Psychological pain — conceptualization and measurement tools

W artykule omówiono ujęcia bólu psychicznego, jego przyczyny oraz sposoby pomiaru tej zmiennej. Szczególną uwagę zwrócono na koncepcję Edwina Shneidmana, zgodnie z którą ból psychiczny jest podstawowym źródłem myśli i zachowań samobójczych. Dokonano przeglądu badań wskazujących na związki bólu psychicznego z tendencjami suicydalnymi i zmiennymi osobowościowymi. W artykule zawarto również postulaty dotyczące dalszych kierunków badań nad bólem psychicznymDifferent ways of understanding the psychological pain, its causes and ways to measure this variable were described in presented article. The special attention was paid to the Edwin Shneidman’s concept in which the psychological pain is the basic source of suicide thoughts and behaviours. Studies which show the relation between the psychological pain and suicidal tendencies and personality variables were overviewed. The article also includes demands for further research on the psychological pain

Zapobieganie nawrotom w chorobie alkoholowej - przegląd piśmiennictwa

The article presents an overview of the conceptions and investigations on alcohol dependence relapses. Studies on variables like stress, personal resources, social, demographic and situational factors which play an important role in relapses were described. Research conducted so far seem to be insufficient, often leads to inconsistent conclusions and do not integrate different aspects of this problem. The interactive and multidimensional model of relapse need to be created. The results of empirical research should have application in therapeutic practice.W pracy dokonano przeglądu dawniejszych oraz aktualnych koncepcji i badań nad nawrotami w chorobie alkoholowej. Omówiono między innymi badania dotyczące roli stresu, radzenia sobie, zasobów osobistych, zmiennych socjodemograficznych oraz sytuacyjnych w łamaniu abstynencji przez pacjentów. Dotychczasowe poszukiwania w tej dziedzinie wydają się niewystarczające; często prowadzą do niejednoznacznych wniosków oraz nie integrują różnych ujęć omawianej problematyki. Istnieje potrzeba stworzenia interakcyjnego i wielowymiarowego modelu dotyczącego powstawania nawrotów. Wyniki badań empirycznych powinny znajdować większe niż dotychczas zastosowanie w praktyce terapeutycznej

Male depression – the concept, measurement tools and relationships with suicidal behaviours

W artykule przedstawiono koncepcję atypowych objawów depresji występujących u mężczyzn. Ważnym źródłem tej koncepcji były doświadczenia wyniesione z programu diagnozowania i leczenia depresji wprowadzonego na Gotlandii (Szwecja) w latach 80. ubiegłego stulecia. Program, skierowany do lekarzy rodzinnych, zmniejszył liczbę zachowań samobójczych wśród kobiet, ale nie wśród mężczyzn. Przyjęto, że jedną z przyczyn takiego stanu rzeczy może być odmienny obraz depresji u obu płci. Różnice między płciami mogą odpowiadać za to, że depresja u mężczyzn znacznie częściej niż u kobiet pozostaje nierozpoznana i nieleczona, co prowadzi do zwiększenia liczby samobójstw. Wśród dominujących objawów depresji u mężczyzn wyróżniono wzrost impulsywności i zachowań agresywnych, nadużywanie substancji psychoaktywnych (alkohol, narkotyki, nikotyna), podejmowanie zachowań ryzykownych (jazda samochodem pod wpływem alkoholu, przypadkowe kontakty seksualne) oraz tłumienie emocji. Jako przyczyna występowania atypowej depresji u mężczyzn najczęściej wymieniane jest rygorystyczne podporządkowywanie się tradycyjnym męskim normom kulturowym. Normy te dotyczą odporności, wytrzymałości, konkurowania, opanowania i tłumienia uczuć oraz konieczności zapewnienia bytu rodzinie. W pracy omówiono najbardziej znane metody badania męskiej depresji – Gotland Male Depression Scale (GMDS) Rutza, Male Depression Risk Scale (MDRS-22) Rice’a i współpracowników oraz Masculine Depression Scale (MDS) Magovcevic i Addisa – a także przedstawiono wyniki badań prowadzonych z użyciem wspomnianych metod. Artykuł kończą refleksje dotyczące dalszych kierunków badań nad problemem męskiej depresji i opis kontrowersji związanych z omawianą koncepcjąThe article presents the concept of atypical symptoms of depression occurring in men. An important source of the concept is the experience of the programme of diagnosis and treatment of depression which was carried out on Gotland (Sweden) in the 1980s. The programme, which was addressed to family practitioners, led to a reduction of suicidal behaviours in women. Among men, these behaviours did not change. It was assumed that one of the reasons for such an outcome could be a different picture of depression in both sexes. These differences could be responsible for the fact that depression in men remains undiagnosed and untreated more often than among women, leading to an increased number of suicides. Increased impulsivity, aggressive behaviour, substance abuse (alcohol, drugs, nicotine), taking risky behaviours (risky driving, casual sex) and suppression of emotions were distinguished among the dominant symptoms of male depression. The rigorous submission to the traditional male cultural roles is often mentioned as the cause of atypical depression in men. These standards refer to resistance, strength, competition, control over and suppression of feelings as well as the need to provide for the family. This article presents the most common methods to study male depression, i.e. the Gotland Male Depression Scale (GMDS) by Rutz, the Male Depression Risk Scale (MDRS-22) by Rice et al. and the Masculine Depression Scale (MDS) by Magovcevic and Addis. The results of research conducted with the use of these methods are also shown. The paper ends with reflections on further research on the problem of male depression and the controversy surrounding this issue

