Internalization of athletic body ideal as a mediating variable between family influence and body image of young women. A cross-cultural study of polish, Italian, and Ukrainian women.

Introduction: Our aim was to analyze the strength of the family's influence on the internalization of the ideal of an athletic figure and, consequently, on the multifactorial image of the body, from the perspective of intercultural differences. Methods: A total of 488 healthy women aged 19-26; of Polish (154), Ukrainian (228), and Italian (106) took part in the study. The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4) and the Multidimensional Body-Self Relations Questionnaire (MBSRQ 69) were used to measure athletic ideal internalization and family pressure. The body image of Ukrainian, Polish, and Italian women depends both on the degree of internalization the ideal of an athletic figure and influence of the family. Results and Discussion: The research also suggests significant differences between the three populations, which may suggest cultural differences between young women living in Eastern, Central, and South European countries.

Quality of Life and Depressive Symptoms in Transcatheter Aortic Valve Implementation Patients-A Cross-Sectional Study.

Quality of life is an important factor influencing mood. In any group of elderly people undergoing valve implementation or surgical aortic valve replacement, one in three will have depressive symptoms. The aims of this study were as follows: 1. to evaluate the impact of health-related quality of life on depressive symptoms in elderly patients undergoing TAVI, and 2. to analyze beliefs about TAVI. Methods: A total of 131 elderly people (mean age: 82.1 ± 6.1 years) scheduled to receive TAVI completed the Geriatric Depression Scale, EQ-5D-3L, and Mini Mental State Examination. A total of 43 patients completed the questionnaires after the treatment. The narrative interview analyses were performed based on 20 randomly selected patients after TAVI. Results: The mean level of general depression before TAVI was 4.19 ± 2.83, and after it was 3.12 ± 2.52 (p = 0.02), and the frequency decreased from 20% to 3%. An increase in the level of activity and number of interests and a decrease in life satisfaction were identified. The higher the general quality of life was, the lower the levels of depressiveness before and after TAVI were (r = 0.26 vs. r = 0.48; p < 0.05). Conclusions: Patients differed in their depressive symptoms, as well as their intensity and frequency, before and after TAVI. These results underscore the importance of screening for depression at baseline and reassessing changes in depressiveness during follow-up.

Involvement of the cerebellum in the regulation of executive functions in children-Preliminary analysis based on a neuropsychological study of children after cerebellar tumour surgery.

Aim: Preliminary assessment of executive functions in children with cerebellar lesions, description of their emotional-social functioning and selection of sensitive neuropsychological tools to detect the cerebellar cognitive affective syndrome (CCAS). Materials and methods: The study group consisted of 10 children after cerebellar tumour surgery. The control group consisted of 10 healthy children, matched for age and sex: The IDS-2 executive functions battery, the Conners 3 ADHD questionnaire, the Autism Spectrum Rating Scales (ASRS) and the International Cooperative Ataxia Rating Scale (ICARS) were used. Results: Statistical analysis showed statistically significant differences between the experimental and control groups in terms of two dimensions of executive functioning. Children from experimental group was characterised by worse planning and divided attention than healthy controls. Moreover children with cerebellar lesions were characterised by significantly higher levels of some behaviours similar to that observed in autism spectrum disorders, namely difficulties in social relationships, self-regulation of emotions, attention, and greater behavioural rigidity. Test power analysis and estimation of the effect size by the Cohen's d coefficient indicated that with a slight increase in the size of the experimental group, the probability of detecting statistically significant difference in the executive functions total measure score as well as in several ASRS subscales increased, but not in Conners 3 subscales. Conclusions: Cerebellar damage may pose a risk for dysexecutive syndrome and social-emotional problems in children. The IDS-2 executive functions battery and the ASRS test are sufficiently sensitive tools to assess elements of the CCAS in children.

Problem Drinking Scale (PDS) - psychometric characteristics. / Skala Picia Problemowego (SPP) ­ wlasciwosci psychometryczne.

