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Adverse cardiovascular effects of inhalatory marijuana use among human subjects

Author(s): Florin Mitu,Vasile Chiriță,Livia Andreea LUPȘA / Language(s): English / Issue: 4/2017

Marijuana is the most largely used drug worldwide, its users counting more than 200 million people globally. Known since antiquity, cannabis has been used for its psychoactive effects, but also for its analgesic and antiemetic properties. Currently, in the USA it is legal to use it both medically and for recreational purposes, similar tendencies being observed in the European Union as well. The current wave of decriminalisation has the potential of increasing recreational use of cannabis, at least in the short and medium term, therefore both cardiologists and psychiatrists are encouraged to carefully look for adverse cardiovascular outcomes, due to their increasing frequency in the population. This study sought to target the cardiovascular effects of inhaled marijuana among human subjects, this being the main route of administration in the EU and the US. Temporal associations between marijuana use and the onset of important adverse effects have been found, including acute myocardial infarction, cardiomyopathy, strokes, transient ischemic attacks, cannabinoid arteritis, changes in blood pressure and heart rate. In conclusion, it is important to note that the current legalisation policy dynamics observed globally impose the need for increasing research efforts regarding safety of marijuana administration and particular attention over its potential side effects.

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Age-related physical and psychological vulnerability as pathways to problem gambling in older adults

Author(s): Adrian Parke,Mark D. Griffiths,Julie Pattinson,David Keatley / Language(s): English / Issue: 1/2018

To inform clinical treatment and preventative efforts, there is an important need to understand the pathways to late-life gambling disorder. Aims: This study assesses the association between age-related physical health, social networks, and problem gambling in adults aged over 65 years and assesses the mediating role of affective disorders in this association. Methods: The sample comprised 595 older adults (mean age: 74.4 years, range: 65–94 years; 77.1% female) who were interviewed using a structured questionnaire to assess physical frailty, geriatric pain, loneliness, geriatric depression, geriatric anxiety, and problem gambling. Results: Pathway analysis demonstrated associations between these variables and gambling problems, providing a good fit for the data, but that critically these relationships were mediated by both anxiety and depression symptoms. Conclusions: This study indicates that late-life problem gambling may develop as vulnerable individuals gamble to escape anxiety and depression consequent to deteriorating physical well-being and social support. When individuals develop late-life problem gambling, it is recommended that the treatment primarily focuses upon targeting and replacing avoidant coping approaches.

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Akıllı telefon bağımlılığı, bağlanma ve duygu düzenlemenin ilişkisi: Mizaç ve karakter özelliklerinin aracı rolü

Author(s): Emine Sevinç Sevi Tok,Halime Şenay Güzel / Language(s): Turkish / Issue: 1/2020

This study aimed to evaluate the relationships between smartphone usage, attachment, emotion regulation difficulties, and temperament-character traits. It was also aimed to test a developmental etiological model of smartphone addiction examining the mediating effect of temperament and character dimensions in the relationship between attachment style and emotion regulation difficulties and smartphone addiction in early childhood. The sample of the study consisted of 400 university students from Ankara Yıldırım Beyazıt University and İzmir Kâtip Çelebi University. Smartphone Addiction Scale, Experiences in Close Relationships-II, Temperament and Character Inventory, and Difficulties in Emotion Regulation Scale-Short Form were used as data collection tools. In the results, it was found that anxious attachment; strategy and impulsivity subtests of Difficulties in Emotion Regulation Scale; self-directedness and self-transcendence subscales of character dimensions significantly predicted the level of smartphone addiction. Finally, the path analysis had a very good fit to the data and suggested that self-directedness acted as a mediating role in the relationship between anxious attachment, strategy, impulsivity, and smartphone addiction. This model has revealed that those who are anxiously attachment, whose emotion regulation strategies are insufficient, and those who are impulsive while regulating their emotions have difficulties in self-directedness and that this plays an important role in increasing the likelihood of smartphone addiction. Therefore, it can be said that these findings will be useful in both theoretical and clinical applications.

