Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study.

BACKGROUND: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents' cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. METHODS: The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children's Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. RESULTS: Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents' and mothers' perspectives as associated with adolescents' MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. CONCLUSIONS: This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence.

Developing Simulated and Virtual Patients in Psychological Assessment - Method, Insights and Recommendations.

The phenomena of the simulated (SP) and virtual patient (VP) is widely described in the literature. Although it is difficult to find any practical information on developing these methods for teaching psychological assessment. Having conducted a long-term research project regarding this topic, we report the experience gained and retrospectively identify many mistakes. In this article, we present a summary of creating and using both SP and VP methods in clinical psychology and propose some insights and tips for their development, based on our experiences. While the project concerned clinical psychology, we believe the reflections might be applicable to a wider group of educational situations in which students develop competencies to carry out a diagnostic process with a real patient.

Fatigue and the psychological characteristics of medical students.

OBJECTIVES: The present study examined the relationship between medical student fatigue with psychological variables: emotional intelligence (EI), sense of coherence (SoC) (comprehensibility, manageability, and meaningfulness), quality of life (QoL), stress, and satisfaction with studying medicine. MATERIAL AND METHODS: The sample consisted of 566 medical students from the Medical University of Gdansk, Poland. The instruments used were the Chalder Fatigue Scale, Schutte Self Report Emotional Intelligence Test, Sense of Coherence Questionnaire, and a questionnaire designed by the authors, comprised questions relating to the quality of life, stress levels, and satisfaction with studying medicine. RESULTS: The results show that fatigue was negatively related to the ability to use emotions effectively in the management of one's activities (EI), 1 aspect of SoC - a level of comprehensibility, QoL, and satisfaction with studying medicine. Fatigue is positively related to the ability to recognize, understand, and control emotions (EI) and stress connected with studying medicine. CONCLUSIONS: The outcomes of the study afford a better understanding of the relation- ship between selected variables in the field of individual differences in the context of fatigue in the medical student population. It may help medical educators and authorities to have a better understanding of the phenomenon of building resilience and increasing abilities to cope with the negative effects of chronic stress such as fatigue in the population of medical students. Early recognition of specific psychological features in medical stu- dents, such as misunderstanding emotions and their perception of environments as unstructured, would make it possible to prepare early support and development programmes. Int J Occup Med Environ Health. 2023;36(4):517-25.

Is there sufficient evidence for the association between executive dysfunction and academic performance in adolescents with major depressive disorder?: a systematic review.

Adult depression, undoubtedly associated with executive dysfunction, leads to poor work performance. As depression in adolescents may have a negative impact on school performance, we aimed to analyse the possible relationship between selected executive deficits and academic performance. Executive dysfunctions may have more severe consequences on school performance at high school, as this stage of education requires engagement in long-term goals, whether writing an essay or preparing for an exam. Whilst inhibitory control is necessary at all educational stages, it seems that planning and decision-making play a greater role in high school than in primary school. We reviewed studies on executive functions conducted in adolescents diagnosed with major depressive disorder (MDD) to establish the possible relationship between executive processes and school performance in depressed adolescents. The search identified 5 studies addressing planning and decision-making in adolescents with MDD, but none of those studies reported educational achievement. We identified a considerable gap in the research on the functional impact of depression in adolescents. Identifying the link between specific executive deficits and school performance could guide tailored therapeutic interventions.

Parental experiences of the liminal period of a child's fatal illness.

The article offers a description of parents' experiences of their child's ultimately fatal illness as it unfolds over the successive stages of medical treatment, in the context of the liminality theory. The parents (N = 23) were interviewed 1-4 years after their child's death. The research method involved conducting narrative interviews with parents in order to obtain a spontaneous narration of the child's illness as it unfolded. The grounded theory approach, including the narrative and performative aspects of such parental utterances, was applied as the main research strategy. The results provide insight into the main areas and processes of common parental experiences, such as the pervasive sense of becoming trapped in timelessness and ambiguity. Further states reported by parents included oscillating between a distancing stance and involvement, and a dualistic relationship with medical staff and the medical system: between alignment and disharmony. The study indicates the importance of treating delivery of such a diagnosis as a process rather than as a one-time event. The sense of ambiguity is treated as a kind of necessary parental coping mechanism, whilst the sense of timelessness gives parents a unique sense of time in which they do not have to think about the child's potentially imminent death.

Affect and Cognitive Closure in Students-A Step to Personalised Education of Clinical Assessment in Psychology with the Use of Simulated and Virtual Patients.

