COMORBID DEPRESSION AND SUICIDE IDEATION IN PATIENTS WITH COMBAT-RELATED PTSD: THE ROLE OF TEMPERAMENT, CHARACTER, AND TRAIT IMPULSIVITY

Background: War veterans with PTSD have a high chance of developing major depressive disorder (MDD) at some point, while they can also exhibit increased suicidal tendencies. The primary goal of this research was to investigate whether personality dimensions, including temperament, character, and trait impulsivity, were associated with comorbid MDD, as well as with suicidal ideation in psychiatric patients suffering from combat-related PTSD. Subjects and methods: The sample consisted of 148 Croatian male war veterans (mean age 49.53 years) treated for PTSD at the National Center for Psychotrauma, Department of Psychiatry, University Hospital Center Zagreb. Fifty-one (34%) of them met ICD- 10 diagnostic criteria for current or lifetime MDD, while 97 (66%) were diagnosed with PTSD alone. All the participants were assessed with the M.I.N.I. diagnostic interview and they completed the following battery of self-report instruments: the Beck Depression Inventory-Second Edition (BDI-II), the Suicidal Behaviors Questionnaire-Revised (SBQ-R), the Temperament and Character Inventory-Revised (TCI-R), and the Barratt Impulsiveness Scale-11 (BIS-11). Results: Comparisons between the two clinical groups showed that PTSD+MDD patients were more suicidal and differed with regard to temperament dimensions Harm Avoidance, Reward Dependence and Persistence, character dimension Self-Directedness, and trait impulsivity. In three multivariate regression analyses, it was revealed that character dimension Cooperativeness as well as trait impulsivity were unique predictors of suicidal ideation, while controlling for the influence of sociodemographics, length of treatment and comorbid depression. Conclusions: Combat-related PTSD patients with comorbid depression exhibit increased suicide thoughts and different personality profiles in comparison with those suffering from PTSD alone. Character dimension Cooperativeness and trait impulsivity seem to be uniquely predictive of suicide ideation in this population. Elucidation of individual psychological factors that increase the risk of MDD and suicidal tendencies in war veterans with PTSD may facilitate more effective prevention and treatment methods

Uloga neurokognitivnih deficita kod shizofrenije - istraživanja i klinička praksa

Shizofrenija je kronična psihijatrijska bolest koju, osim pozitivne i negativne simptomatike, karakterizira deficitarno kognitivno funkcioniranje. U ovom preglednom radu opisali smo opće intelektualne, kao i specifične kognitivne sposobnosti tipično narušene kod pacijenata sa shizofrenijom. Pokušali smo odgovoriti na pitanja vezana uz njihovu učestalost, dijagnostičku specifičnost, odnos s ostalim simptomima bolesti, longitudinalni tijek i neuroanatomsku podlogu. Navedene kliničke implikacije ovih istraživanja odnose se na upotrebu standardne neuropsihologijske dijagnostike te provođenje nefarmakoloških oblika tretmana, poput kognitivne remedijacije i kognitivne rehabilitacije. Podrobnije je opisan relativno noviji oblik terapije - tzv. metakognitivni trening (MKT) za shizofreniju - pri čemu provedene empirijske studije ukazuju na obećavajuću tretmansku učinkovitost. Općenito govoreći, relevantnost istraživanja kognitivnih deficita leži u u potencijalnim mogućnostima predviđanja razvoja budućih psihotičnih poremećaja kod pojedinih osoba, kao i u prognoziranju funkcionalnih ishoda kod već oboljelih

Pathological narcissism and narcissistic personality disorder - A review of current research

