Problematic Internet Use, health behaviors, depression and eating disorders: a cross-sectional study among Polish medical school students.

BACKGROUND: Problematic Internet Use is defined as a use of the Internet which leads to various difficulties. The aim of this study was to check whether Problematic Internet Use is associated with health risks, such as: anti-health behaviors, depressive symptoms, abnormal body weight or eating disorders. METHODS: This cross-sectional study included 540 medical school students of Polish descent (83.5% females; 16.5% males), whose mean age was 22.49 years (SD = 5.20). The participants were asked to complete a questionnaire set, including the Problematic Internet Use Test, Juczynski's Health-Related Behavior Inventory, the Beck Depression Inventory, the Eating Attitudes Test and a self-designed demographic survey. RESULTS: Increased Problematic Internet Use scores were observed in male, full-time students, persons who use the Internet on the computer (compared to those who mostly use it on the phone), and those who go online mainly for entertainment purposes (compared to those who indicated another main purpose of using the Internet). 47.6% of the sample reported poor health behaviors, while 27.1% met the criteria of a depressive episode and 6.9% of an eating disorder. High risk of Problematic Internet Use was observed in 2.8% of the sample, particularly those who reported having more free time during the day, engaged in fewer health protective behaviors, manifested more severe depressive symptoms and scored higher on the Eating Attitudes Test. CONCLUSION: Such results indicate that students with Problematic Internet Use lead an unhealthy lifestyle and more often show symptoms of depression and eating disorders than students without Problematic Internet Use.

Sexual inhibition and sexual excitation in a sample of Polish women.

The contemporary concept of sexual counseling for women with sexual problems, distress, and female sexual dysfunction (FSD) includes tailored medical and/or psychological intervention. The dual control model and the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) are helpful for identifying risk factors and tailoring therapy for FSD. The current study aimed to (1) validate the Polish translation of the SESII-W in a sample of Polish women, and (2) verify the usefulness of the SESII-W in clinical practice. Five hundred nine white women age 18 to 55 years old (M ± SD age = 39.7 ± 11.3 years) were included in this cross-sectional study. Linguistic validation of the Polish translation of the SESII-W was first performed. A battery of tests was then used to evaluate reliability, convergent and discriminant validity, measurement invariances, and correlations between the SESII-W and other measures. Given that the original version of the SESII-W had unsatisfactory model fit, exploratory and confirmatory factor analyses were subsequently performed. Results showed a new final model that included 26 items with seven lower- and two higher-order factors and explained 58.9% of the variance in the data, with CFI = 0.93, RMSEA = 0.05 and χ2 = 693.39, p < 0.001. Cronbach's α was 0.77 for Sexual Excitation (SE) and 0.88 for Sexual Inhibition (SI) scales. A moderate negative association between SI and the presence of FSD according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria was noted. SE was positively associated with engaging in risky sexual behaviors, Extraversion and Openness to Experiences traits, and was negatively correlated with relationship quality. Finally, age was negatively correlated with all domains of the SESII-W except Arousal Contingency. SE and SI were both lower in older women as compared to younger once. These results demonstrate that the Polish version of SESII-W shows good psychometric properties. A higher propensity for SI was associated with the presence of sexual problems, distress, and FSD, whereas a higher propensity for SE was associated with greater engagement in risky sexual behaviors and personality type. However, future studies on larger and more diverse populations are required to confirm the replicability of the factor structure of the scale.

Sexual Inhibition and Sexual Excitation Scales in Men: Psychometric Properties of a Polish Adaptation.

The present study aimed to develop a Polish version of the Sexual Inhibition/Sexual Excitation Scale (SIS/SES-PL) and explore its psychometric validity in a sample of 498 men aged between 18 and 55 years. We used exploratory and confirmatory factor analyses to obtain the best model fit. Out of the 45 items in the original scale, 32 items with eight subscales and three higher-order factors: (sexual excitation [SES], sexual inhibition due to performance failure [SIS1], and sexual inhibition due to performance consequences [SIS2]) were included in the SIS/SES-PL. The SIS/SES-PL was found to have a good and satisfactory fit (comparative fit index = .87; Tucker-Lewis Index = .85; root mean square error of approximation = .054; χ2 = 1108.7; p < .001; test-retest reliability Cronbach's alpha = .93). A small correlation between age and the SIS1 and SIS2 scores was detected. However, forward multiple regression analysis revealed a significant correlation only between age and SIS1 [ß = .23, p < .001, R2 for model = .05; F(1, 494) = 27.52, p < .001]. Furthermore, a moderate correlation between SIS1 and SES2, as well as SIS1 and general inhibition properties (measured using the Behavioral Inhibition Scale), was noted. In the case of SIS2, only small effects were observed, with the highest values for engaging in risky sexual behavior. Out of the total number of 42 variables, a moderate correlation between SES and the following was described: importance of sex, hypersexual behaviors, frequency of masturbation, frequency of sexual activities per month, sexual risk-taking, high promiscuity (measured using the Sociosexual Orientation Inventory Revised-Drive), general activation properties (measured using the Behavioral Activation Scale), neuroticism, and erotophilic tendencies (measured using the Sexual Opinion Survey-Short Form). The results of the study allowed us to conclude that the SIS/SES-PL might be a useful tool for tailoring therapy for men with sexual problems, as well as in the field of clinical research on sexual inhibition and excitation. Furthermore, it is a reliable and useful tool for measuring propensities for sexual excitement and inhibition.

