Jaksic, Nenad

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ABSTRACTS Psychiatria Danubina, 2022; Vol. 34, Suppl. 6, pp 3-32  S21 presentations of pathological narcissism suggest that empathy is deficient in these individuals with implications to a diverse set of motivational and social factors. Consistent with research, empathy is multidimensional, involving emotional and cognitive processes associated with a capacity to respectively understand and respond to others’ mental and affective states. Given the complexity of pathological narcissism, empathy and social parameters, my team proposes that multiple relationships can exist between these constructs. Our experience regarding therapy in the treatment of difficult personality and eating disorders patients show that psychodynamic is crucial for understanding individual cases. Many difficult patients with pathological narcissism have a so-called borderline personality organization (the term created by psychiatrist Otto Kernberg), which would explain why so many difficult patients have a highly ambivalent relationship and significant problems in social relationships. The aim of this work is analysis of some fundamental questions about detection, management and treatment for people with pathological narcissism and/or personality disorders with some social implications. At the end of this work, I summarize the literature on empathy, mentalization and pathological narcissism regarding social implications. Key words: Narcissism, personality pathology, empathy *  *  *  *  * THE EVOLUTION OF THE CONCEPT OF TRANSGENERATIONAL TRAUMA AND PSYCHODYNAMICS Tatjana Buklijas1 & Darko Marcinko2 1Koi Tū Centre for Informed Futures, The University of Auckland 2Department of Psychiatry and Psychological Medicine, Clinical Hospital Center Zagreb In this talk we examine the concept of transgenerational (including intergenerational and historical) trauma, its recent history and the contemporary trends. We start with an examination of how the idea of heritable, transgenerational (initially “second generation”) trauma was first developed by the psychoanalytic psychiatrists working with the communities of Holocaust survivors in the North American cities after the Second World War. From there, through the work of psychiatrists and social workers, this concept has spread worldwide. It has found especially fertile ground among indigenous peoples of former colonial empires who explained persistent health and social disparities (such as high rates of alcoholism, mental illness and incarceration) as the consequences of deep trauma inflicted by colonization. Yet in the 1990s, in line with the broader trend towards biological psychiatry and following on from the work with the Vietnam war veterans, the transgenerational trauma was increasingly conceptualized in terms of the changes in the levels of stress hormones in the parental generation and the impact of the parental hormone level on the offspring corticosteroid hormone receptors. The new field of epigenetics has provided a molecular link between early developmental environments of and the activity of genes coding for hormones and receptors. “Epigenetics” has become synonymous with transgenerational trauma, yet human epigenetic studies of transgenerational trauma are still in their early days. Most studies of transgenerational trauma continue to be conducted using the tools of psychologists and psychiatrists. What is interesting, however, is that most focus on the large scale, collective trauma, similar in nature if not in scale to the Holocaust, and many are used to support a political argument rather than to consider how transgenerational trauma could be healed. In the final part of this talk we will discuss psychodynamic approaches to the treatment. Key words: Trans-generational trauma, psychodynamics, epigenetics, Holocaust survivors, Vietnam war veterans *  *  *  *  * PSYCHOTRAUMA AND RESILIENCE IN THE MODERN WORLD: PUBLIC AND GLOBAL MENTAL HEALTH PERSPECTIVE Nenad Jaksic Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia ABSTRACTS Psychiatria Danubina, 2022; Vol. 34, Suppl. 6, pp 3-32  S22 Resilience is a multidisciplinary concept of growing research and clinical interest, investigated in both general and treatment populations. Given the increasing occurrence of global stressful and traumatic events, in no small part due to recent medical (i.e., COVID-19 pandemic) and political/military developments around the world, a strong focus has been placed on the promotion of resilience within individuals as well as societies. Having in mind that stressful and traumatic experiences can lead to significant individual mental and somatic health problems and societal disturbances, teaching and promoting resilience could better prepare future generations for coping with inevitable stress. Resilience, being a broader interdisciplinary phenomenon, is explored within various fields of expertise: genetics, neurobiology, clinical and personality psychology, psychiatry, sociology and global politics, as well as religion. Clinical psychologists and psychiatrists are especially interested in resilience-based protective factors that could partly save individuals from developing mental disorders following stress and trauma, such as anxiety, depression and PTSD. Several standardized psychometric instruments have been developed in order to objectively measure one’s level of psychological resilience, and even more are currently in initial phases of development. Here we summarize some of the important perspectives and research findings, particularly from the perspective of personality psychology in terms of the Cloninger’s model of temperament and character. We also suggest ways in which promotion of resilience might help avoid some of the individuals’ stress-related psychological suffering and facilitate more tolerable and emphatic society. Because resilience is a process that that can be explored via numerous perspectives, from molecular to spiritual, future theoretical and empirical work has a giant task of integrating resilience- and psych trauma-focused literature into a coherent model useful both for clinicians and policy-makers. Key words: Resilience, psych trauma, global mental health, stress, personality *  *  *  *  * NEW CHALLENGES — FETAL ORIGINS OF MENTAL DISORDERS Asim Kurjak1,2, Miro Jakovljević2,3,4 & Aida Salihagić Kadić2,5 1Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina 2International Academy of Science and Art in Bosnia and Herzegovina 3School of Medicine, University of Zagreb, Croatia 4Croatian Institute for Research and Education on Mental Health, Zagreb, Croatia 5Department of Physiology, Medical School University of Zagreb, Zagreb, Croatia Fetal brain development requires appropriate combination of both genetic/epigenetic and environmental factors. Dysregulation of intrauterine environment may result in disturbances in fetal brain development which may be critical for different mental disorders (ADHD, autism, anxiety, bipolar disorder, depression, schizophrenia, and substance abuse) over the lifespan. The fetus lives in a stimulating matrix of motion as well as tactile, chemical and auditory sensory information, and it is exposed to hundreds of specific and patterned stimuli each day. The structure and function of brain are shaped by these stimuli. It is now known that the fetus can identify, respond and remember for a relatively long-time stimuli experienced during the prenatal period. Higher order sensory perception begins in fetal life when fuctional thalamocortical connections are present enabling fetal awareness of noxious stimuli. Fetus is capable of action, planing and learning. Fetal movements are reflecting development of the brain but at the same time they are stimulating the brain to develop. As we have few years ago developed KANET test, we’ve been able to study motor function which undoubtedly reflects development of diverse cognitive sensory and motor systems. The face is the mirror of the brain, many expressions can be depicted during fetal life which are proving that fetal life in utero is very dramatic and rich in different experiences. With a recent development of 4D sonography we indirectly proved that old Chinese medicine is right in belief that they are 10 months older than the rest of the world.  It will be illustrated how fetus who may develop communication or some other psychiatric disorders which are even now recognized prenatally. Obviously, we are entering the field of antenatal psychiatry, however we have to go long way to understand all the fetal behavioral parameters which we are now able to visualize. We are however quite aware that to visualize does not mean to understand. Key words: Fetal brain, 4D sonography, predisposition, epigenetics, postnatal mental disorders *  *  *  *  * 

PSYCHOTRAUMA AND RESILIENCE IN THE MODERN WORLD: PUBLIC AND GLOBAL MENTAL HEALTH PERSPECTIVE

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