U ovom preglednom radu riječ je o novijoj konceptualizaciji narcističnih osobina koje variraju s obzirom na stupanj adaptivnosti pojedinčeve ličnosti. Dok se blaža zastupljenost tih osobina smatra zaštitnim faktorom od problema sa samopouzdanjem i sniženim raspoloženjem, patološke varijante itekako dovode do disfunkcionalnih obrazaca ponašanja, povećanog stresa i komorbiditetnih psihijatrijskih stanja. U kliničkoj psihologiji i psihijatriji to je najpoznatije kao narcistični poremećaj ličnosti, pri čemu ti dijagnostički kriteriji vrlo vjerojatno ne zahvaćaju čitav raspon problematičnih osobina i ponašanja koja su karakteristična za osobe s patološkim narcizmom. Naime, brojne kliničke opservacije i novija empirijska istraživanja pokazuju širu sliku patološkog narcizma u kojoj se ističu grandiozne i vulnerabilne karakteristike ovog poremećaja, što je posebno relevantno zbog preinaka koje se očekuju u novom izdanju DSM-a-V. Nažalost, službena klasifikacija prenaglašava kriterije grandioznog tipa, što je u neskladu s istraživačkim nalazima koji u posljednje vrijeme dovode do konstrukcije psihologijskih instrumenata predviđenih za ispitivanje dvofaktorske slike patološkog narcizma. Nadalje, pokušaji utvrđivanja etioloških faktora u podlozi narcističnog poremećaja ličnosti nisu doveli do konzistentnih nalaza i modela, već je čitavo područje obilježeno prevelikim paradigmatskim neslaganjima, prvenstveno između psihodinamskih i kognitivnih perspektiva. Također, postoje indikacije o širim kulturalnim utjecajima pri čemu su narcistične osobine prisutnije u Zapadnjačkim društvima.In this review paper we discuss a more recent conceptualization of narcissistic traits that vary in degree of individual’s personality adaptiveness. While a milder representation of these qualities is considered a protective factor against self-confidence issues and lowered mood, pathological variants certainly lead to dysfunctional behavior patterns, increased stress and comorbid psychiatric conditions. In clinical psychology and psychiatry this is best known as narcissistic personality disorder although these diagnostic criteria probably don’t include the whole range of problematic traits and behaviors which are characteristic of persons suffering from pathological narcissism. In fact, numerous clinical observations and recent empirical studies show a broader picture of pathological narcissism with emphasis on the grandiose and vulnerable features of this disorder, which is particularly relevant because of the modifications which are expected in the new edition of the DSM-V. Unfortunately, official classification criteria overemphasize the grandiose type which is at odds with research findings that recently led to constructions of psychological instruments intended for testing two-factor structure of pathological narcissism. Furthermore, attempts to determine the etiological factors underlying narcissistic personality disorder did not lead to consistent empirical findings and models and this entire area is characterized by excessive paradigmatic disagreements, primarily between the psychodynamic and cognitive perspectives. Also, there are indications of broader cultural influences on narcissistic traits that are more widespread in Western societies

THE IMPORTANCE OF PSYCHODYNAMIC APPROACH DURING COVID-19 PANDEMIC

The coronavirus (COVID-19) outbreak was labeled a global pandemic by the WHO in March of 2020. Understanding how crisis influence an individual’s reactions to stressful events (and vice versa) is important in order to create meaningful and effective interventions. Our literature search have revealed lack of the papers related to psychodynamic approach to recent crisis. Psychodynamic places a large emphasis on defense mechanisms and unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Even though these painful feelings and thoughts are outside of our awareness, they still influence our behavior in many ways. Optimal application of psychodynamic approach offers the frame for acceptance of psychological stress in a more positive way and benefits psychological growth. We believe that including psychodynamic approach in the national public and mental health emergency system will empower Croatia and the world during (and after) COVID-19 pandemic crisis

Anti-Cancer Activities of Nano Amorphous Calcium Phosphates toward Premalignant and Oral Cancer Cells