OBJECTIVES: The presented study aims at checking and demonstrating the psychometric characteristics of the new tool - the Problem Drinking Scale (PDS), which is used for quantitative and qualitative analysis of alcohol use disorders conceptualized according to DSM-5. METHODS: 08 adults with different levels of alcohol consumption were examined, including 91 individuals recruited in addiction treatment clinics. The remaining persons, with different socio-demographic characteristics, were recruited using the snowball method. Validity of the scale was assessed by correlating the obtained results with the AUDIT (Alcohol Use Disorder Identification Test), while reliability was assessed by internal consistency analysis. RESULTS: The presented analysis demonstrates high validity and reliability in most areas, which means that the PDS is a tool that can be used in clinical practice. Criterion validity was calculated by correlating PDS results with the AUDIT (r = 0.88, p < .01). The results in particular areas range from r = 0.86 (Difficulty in controlling drinking) to r = 0.77 (Pharmacological dependence). Reliability was calculated using the split-half method, individual values of Cronbach's alpha coefficients with the Spearman-Brown correction vary in specific areas from 0.89 (Difficulty in controlling drinking) to 0.65 (Risky use of substances). In none of the areas the results were lower than 0.60. CONCLUSIONS: The PDS is a useful research tool for quantitative and qualitative analysis of alcohol use disorders. This scale is helpful in making a full and accurate clinical diagnosis taking into account the severity of the disorder and in monitoring changes in the treatment process.

Personality characteristics of empathy profiles - practical implications for education of medicine students.

BACKGROUND: Empathy plays the key role in the doctor - patient relationship. The research of empathy determinants plays an important role in formulating practical guidelines for the education of medical students. The aim of this study was to analyse personality characteristics of empathy profiles among students of medicine, with consideration of chief personality factors and their subdimensions according to the FFM model. METHODS: During workshops in Clinical Psychological Skills, 153 students (M = 57, F = 96; mean age 23 years) analysed their psychological functioning styles by examining their personality profiles and empathy indicators. Empathic Sensitiveness Scale (ESS) and Personality Inventory (NEO-PI-R) were applied for this purpose. The analyses of empathy indicators were presented by means of cluster analysis. Variance analysis with post hoc Tukey-b test was performed for differences between clusters and to differentiate between personality factors and their components in empathy clusters. This study was approved by the Jagiellonian University Bioethics Committee (approval number: 1072.6120.175.2018 date: 28.06.2018). RESULTS: The first cluster included students who presented high empathetic concern for others, understood their perspective and needs characterised by medium level of Neuroticism, high levels of other dimensions The second group included students who could understand others very well, yet with lower tendency to react emotionally to suffering, characterised by medium level of Neuroticism, Extraversion, Openness, high Conscientiousness and low Agreeableness. The third cluster included students who react strongly to painful and unpleasant reactions of others, characterised by high Neuroticism and Agreeableness, low Extraversion. CONCLUSIONS: Each empathy profile is manifested in relations with patients in a specific way. Medical education in empathy holds great potential to reduce anxiety, stress, and burnout associated with the medical profession. Discussion of individual results with students, gives an opportunity to talk about how their empathy and personality characteristics may influence their everyday medical practice.

Comparison of cognitive functioning of elders with late-life depression and patients with and without a history of depressive episodes: a cross-sectional study.

Nowadays there are numerous studies on the occurrence of cognitive dysfunction in late-life depression (LLD). The role of executive dysfunctions in the psychopathology of depression is particularly emphasized and needs further examination. The aim was to assess cognitive functions and their relation to depressive symptoms in elders with LLD, previously depressed, and patients without the history of depressive episodes. The study consisted of 824 older adults who underwent a neuropsychological evaluation (97 currently depressed, 114 previously depressed and 613 patients without the history of depressive episodes). LLD patients performed poorer in ACE-III and AVLT and poorer in TMT-B than those previously depressed and never depressed. The LLD group also performed significantly poorer than the previously depressed on Digit Span Forward. Results of a multiple regression analysis indicated that performance on measures of executive functioning was associated with depression severity in LLD (ß =.227, P =.024). The results of this study suggest that executive functions are the most impaired in the elderly with LLD. Furthermore, there is a relationship between executive dysfunction and the severity of depression in LLD. Executive dysfunction appears to be the core neurocognitive deficit in LLD.

Subjective experience, cognitive functioning and trauma level of patients undergoing awake craniotomy due to brain tumor - Preliminary study.

