PSYCHIATRIC CONSEQUENCES OF STRESS AFTER A VEHICLE ACCIDENT

Background: Vehicle accidents are a common cause of disease and death among people over 30 years of age. Essentially, reaction to stress due to the vehicle accident does not differ from the reaction to other stress factors. There are still no uniform viewpoints about the kind of sequels and their percentage representation after vehicle accidents. Subjects and methods: The research was provided as a prospective study, included 150 subjects who had vehicle accident minimum 2 years prior to the examination. A questionnaire adjusted to the needs of the research and a battery of psychological tests was used. Results: Affective disorders occurred in 35.33% of subjects, 65% of persons suffer from travel anxiety, 9% of the total number of examinees doesn’t drive any more, 65% have somatisational dysfunctions of the vegetative nervous system, while the posttraumatic stress disorder is present in 36% of subjects. Conclusion: In 87.4% of persons psychiatric consequences last over two years. Long term consequences in 60% of subjects occur as a combination of multiple psychiatric disorders, so the posttraumatic stress disorder and affective disorders never occur one at a time

ATTITUDE TOWARDS ONESELF AND OTHERS IN NON-CLINICAL POPULATION, DEPRESSED AND PARANOID EXAMINEES

Background: The theoretical concept of existential/life positions describes person’s basic beliefs about oneself and others. Most of authors on TA postulated that every person has one of four possible basic life positions: I’m OK, you’re OK; I’m not OK, you’re OK; I’m OK, you’re not OK and I’m not OK, you’re not OK. The aim of this study was the authentication of Existential positions as theoretical concepts in Transaction Analysis, and it’s potential to discriminate clinical from non-clinical examinees, and paranoid from depressive examinees within the clinical population. Subjects and methods: The research conducted was co-relational. The sample belongs to the convenience sample type, and comprised 200 examinees, 100 from the non-clinical and 100 from the clinical population of adults. Results: The results of the research confirm a statistically significant difference between the non-clinical and clinical part of the sample in the examined theoretical concept. The “I am not OK” existential position is more expressed in the clinical part of the sample. The differences between the examinees with depressive and paranoid disorders indicate that the examinees with the depressive disorder are more likely to express the “I am not OK, you are OK” and “I am not OK, you are not OK” Existential position. Conclusion: In general, we can infer that the assumptions which the research was aimed at testing received partial validation. Examinees from the clinical part of the sample have a statistically significantly higher score at the position “I am not OK”. Examinees with depressive characteristics have a more pronounced “I am not OK, you are not OK” position

Prikupljanje obaveštenja od korisnika psihoaktivnih supstanci

U teoriji se ne gleda blagonaklono na vrednost obaveštenja prikupljenih od korisnika psihoaktivnih supstanci, s obzirom da se njihov iskaz, zbog specifičnog psihofizičkog stanja organizma zavisnika i drugih okolnosti vezanih za specifičan kriminalni milje s kojim ova lica imaju svakodnevni kontakt, uglavnom označava nepouzdanim. Autori su nastojali da ovu pretpostavku provere empirijskim istraživanjem. Naime, anketiranjem više od 100 zavisnika koji su bili privođeni u policijske prostorije, nastojali su da saznaju da li su i u kojoj meri policijski službenici nastojali da od njih prikupe obaveštenja, na šta su se ona odnosila, kao i spremnost ovih lica za davanje iskaza, odnosno stepen istinitosti u iskazivanju, kao i druge aspekte tokom boravka u policijskim prostorijama, poput njihovog viđenja poštovanja integriteta ispitanika i sl. S druge strane, putem intervjua istraživani su i stavovi kriminalističkih policajaca vezani za vrednost i verodostojnost iskaza dobijenih od strane korisnika psihoaktivnih supstanci, kako bi se ustanovilo da li se u praktičnom postupanju potvrđuje s početka izneta hipoteza

The relation of stress coping strategies and self-handicapping strategies to the process of opiate addicts behavior changes