Despite advancements in treatment, the squamous cell carcinoma (OSCC) patient survival rate remains stagnant. Conventional therapies have limited effectiveness, necessitating novel agents. Our study aims to synthesize and characterize amorphous calcium phosphate nanoparticles (nACPs), assess their potential cytotoxic effects on premalignant and malignant OSCC cells, and investigate possible mechanisms of action. The morphological features of nACP were investigated by field emission scanning coupled with energy dispersive spectroscopy (EDS), Fourier transform infrared spectroscopy (FTIR), and particle size distribution (PSD). Then, we examined the effect of nACPs on nanoparticle uptake, cell adhesion, viability, invasion ability, cell cycle, and gene expression. nACP uptake was dose-dependent, induced limited selectivity in cytotoxicity between healthy and malignant cells, and affected cellular adhesion and invasion. Early apoptosis was the predominant type of cell death. The nACP effect on viability was verified by alterations in the genes associated with apoptosis and proliferation. A high concentration of nACP was shown to arrest the cell cycle progression in the G0/G1 phase of both malignant and premalignant cells. This type of nACP justifies the development of a strategy for its potential use as an anti-cancer agent and/or anti-cancer active carrier for various drugs in oral cancer treatments

MENTALIZATION AND PSYCHOPHARMACOTHERAPY IN PATIENTS WITH PERSONALITY AND EATING DISORDERS

Contemporary psychiatry pays more and more attention to the patient’s capacity regarding acceptance of psychiatric drugs. Understanding the basis of our treatment’s effectiveness becomes more challenging. To understand psychiatric treatment psychiatrists must pay full attention to mentalizing and the conditions under which this basic human capacity becomes impaired especially in those suffering from personality and eating disorders. This paper discusses the meaning and clinical applications of the mentalizing related to psychopharmacotherapy for personality and eating disorders patients, including suicidality

PERSONALITY AND STIGMA IN LUNG CANCER PATIENTS

Background: Stigma in lung cancer has been associated with diagnostic and treatment delay and with poor outcomes. Personality has impact on the perception of someone\u27s life situation and interacts with psychosocial variables and coping strategies. The vulnerability to stigma is still under-researched. The aim of this study was to investigate this vulnerability by examining the associations between stigma and personality dimensions (i.e., temperament and character traits). Subjects and methods: Seventy six (76) inpatients of the two teaching hospitals with the diagnosis of non-small-cell lung cancer were consecutively included in the study. Patients were assessed with self-reporting scales: Cataldo Lung Cancer Stigma Scale (CLCSS) and Temperament and Character Inventory (TCI). Sociodemographic and clinical data were also collected. Results: Personality dimensions Self-directedness and Persistence showed to be significant predictors of stigma in the linear regression (R=0.519; F=3.104; P=0.007). Stigma and personality dimensions were not associated with age, gender, tumor stage and smoking status. Conclusion: Stigma is associated with particular character (i.e., Self-directedness) and temperament (i.e., Persistence) dimensions. Given the negative clinical outcomes of stigma in lung cancer patients, personality should be taken into account during screening and treatment planning phases

DOES PERSONALITY PLAY A RELEVANT ROLE IN THE PLACEBO EFFECT?

Subjective factors influencing placebo response have been a focus of numerous theoretical conceptualizations and empirical research. One such factor, individual\u27s personality, has been linked to different clinical conditions, their expressions and treatment outcomes. Thus, there is little surprise many researchers have tried to identify placebo-prone personality over the years. Because of certain methodological and conceptual issues of the earlier studies, these efforts have not been very fruitful. However, recent scientific endeavours, facilitated by improved experimental designs and neuroimaging technology, have \u27reignited the old fires\u27. It is now suggested that studies exploring the placebo-related personality traits, such as optimism/pessimism, neuroticism, and novelty seeking, need to take into account situational variables (e.g., positive or negative expectations, patient-clinician relationship) and relevant underlying neurobiological mechanisms (e.g., endogenous opioid and dopaminergic systems). Even though many questions still remain to be answered, such as the identification of different situational variables interacting with personality traits, exploration and better understanding of placebo-related personality would facilitate the use of placebo in clinical practice and improve the methodology of clinical trials