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Alexithymia Levels and Facial Emotion Recognition Skills in Psoriasis Patients

Author(s): Onur Yılmaz,Didem Dizman,Tezer Kılıçarslan,Özgür Bölükbaşı,Nahide Onsun / Language(s): English / Issue: Suppl. 1/2019

The purpose of this study was to examine alexithymia levels and abilities to recognize facial emotions among psoriasis patients and compare with healthy controls. Sixty psoriasis patients diagnosed in dermatology clinics, and 65 age, sex and educationally matched healthy controls were assessed for this randomized controlled trial. Psoriasis Area Severity Index (PASI) was applied to patients in dermatology clinics, Structured Clinical Interview for DSM-IV Axis-1 Disorders, 20-item Toronto Alexithymia Scale (TAS-20), Facial Emotion Recognition Test (FERT) were applied to patients and controls in psychiatry clinics. Patients’ mean TAS-20 total scores were higher, while their ability to recognize negative facial emotions were lower than the control group Patients might have underestimated especially negative emotions over time, for a possible defense mechanism against depression and anxiety. Alexithymia levels were significantly related with psoriasis disease severity. Thus, alexithymia might be a predictor for severity of psoriasis.

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Amending the revisionist model of the Capgras delusion. A further argument for the role of patient experience in delusional belief formation

Author(s): Garry Young / Language(s): English / Issue: 3/2014

Recent papers on the Capgras delusion have focused on the role played by subpersonal abductive inference in the formation and maintenance of the delusional belief. In these accounts, the delusional belief is posited as the first delusion-related event of which the patient is conscious. As a consequence, an explanatory role for anomalous patient experience is denied. The aim of this paper is to challenge this revisionist position and to integrate subpersonal inference within a model of the Capgras delusion which includes a role for experiential content. I argue that the following revisionist claims are problematic: (a) that a fully-formed belief enters consciousness, and (b) that this is the first conscious delusion-related event. Instead, it is my contention that a delusional thought (arrived at through subpersonal abductive inference) and an anomalous experience co-occur in consciousness prior to the formation of the delusional belief. The co-occurrence of thought and anomalous experience overcomes problems with the revisionist position resulting in an account of the Capgras delusion with greater explanatory efficacy.

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An Example of a Model for Practicing Community Mental Health Nursing: Recovery

Author(s): Beyhan Bag / Language(s): English / Issue: 4/2018

There are some uncertainties about the services that will be offered to patients with mental disorders in the community mental health centers opened in our country. One-fourth of the employees in these centers are nurses. This is an important figure that could affect the quality of the services offered. In order to improve the quality of the services offered, nurses need models that can be applied in the field. In this sense, “Recovery” model, is a model that is quite suitable for the community mental health services which centers the individual as a part of its basic philosophy. The aim of this study is to define the “Recovery” model and to discuss it as model for the treatment and maintenance of patients by nurses working in community mental health centers.

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An Investigation of Developmental Goals and Well-Being in Emerging Adulthood

Author(s): Deniz Kurt,Zehra Uçanok / Language(s): English / Issue: Suppl. 1/2019

The main purpose of this study is to investigate emerging adulthood from a goal-setting perspective in the frame of a developmental regulation model. The sample consisted of 396 participants aged between 18 and 30 years. The participants were administered a battery that consisted of Self-Esteem Scale, Satisfaction with Life Scale, Loneliness Scale, Brief Symptom Inventory and questions to determine their life goals and appraisals of these goals. Both future and pasts goals were assessed. Qualitative data analysis indicated that emerging adults’ future goals were mostly related to occupation, education and family and their previous goals were frequently related to education and occupation. Furthermore, older or engaged/married participants stated goals related to family, while single participants most frequently stated goals related with occupation. The study revealed that life satisfaction of the goal engagement participants was significantly higher than those of the goal striving participants. The results showed that young adults set goals appropriate to properties of their developmental period. Furthermore, the results were emphasized the importance of goal appraisals and goal engagement for emerging adults’ well-being.

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An Overlooked Group in the Psychosocial Care in Breast Cancer: Spouses

Author(s): Gülşah Yıldız,Duygu Hiçdurmaz / Language(s): English / Issue: 2/2019

Breast cancer directly affects women physically, psychologically and socially in the process of diagnosis, treatment and post-treatment, leads to the deterioration of psychosocial adaptation, and affects the family and social relations negatively. The family, which is an important source of support in the breast cancer process, can face the same psychosocial troubles with women. The results of the research show that the most preferred source of support in families is spouses and their quality of life is lower than the other family members.Psychosocial care which is biasedly solely canalized to women by the healthcare professionals often overlooked their spouses and leads to be received inadequate support by them. In this context with the awaring of the psychosocial problems spouses facing, it is important to include spouses to psychosocial care which healthcare professionals provide to women with breast cancer. In this article, it is aimed to raise awareness about psychosocial problems experienced by the spouses of breast cancer patients as a mostly neglected group and possible interventions.