INTRODUCTION: Since there was no general model of competencies to determine a successful clinical assessment, we based our study on the many skills that are needed to perform one. We analysed students' learning performance based on inner determinants, such as affect and cognitive closure, with the use of two teaching methods (i.e., simulated patient (SP) or virtual patient (VP)). METHODS: The sample comprised 56 fifth-year clinical psychology students. The need for closure (NFC) and efficacy in fulfilling the need for closure (EFNC) were measured using standardised questionnaires. The authors' VP and SP tools were used to teach and measure the effectiveness of learning psychological interview techniques and clinical reasoning. Clinical interview skills included building contact with the patient, gathering important information and making mistakes. Clinical reasoning skills were divided into eight dimensions for the assessment of mental health. RESULTS: Affect and cognitive closure are important psychological variables in anticipating and developing interview and clinical reasoning skills for psychology students. The simulated patient was more effective for interview skills, while the virtual patient was a beneficial teaching tool for most clinical reasoning skills. Virtual patient training was a useful teaching method for students with a low EFNC, probably because it provided a stable and strong structure. Simulated patient training was effective for people with a high EFNC, presumably because it allowed them to build on their advanced structuring skills. CONCLUSIONS: Affect and cognitive closure can be used to identify students' learning abilities to provide a more personalised education. The results of the present study may be useful for evaluating different teaching methods, monitoring their effectiveness and enhancing students' performance.

Availability of psychological support for medical students in Poland.

OBJECTIVES: Medical students suffer from a considerable level of stress, which can result in the deterioration of their mental health, including depression or suicidal ideation. They are afraid to seek help due to stigmatization and environmental ostracism. The goal of the study is to analyze the psychological support and stress management programs for students supported by medical schools in Poland. MATERIAL AND METHODS: The authors sent out e-mails with 9 questions regarding the issue being analyzed to all 19 medical schools in Poland. They obtained answers from 15 such schools, which corresponds to a response rate of 79%. The study was conducted in 2018-2019, before the SARS-CoV-2 pandemic. RESULTS: Due to the lack of central regulations, support is provided by medical schools individually. Those solutions focus on short-term, temporary therapy. If a longer therapy is needed, students are redirected to external health providers. Moreover, information about the support is not transferred by student-friendly communication channels. CONCLUSIONS: Support should be flexible, and it should quickly adapt to the emerging trends and consider students' feedback. A future model of psychological support could be a center organized as a transfer point between a university problem-solving facility and external health providers, concentrating on short-term activity. Quick support would eliminate potential complications and more serious mental problems. Int J Occup Med Environ Health. 2021;34(1):87-99.

Psychological characteristics of students in learning clinical interview skills with the use of virtual patient.

BACKGROUND: The goal of this exploratory study is to analyse which psychological characteristics of students are related to the effectiveness of learning clinical interview skills with the use of a virtual patient (VP). METHODS: The sample consisted of 29 final-year clinical psychology students. The authors' VP tool was used for measuring and teaching clinical interview skills: building contact with the patient, gathering important information, and identifying the students' mistakes. Psychological questionnaires were used to measure the students' psychological features: need for cognitive closure, ability to achieve cognitive structure, beliefs in the changeability of human traits, level of hope, intelligence, positive vs negative affect, and academic knowledge. RESULTS: The most important aspect of the diagnostician's psychological features which substantially influence effectiveness of learning interview skills is belief in the stability or changeability of human traits and the need to achieve cognitive closure. Participants who have a belief in human changeability are able to perform the task correctly even without training, while those who believe in human stability improve only slightly with training. Students with lower need of cognitive closure successfully learned to build a good relation with the patient. CONCLUSIONS: The study allows a better understanding of the phenomena occurring during the learning of clinical interview skills with the use of a VP.

The system of values and styles of success in the medical career: A longitudinal study.

OBJECTIVES: The purpose of the study was to investigate the relation between system values during medical education and styles of success in the medical career. MATERIAL AND METHODS: The participants were first examined when they applied to the medical school. Questionnaires were given to these students each academic year. Medical doctors who had participated in the first phase of the study completed a questionnaire 4 years after their graduation, too. The baseline questionnaire measured the system values. The follow-up questionnaire included measures of quality of life, work stress and burnout, satisfaction with medicine as a career and professional competency. RESULTS: The identified 3 groups of students representing 3 types of careers had been different regarding their preferred terminal values and instrumental values. Out of 3 groups, 2 presented a high risk of burnout. What is more the life goals (terminal values) are relatively stable, but preferable modes of behavior (instrumental values) are likely to change. The most important differences between students who may suffer from burnout later as doctors and those who are at a lower risk are e.g., family security, freedom, happiness, mature love, self-respect, social recognition and wisdom. CONCLUSIONS: The Rokeach Value Survey may be applied to identify specific tendencies in the development of medical career. The obtained results may be used by the medical school admission officers as well as resident selection committees in order to identify candidates who may be at risk of professional difficulties. Authors can identify during medical education which student will be at risk of professional burnout after studies. Thus there could be a selection of interventions directed toward differentiated groups of students, e.g.: supplying them with proper coping vs. guiding them, to increase life satisfaction and productivity. Int J Occup Med Environ Health 2018;31(6):823-835.