Wczesne nieadaptacyjne schematy a poziom depresji u osób uzależnionych od alkoholu

Celem przeprowadzonego badania było sprawdzenie, czy istnieje związek między wczesnymi nieadaptacyjnymi schematami wyróżnionymi przez Younga i współpracowników a depresją u osób uzależnionych od alkoholu. Podjęto też próbę odpowiedzi na pytanie o związki schematów z wybranymi zmiennymi dotyczącymi uzależnienia od alkoholu, a także występowaniem tendencji suicydalnych u alkoholików. Materiał i metody: W badaniu wzięło udział 77 osób uzależnionych od alkoholu – 19 kobiet oraz 58 mężczyzn. Zastosowano Kwestionariusz Schematów Younga (Young Schema Questionnaire, YSQ-S3), Skalę Depresji Becka (Beck’s Depression Inventory, BDI), Michigan Alcoholism Screening Test (MAST). Wyniki: Na podstawie otrzymanych wyników można stwierdzić, iż 16 z 18 schematów jest powiązanych dodatnio i istotnie statystycznie z poziomem depresji u osób uzależnionych od alkoholu. Najsilniejsze związki odnotowano w przypadku schematu deprywacji emocjonalnej, izolacji/wyobcowania i podporządkowania. Stwierdzono także związki schematów z głębokością uzależnienia oraz wiekiem rozpoczęcia picia. Różnice w natężeniu niektórych schematów występowały również między osobami doświadczającymi myśli samobójczych i osobami bez tych myśli. Wnioski: Należy rozważyć włączenie do terapii odwykowej pracy ukierunkowanej na zmiany destrukcyjnych schematów poznawczych występujących u osób uzależnionych. Dotyczy to zwłaszcza schematu izolacji społecznej, deprywacji emocjonalnej i podporządkowania. Istnieje również potrzeba prowadzenia dalszych badań tego obszaru problemowego.The purpose of the study was to determine whether a link exists between early maladaptive schemas identified by Young et al. and depression in alcoholics. The relationships of schemas with selected alcohol dependence variables and suicidal thoughts in alcoholics were also checked. Material and methods: Seventy-seven alcohol addicts participated in the study – 19 women and 58 men. Young Schema Questionnaire (YSQ-S3), Beck’s Depression Inventory (BDI) and Michigan Alcoholism Screening Test (MAST) were used. Results: Based on the results obtained, 16 out of 18 schemas are positively and statistically correlated with depression among alcoholics. The strongest relationships were noted for emotional deprivation, social isolation/alienation and subjugation. Correlations between the schemas and the severity of addiction and the age of drinking initiation were also found. Differences in the intensity of some schemas occurred between people experiencing suicidal thoughts and people without these thoughts. Conclusions: There is a need to consider inclusion therapy focused on changing maladaptive schemas in alcoholics. This is especially true of the schemas of social isolation, emotional deprivation and subjugation. There is also a need for further research in this area

Life-satisfaction and self-efficacy, social support and general health among women with overweight and obesity

