Psychopathology and resilience in relation to abuse in childhood among youth first referred to the psychiatrist

Uvod/Cilj. Zlostavljanje u detinjstvu može biti uzrok različitih psiholoških problema kod odraslih osoba. Malo se, međutim, zna o specifičnim kliničkim i porodičnim profilima, kao i karakteristikama rezilijentnosti adolescenata koji su doživeli zlostavljanje u detinjstvu. Cilj našeg rada bio je ispitivanje simptoma, porodičnog funkcionisanja i rezilijentnosti adolescenata sa iskustvom zlostavljanja u detinjstvu upućenih na psihijatrijski pregled. Metode. Uzorak se sastojao od 84 konsekutivno regrutovana mlada ispitanika (prosečne starosti 14,90 ± 3,10, u rasponu od 11 do 18 godina) upućena na prvi pregled u Kliniku za decu i omladinu Instituta za mentalno zdravlje u Beogradu, koji su na osnovu Matrice rizika za zlostavljanje i zanemarivanje dece bili podeljeni u dve grupe. Prvu grupu činili su adolescenti sa iskustvom zlostavljanja u detinjstvu (n = 38, 13 dečaka, 25 devojčica), a drugu, kontrolnu grupu, adolescenti bez iskustva zlostavljanja u detinjstvu (n = 47, 20 dečaka, 27 devojčica). U istraživanju su korišćeni sledeći upitnici: Upitnik za samoprocenu adolescenata (Youth Self-Report - YSR), Skala adolescentnih rezilijentnih stavova (Adolescent Resilience Attitudes Scale - ARAS) i Upitnik za porodicu, (Self-Report Family Inventory - SFI). Rezultati. Značajne razlike pronađene su kod adolescentkinja. Na upitniku YSR, zlostavljane adolescentkinje imale su značajno više skorove delinkventnog ponašanja i marginalno veće skorove anksioznosti/depresivnosti i socijalnih problema. Analize upitnika SFI pokazale su značajno lošije funkcionisanje kod zlostavljanih adolescentkinja u svim podskalama osim na podskali direktivnog vođstva. Na upitniku ARAS, zlostavljane adolescentkinje imale su značajno niže skorove na podskali uvida i marginalno niže skorove na podskali za inicijativu. Zaključak. Navedeni rezultati mogli bi imati praktičnu primenu pri planiranju specifičnih preventivnih strategija i tretmana koji se posebno fokusiraju na delinkventne tendencije kao i na jačanje rezilijentnosti obezbeđivanjem pozitivnog okruženja u okviru porodice, škole i zajednice.Background/Aim. Child abuse may be related to adverse psychological outcomes in adult life. However, little is known about specific clinical, family and resilience profiles of adolescents that have experienced child abuse. The aim of this study was to investigate clinical symptoms, family functioning and resilience characteristics of adolescents with the experience of abuse, first referred to psychiatrists. Methods. The study included 84 young participants (mean age 14.90 ± 3.10, ranging from 11 to 18 years) as consecutive first referrals to the Clinic for Children and Youth of the Institute of Mental Health, Belgrade, Serbia. The sample consisted of two groups, based on the Child Abuse Matrices of Risks. The first group included adolescents with the experience of abuse in childhood (n = 38, 13 males, 25 females), whereas the second, control group, comprised of non-abused adolescents (n = 47, 20 males, 27 females). The presence of abuse was evaluated by the Child Abuse Matrices of Risks. The study used the following questionnaires: Youth Self-Report (YSR), Adolescent Resilience Attitudes Scale (ARAS), and Self-Report Family Inventory (SFI). Results. Significant differences were found only among females. According to YSR, the abused girls had significantly higher scores on the Delinquent Behavior scale and marginally higher scores on Anxious/ Depressed and Social Problems scales. Analyses of the SFI showed significantly lower family functioning among the girls with the child abuse history for all scales except for the Directive Leadership. The abused girls also showed significantly lower scores on the Insight scale, and marginally lower Initiative scores at the ARAS. Conclusions. These findings may have practical application in the creation of specific preventive and treatment strategies, particularly focused on delinquent tendencies, as well as on enhancing resilience through providing positive environments within families, schools and communities