The Rites of Passage Framework as a Matrix of Transgression Processes in the Life Course.

This work shows the contribution of concept of rites of passage and theory of liminality to the understanding of transformations in the course of a person's life. The structural-functional analysis of empirical studies of physical changes, changing roles in society, and key changes in the area of mental and physical health conducted from the perspective of these theories has allowed to identify the three fundamental processes that govern the attainment of transformation and transgression into a new phase of life. The aim of this paper is to set out the processes identified in the course of functional-structural analysis of chosen studies and they comprise: (1) preservation of the sequence of the life course; (2) liminality: deconstruction, integration, and transformation; and (3) performativity. These processes provide a structural framework for understanding life crises, thus facilitating their study as phases of dynamic transformations connected with the successive roles and tasks over the life course.

Adaptive and maladaptive perfectionism, and professional burnout among medical laboratory scientists.

BACKGROUND: The goal of this paper is to verify the correlations between adaptive and maladaptive perfectionism and the selected demographic and job characteristics vs. professional burnout among medical laboratory scientists in Poland. MATERIAL AND METHODS: The study group consisted of 166 laboratory scientists. The Polish Adaptive and Maladaptive Perfectionism Questionnaire (Szczucka) was used for testing perfectionism. The Oldenburg Burnout Inventory was used for examining burnout syndrome. RESULTS: Adaptive perfectionism was positively and maladaptive perfectionism was negatively correlated with both aspects of professional burnout: the disengagement from work and exhaustion. What is more, maladaptive perfectionism was correlated negatively with age and work experience. People in relationships have a higher level of disengagement and a higher level of exhaustion than single ones. The results of hierarchical regression analyses have revealed, after having controlled selected demographic and job factors, that a significant predictor of disengagement is the high level of adaptive perfectionism and low level of maladaptive perfectionism. In addition, a significant predictor of high level of exhaustion is the low level of maladaptive perfectionism. CONCLUSIONS: Professional burnout among medical laboratory scientists is of a specific nature. The "healthier" perfectionism they reveal, the higher level of burnout they present. In this profession, lower risk of burnout is represented by those who are characterized by the lack of confidence in the quality of their actions and a negative reaction to their own imperfections associated with imposed social obligation to be perfect. The individuals pursuing their internal high standards experience burnout faster. Med Pr 2018;69(3):253-260.

Vulnerability of medical students and professionals to extreme work stress: A select review of the literature.

The goal of the paper is to describe the extent to which medical students and professionals are vulnerable to extreme stress. A select review of existing literature on this area has been undertaken, using the English-language online databases EBSCO, Medline and PubMed. The search has identified 36 citations relating to 6324 medical students and 28,285 medical staff (physicians, residents, nurses). The review indicates that merely beginning medical studies is a risk factor for stress, and that medical professionals, who are vulnerable to extreme work stress, say that they do not receive enough support from their co-workers. They are also often notably impulsive, introverted, neurotic and perfectionist, with low emotional intelligence and agreeableness, as well as low and external locus of control. Additionally, from longitudinal studies we have been able to identify psychological factors underpinning admission to a medical university that may be useful for predicting future stress in medical career. The results of this study may be taken into account when organizing psychological intervention programs targeted at educating future medical professionals. It seems that early identification of people at risk could reduce the impact of stress related to medical career and enhance the somatic and mental health of medical professionals.

The coping strategies during medical education predict style of success in medical career: a 10-year longitudinal study.