Background/Aim. During a progress of addictive behavior treatment, the strategies of coping with stress are engaged, but addicts may continue with self-handicapping behavior which is opposite to changing a problematic behavior. The aim of this study was to examine the stress coping (CS) strategies and self-handicapping (SH) strategies in relation to the process of addictive behavior change. Methods. In the descriptive clinical study, the sample of 200 consecutively recruited inpatient opiate addicts were explored. They underwent methadone therapy. The general information questionnaire, the Indicator of coping strategies (CSI), SHquestionnaire for assessing self-handicapping behavior (SH) and the University Rhode Island Change Assessment (URICA) questionnaire for the assessment of process of change were completed. The Student t-test, Pearson’s correlation coefficient and multiple regression analysis were applied. The SPSS for Windows was used and the p ≤ 0.05 defined as statistically significant. Results. Among the CS, there were significant correlations between avoiding problems strategy and all SH strategies (p ≤ 0.02). The social support was directly proportionate to the process of change (p = 0.03, β = 0.35). However, the process of change inversely correlated to internal handicaps in interpersonal relationships strategy (IHI) (p = 0.02; β = -0.54) and strategy of focusing to the problem (p = 0.00, β = -0.44). Conclusion. The significant positive predictor for the process of addictive behavior change was a strategy of social support, but focusing on the problem and the strategy of internal handicaps in achievement situations were significant negative predictors. The evaluation of motivation process and stress coping strategies could be useful for creation of improved tailored treatment of opiate addiction. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. OI 175014

Reaction time in relation to duration of heroin abuse

Introduction. Consequences of heroin abuse include organic damage of cerebral structures. The level of impairments is in a direct and positive relation with the length of heroin abuse. Objective. The aim of this research was the evaluation of the reaction time with heroin addicts with different length of substance abuse. Methods. Research method: 90 examinees were divided into three groups with relation to the length of heroin abuse. Data collection included a questionnaire referring to socio-demographic and addictive characteristics. A specially designed programme was used for the evaluation of reaction time to audio/ visual signal. Results. In relation to the reaction time as overall model, the difference between examinees with different length of heroin abuse can be found on the marginal level of significance (F=1.69; df=12; p=0.07). In visual modality, with the increase of length of heroin abuse leads to a significant prolongation of simple (the first visual sign: F=3.29; df=2; p=0.04) and choice reaction time (the second visual sign: F=4.97; df=2; p=0.00; the third visual sign: F=3.08; df=2; p=0.05). Longer heroin consumption also leads to the prolongation of the simple (the first auditory task: F=3.41; df=2; p=0.04) and the complex auditory reaction time (the second auditory task: F=5.67; df=2; p=0.01; the third auditory task: F=6.42; df=2; p=0.00). Conclusion. Heroin abuse leads to the prolongation of both simple and choice reaction time in visual as well as auditory modality. The average daily dose of opiates was the most important predictor of the abovementioned cognitive dysfunction

AD/HD IN THE GENESIS OF CONDUCT DISORDER - DOES BIOPSYCHOSICIAL APPROACH MAKE SENSE?

There are numerous theories approaching the source of mental disorders (including conduct disorder) from different perspectives – biological, psychological, social and multifactorial. The question that arises is which theory is to be used to explain the issue. In the interpretation of phenomena in psychiatry, Kecmanović discusses possibilities of different approaches (biological, psychological, social and biopsychosocial models) and concludes that none of them provide a complete solution as to how to approach different disorders. The question, therefore, is how to proceed? Although according to Kecmanović, the biopsychosocial model, as Engel has formulated it, “provides only ingredients not a prescription”, it is our opinion that it indeed does not need to provide prescriptions- it is sufficient if it indicates the necessary ingredients. The prescription itself is to be found in novel scientific disciplines, in particular neuropsychology and epigenetics. Gilbert, on the other hand, points out that the bio- psychosocial approach is holistic, and more than that. „The bio psychosocial approach addresses the complexity of interactions between different domains of functioning and argues that it is the interaction of domains that illuminates important processes” e.g. a hierarchical dimension of the model as one and development as another dimension provide the basis for a comprehensive perspective on psychiatric disorders, in this case of AD/HD as a risk factor for conduct disorder

Heroin overdose - suicide or accident?