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Anksiozni i depresivni poremećaji ‒ jedan, dva ili tri poremećaja

Author(s): Zdenka Novović / Language(s): Serbian / Issue: 3/2004

The study deals with theoretical psychiatric proposals about relations between anxiety and depressive disorders. Three theoretical positions developed on the basis of numerous evidence on relationship of anxiety and depressive disorders: unitaristic (anxious and depressive disorders represent one disorder with different clinical pictures or phases of the disorder), pluralistic (there are two classes of disorders with clearly recognizable boundaries) and anxious-depressive position (mixed anxious-depressive disorder represents also a single disorder). Possible reasons for antagonisms, connections (i.e. lack of connections) to some proposals of psychologists are commented upon, as well as the significance of this problem for classification of mental disorders in general.

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Anksiyete Bozukluklarında Sanal Gerçeklik

Author(s): Elif Üzümcü,Burçin Akın,Hüseyin Nergiz,Müjgan İnözü,Ufuk Çelikcan / Language(s): Turkish / Issue: 1/2018

Virtual reality is a relatively new exposure tool that uses three-dimensional computer-graphics-based technologies which allow the individual to feel as if they are physically inside the virtual environment by misleading their senses. As virtual reality studies have become popular in the field of clinical psychology in recent years, it has been observed that virtual-reality-based therapies have a wide range of application areas, especially on anxiety disorders. Studies indicate that virtual reality can be more realistic than mental imagery and can create a stronger feeling of “presence”; that it is a safer starting point compared to in vivo exposure; and that it can be applied in a more practical and controlled manner. The aim of this review is to investigate exposure studies based on virtual reality in anxiety disorders (specific phobias, panic disorder and agoraphobias, generalized anxiety disorder, social phobia), posttraumatic stress disorder and obsessive compulsive disorder.

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Anthropologische Psychiatrie. Eine Referenz der Kępiński-Rezeption?

Author(s): Thomas Reuster / Language(s): German / Issue: 28/2016

It is suggested to link Antoni Kępiński to the vicinity of the so-called Anthropological Psychiatry. This hypothesis is supported by his criticism of psychiatric objectivity, his personally committed style of psychotherapy and his assumption that mental sanity and illness is based on a constitutive value-based condition according to the model of information metabolism. This paper examines the most important criteria of his psychiatric work and research in contrast to Humanistic Psychology. The provisional conclusion that Kępiński and Anthropological Psychiatry are in accordance cannot be fully justified. However, with a broader concept of anthropological psychiatry it is possible to integrate Kępiński's views.

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ANTIBIOTIC RESISTANCE IN ROMANIA –AN ECONOMIC AND MEDICAL CHALLENGE -

Author(s): Bogdan Cătălin Aluculesei / Language(s): English / Issue: 1/2017

The use of antibiotics, without regard to the importance of first obtaining a prescription, is one of the current challenges, both in health and economic terms. At the global level, resistance to different classes of antibiotics is developing at an alarming rate, and the effects over time are worrying. Romania is one of the European countries facing this problem at the macro level, with the latest statistical data exposing this alarming situation. The lack of basic knowledge of the population regarding the purchase of medication and the habit of administering treatment without the clinician’s advice make this situation difficult to improve. This article discusses the importance of adequate education in antibiotic use, proposing concrete measures to improve the current situation. This study is based on results obtained by the author in previous research on antibiotic resistance in children diagnosed with unitary tract infection in the Braşov area. Thus, the need to apply the proposed solutions is based on the reality found in hospitals

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Antisocial behavior: Dimension or category(ies)?