Sexual self-schema: a cognitive schema and its relationship to choice of contraceptive method among Polish women.

Objectives: The aim of the study was to examine sexual self-schema in women using different methods of contraception. Methods: Women (N = 560) aged 18-55 years were divided into two groups: those who used hormonal contraception (n = 285) and those who used non-hormonal contraception (n = 275). Participants were assessed using the Sexual Self-Schema Scale (SSSS), the Well-Matched Marriage Questionnaire and the Hospital Anxiety and Depression Scale and were also asked to fill in a structured questionnaire, giving information on their socioeconomic status, reproductive and medical history, sexual behaviours, psychosexual orientation, sexual experience and type of contraception used. Results: Women in the hormonal group scored lower on romantic, passionate and direct subscales of the SSSS, compared with women in the non-hormonal group. Of the total sample, 35% were classified as positive schematic. Women in the hormonal group were found to be more negative schematic and aschematic as well as less co-schematic compared with women in the non-hormonal group. Furthermore, women in the hormonal group were significantly less religious and perceived their self-evaluated weight to be higher compared with women in the non-hormonal group. Logistic regression revealed that negative schematic (odds ratio [OR] 6.6) and aschematic women (OR 3.7), as well as women with more deliveries (OR 1.6), were more likely to choose hormonal contraception. Conclusion: A sexual self-schema might be a relevant factor affecting the choice of contraceptive method. All women seeking hormonal contraception who are aschematic or negative schematic should consult with a sexual medicine specialist, because those individuals may have more profound reasons underlying their need for this type of contraception.

Body image during sexual activity in the population of Polish adult women.

INTRODUCTION: Recently it has been shown that body image during sexual activities is a better predictor of the diversity of sexual experience than body image as a psychological trait. To measure contextual body image (as a state) the Body Exposure During Sexual Activity Questionnaire (BESAQ) was developed. MATERIAL AND METHODS: 845 women aged 18-55 years were included in the study. The original model was first translated into Polish and consulted to create the version to be further validated. The original model was tested using confirmatory factor analysis (CFA). The population was divided in two equal groups - group 1 was used for exploratory factor analysis. Discriminant and convergent validity were checked. Sexual function was assessed by the Changes in Sexual Function Questionnaire. RESULTS: The Polish model of BESAQ (BESAQ-PL) consisted of 28 items with 2 lower-order factors. It had a satisfactory goodness of fit - comparative fit index (CFI) = 0.93, Tucker-Lewis index (TLI) = 0.94, root-mean-square error of approximation (RMSEA) = 0.06 and χ2 = 1360.0, df = 337, p< 0.001, excellent internal consistency measured by Cronbach's α = 0.88 and satisfactory discriminate validity. State body image (BESAQ-PL) did not predict sexual functioning. Face was the most important for self-consciousness during sexual contact in the population of Polish women. CONCLUSIONS: State body image correlates with sexual functions but is not a major factor influencing sexual performance. Women in Poland are not anxious about body exposure during sexual activity. The BESAQ-PL may be used in the population of Polish women between 18 and 55 years of age.

Sexual Self-Schema Scale for Women-Validation and Psychometric Properties of the Polish Version.