Time Integration Questionnaire - Construction and empirical validation of a new instrument for the assessment of subjective time experience

The paper presents the Time Integration Questionnaire (TIQ) for the assessment of subjective time experience, constructed in a phenomenologically enriched form, as compared to those reduced to succession and three basic dimensions: the past, the present, and the future. In the formulation of items we utilized the questionnaire empirical procedure, commencing from 233 dictionary terms of the meaning of time. Based on the statistical analyses of 213 university students' responses to the initial version of the questionnaire, we constructed eight preliminary scales to assess tentative aspects of time organization of psychological functioning: Speed, Repetition, Continuity, Stability, Retroversion, Progression, Contiguity, and Anteversion. Because exploratory factor analysis of 73 items from the preliminary questionnaire on the sample of 473 medical students did not support eight preliminary scales and rather suggested a two-factor structure of the questionnaire, new final scales were proposed: Succession and Integration. The Succession scale comprises mainly the items from the preliminary Speed, Repetition, and Continuity scales, whereas the Integration scale encompasses items from the preliminary Progression, Contiguity, and Anteversion scales. Factor loadings of the items from the final Succession and Integration scales on the new sample of 97 adults were consistent with item assignment to two respective scales. Indices of internal, factorial, and concurrent validity of Succession and Integration Scales as obtained on the samples of 97 healthy adults and 85 subjects with psychiatric diagnosis further justified two final scale construction as a better solution in comparison with eight preliminary scales. The Temporal Integration Questionnaire, in its present form, may be utilized primarily in research, while the justification of its usage in psychodiagnostics would depend on a future results achieved in the various homogeneous clinical populations

Disturbed subjective time experience in post-traumatic stress disorder

Background and objectives: Disturbance of subjective time experience in PTSD has not heretofore constituted a subject of focused empirical research, in spite of previous theoretical insights concerning the phenomenological importance of subjective time distortions in PTSD. Aim of the study was confirming the presumption that an alteration in subjective time experience is an essential feature of PTSD. Methods: Sets of instruments for diagnostic assessment of PTSD and other psychiatric disorders, and for assessing subjective time experience, have been used to investigate the differences between the subjects with PTSD (n = 58), subjects with other psychiatric disorders (n = 34) and healthy participants (n = 135). Results: On average, subjects with PTSD differ significantly from the remaining two groups in succession and goal directedness aspects of subjective time experience, while PTSD group differs from healthy group in all aspects except future and past temporal extension. As expected, the covariates adjusted means on the Succession, Integration, Temporal Distinction and Goal Directedness scales are lowest in subjects with PTSD, higher in other disorders and highest among healthy individuals. Conclusions: Most aspects of the subjective time experience in subjects with PTSD show significant alterations compared to healthy ones. Moreover, disturbed succession and goal directedness aspects are most specific because they also significantly differentiate the group with PTSD from the group of those with other disorders. Increased intensity of PTSD symptoms is associated with stronger alteration of time experience. There is a stronger association of temporal disorganization with avoidance/numbing and hyper-arousal than with intrusions

Changing discriminatory and negative attitudes towards mentally ill students

Polje interesovanja i delovanja preventivnog programa koji je u ovom radu prikazan predstavlja diskriminacija mladih sa mentalnim poremećajima. Postoje mnogi praktični načini da se radi na rešavanju problema diskriminacije - kroz reformisanje službi i institucija sistema predstavljanja anti-diskriminacionih politika i zakona, delovanjem putem medija i kroz edukativne programe u sklopu medicinskih ustanovi koje se bave ovom problematikom, za koji smo se mi odlučili. U prvom delu rada određuju se pojmovi stigme i diskriminacije i prikazuje se zastupljenost mentalnih poremećaja kod mladih. U drugom delu opisali smo pilot-program koji je realizovan u jednoj beogradskoj srednjoj školi, predstavili smo razloge za njegovo sprovođenje, način rada, kao i rezultate koje smo dobili.A preventive program presented in this paper is focused on discrimination of the young people with mental disorders. There are many ways to fight this form of discrimination - by reforming services and institutions of the system, recommending and passing anti-discriminatory laws and policies media campaigns, educational courses in relevant medical institutions, the last one being the area we decided to act in. In the first part of the paper the concepts of stigma and discrimination are defined and statistic data on mental disorders among young people are presented. In the second part we described a pilot program realized in a Belgrade high school, presented our reasons for our undertaking, and described the techniques we used, as well as the results we obtained

