Nejvíce citovaný článek - PubMed ID 18207424
Pain, dissociation and subliminal self-representations
BACKGROUND: Burnout syndrome usually begins with feelings of enthusiasm and idealized visualizations, and it is in contrast with subsequent disillusionment, disappointment, and symptoms which are related to chronic stress experienced later. This tendency to idealization is a parallel to the concept of "mental splitting" described by Kernberg with a pronounced "black and white" perceptual dichotomy between the early idealization and later disillusionment. This study intends examination of relationships between burnout syndrome, traumatic stress and Kernberg's concept of splitting. METHODS AND PARTICIPANTS: In this study we have assessed 90 health care professionals (50 women and 40 men) working with a population of diabetic patients utilizing Burnout Measure (BM), Splitting index (SI) and Traumatic Stress Checklist - 40 (TSC-40). RESULTS: Study results indicate significant Spearman correlations between burnout syndrome (BM) and traumatic stress (TSC-40) in population of men (R=0.75, p<0.01) and of women (R=0.61, p<0.01), as well as between burnout syndrome (BM) and splitting (SI) for both genders: men (R=0.40, p<0.01), women (R=0.51, p<0.01). These findings may have implications for prevention and treatment of burnout syndrome. CONCLUSION: The current study findings provide implications that the defensive mechanisms of splitting and traumatic stress may allow for the prediction of burnout symptoms. This relation may potentially be of use in both the potential detection and prevention of burnout syndrome.
- Klíčová slova
- burnout, dissociation, mental splitting, stress, traumatic stress,
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: The burnout syndrome represents a defence mechanism against stress and includes stages with decreased ability to experience feelings and emotional states. This finding suggests that burnout might be closely linked to emotional ‘blindness’ as a defence mechanism against negative and overwhelming emotions known as alexithymia. The aim of this study is to examine the relationships between burnout syndrome, alexithymia, depression and traumatic stress symptoms in healthcare professionals. METHODS: This empirical study assessed female healthcare professionals who work with a population of patients with diabetes, utilizing the Maslach Burnout Inventory (MBI-HSSMP), Burnout Measure (BM), Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI-II) and Traumatic Stress Checklist (TSC-40). Data were analysed using Spearman’s correlation coefficient. RESULTS: A total of 114 female participants were included (age range, 31–60 years; mean age, 46.62 ± 8.71 years). Statistically significant associations were found between burnout syndrome (BM scores) and alexithymia (TAS-20) (r = 0.41), and between BM scores and traumatic stress (TSC-40; r = 0.63). The MBI-HSSMP emotional exhaustion subscale also correlated with alexithymia (TAS-20) (r = 0.37). CONCLUSION: Findings of this study suggest that alexithymia and traumatic stress are related to burnout symptoms. This dynamic may be potentially useful for detecting and preventing burnout syndrome.
- Klíčová slova
- Burnout syndrome, alexithymia, depression, traumatic stress,
- MeSH
- afektivní symptomy epidemiologie psychologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- poskytování zdravotní péče MeSH
- profesionální vyhoření epidemiologie psychologie MeSH
- průzkumy a dotazníky MeSH
- psychický stres psychologie MeSH
- stresové poruchy vyvolané traumatem epidemiologie psychologie MeSH
- zdravotnický personál psychologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND: According to recent data, dissociation may play an important role in borderline personality disorder (BPD), nevertheless specific influences of psychotropic medication on dissociative symptoms in BPD and their therapeutic indications are largely unknown. The purpose of this study was to assess relationships of dissociative symptoms in BPD patients with levels of psychotropic medication and compare these results with a subgroup of patients with schizophrenia. MATERIALS AND METHODS: In this study, we investigated 52 BPD patients and compared the results with a control group of 36 schizophrenia patients. In all participants, we assessed actual day doses of antipsychotic medication in chlorpromazine equivalents and antidepressant medication in fluoxetine equivalents. Dissociative symptoms were measured by Dissociative Experiences Scale (DES), and other psychopathological symptoms were measured using Health of the Nation Outcome Scales. RESULTS: Results indicate that dissociative symptoms measured by DES were significantly correlated with antipsychotic medication (Spearman R=0.45, P<0.01) in chlorpromazine equivalents and antidepressant medication in fluoxetine equivalents (0.36, P<0.01). These relationships between medication and dissociative symptoms were not found in the control group of schizophrenia patients. CONCLUSION: The results suggest that levels of antipsychotic medication and antidepressant medication are significantly associated with dissociative symptoms in BPD but not in schizophrenia.
- Klíčová slova
- antidepressants, antipsychotics, dissociation, stress,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Splitting represents a defense mechanism that describes fragmentation of conscious experience that may occur in various psychopathological conditions. The purpose of this study was to examine the relationship of splitting with disturbed cognitive and affective functions related to impulsivity and intimate partnerships in a group of obese patients indicated for bariatric treatment and compare the results with other obese patients and patients with bulimia nervosa. METHODS: In this clinical study, we assessed 102 young women. The sample was divided into three subgroups: obese women (N=30), obese women indicated for bariatric treatment (N=48), and patients with bulimia nervosa (N=24). The patients were assessed using Splitting Index and Barratt Impulsivity Scale, and selected information about their intimate partnership was documented for all the participants. RESULTS: The main results of this study indicate significant differences in the relationship of splitting and impulsivity with difficulties in intimate partnerships. These differences discriminate obese patients indicated for bariatric treatment from other obese patients and patients with bulimia nervosa. CONCLUSION: These findings may have significant implications for treatment of the obese patients indicated for bariatric treatment and their presurgery psychological evaluations.
