PURPOSE: Child abuse and trauma are significant risk factors in the etiology of borderline personality disorder (BPD). Apart from affecting the risk of developing BPD, adverse childhood experiences seem to increase its symptoms and related disability. Self-stigma presents another common issue with equally prominent consequences for mental health. Despite being theoretically linked, the connections among childhood trauma, self-stigma, and mental health have not been explored in patients with BPD. This study aimed to provide first insights into this understudied topic. PATIENTS AND METHODS: This cross-sectional study included 283 inpatients diagnosed with BPD participating in a residential transdiagnostic psychotherapeutic program. The patients completed several measurements - the Internalized Stigma of Mental Illness Scale, the Childhood Trauma Questionnaire - Short Form, the Clinical Global Impression - Severity, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Dissociative Experiences Scale, the Sheehan Disability Scale, and a demographic questionnaire. The data was statistically analyzed using IBM SPSS and AMOS 26 programs, and bivariate correlation tests and structural equation modeling explored the hypotheses. RESULTS: Retrospectively reported childhood trauma positively correlated with current self-stigma. Both childhood trauma and self-stigma were also positively related to several indicators of general psychopathology and disability. The significance of these connections was subsequently confirmed by structural equation modeling, where self-stigma acted as a partial mediator of childhood trauma, general psychopathology, and disability. CONCLUSION: Self-stigma significantly mediates the relationship between childhood trauma and selected mental health symptoms among adult patients diagnosed with BPD. Longitudinal studies are necessary to explore the causality of the findings. Therapeutic and societal efforts to tackle childhood trauma or self-stigma might benefit from reflecting its broader psychosocial context.

• Keywords
• anxiety, borderline personality disorder, childhood trauma, depression, disability, self-stigma,
• Publication type
• Journal Article MeSH

OBJECTIVE: The study worked with depressive symptoms, anxiety score and cognitive functions in obstructive sleep apnea (OSA) patients treated with CPAP. METHODS: Eighty-one subjects with OSA and without psychiatric comorbidity were treated with CPAP for one year and completed the following scales and cognitive tests: Trail Making Test, Verbal Fluency Test, d2 Test, Beck Depression Inventory-II and Beck Anxiety Inventory. MINI ruled out psychiatric disorder. At the two months check-up, subjects were re-evaluated for depressive and anxiety symptoms, and after one year of CPAP treatment, subjects repeated cognitive tests and scales. Data about therapy adherence and effectiveness were obtained from the patient's CPAP machines. RESULTS: The study was completed by 59 CPAP adherent patients and eight non-adherent patients. CPAP therapy effectiveness was verified in all patients by decreasing the apnea-hypopnoea index below 5 and/or 10% of baseline values. The adherent patients significantly improved depressive and anxiety symptoms. There was also an improvement in overall performance in the attention test; however, performance in many individual items did not change. The adherent patients also improved verbal fluency and in the Part B of the Trail making test. The non-adherent group significantly increased the number of mistakes made in the d2 test; other results were non-significant. CONCLUSION: According to our results, OSA patients' mood, anxiety and certain cognitive domains improved during the one-year therapy with CPAP. TRIAL REGISTRATION NUMBER: NCT03866161.

• Keywords
• CPAP treatment, Trail Making Test, Verbal Fluency Test, cognitive functions, depression, obstructive sleep apnoea, treatment efficacy,
• Publication type
• Journal Article MeSH

OBJECTIVE: The aim of this prospective observational study was to investigate the effects of a novel Wim Hof psychophysiological training program on stress responses and hormone release in healthy participants during an Antarctic expedition. METHODS: All members of an Antarctic expedition were included in the study. The participants were healthy volunteers allocated to an intervention group (n = 6) and a control group (n = 7). The intervention consisted of 8 weeks of Wim Hof training. The training program comprised three integrated parts: breathing exercises, cold exposure and meditation. Psychometric measures (the Beck Depression Inventory and the Trauma Symptom Checklist-40) and neuroendocrine measures (cortisol, melatonin) were assessed pre- and post-intervention. RESULTS: The results showed that the 8-week training program significantly reduced stress responses, as indicated by a reduction in depressive symptoms. A non-significant reduction in cortisol was also observed. CONCLUSIONS: These data constitute preliminary findings indicating that the Wim Hof Method may positively affect stress symptoms and adaptability of the hormonal system to respond adequately to the circadian rhythm in healthy volunteers who participated in an Antarctic expedition.