BACKUP AND OBJECTIVE: Awake craniotomy (AC) for brain tumors, when the patient is conscious during the operation, allows to reduce the risk of motor disability and aphasia, however, it may be a source of extreme stress. The aim of our study was to examine the patients' subjective experience of the surgery including the level of psychological trauma and cognitive functioning. METHOD: Eighteen patients operated due to brain tumor were enrolled in this study. The Essener Trauma-Inventory Questionnaire and the Addenbrooke's Cognitive Examination (ACE III) were administrated. The patients' experience with awake craniotomy was evaluated with a qualitative descriptive survey. RESULTS: All patients remembered the intraoperative neuropsychological examination and several sensations like: drilling, cold, head clamp fixation or having eyes covered. In most of the patients the postoperative psychological trauma experience did not reach the clinical level. The ACE III postoperative scores revealed partial cognitive deficits with the lowest scores in memory and word fluency domains. Slight amnestic aphasia was observed postoperatively only in two patients. CONCLUSIONS: Awake craniotomy for resection of brain tumors is well-tolerated by patients and does not cause significant psychological trauma. Nonetheless, anxiety about the procedure warrants further study and individualized neuropsychological care is needed for the emotional preparation of the patient.

Is Addenbrooke's Cognitive Examination III Sensitive Enough to Detect Cognitive Dysfunctions in Patients with Focal Cerebellar Lesions?

OBJECTIVE: The main aim of the study was to evaluate whether the available brief test of mental functions Addenbrooke's cognitive examination III (ACE III) detects cognitive impairment in patients with cerebellar damage. The second goal was to show the ACE III cognitive impairment profile of patients with focal cerebellar lesions. METHOD: The study sample consisted of 31 patients with focal cerebellar lesions, 78 patients with supratentorial brain damage, and 31 subjects after spine surgery or with spine degeneration considered as control group, free of organic brain damage. The ACE III was used. RESULTS: Patients with cerebellar damage obtained significantly lower results in the ACE III total score and in several subscales: attention, fluency, language, and visuospatial domains than healthy controls without brain damage. With the cut-off level of 89 points, the ACE III was characterized by the sensitivity of 71%, specificity of 72%, and accuracy of 72%. The cerebellar cognitive impairment profile was found to be "frontal-like" and similar to that observed in patients with anterior supratentorial brain damage, with decreased ability to retrieve previously learned material and its preserved recognition, impaired word fluency, and executive dysfunction. The results are consistent with cerebellar cognitive affective syndrome. CONCLUSIONS: The ACE III can be used as a sensitive screening tool to detect cognitive impairments in patients with cerebellar damage.

Cerebellar Functional Lateralization From the Perspective of Clinical Neuropsychology.

Objective: The cerebellar functional laterality, with its right hemisphere predominantly involved in verbal performance and the left one engaged in visuospatial processes, has strong empirical support. However, the clinical observation and single research results show that the damage to the right cerebellar hemisphere may cause extralinguistic and more global cognitive decline. The aim of our research was to assess the pattern of cognitive functioning, depending on the cerebellar lesion side, with particular emphasis on the damage to the right cerebellar hemisphere. Method: The study sample consisted of 31 patients with focal cerebellar lesions and 31 controls, free of organic brain damage. The Addenbrooke's Cognitive Examination ACE III and the Trail Making Test TMT were used to assess patients' cognitive functioning. Results: Left-sided cerebellar lesion patients scored lower than controls in attention and visuospatial domain, but not in language, fluency, and memory functions. Participants with right-sided cerebellar lesion demonstrated a general deficit of cognitive functioning, with impairments not only in language and verbal fluency subscales but also in all ACE III domains, including memory, attention, and visuospatial functions. The TMT results proved that cerebellar damage is associated with executive function impairment, regardless of the lesion side. Conclusion: The cognitive profiles of patients with cerebellum lesions differ with regard to the lesion side. Left-sided cerebellar lesions are associated with selective visuospatial and attention impairments, whereas the right-sided ones may result in a more global cognitive decline, which is likely secondary to language deficiencies, associated with this lateral cerebellar injury.

Differences in personality related determinants of empathetic sensibility in female and male students of medicine.