Author(s): Mikloš Biro,Snežana Smederevac,Zdenka Novović / Language(s): English / Issue: 3/2008

Classificatory systems (DSM-IV, ICD-10) use different criteria for defining a rather common antisocial disorder, traditionally referred as psychopathy. Most empirical studies of this phenomenon use Cleckley’s operational definition that was applied and amended in Hare’s revised Psychopathy Checklist (PCL-R). In modern literature, the fact that there is less than a perfect correspondence between classificatory systems and Hare’s PCL-R is often cited as an indication that antisocial behavior is not confined to a distinct category of people but is rather a continuous personality dimension. In order to further elucidate the nosology of antisocial behaviors, a Psychopathy Assessment Questionnaire (PAQ) based on Cleckley – Hare’s criteria and consisting of 40 binary items was administered to 339 men (135 prisoners and 204 members of the general population). Four distinct clusters of respondents were identified by means of hierarchical cluster analysis: Psychopathic type (characterized by high positive scores on dimension of Unemotionality; Antisocial type (characterized by high positive scores on Social deviance dimension); Adapted type (characterized by negative scores on all dimensions); and Hyper-controlled type (characterized by extremely negative scores on dimension Social deviance accompanied with positive scores on Unemotionality dimension). Additional comparison with MMPI profiles which classified prison sample in two groups (“Psychopathic profiles” and “NonPsychopathic profiles”) shows that there is no expected compatibility between MMPI and PAQ. We conclude that Antisocial type can be treated as a distinct category, while Psychopathic type displays characteristics of dimensional distribution.

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Antoni Kępiński's Philosophy of Medicine - an alternative reading

Author(s): Jakub Zawiła-Niedźwiecki / Language(s): English / Issue: 28/2016

Antoni Kępiński remains an often read and quoted author even 40 years after his premature death. Usually he is read in the context of his times and his connections with contemporary philosophy. This paper aims to show other aspects of his reflections on psychiatry. His views on the position of psychiatry within medicine, its methods, psychophysical problems, and other issues are compared with current knowledge and current thought paradigms. The goal is to show that while Kępiński was obviously functioning within a different scientific and philosophical paradigm many of his ideas and reflections can still be found within current debates. The important conclusion is to not hold on to the views that Kępiński held himself because he did not know as much as we do, but to see the importance of the debates that he foresaw even then and possibly learn something from his extensive clinical experience.

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Anxious attachment and excessive acquisition: The mediating roles of anthropomorphism and distress intolerance

Author(s): Melissa M. Norberg,Cassandra Crone,Cathy Kwok,Jessica R. Grisham / Language(s): English / Issue: 1/2018

Most individuals with hoarding disorder (HD) are prone to excessively acquiring new possessions. Understanding the factors that contribute to this collecting behavior will allow us to develop better treatment approaches for HD. The aim of this study was to test our assumption that an anxious attachment style is associated with a tendency to anthropomorphize comforting objects and an inability to tolerate distress, which in turn leads to excessive acquisition. Methods: A total of 361 participants with subclinical to clinical acquisition problems (77.8% female) completed a series of self-report measures. Results: As expected, greater anxious attachment was related to greater distress intolerance and stronger tendencies to anthropomorphize inanimate objects. In turn, greater distress intolerance and anthropomorphism were related to more excessive buying and greater acquisition of free items. Examination of the pathways and indirect effects showed support for double mediation rather than serial mediation, as distress intolerance did not predict anthropomorphism. Discussion and conclusion: These novel findings, if replicated, suggest that adding treatment modules that target improving distress tolerance and reducing anthropomorphism to standard treatment for HD may lead to further reductions in excessive acquiring.

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Are all features of psychopathy associated with decreased health? Psychopathy, dysfunctional family characteristics, and health problems in convicts

Author(s): Janko Međedović,Daliborka Kujačić / Language(s): English / Issue: 2/2020

Previous research suggested that psychopathy is related to diminished physical and mentalhealth. However, this link could be specific to psychopathic lifestyle and antisocial behavior,while manipulative characteristics and emotional superficiality could be unrelated or even positively related to physical and mental health. Furthermore, psychopathic features could mediate the link between detrimental family characteristics and health problems. We tested these hypotheses in a sample of male convicts (N = 224). Psychopathy was explored via a rating method (PCL–R). Dysfunctional family characteristics were extracted from participants’prison files. Finally, self-reported biographical data was used to estimate problems in physical and mental health. Behavioral psychopathy tendencies and especially impulsive and erratic behavior turned out to be positively related both to physical and mental health problems. On the other hand, Interpersonal and Affective psychopathy features were mostly unrelated or negatively related to health problems. Finally, Antisocial and especially Lifestyle characteristics turned out to be significant mediators of the link between dysfunctional family characteristics and health problems. Research results showed that narrow psychopathy facets are differentially related to health status. Psychopathic lifestyle and criminal behavior are positively related with problems in physical and mental health, while manipulative characteristics and affective shallowness are associated with better health. The results are in accordance with the concept of successful psychopathy and evolutionary accounts on psychopathy.