• Keywords
• Cortisol, Wim Hof Method, depression, hormone release, melatonin, observational study, psychophysiological training, stress,
• MeSH
• Circadian Rhythm MeSH
• Expeditions * MeSH
• Hydrocortisone MeSH
• Humans MeSH
• Meditation * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Geographicals
• Antarctic Regions MeSH
• Names of Substances
• Hydrocortisone MeSH

PURPOSE: Obsessive compulsive disorder (OCD) is a debilitating mental disorder that often takes a chronic course. One of the factors influencing the treatment effectiveness in anxiety and depressive disorders is the self-stigma. This study focused on the relationship between the self-stigma, symptomatology, and therapeutic outcomes in patients with OCD. PATIENTS AND METHODS: Ninety-four inpatients with OCD, who did not sufficiently respond to at least one selective serotonin reuptake inhibitor trial, participated in the study. They attended a six-week therapeutic program consisting of exposure and response prevention, transdiagnostic group cognitive behavioral therapy, individual sessions, mental imagery, relaxation, sport, and ergotherapy. The participants completed several scales: the Internalized Stigma of Mental Illness Scale (ISMI), the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR), Beck Anxiety Scale (BAI), Beck Depression Scale-II (BDI-II), and Dissociative Experiences Scale (DES). A senior psychiatrist filled in the Clinical Global Impression (CGI-S). RESULTS: The average scales' scores considerably declined in all measurements except for DES. The self-stigma positively correlated with all psychopathology scales. It was also higher in patients with a comorbid personality disorder (PD). The higher self-stigma predicted a lower change in compulsion, anxiety, and depressive symptoms but not the change of obsessions or the overall psychopathology. CONCLUSION: The self-stigma presents an important factor connected to higher severity of OCD. It is also a minor predictor of a lower change in symptomatology after combined treatment.

• Keywords
• cognitive behavioral therapy, exposure and response prevention, non-response, obsessive compulsive disorder, self-stigma,
• Publication type
• Journal Article MeSH

PURPOSE: Self-relation is a profound connection that influences one's life. As such, it presents an important topic for various areas of research and psychotherapy. The goal of this study was to develop and evaluate a brief scale that would assess positive aspects of self-relation. SAMPLE AND METHODS: The Positive Self-Relation Scale (PSRS) consists of 16 items divided into 4 subscales - Self-Acceptance, Self-Confidence, Authenticity and Assertiveness, and Fulfilled Experience. Two samples were used for the evaluation of its content and factor structure. The final sample's data used for validation assessment. This sample consisted of 1234 adults from a general population (mean age 34.8±14.2 years, 70.8% women). All participants completed PSRS. Subgroups also filled in Rosenberg Self-Esteem Scale (RSES), Adult Dispositional Hope Scale (ADHS), Beck Depression Inventory-II (BDI-II), Liebowitz Social Anxiety Scale (LSAS), and Dissociative Experiences Scale (DES). RESULTS: Differences in scores among demographic groups were small to none. Internal consistency was good (Composite Reliability Coefficients - the whole scale: 0.93; the subscales: 0.73-0.80). Temporal stability, assessed 2 weeks apart, was satisfactory (intraclass correlation coefficients - the whole scale: 0.86, the subscales: 0.60-0.82). Factor loadings in confirmatory factor analysis were 0.45-0.80, fit indices mostly showed an adequate model. The correlation coefficients between PSRS and RSES/ADHS were strong (r=0.79/0.55). The scale also strongly correlated with LSAS, BDI-II, and DES (r=-0.61/-0.48/-0.30, all ps<0.001). CONCLUSION: PSRS showed adequate psychometric properties in the general population. Future studies should include clinical samples. The areas of application lie mainly in research and psychotherapy.

• Keywords
• positive psychology, psychometric properties, self-acceptance, self-esteem, self-relation,
• Publication type
• Journal Article MeSH