The issues of personality and its relations with the level of empathetic sensibility of medical doctors are broadly discussed in the literature. The aim of this study was an assessment of personality related predictors of empathy indicators in female and male students of medicine with consideration of gender differences. Methods applied were Empathic Sensitiveness Scale (ESS) and Personality Inventory (NEO-PI-R). The study included 153 participants, who were students of the fifth year of medical studies. Students filled in questionnaires during workshops in clinical psychological skills. Participation in the study was voluntary and anonymous. The statistical analysis was performed using Statistica 13 PL and PS IMAGO PRO (SPSS). Linear regression analysis with the interaction component was performed to explore the relationship between personality factors and gender and their interaction with the variable dependent level of empathy. The analysis showed that Extraversion, Openness and Agreeableness are associated with the level of Empathic Concern. Neuroticism, Extraversion, Agreeableness and Conscientiousness are associated with the level of Personal Distress. Extraversion, Openness, Agreeableness and Conscientiousness are associated with the level of Perspective-taking. The regression analysis with the interactive component showed that there is no relationship between gender and the level of empathy, therefore the interactions were insignificant. Empathetic sensibility is related to personality dimensions of the students of medicine. Although there has been no interaction among chief personality dimensions, empathy indicators and gender, detailed analysis of personality dimensions' components has shown differences between men and women.

Backstage of Eating Disorder-About the Biological Mechanisms behind the Symptoms of Anorexia Nervosa.

Anorexia nervosa (AN) represents a disorder with the highest mortality rate among all psychiatric diseases, yet our understanding of its pathophysiological components continues to be fragmentary. This article reviews the current concepts regarding AN pathomechanisms that focus on the main biological aspects involving central and peripheral neurohormonal pathways, endocrine function, as well as the microbiome-gut-brain axis. It emerged from the unique complexity of constantly accumulating new discoveries, which hamper the ability to look at the disease in a more comprehensive way. The emphasis is placed on the mechanisms underlying the main symptoms and potential new directions that require further investigation in clinical settings.

Changes in cognitive functions and quality of life in patients after transcatheter aortic valve implantation.

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has emerged as a therapeutic option for patients with severe aortic stenosis (AS). However, an association between cognitive functions (CF) and health-related quality of life (HRQoL) in TAVI patients is still unclear. AIM: To assess the long-term changes in CF and HRQoL in elderly patients with AS after TAVI. MATERIAL AND METHODS: A total of 259 patients who underwent cardiological and psychological TAVI qualification were enrolled and divided into the normal (n = 174) and impaired cognition group (n = 85). CF and HRQoL characteristics assessed at baseline and 13 months were compared between groups. The analysis of multiple linear regression was performed to identify the association between HRQoL and CF and to assess the influence of TAVI on HRQoL. RESULTS: There was no difference in CF between baseline and follow-up. However, an improvement in attention functions and memory skills in the cognitively impaired group was noted at follow-up. In addition, HRQoL scores increased in both groups. An independent predictor associated with HRQoL was global CF (ß = -213, p = 0.01), which explained 7% of CF variation. Improvements in all five dimensions of HRQoL, from 4.8% in self-care and up to 33.6% in pain/discomfort, were found. At follow-up, 60% of TAVI patients had improved health, 12% had worse health, 4% showed no change and 24% had a "mixed" change. CONCLUSIONS: TAVI is associated with positive changes in the functioning of elderly patients at long-term follow-up.

[Clinical and demographic predictors of mild cognitive impairment - cross-sectional study].

