Cognitive-Behavioral Therapy and Neuroscience: Towards Closer Integration

The aim of this review article is to provide an integrative perspective by combining basic assumptions of cognitive behavioral therapy (CBT) with neuroscience research results. In recent years, interdisciplinary research in the field of neuroscience has expanded our knowledge about neurobiological correlates of mental processes and changes occurring in the brain due to therapeutic interventions. The studies are largely based on non-invasive brain imaging techniques, such as functional neuroimaging technologies of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The neuroscientific investigations of basic CBT hypotheses have shown that (i) functional and non-functional behavior and experiences may be learned through lifelong learning, due to brain neuroplasticity that continues across the entire lifespan; (ii) cognitive activity contributes to dysfunctional behavior and emotional experience through focusing, selective perception, memory and recall, and characteristic cognitive distortion; on a neurobiological level, there is a relationship between top-down and bottom-up regulation of unpleasant emotional states; and (iii) cognitive activity may be changed, as shown by therapeutic success achieved by metacognitive and mindfulness techniques, which also have their neurobiological correlates in the changes occurring in the cortical and subcortical structures and endocrine and immune systems. The empirical research also shows that neurobiological changes occur after CBT in patients with arachnophobia, obsessive-compulsive disorder, panic disorder, social phobia, major depressive disorder and chronic fatigue syndrome.disorder and chronic fatigue syndrome

Cognitive-Behavioral Therapy and Neuroscience: Towards Closer Integration

The aim of this review article is to provide an integrative perspective by combining basic assumptions of cognitive behavioral therapy (CBT) with neuroscience research results. In recent years, interdisciplinary research in the field of neuroscience has expanded our knowledge about neurobiological correlates of mental processes and changes occurring in the brain due to therapeutic interventions. The studies are largely based on non-invasive brain imaging techniques, such as functional neuroimaging technologies of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The neuroscientific investigations of basic CBT hypotheses have shown that (i) functional and non-functional behavior and experiences may be learned through lifelong learning, due to brain neuroplasticity that continues across the entire lifespan; (ii) cognitive activity contributes to dysfunctional behavior and emotional experience through focusing, selective perception, memory and recall, and characteristic cognitive distortion; on a neurobiological level, there is a relationship between top-down and bottom-up regulation of unpleasant emotional states; and (iii) cognitive activity may be changed, as shown by therapeutic success achieved by metacognitive and mindfulness techniques, which also have their neurobiological correlates in the changes occurring in the cortical and subcortical structures and endocrine and immune systems. The empirical research also shows that neurobiological changes occur after CBT in patients with arachnophobia, obsessive-compulsive disorder, panic disorder, social phobia, major depressive disorder and chronic fatigue syndrome.disorder and chronic fatigue syndrome

MENTAL HEALTH OF PSYCHIATRISTS AND PHYSICIANS OF OTHER SPECIALTIES IN EARLY COVID-19 PANDEMIC: RISK AND PROTECTIVE FACTORS

Background: Many research has indicated that, during the COVID-19 pandemic, health care workers are under greatly increased pressure and at increased risk for the development of mental health problems. Furthermore, previous research has indicated that psychiatrists are exposed to a number of unique stressors that may increase their risk for poor mental health. The aims of the present study were to assess the level of COVID-19 related concerns, psychological distress and life satisfaction among psychiatrists and other physicians during the first period of the pandemic and to examine whether individual differences in COVID-19 concerns, psychological flexibility, psychological resilience and coping behaviors account for differences in mental health indicators. Subjects and methods: The sample consisted of N=725 physicians, among whom 22.8% were psychiatrists. This study was conducted online during the first lockdown in Croatia and collected data regarding COVID-19 related concerns, coping behaviors and mental health indicators (Psychological Distress and Life Satisfaction). Results: Physicians of other specialties had higher scores on a measure of COVID-19 anxiety than psychiatrists (p=0.012). In addition, a number of differences in coping behaviors are evident. Specifically, psychiatrists were less likely than physicians of other specializations to believe that being informed about COVID-19 is an effective coping strategy (p=0.013), but more prone to using sedatives and drugs as a coping strategy (p=0.002; p=0.037). Conclusions: Psychiatrists are at special risk for substance abuse. Younger age, psychological inflexibility, low resilience and greater COVID-19 concerns might act as specific risk factors for distress. Our findings highlight the need for promoting a healthy lifestyle and psychological flexibility as universal protective factors