BACKGROUND: The stress associated with the physician's work is generally acknowledged and is related to well-being and life satisfaction. The presented study was designed to extract the role of coping strategies in identifying differentiated styles of success in a medical career during medical education. METHODS: The participants were examined when they applied to medical school and each subsequent academic year. The final study took place four years after graduation. The baseline questionnaire measured coping strategies. The follow-up questionnaire consisted of measures of: quality of life, work stress and burnout, satisfaction with medicine as a career, and professional competency. RESULTS: Based on coping strategies assessed during admission and preclinical years of medical study, some aspects of success in the participants' future medical career can be predicted. Students who take action and deal directly with a problem, neither accept resignation, nor reduce tension by expressing feelings would most probably resist future burnout. However, despite the fact that they obtain the highest quality of life or earn the highest income they would be, at the same time, the least satisfied with chosen career, as well as being more likely to be characterised by a low level of competence. CONCLUSIONS: Assessment of coping strategies at the beginning of medical education could be taken into consideration as an instrument to diagnose a specific trend in physicians' career development.

The sense of coherence and styles of success in the medical career: a longitudinal study.

BACKGROUND: Sense of coherence is related to well-being, stress and life satisfaction among medical students and physicians. The purpose of the study was to investigate relation between sense of coherence during medical education and styles of success in the medical career. METHODS: The participants were first examined when they applied to medical school in 1999. Questionnaires were given to these students each academic year from 2000 to 2005. Also, 54 medical doctors who had participated in the first phase of the study completed a questionnaire in 2009, four years after graduation. The baseline questionnaire measured the sense of coherence. The follow-up questionnaire included measures of quality of life, work stress and burnout, satisfaction with medicine as a career, and professional competency. RESULTS: Medical students with the highest sense of coherence later have the highest quality of life and income, and are the least overwhelmed by work stress, but they also show the least satisfaction with medicine as a career and a low level of professional competence. CONCLUSIONS: Antonovsky's SOC-29 questionnaire can be used to identify specific tendencies in the development of the medical career. Our results may be useful to medical school admissions officers and resident selection committees, in order to identify candidates at risk for failure.

[Burnout in medical profession--a literature review]. / Wypalenie zawodowe wsród personelu medycznego--przeglad literatury.

The goal of this paper is to present the latest trends and research reports on burnout syndrome among doctors and nurses. In the first part we present the most recent research tools used in the study of burnout among medical personnel. Then we present results by three areas: demographic factors, personality and coping styles, and finally organizational aspect of the work. Based on the presented literature we attempt to determine the profile of health care worker who is at highest risk of burnout syndrome. It seems that it would be worth to take under consideration medical students who are in risk group and to offer them some special psycho educational programs since the beginning of education.

Academic achievement, depression and anxiety during medical education predict the styles of success in a medical career: a 10-year longitudinal study.

AIM: Our study investigated the styles of success in the medical career in young physicians, in comparison with the same subjects examined 4-10 years earlier. METHODS: The participants were first studied when they applied to the medical university (1999). Questionnaires were sent to all students each year (2000-2005). Fifty-four medical doctors participated in the first phase of the study completed a questionnaire four years after graduation. The current questionnaire included measures of burnout, satisfaction with medicine as a career, quality of life (QOL) and postgraduate examination results. Previous questionnaires had included measures of academic achievement, depression and anxiety. RESULTS: We can describe three different styles of success, which can be predicted during medical education. Physicians with the best professional competence have the lowest income. However, physicians with the lowest professional competence gain the highest income. Those with the highest QOL (general well-being and life satisfaction) have the lowest professional stress and vulnerability to burnout. Anxiety and academic achievement (during the second and fourth year of study) are the significant predictors of specific style belonging. CONCLUSIONS: Our results may be useful to medical school admissions and resident selection committees to identify candidates at risk for less satisfaction or less competence.

Psychological factors determining success in a medical career: a 10-year longitudinal study.

BACKGROUND: Systemic review of predictors of success in medical career is an important tool to recognize the indicators of proper training. AIM: To determine psychological factors that predict success in a medical career. The success is defined as professional competence, satisfaction with medicine as a career, occupational stress and burnout and quality of life (QOF). METHODS: Part I (1999-2005), medical students were examined each subsequent year, beginning with admission. Assessment included academic achievement (high school final examination results, entrance exam results, academic results during medical school) and psychological characteristics (sense of coherence (SOC), depression, anxiety, coping styles, value system and need for social approval). Part II (2008-2009), the same participants completed an Internet survey 4 years after graduation. Results of the postgraduate medical exam were taken under consideration. RESULTS: Academic achievement predicts only professional competence. Coping styles are significant indicators of satisfaction with medicine as a career. SOC, while assessed with anxiety and depression during studies, enabled us to recognize future QOF of medical graduates. Professional stress is not predictable to such an extent as other success indicators. CONCLUSIONS: There are significant psychological qualities useful to draw the outline of the future job and life performance of medical graduates.