Changing attitudes of high school students towards peers with mental health problems

Background. Stigma refers to the undesirable characteristics linked to mental illness and the adverse cognitive and behavioral consequences. Stigma causes a spiral of alienation and discrimination, leading to social isolation that diminishes chances for recovery. There is a great need for antistigma programs in order to decrease stigma related to persons with mental health problems. The antistigma program was initiated in schools of Serbia with the aim to address and decrease discrimination of adolescents with mental disorders. Subjects and methods: Sixty-three students from high schools voluntarily participated in the program. The effect of the program on the attitudes of students If was evaluated by the Opinion about Mental Illness Questionnaire given to adolescents prior to its implementation and six months afterwards. Results: Social discrimination and the tendency towards social restriction were reduced, while, at the same time, social awareness of mental health-related problems was increased among young people six months after program implementation. The results obtained clearly indicate positive changes in adolescents' attitudes and demonstrate a need for further educational activities regarding stigma and mental disorders. Conclusion: Stigma and discrimination reduction programs for adolescents are aimed at achieving a change of their attitudes toward the mental health problems of their peers and themselves through organized education. Our program demonstrates the necessity for youth participation in mental health services and system, and antistigma actions are seen as important aspects

Attitudes of psychiatry residents toward mental illness

Predrasude prema osobama koje imaju mentalne poremećaje često su prisutne, kako među laicima, tako i kod lekara raznih specijalnosti. U radu se ispituju razlike u stavovima prema mentalnim bolestima između specijalizanata psihijatrije i specijalizanata interne medicine. Pored toga, ispitivanjem smo nastojali da utvrdimo postoji li povezanost između stavova prema mentalnim bolestima i osobina ličnosti u ispitivanim grupama. Uzorak se sastojao od 45 specijalizanata psihijatrije i 36 specijalizanata interne medicine. Stav prema mentalnim bolestima ispitivan je Upitnikom za ispitivanje stavova prema mentalnim bolestima (Opinions about Mental Illness Questionnaire), a karakteristike ličnosti ispitivane su korišćenjem Ajzenkovog upitinika ličnosti (Eysenck Personality Questionnaire). Rezultati su pokazali da specijalizanti psihijatrije ređe nego specijalizanti interne medicine doživljavaju pacijente sa mentalnim bolestima kao inferiorne ili preteće. Takođe, specijalizanti psihijatrije imaju benevolentniji stav prema pacijentima sa mentalnim poremećajima. Karakteristike ličnosti specijalizana psihijatrije nisu povezane sa njihovim stavovima prema mentalnim poremećajima. Dobijeni rezultati ukazuju na to da postoji potreba za promenom programa specijalizacije svih disciplina, što podrazumeva bolju edukaciju iz oblasti mentalnog zdravlja. Tako bi se pomoglo u procesu destigmatizacije pacijenata sa mentalnim poremećajima i povećao bi se obim znanja i kompetentnosti lekara u radu sa osobama koje imaju mentalne poremećaje. .Introduction. Attitudes of lay people and physicians towards mentally ill patients are frequently highly biased. The aim of this study was to investigate differences in attitudes of psychiatry and internal medicine residents toward mental illness and to establish the relationship between their attitudes and their personal characteristics. Material and methods. The sample consisted of 45 psychiatry and 36 internal medicine residents. The attitudes toward mental illness were assessed using Opinions about Mental Illness Questionnaire (OMI) and personality traits were examined using the Eysenck Personality Questionnaire (EPQ). Results. Our findings showed that in regard to internal medicine residents, psychiatry residents do not consider mentally ill patients to be inferior and dangerous. Psychiatry residents have a benevolent attitude toward the mentally ill. Personality traits of psychiatry residents were not related to their opinions about mental illness. Discussion. The results suggest that there is a need to develop strategies that would bring about changes in the curriculum of training programs for medical residents, including proper training in mental health issues. Such strategies should help in destigmatization of persons with mental disorders and increase the competence of physicians to deal with mentally ill.