Mental health of physicians in Croatia during the COVID-19 pandemic

Cilj istraživanja: Cilj provedenog istraživanja jest usporedba zdravstvenih briga i ponašanja pripadnika opće populacije i liječnika, kao i indikatora njihovoga mentalnog zdravlja tijekom pandemije COVID-19 u Hrvatskoj. Ispitanici i metode: Istraživanje je provedeno u ožujku i travnju 2020. na dva uzorka. Uzorak liječnika sastojao se od 725 sudionika, od kojih su većina žene (71,9%) u dobi između 26 i 81 godine (M=48,3; SD=11,26). U uzorku iz opće populacije sudjelovalo je 780 sudionika, također većinom žene (72,7%); raspon dobi kretao se od 19 do 77 godina (M=40,2; SD=12,27). Sudionici su ispunili Upitnik ponašanja vezanih uz COVID-19, Ljestvicu COVID-19 briga, Ljestvicu briga vezanih uz pandemiju, a kao indikatori mentalnog zdravlja korišteni su CORE-YP i procjena kvalitete života. Rezultati: Liječnici, u odnosu na opću populaciju, imaju izraženije brige vezane za COVID-19 i brige vezane za funkcioniranje zdravstvenog sustava. Manje su zabrinuti za vlastito mentalno zdravlje, nisu psihološki uznemireniji niti imaju lošiju kvalitetu života u odnosu na opću populaciju. Međutim, imaju izraženije teškoće sa spavanjem, bili su manje zainteresirani za razgovor o svojim teškoćama, ali su imali dojam adekvatne socijalne podrške i samoefikasnosti. Iako nema razlike između liječnika i opće populacije u općoj razini psihološkog distresa, u objema skupinama ta je razina značajno viša nego u razdoblju prije pandemije. Zaključci: Pandemija je izazvala situacijske specifične zabrinutosti kod liječnika, no njihov stupanj opće uznemirenosti i razina procijenjene kvalitete života jednaki su kao i u općoj populaciji. Iako se prema dosadašnjim stranim istraživanjima očekivalo narušeno psihičko zdravlje liječnika u pandemiji, naši rezultati to nisu potvrdili. Jedan je od mogućih razloga povoljna epidemiološka situacija u Hrvatskoj, koja je pokazivala linearni porast oboljelih od COVID-19.Research aim: The aim of this research is to compare health concerns and behaviours, as well as mental health indicators, among members of the general population and physicians during the COVID-19 pandemic in Croatia. Participants and methods: The research was conducted in March and April of 2020 with two samples. The sample of physicians consisted of 723 participants, most of whom were women (71.9%) aged between 26 and 81 years (M = 48.3; SD = 11.26). The sample from the general population included 780 participants, who were also predominantly women (72.7%) with an age range of 19 to 77 years (M = 40.2; SD = 12.27). All participants completed the COVID-19 Behaviour Questionnaire, the COVID-19 Care Scale and the Pandemic Care Scale. The CORE-YP and quality of life assessment were used as indicators of mental health. Results: In comparison to the general population, physicians demonstrate more pronounced concerns about COVID-19 and about the overall function of the health care system. They are less concerned about their own mental health, are not more psychologically distressed, nor do they have a poorer quality of life than the general population. However, physicians indicated more pronounced difficulty sleeping and were less inclined to talk about their difficulties, but had the impression of adequate social support and self-efficacy. Although there is no difference between physicians and the general population in terms of general levels of psychological distress, distress is significantly higher in both groups than during the period prior to the pandemic. Conclusions: While the pandemic has caused situation specific concerns among physicians, the degree of general anxiety and level of estimated quality of life are the same as that observed in the general population. Although the results from international research to date would lead one to expect that mental health among physicians during the pandemic would deteriorate, this was not confirmed by our results. One of the possible reasons for this finding is the favourable epidemiological situation in Croatia, which exhibited a linear increase in COVID-19 cases over the pandemic period

Psychosocial Adjustment to Sex Reassignment Surgery: a Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia

In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS). A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia

Health Information Seeking on the Internet - Implications for Health Anxiety in the Elderly

Pretraživanje o zdravlju na internetu postalo je vrlo rašireno. Kako starije osobe imaju više zdravstvenih problema, mogle bi postati sve veći konzumenti digitalnih zdravstvenih sadržaja. No, budući da imaju slabije računalne vještine te da nisu naviknute na ulogu „osnaženog pacijenta“, mogle bi doživjeti pretjeranu zabrinutost dok pretražuju o svojim simptomima. Istraživanja sugeriraju da je pretraživanje o zdravlju na internetu potencijalni rizični faktor za patološku zdravstvenu anksioznost, a možda na poseban način djeluje upravo na starije osobe. Istraživanja o pretraživanju kod starijih malobrojna su i uglavnom provedena bez jasnog teorijskog okvira što otežava smislenu interpretaciju i integraciju njihovih nalaza. Stoga je cilj ovoga preglednog rada ponuditi takav teorijski okvir (Leventhalov model zdravorazumske regulacije) te dati pregled nalaza dosadašnjih istraživanja u području integrirajući ih u predloženi model. Ovaj model predviđa da dob i dobne promjene u doživljaju sebe rezultiraju promjenama u zdravstvenim kognicijama i ponašanjima. Pretraživanje o zdravlju na internetu može se konceptualizirati kao strategija suočavanja i sa zdravstvenom prijetnjom i emocionalnom neugodom, a koja ima posljedice na kognitivne reprezentacije bolesti (identitet, uzrok, posljedice, mogućnost kontrole i vremensku dimenziju), zdravstvena ponašanja i ishode. Polazeći od pretpostavki modela, raspravljeno je kako pretraživanje može rezultirati zdravstvenom anksioznošću. Na kraju su pružene smjernice za buduća istraživanja i razmotrene njihove praktične implikacije.Health information seeking on the Internet has become widespread. Since the elderly experience more health issues, they might become more frequent users of digital health content. But, since their computer skills are less advanced and since they are not used to the role of the „empowered patient“, researching their symptoms online might result in excessive anxiety. Research suggests that health information seeking might be a risk factor for pathological health anxiety, yet it may have a specific effect on the elderly. Studies on health information seeking in older adults are sparse and mostly conducted without a clear theoretical framework which complicates meaningful interpretation and integration of their findings. Therefore, the aim of this review paper is to propose such theoretical framework; Leventhal’s Common-sense model of self-regulation, and to review findings of previous studies in the area integrating them in the proposed model. According to this model, ageing and age-related changes in the self, affect health-related cognitions and behaviours. Health information seeking may be conceptualized as a coping response to both health threat and emotional discomfort, which has consequences on illness representations (identity, cause, consequences, control, and timeline), health behaviours and outcomes. Special emphasis was placed to a way in which health information seeking online can result in health anxiety according to the proposed model. Finally, avenues for future research are provided and their practical implications considered