- Klíčová slova
- bariatric treatment, bulimia nervosa, impulsivity, obesity, splitting,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Dissociation likely plays a key role in schizophrenia and borderline personality disorder (BPD), although empirical studies that compare specific manifestations of these symptoms in schizophrenia and BPD are rare. In this context, the purpose of this study was to compare the occurrence of dissociative and other psychopathological symptoms in these disorders, and to assess the possible influence of antipsychotic medication on the dissociative symptoms. METHODS: We assessed 31 patients with schizophrenia and 36 patients with BPD. Dissociative symptoms were measured by the Dissociative Experiences Scale (DES), symptoms related to stress and traumatic experiences were assessed using the Trauma Symptom Checklist-40 (TSC-40), and other psychopathological symptoms were measured with the Health of the Nation Outcome Scales (HoNOS). We also assessed actual daily doses of antipsychotic medication in chlorpromazine equivalents in all participants. RESULTS: The results show that symptoms of traumatic stress measured by the TSC-40 had significantly higher scores in the BPD group. The data also show that dissociative symptoms (DES) were significantly correlated with symptoms of traumatic stress (TSC-40) and with symptoms assessed by the HoNOS. Remarkably significant correlations were found between levels of antipsychotic medication and the DES and between antipsychotic medication and the depersonalization/derealization component of the DES in BPD patients. CONCLUSION: The results support an important role of dissociative processes in schizophrenia and BPD and suggest a significant relationship between manifestations of dissociative symptoms in BPD and antipsychotic medication.
- Klíčová slova
- antipsychotic medication, borderline personality disorder, dissociation, schizophrenia, stress-related symptoms,
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Splitting describes fragmentation of conscious experience that may occur in various psychiatric disorders. A purpose of this study is to examine relationships between psychological process of splitting and disturbed cognitive and affective functions in schizophrenia and borderline personality disorder (BPD). METHODS: In the clinical study, we have assessed 30 patients with schizophrenia and 35 patients with BPD. The symptoms of splitting were measured using self-reported Splitting Index (SI). As a measure of semantic memory disorganization we have used verbal fluency test. Other psychopathological symptoms were assessed using Health of the Nation Outcome Scale (HoNOS). RESULTS: Main results show that SI is significantly higher in BPD group than in schizophrenia, and on the other hand, verbal fluency is significantly lower in schizophrenia group. Psychopathological symptoms measured by HoNOS are significantly higher in the BPD group than in schizophrenia. Significant relationship was found between verbal fluency and the SI "factor of others" (Spearman r = -0.52, p<0.01) in schizophrenia patients. CONCLUSIONS: Processes of splitting are different in schizophrenia and BPD. In BPD patients splitting results to mental instability, whereas in schizophrenia the mental fragmentation leads to splitting of associations observed as lower scores of verbal fluency, which in principle is in agreement with Bleuler's historical concept of splitting in schizophrenia.
- MeSH
- dospělí MeSH
- hraniční porucha osobnosti psychologie MeSH
- lidé MeSH
- neparametrická statistika MeSH
- neuropsychologické testy MeSH
- schizofrenie (psychologie) * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Somatoform dissociation is a specific form of dissociation with somatic manifestations represented in the form of 'pseudoneurological' symptoms due to disturbances or alterations of normal integrated functions of consciousness, memory or identity mainly related to trauma and other psychological stressors. With respect to the distinction between psychological and somatoform manifestations of dissociation current data suggest a hypothesis to which extent mild manifestations of 'pseudoneurological' symptoms in healthy young population may be linked to stress-related psychopathological symptoms or whether these symptoms more likely could be attributed to unexplained somatic factors. METHODS: With this aim we have assessed the relationship between somatoform dissociation and stress-related psychopathology (i.e. anxiety, depression, symptoms of traumatic stress, alexithymia) in a group of 250 healthy non-psychiatric and non-clinical young adults. RESULTS: Results of this study show that the symptoms of somatoform dissociation are significantly linked to stress-related psychopathology. CONCLUSIONS: Findings of this study show that the 'pseudoneurological' symptoms may be linked to stress-related psychopathological processes which indicate that also mild levels of stress may influence somatic feelings and may lead to various somatoform dissociative symptoms.
- MeSH
- afektivní symptomy diagnóza psychologie MeSH
- deprese diagnóza psychologie MeSH
- disociační poruchy diagnóza psychologie MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladiství MeSH
- psychiatrické posuzovací škály MeSH
- psychický stres diagnóza psychologie MeSH
- somatoformní poruchy diagnóza psychologie MeSH
- úzkost diagnóza psychologie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH