professional backgrounds (psychiatrists, psychologists and other therapists) using the Mini-ICF-APP and measures of psychopathology (Brief Psychiatric Rating Scale – BPRS) and level of psychosocial functioning (Global Assessment of Functioning Scale – GAF; Personal and Social Performance Scale – PSP). Feasibility, reliability (internal consistency and inter-rater agreement), and validity (content, criterion and construct) were analysed. Results: Feasibility was concluded on the basis of positive feedback from clinicians, diversity of distribution and good item performance. Internal consistency was high, both when analysed jointly and separately for particular groups of clinicians. Measures of inter-rater agreement reached high values for the scale and were significant for each item. Criterion validity was indicated by high correlations with the GAF and the PSP, and slightly weaker with the BPRS. The construct validity of the Mini-ICF-APP was inferred ISSN: 1230-2813 volume 26 / Issue 1 2017 ADVANCES IN PSYCHIATRY & NEUROLOGY","PeriodicalId":39142,"journal":{"name":"Postepy Psychiatrii i Neurologii","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5114/PPN.2018.78715","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70509195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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