Background/Aim. Suicide is a public health problem. Due to frequent overdose among drug addicts, there is a question about suicidality in this population. The aim of this study is to determine the specificity and distinctive factors in opiate addicts who have overdosed with an intention to commit suicide compared to addicts who have overdosed accidentally. Methods. The survey included 150 heroin addicts who were in the substitution program: 49 subjects who overdosed with a clear suicidal intention and 101 addicts who overdosed without suicidal intention. The subjects filled out the questionnaire about socio-demographic data and data regarding their addiction, the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) as well as the Manchester Short Assessment of Quality of Life (MANSA) questionnaire about the quality of life. For statistical analysis, Pearson's χ2 test, Student t-test and univariate variance analysis were used. Results. The addicts who attempted suicide wеre younger persons (29.7 vs. 36.3 years of age), started to take heroin earlier (17.8 vs. 21.3 years of age; p= 0.013), they use it for a longer period (14.1 vs. 9.2 years; p = 0.00) and take it intravenously for a longer period (11.6 vs. 6.5 years; p = 0.00). The suicide was preceded by a traumatic event (p = 0.015) and there were several attempts of suicide (p = 0.004). The quality of life regarding accommodation, friends and organization of their free time was assessed as not so good (p = 0.03). Conclusion. In accordance with the obtained data, it is necessary to design programs for the prevention of suicide among addicts in general and especially programs that would be aimed at younger addicts

THE EFFECT OF HEROIN ON VERBAL MEMORY

Background: As a result of long-term heroin abuse we can see impairment of cerebral structures, that leads to specific psychopathological and neuro - physiological deficits in the cognitive and connative areas. There is a positive correlation between the mentioned deficits and the duration of heroin abuse. The memory is a cognitive function highly sensitive to toxic effects of opiates. The aim of this study was to establish the psychiatric and psychological consequences of heroin abuse, in the sense of verbal memory deficits, and the specific relation between mentioned deficits with the duration of abuse. Subjects and methods: The research was devised as a prospective study, including ninety heroin addicts, divided into three groups, based on the abuse duration. The following instruments were used for data collecting: questionnaire, with basic socialdemographic and addictive characteristics of subjects and Rey Test of Verbal Learning, a neuropsychological test for verbal memory estimation. Results: Only the examinees who have abused heroin for less than a year obtained scores within the domain of the expected performances within the part of the test which relates to the direct verbal memory, as well as, the part of the test that relates to delayed verbal memory. With regard to the mentioned criteria, the difference between examinees with different length of opiates abuse is statistically important (direct memory: F=2.706; p=0.063, delayed memory: F=2.538; p=0.045). With the increase of heroin abuse length the number of examinees with a rising learning curve is decreased significantly, and the number of examinees with a flat learning curve is increased (Chi-square=19.589; p=0.003). Conclusion: Heroin abuse, lasting longer than one year, is connected with impairment of short-term and delayed verbal memory. The intensity of the mentioned effects is higher with addicts who use a higher daily dose of heroin

The presence of injunctions in clinical and non-clinical populations

Various authors within the transactional analysis community have postulated that a person’s life script is formed on the basis of received injunctions, that people with mental disorders have more destructive and numerous injunctions and that people with depressive and paranoid pathology have different sets of injunctions, with Don’t belong being more common in paranoid disorders and Don’t be important in depressive disorders. This research was conducted to check such assertions, and used Script Injunctions Scale (Gavrilov-Jerković et al., 2010) applied to a convenience sample of 100 adult subjects identified as non-clinical via interviews and 100 adult subjects, equally divided between paranoid and depressive, identified by psychiatrist classification based on ICD-10 criteria. The results provide partially expected validation, with statistically significant difference between the non-clinical and clinical part of the sample. The clinical group had statistically significantly higher scores on the 12 injunctions studied. Subjects with depressive characteristics had seven Injunctions which were more pronounced Don’t feel, Don’t exist, Don’t be well, Don’t be a child, Don’t, Don’t think, and Don’t be close Injunctions