OBJECTIVE: Introduction: Cognitive limitations are a serious health and social problem, which concerns elderly people. Effective prevention and treatment of cognitive dysfunction is one of the challenges of modern medicine. There is not enough consistent data in the literature to indicate to indicate the relationship between various clinical and demographic factors with cognitive functioning in different age ranges. The aim: To analyze clinical and demographic predictors of mild cognitive impairment by age group. PATIENTS AND METHODS: Material and methods: The analysis included 817 participants (669 with normal cognitive function and 148 people with MCI). The evaluation of the level of depressive symptoms was measured by the Short Form Geriatric Depression Scale. All participants were screened for cognitive functioning using the Mini-Mental State Examination and Addenbrooke's Cognitive Examination-III. Different cognitive domains were evaluated with different neuropsychological tools: the Rey Auditory Verbal Learning test, Clock Drawing test, Verbal Fluency test, Digit Span Test and Trail Making test. RESULTS: Results: It has been shown that independently associated with MCI ware age (OR = 1.09, 95% CI: 1.05-1.13) and level of education (OR = 0.75, 95% CI: 0.69-0.81). Depending on the age, it turned out that in the younger MCI group, age, education and depression were significant, and the age and level of education were significant in the older MCI group. CONCLUSION: Conclusions: The identification of cognitive dysfunctions is an important element of the diagnostic and therapeutic process.

Profiles of empathic sensitivity in students of the last year of medicine.

Developing the empathic attitude is one of the tasks of medical education as it affects the quality of therapeutic contact in the relationship between the doctor and the participant, conditioning the treatment process. According to Davis's concept, empathy is defined as an affective-cognitive reaction in the context of the other person's experience. AIM: Analysis of profiles of empathic sensitivity in students of medicine. Group: Male and female students of the fifth year of medicine who agreed to participate in an anonymous study (n = 153; M = 57, F = 96; mean age: 23 years). Tools: The Empathetic Sensitivity Scale (EES), which is the Polish tool for Davis's Interpersonal Reactivity Index (IRI) was used. The ESS includes three sub-scales: Empathic Care (EC), Personal Distress (PD) and Adopting Perspective (AP). RESULTS: The raw results were converted into sten scores and for sten scores for all three dimensions of empathetic sensitivity no differences were found between male and female students. Three clusters (1: n = 33%, 2: n = 39%, 3: n = 28%), which differ in terms of each distinguished indicator, were identified. CONCLUSIONS: The first cluster characterizes empathetic people, both in the affective and cognitive spheres, and those dealing well with unpleasant emotions in situations difficult to others. The second cluster characterizes participants with the ability to recognize the needs of others and to take into account their perspectives; the third cluster includes participants with a tendency to focus on own experiences emerging in response to other people's suffering but with the ability to understand a situation and show empathic concern for the other person. The most favourable profile - for a future doctor as well as for his participants - is the first cluster because the doctor, with his empathic sensitivity directed towardsthe other man, can deal with his own unpleasant emotions.

Main communication barriers in the process of delivering bad news to oncological patients - medical perspective.

Delivering bad news is a major aspect of a doctor's work. The literature most often refers to patient's expectations or needs, and methods of delivering bad news, while medical perspective is often skipped. The purpose of this paper is to examine competencies (knowledge, skills and experience) in delivering bad news by medical specialists in the areas related to the causal and symptomatic treatment of oncological patients; identification of major communication problems and obstacles in this specific situation and evaluation of teaching needs for delivering bad news. The study was performed on a group of 61 medical specialists in the areas related to the causal and symptomatic treatment of oncological patients, using a self-generated questionnaire based on other studies in the literature. Topics that are considered most demanding are: delivering news on the termination of causal treatment and preparing the patient/ close ones for death. The most difficult aspect of such discussions for the respondents was associated with the emotions manifested by the patient. On the other hand, doctors were mostly distressed by the feeling of taking the patient's hope away. The study points to the need for education of doctors in the eld of techniques for delivering bad news, particularly in the area of dealing with the emotions manifested by the patient and giving them real hope. The results encourage to conduct studies on a larger group of doctors.

Psychooncology in Poland. / Psychoonkologia w Polsce.

Psycho-oncology is an interdisciplinary field of medicine that deals with the psychological aspects of cancer. Psycho-oncology is a sub-discipline of clinical oncology, psychiatry, clinical psychology and health psychology. It was formally established in 1975. In Poland, the Polish Psycho-Oncology Association deals with the issues of psycho-oncology since 1992. Despite the dynamic development of psycho-oncology, in Poland psychological help for people with cancer covered under the health insurance is not sufficient. The main tasks facing the Polish psycho-oncology is: to define psycho-oncologist profession and to make it administratively independent profession, to identify psycho-oncological benefits under the health insurance and to determine standards of psycho-oncological care in the National Program of Cancer Prevention.