INTRODUCTION: The sexual self-schema is a part of a broader concept of the self that is believed to be crucial for intrapersonal and interpersonal sexual relationships. AIM: To develop and perform psychometric validation of the Polish version of the Sexual Self-Schema Scale for Women (SSSS-W-PL). METHODS: 561 women 18 to 55 years old were included in the final analysis. Linguistic validation was performed in 4 steps in line with the MAPI Institute guidelines. Convergent validity was calculated using the Pearson r product-moment coefficient between different measures of sexuality (attitudes and experience, behavior, arousal, romantic relationship) and SSSS-W-PL total and factor scores. To test discriminant validity, we applied hierarchical regression analyses predicting the number of lifetime sexual partners, self-rating as a sexual person (1 item, "I feel sexually attractive"; on a 5-point Likert scale), and arousability, with independent variables being extraversion (Ten-Item Personality Inventory), self-esteem (Rosenberg Self-Esteem Scale), and the SSSS-W-PL (total and factor scores). MAIN OUTCOMES MEASURES: Sexual self-schema was measured by the SSSS-W-PL, whereas arousability was measured by the arousal/excitement scale of the Changes in Sexual Functioning Questionnaire. RESULTS: The mean age of the study population was 29.0 ± 7.6 years. The final scale consisted of 24 adjectives grouped within 4 factors: romantic, passionate, direct, and embarrassed. The 4-factor model accounted for 39% of the variance. The Cronbach α was 0.74 for the SSSS-W-PL total score and 0.61 to 0.84 for individual factors. Test-retest reliability of the scale after 2- to 8-week intervals was 0.87 (95% CI = 0.82-0.86, P < .001). The increment variances were statistically significant and ranged from 3.8% to 11.6%. CONCLUSION: The analysis showed good psychometric properties and internal validity of the SSSS-W-PL. The SSSS-W-PL might be helpful in consulting and/or providing sexual therapy to gynecologic cancer survivors or women with a history of childhood sexual abuse. Nowosielski K, Jankowski KS, Kowalczyk R, et al. Sexual Self-Schema Scale for Women-Validation and Psychometric Properties of the Polish Version. Sex Med 2018;6:131-142.

Personality traits, gender roles and sexual behaviours of young adult males.

BACKGROUND: Previous studies have shown that personality characteristics affect sexual functioning. The aim of this exploratory study was to assess and describe the relationship between global personality traits and the stereotypical femininity and masculinity levels with the broad aspects of sexual behaviours and attitudes in the group of 97 heterosexual young adult men aged 19-39 and living in Poland. METHODS: The 'Big Five' personality traits were measured with the NEO-FFI questionnaire; stereotypical femininity and masculinity with the Bem sex role inventory (BSRI); sexual disorders with the International index of erectile function (IIEF); socio-epidemiological data, sexual behaviours and attitudes towards sexuality with a self-constructed questionnaire. RESULTS: We identified weak to moderate associations with particular sexual behaviours and attitudes. Neuroticism correlated positively with lower sexual satisfaction, self-acceptance and more negative attitudes towards sexuality; extraversion with higher desire, frequency of sexual intercourses, their diversity, sexual satisfaction, masculinity level and lower report of erectile problems; openness to experience with better quality of partnership, more positive attitudes towards sexual activity and masculinity level; conscientiousness with later sexual initiation age, more frequent and diverse sexual behaviours (but lower interest in masturbation and coitus interruptus), overall sexual satisfaction, satisfaction with one's body and femininity level; agreeableness with a better quality of relationship with a partner, satisfaction from body, lower number of previous partners and more frequent sexual encounters (but less masturbation). Stereotypical masculinity, more so than femininity, was related to a wide range of positive aspects of sexuality. CONCLUSIONS: The Big Five personality traits and stereotypical femininity/masculinity dimensions were found to have a noticeable, but weak to moderate influence on sexual behaviour in young adult males.

Pharmacy switch of antipsychotic medications: patient's perspective.

BACKGROUND AND AIM: Several studies have raised concerns over consequences of brand-to-generic and generic-to-generic pharmacy-generated medication substitutions in psychiatric and non-psychiatric patients. The purpose of this retrospective study was to assess behavioral and emotional responses of patients with schizophrenia to antipsychotic medication substitution performed by pharmacies. METHODS: A group of Polish ambulatory patients with schizophrenia (n = 196) chronically treated with antipsychotic medications were asked whether antipsychotic medication substitution had been proposed by a pharmacist in the last 12 months. Ninety-nine patients answering positively were administered more questions addressing the patient's emotional and behavioral response to the pharmacy proposal. RESULTS: The most important findings of the present study can be summarized as follows: (1) approximately half of the patients were confronted with a pharmacy proposal to switch their antipsychotic medications in the last 12 months, (2) one quarter of these patients did not accept the pharmacy switch, (3) a substantial proportion of patients (>40 %) did not receive any explanation from a pharmacist offering medication substitution, (4) pharmacy-generated substitution proposals were mainly associated with negative patient attitudes and negative emotional responses, (5) substitution proposals provoked an unscheduled psychiatric visit in approx. 10 % of patients, (6) despite the negative attitudes reported by patients, the pharmacy switch rarely led to treatment discontinuation, but did provoke a change in drug dosing in 7 % of patients accepting the switch. CONCLUSIONS: A pharmacy proposal to switch their antipsychotic medications is a relatively common experience of Polish ambulatory patients with schizophrenia. Pharmacy-generated substitution proposals are mainly associated with negative patient attitudes, but rarely lead to antipsychotic treatment discontinuation in this group of patients.