INTRODUCTION: More sexual problems are reported among people treated for diabetes; however, this situation is less explored in women than in men. AIM: To analyze the presence and causal links of female sexual dysfunction (FSD) among Czech women treated for type 1 diabetes. METHODS: 40 women completed a national version of the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-revised (FSDS-R), and Beck's Depression Inventory-II (BDI-II). A metabolic and endocrine analysis was done using blood samples. Data were statistically analyzed using SPSS v.24 and the R environment. MAIN OUTCOME MEASURES: Patient details (personal information, diabetes-related data, and sex history), sexual performance (the FSFI and FSDS-R scores), and level of depression (the BDI-II score) were measured. RESULTS: FSD was present in 58% of the participants (based on the FSFI score), and 38% women declared significant sexual distress (according to their FSDS-R score). Even though only 4 women fulfilled the criteria for depression, we observed a strong association between BDI-II and FSFI (for total FSFI score P = .012, ρ = -0.394) resp. FSDS-R scores (P < .001, ρ = 0.552). Although we were not able to establish a clear direct connection between FSD and metabolic control, BDI-II scores were closely correlated with glycosylated hemoglobin (P = .009, ρ = 0.407). The duration of diabetes (based on FSDS-R: P = .046) but neither age nor the presence of chronic diabetic microvascular complications was associated with a higher FSD occurrence. We also observed an association between FSD and the presence of autoimmune hypothyroidism, even when successfully treated (FSDS-R: P = .009; FSFI: P = .067). CONCLUSION: FSD is more common in women with type 1 diabetes than in healthy women, and coexisting thyroid autoimmune disease seems to exacerbate FSD. Women suffering from type 1 diabetes, and particularly those with additional endocrinopathies, should be actively screened for FSD. Stechova K, Mastikova L, Urbaniec K, et al. Sexual Dysfunction in Women Treated for Type 1 Diabetes and the Impact of Coexisting Thyroid Disease. Sex Med 2019;7:217-226.

• Keywords
• Autoimmune Thyroid Disease, BDI-II, Diabetes, FSDS-R, FSFI, Female Sexual Dysfunction, Insulin, Insulin Pump, Life Quality, Sexarche,
• Publication type
• Journal Article MeSH

BACKGROUND AND AIM: Patients who have schizophrenia are more prone to suicidal behavior than the general population. This study aimed to find connections between suicidality and self-stigma, hope, and personality traits in patients with schizophrenia. METHODS: Forty-eight stabilized outpatients with schizophrenia attended this cross-sectional study. Patients were diagnosed by the Mini International Neuropsychiatric Interview (MINI) using the ICD-10 research diagnostic criteria. The assessments included Positive and Negative Syndrome Scale, objective and subjective Clinical Global Impression, Liebowitz Social Anxiety Scale, Beck Depression Inventory-second edition, Internalized Stigma of Mental Illness, the Temperament and Character Inventory, and Adult Dispositional Hope Scale. RESULTS: The individual rate of suicidality (suicidal index from MINI) strongly positively correlated with self-stigma, level of depression, social anxiety, and harm-avoidance, and negatively correlated with hope, self-directedness, and stigma resistance. CONCLUSION: Individuals with additional symptoms of depression, social anxiety, trait-like anxiety, and self-stigma should be carefully monitored for suicidal ideation. On the opposite side, patients with sufficient hope, self-esteem, and goal-directed attitudes are less likely to have suicidal thoughts and may potentially be role models in group rehabilitation programs, motivating more distressed colleagues and showing them ways to cope.

• Keywords
• hope, personality traits, positive and negative symptoms, schizophrenia, self-stigma, social anxiety, suicidality,
• Publication type
• Journal Article MeSH

GOAL: The goal of this study was to explore the impact of self-stigma on the treatment outcomes in patients with anxiety disorders and to find possible mediators of this relationship. METHOD: Two hundred and nine patients with anxiety disorders, who were hospitalized in a psychotherapeutic department, attended the study. The average age was 39.2±12.4 years; two-thirds were women. Most of the patients used a long-term medication. The participants underwent either cognitive behavioral therapy (CBT) or short psychodynamic therapy. The selection to the psychotherapy was not randomized. All individuals completed several scales - Beck Depression Inventory, the second edition (BDI-II), Beck Anxiety Inventory (BAI), Dissociative Experience Scale (DES), Sheehan Disability Scale (SDS), subjective Clinical Global Impression (subjCGI), and The Internalized Stigma of Mental Illness Scale (ISMI). A senior psychiatrist filled out the objective CGI (objCGI). RESULTS: The patients significantly improved in the severity of anxiety (BAI), depression (BDI-II), and overall severity of the mental disorder (objCGI). The self-stigma predicted a lower change of the objCGI, but not a change of the anxiety and depressive symptoms severity. Anxiety, depressive symptoms, dissociation, and disability were assessed as possible mediators of the relationship between the self-stigma and the treatment change. None of them were significant. CONCLUSION: Self-stigma lowers the effectiveness of the combined treatment of anxiety disorders. Future research should explore other possible mediators influencing this relationship.

• Keywords
• anxiety disorders, medication, self-stigma, treatment effectiveness,
• Publication type
• Journal Article MeSH