[Cancer patients expectations of their doctors].

The evaluation of expectations of patients is one of the elements of evaluation of patient's satisfaction from the received medical services. The degree to which these expectations are met determinates the level of patient's motivation to complete doctor's orders and undertake actions aiming the diagnostic and therapeutic process. Cancers as diseases of affluence are a significant clinical and social issue. In the context of holistic patient care the research of cancer patient's expectations are of special importance. The aim of the work is to present definitions and types of expectations that the cancer patients have of their doctors and the methodology of research in this field. The work was performed on basis of analysis of publications found in MEDLINE , EMBASE, PsycINFO, Web of Science databases and concerning results of research of patient's expectations. First part of the article discusses the definitions and type of patient's expectations of doctors. Then the begins of research on the expectations of patients were described, including the input of Polish authors in this field. Then we moved on to discuss research evaluating the expectations of cancer patients. In comparing the different researches we conclude, that the cancer patients declare their need of support and expect information regarding their treatment. What those expectations require from the doctors, is the development of communication skills that are adjusted to the situation on every stage of the diagnostic and therapeutic processes as well as knowledge of the ways the patients can cope with their disease.

[Personality in the big five model and maintaining abstinence after one year follow-up]. / Osobowosc w Modelu Wielkiej Piatki a utrzymywanie abstynencji od alkoholu przez rok od rozpoczecia leczenia.

AIM: To compare Five-Factor personality traits in patients maintaining abstinence and relapsed patients (i.e. those who relapsed within a year after treatment), following eight weeks of in-house treatment and three months of out-patient treatment. METHOD: In longitudinal studies, a sample of 190 patients was analysed (49 females and 141 males; mean age: 43). The patients participated in therapeutic programmes at several addiction treatment centres across Poland. Personality traits were measured using the NEO PI-R inventory proposed by Costa and McCrae (adapted into Polish by Jerzy Siuta) at the initial stage of the treatment. Abstinence was assessed based on the interview. RESULTS: As far as the main traits are concerned, abstinent patients have higher levels of Agreeableness and Conscientiousness than patients who relapsed within a year following the therapy. Moreover, they are characterised by higher levels of constituent traits: Straightforwardness, Ideas and Altruism, as well as higher levels of Order, Self-Discipline and Dutifulness. However, their levels of Hostility are lower compared to patients not maintaining abstinence. CONCLUSIONS: After one year follow-up, the group maintaining abstinence is characterised by a higher Agreeableness and Conscientiousness, which is beneficial for cooperation with others as well as undertaking and realising tasks. Moreover, lower constituent values of Neuroticism are linked to higher adaptability and greater therapy participation than in a relapsed group. An early identification of patients bearing traits linked to lower adaptability will decrease the possibility of relapse thanks to making a greater effort at enhancing treatment participation while paying special attention to any co-existing psychopathology.

[Anxiety and body image among women growing up in families with addiction problem]. / Lek a obraz wlasnego ciala u kobiet dorastajqcych w rodzinie z problemem uzaleznienia.

AIM: The aim of the study was to analyse the correlation between body image and anxiety symptoms as well as psychological discomfort experienced by women growing up in alcoholic families. METHOD: The group of 61 women (27 years old on average) was surveyed with Body Self Questionnaire and MMPI-2 personality test questionnaires and the results were measured on Scale 7 (Pt). All the participants also attended psychotherapy sessions focused on disorders resulting from growing up in families with alcohol problems. RESULTS: The analysis showed negative correlation (p < 0.05) between the results of Scale 7 (Pt) and one's body acceptance (r = -0.44), attitude to eating (r = -0.3), femininity disclosure (r = -0.28)and the experience of intimate relations (r = -0.27). CONCLUSIONS: The study showed that disordered body image is related to the symptoms described by Scale 7 (Pt): tendency to react with fear, worriment, stronger discomfort in social situations, fear of rejection, difficulties in interpersonal relations, poor self-confidence as well as perfectionism and tensed behaviour. A crucial factor that could improve the effectiveness of therapies for women from alcoholic families appears to be an attempt to combine the experience of oneself in physical and emotional spheres, as well as functioning cognitive schemes.