WSTĘP. Otyłość w istotny sposób wpływa na społeczne, fizyczne i psychologiczne funkcjonowanie jednostki. Zadowolenie z życia może być determinowane przez wiele czynników, w tym również przez ocenę stanu swojego zdrowia. Celem pracy było sprawdzenie, jakie zmienne psychologiczne i społeczne wiążą się z oceną zadowolenia z życia u kobiet z nadwagą i otyłością oraz określenie wyznaczników wybranych aspektów oraz ogólnego zadowolenia z życia. MATERIAŁ I METODY. W badaniach uczestniczyło 37 kobiet (średni wskaźnik masy ciała BMI (body mass index) = 31,65, średnia wieku - ± 49,97). Zastosowano następujące metody pomiaru: Kwestionariusz Zadowolenia z Życia Fahrenberga i wsp., Skalę Wsparcia Społecznego Fydricha i wsp., Skalę Uogólnionej Własnej Skuteczności Schwarzera i wsp. oraz Kwestionariusz Ogólnego Stanu Zdrowia GHQ 28 Goldberga. WYNIKI. Ogólne zadowolenie z życia powiązane jest dodatnio z wszystkimi wymiarami wsparcia społecznego oraz z poczuciem własnej skuteczności, natomiast ujemnie z lękiem, depresją oraz ogólnym stanem zdrowia. Innymi aspektami zadowolenia z życia znacząco powiązanymi z wieloma uwzględnionymi w badaniu zmiennymi okazały się satysfakcja z seksu, małżeństwa, czasu wolnego oraz ocena własnej osoby. Ustalono predyktory zadowolenia z czasu wolnego, oceny własnej osoby, małżeństwa oraz seksu. Zadowolenie z własnej osoby wyjaśnia poczucie własnej skuteczności, a na zadowolenie w sferze seksualnej znaczący wpływ ma wsparcie emocjonalne. Natomiast im mniejsze nasilenie symptomów somatycznych, depresji oraz lęku tym większe zadowolenie z małżeństwa. Predyktorami ogólnej satysfakcji z życia okazały się wsparcie emocjonalne, depresja oraz BMI, wyjaśniające w 69% zmienność wyników. WNIOSKI. Zasoby osobiste, takie jak poczucie własnej skuteczności i wsparcie społeczne, a także ogólny stan zdrowia i BMI wykazują znaczące związki z zadowoleniem z życia u otyłych kobiet. Endokrynologia, Otyłość i Zaburzenia Przemiany Materii 2010, tom 6, nr 4, 171-178INTRODUCTION. Obesity exerts a significant impact upon an individual’s social, physical and psychological functioning. Life-satisfaction may be determined by numerous factors, including also one’s own health evaluation. The aim of the study was examining which psychological and social variables are linked with life- satisfaction among women with overweight and obesity and defining determinants of general lifesatisfaction and its selected aspects. MATERIAL AND METHODS. The research was carried out in a group of 37 women (mean BMI = 31.65, mean age - ± 49.97). The following methods were used: Life-satisfaction Questionnaire by Fahrenberg et al., Social Support Scale by Fydrich et al., General Self-Efficiency Scale by Schwarzer et al. and General Health Questionnaire GHQ-28 by Goldberg. RESULTS. General life-satisfaction is positively linked with all the dimensions of social support and with self-efficiency, and it is negatively linked with anxiety, depression and general health. Other aspects of life-satisfaction that are significantly linked with numerous research variables include satisfaction with sex, marriage, spare time, and self-evaluation. There have been found predictors of satisfaction with spare time, self-evaluation, marriage and sex. Satisfaction with oneself is explained by self-efficiency, and satisfaction with sex is significantly influenced by emotional support. Satisfaction with marriage is greater when intensity of somatic symptoms, depression and anxiety is lower. Predictors of general life-satisfaction include emotional support, depression and BMI, which explain variability of results in 69%. CONCLUSIONS. Personal resources as self-efficacy and social support and also general health and BMI indicator shows significant relations with life-satisfaction among obese woman. Endocrinology, Obesity and Metabolic Disorders 2010, vol. 6, No 4, 171-17

Factors Related to the Level of Depression and Suicidal Behavior Among Men With Diagnosed Depression, Physically Ill Men, and Healthy Men

Depression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians. The study was aimed at establishing models of factors related to the level of depression and suicidal behavior among men from three different groups—in men with depressive disorder, in comparison to men with physical disorder and healthy men. A total of 598 men were included in the study. The following questionnaires were used in research model: test with sociodemographic variables, AUDIT Test, Fagerström Test, Generalized Self-Efficacy Scale (GSES), Inventory for Measuring Coping with Stress (Mini-COPE), Resilience Evaluation Questionnaire (KOP-26), Suicide Behaviors Questionnaire—Revised (SBQ-R) by Osman, and Gotland Male Depression Scale. In men with depression, the positive factors strongly related to the intensity of depression and suicidal behavior were as follows: vocational education, active coping, turning toward religion, social competence for resilience, and bachelor status. The factors negatively related to the intensity of depression and suicidal behavior in this group were as follows: unemployed status, student status, low satisfaction with the financial situation, having children, history of mental disorders in family, alcohol addiction, and seeking instrumental support. In the group of men with physical disorders, the following protection factors were identified: the medium or small city as a place of living, active coping, venting, and personal competence. The following risk factors were identified in this group: psychiatric treatment in the past. In the group of healthy men, the following protective factors were identified: the medium city as a place of living, positive reappraisal, planning abilities, and personal and social competence for resilience. In this group, the following risk factors were identified: vocational and higher education, student status, satisfaction with the financial situation, having more than one children, the occurrence of mental disorders in the family, the occurrence of alcohol abuse in the family, and use of psychoactive substances as a strategy of dealing with stress. The risk factors identified in this study should be included in the clinical assessment of depression and suicidal behavior risk in male patients. There are some protective factors identified, including productive coping and personal and social competencies, which can be developed and should be especially considered and strengthened in mental health promotion programs aimed at men