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Art therapy in nursing

Author(s): Gergana Avramova-Todorova / Language(s): English / Issue: 3/2017

Illness, emotions, art and therapy – is there a connection between them? Is there a significant bond betweennursing and art therapy and if there is one, how can we put it in practice?The belief that the mind plays an important role in physical illness goes back to the earliest days of medicine.New molecular and pharmacological tools have made it possible to identify the network that exists between theimmune system and the brain, and allows the two system to signal each other continuously and rapidly. Disruptionof this communication in any way exacerbates the diseases that the immune system guards against. Itis getting clear now for scientists how signals from the immune system can affect the brain and the emotionaland physical responses it controls: the molecular basis of feeling sick. In all this, the boundaries between mindand body are beginning to blur.The significance of these findings seems promising to extend the range of therapeutic treatments available forvarious disorders.Nursing, as identified with keeping care for the patients during the process of healing, is facing the challengeto create and maintain a relationship with the patients. And this unity between nurses and patients should bebuilt on the base of commitment, compassion, good will and empathy. The art of nursing is the heart of caring.It is obvious in recent years, that there are great benefits in asking patients to connect themselves in any kind ofart therapy. Artistic expression is an activity that involves the brain in ways that can be used to enhance therapeutictreatment and evaluation.This article is showing that there is a bond between illness and emotions, and that art therapeutic methods canbe used in nursing, in order to achieve better results in the process of healing.Using art therapeutic methods in nursing practice gives a way to improve the well-being of the patients, to createa relationship filled with empathy, courage and compassion.

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Art Therapy in Patients with Psoriasis

Author(s): Aslı Sarandöl,Birgül Aydın,Hayriye Sarıcaoğlu,Arife Öz,Emel Bülbül Başkan,Selçuk Kırlı / Language(s): English / Issue: Suppl. 1/2019

This study aimed at investigating the themes that emerged after an art therapy and assessing the effectiveness of art therapy using psychological scales and dermatological evaluation indices before and after the therapy in individuals with psoriasis. The study included patients aged 18-65 with moderate psoriasis who had the disease for 5 or more years and were in need of systemic treatment. Those who had a concomitant physical disorder including another skin disease, an active joint disorder or a psychiatric diagnosis other than adjustment disorder were excluded from the study. A total of 15 sessions each lasting 150 minutes were held once a week. Various art techniques including music, painting, and ceramics were practiced to evaluate within the group patients’ understanding of the illness and their self-awareness. The outcomes of the study were presented over three patients who attended the sessions regularly. The dermatological evaluations, patient feedback, and observations of the psychotherapists have shown that art therapy can be an effective method in attenuating the symptoms of psoriasis and evoking awareness of repressed experiences or feelings.

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Arteterapie: umění léčby traumatu

Author(s): Jakub Hučín,Karin Alice Schouten / Language(s): Czech / Issue: 2/2017

Interview with Karin Alice Schouten by Jakub Hučín

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Asertivni trening: Efekti tretmana, održivost promena i udeo terapeuta u terapijskom ishodu

Author(s): Snežana Tovilović / Language(s): Serbian / Issue: 1/2005

In this research is shown part of results concerning evaluation study of group assertiveness training. Treatment, which has been organized as structured program of assertiveness training, has been applied on 18 groups of subjects during 9 group sessions. This treatment has been adjusted to non-psychiatric clients from our country. Groups were lead by two therapists. During 20 months of our research 215 voluntary participants of full age have joined training groups. Final sample consisted of 158 subjects who had finished treatment and who had fulfilled criteria for taking repeated measurement. Subjects had taken battery of questionnaires before the treatment and eight weeks after they had completed treatment. Subsample, which included 35 subjects from one therapist’s groups, took retest after twice longer time period. Results of conducted research have confirmed the hypothesis concerning the potentiality of assertiveness training to produce expected and significant improvements of treated subjects. Therapy effect is found on symptomatic level through reduction of symptoms of non-assertive behaviors, which were target of the treatment. Contrary to expectation interactive effect of treatment and therapist to reduction of symptoms of non-assertive behavior has been found, which implies need for further investigation of variables that are related to therapists. Through the medium of treatment therapeutic changes in structural level, in domain of general assertiveness, social anxiety and treated subjects' self-concept are produced. The effect of therapy we might consider stabled and maintained after 16 weeks of finishing the treatment.

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