Promotion of men’s mental health

Introduction: Despite the fact that the knowledge of health differences between males and females is more and more available, it does not always translate into the differentiation of health programmes. Undoubtedly, there is a need for innovative programmes promoting the mental health of men and accounting for male standards. Material and methods: Review of scientific literature concerning mental health promotion, with special regard to recommendation to create programmes of promotion of men’s mental health searched in Pubmed, Scopus and Google Scholar. Results: Health promotion is a process enabling people to increase their control over health and to improve it. Mental health promotion is a rarely discussed branch of health promotion, and its characteristics differ from physical health promotion. Currently, no organised activities are conducted in Poland aiming at the promotion of men’s mental health. Looking at suicide statistics, according to which men take their lives seven times more often than women, it seems essential to design comprehensive activities targeting this specific group. Male-specific determinants of mental health should constitute a reference point for health promoters in the process of designing programmes of mental health promotion. Conclusions: It seems necessary to consider gender factor while designing activities related to mental health promotion. The activities directed to men should be planned according to specific principles. Their implementation may have a positive effect on male participation and involvement in the suggested programme of mental health promotion, and in turn on its efficacy.Introduction: Despite the fact that the knowledge of health differences between males and females is more and more available, it does not always translate into the differentiation of health programmes. Undoubtedly, there is a need for innovative programmes promoting the mental health of men and accounting for male standards. Material and methods: Review of scientific literature concerning mental health promotion, with special regard to recommendation to create programmes of promotion of men’s mental health searched in Pubmed, Scopus and Google Scholar. Results: Health promotion is a process enabling people to increase their control over health and to improve it. Mental health promotion is a rarely discussed branch of health promotion, and its characteristics differ from physical health promotion. Currently, no organised activities are conducted in Poland aiming at the promotion of men’s mental health. Looking at suicide statistics, according to which men take their lives seven times more often than women, it seems essential to design comprehensive activities targeting this specific group. Male-specific determinants of mental health should constitute a reference point for health promoters in the process of designing programmes of mental health promotion. Conclusions: It seems necessary to consider gender factor while designing activities related to mental health promotion. The activities directed to men should be planned according to specific principles. Their implementation may have a positive effect on male participation and involvement in the suggested programme of mental health promotion, and in turn on its efficacy

Original article Determinants of personality in the scope of motivation for maintaining abstinence in the case of male alcohol-dependent individuals concluding therapy

Background The results of numerous studies indicate strong associations of personality with the occurrence, and also with the treatment, of alcohol dependence. However, there is no agreement regarding the role of particular dimensions of temperament and character in the course of, and for the results of, alcohol rehabilitation therapy. The objective of the present research was to investigate the relationships between the dimensions of temperament and character as they are presented by Robert Cloninger and motivation for maintaining abstinence in the case of male alcohol-dependent individuals concluding the therapy. Participants and procedure Eighty-nine male alcohol-dependent individuals, concluding alcohol rehabilitation therapy in an outpatient setting, were studied. The following research tools were applied: the Temperament and Character Inventory (TCI) of R. Clo­ninger in the Polish adaptation of E. Hornowska (2003), and the Motivation for Maintaining Abstinence Inventory, the author of which is M. Ziółkowski. Results Two clusters, differing in the aspect of motivation for maintaining abstinence after the conclusion of the treatment, were distinguished: of individuals manifesting weaker motivation (n = 39) and those manifesting stronger motivation (n = 50). The patients with stronger motivation manifested the following major features: a lower level of harm avoidance, a higher level of reward dependence, and a higher level of cooperativeness. Conclusions Personality as it is presented by Cloninger manifests connections with motivation for maintaining abstinence. The research confirms the need for diagnosing addicted patients in the scope of temperament and character traits

Decisional Balance Scale – Polish adaptation and application in research of alcohol addicted

The aim of the presented study was to conduct a Polish adaptation of the Decisional Balance Scale by W. Velicer et al. The attempt was also made to answer a question about the differences in the area of decisional balance in addicts who complete or break therapy, continue abstinence after treatment and those who return to drinking. Research was conducted on 397 alcohol addicted persons who begin a therapy. Patients who completed treatment were retested in the last week of stay at the Centre. A group of people maintaining abstinence one year after the start of therapy and those who returned to drinking were distinguished. The Decisional Balance Scale by Velicer et al. and the Motivation Questionnaire to Maintain Abstinence from Alcohol by Ziółkowski were used. Results. The Polish version of the Scale was found to be reliable and valid method. Principal component analysis identified 2 factors (like in original version). Differences within a single dimension of decisional balance between people who completed and those who broke therapy were noted. In the course of therapy an increase in decisional balance scale, advantage of arguments against drinking was proved