Validation of the greek version of the Young Schema Questionnaire-Short Form 3: Internal consistency reliability and validity.

Schema therapy (ST) is an integrative therapy, which combines elements of cognitive behavior therapy, attachment theory, object relations theory and emotional-focused models. Schema therapy is an effective treatment for patients with personality disorders and other chronic psychological disorders. Early Maladaptive Schemas (EMSs) are a main concept in schema theory referring to self-defeating, core themes or patterns. They develop as a result of traumatic or toxic childhood experiences and the frustration of the core emotional needs in childhood. To date 18 EMSs have been identified and grouped into five higher order structures, known as domains. For the evaluation of the EMSs, Young developed a self-report inventory, the Young Schema Questionnaire (YSQ). There are two forms of the YSQ, the Young Schema Questionnaire - Long Form 3 (YSQ-L3) a 232-item inventory and the Young Schema Questionnaire - Short form 3 (YSQ-S3), a 90-item inventory, which is a subset of the Long form. The aim of this study was to validate the Greek Version of the YSQ-S3. A non-clinical sample of 1,236 undergraduate students completed the YSQ-S3 and 124 patients with Axis-I, Axis II or comorbid diagnosis, completed the YSQ-L3. Moreover, both samples completed the second part of the Adults Self Report (ASR). Internal consistency reliability, discriminative, convergent and predictive validity were examined. The internal consistency reliability of the schema factors was satisfactory with a Cronbach's alpha coefficient of 0.70 or above, for all factors in both student's and clinical sample. The effect sizes were high for most of the scales, regarding the differences between clinical and non-clinical sample. Emotional Deprivation, Vulnerability to harm or Illness, Subjugation, Social Isolation/Alienation and Defectiveness/Shame had the highest effect sizes in the clinical sample and in the non-clinical sample according to whether they had ever visited a mental health specialist. This may suggest that these EMSs are more sensitive and useful markers of psychological problems. In addition, patients with Axis II pathology scored significantly higher on Emotional Deprivation, Abandonment, Mistrust/Abuse, Social Isolation/Alienation compared to patients with only Axis I pathology. This finding is consistent with Schema theory, as these EMSs are associated with earlier in life traumatic experiences and insecure attachment and lie in the core of personality pathology. YSQ-S3 factors were significantly correlated with all ASR dimension and linear regression analysis showed that certain EMSs could predict Depressive and Anxiety problems. In total, the greek version of the YSQ-S3 showed good reliability and validity.

Predictors and characteristics of anxiety among adolescent students: a Greek sample.

In the Greek society, there is a strong cultural tendency to overestimate the value of University studies. So students are under high emotional pressure during the long lasting period of the preparation for the university entrance exams. The aim of the present study was to evaluate the level of anxiety in a general adolescent population of senior high school students in Athens, Greece. Also to examine the association between the anxiety's severity with various demographic and socio-cultural factors, as well as with academic performance, extracurricular activities, sleep duration and presence of somatic problems. The sample consisted of 696 adolescent students of three Senior High Schools (SHS) (391 girls and 305 boys). Two of the schools were general education institutions (GE1 and GE2, N=450), while the third was a technical one (TE, N=246). The school sample was selected to reflect the proportion between the two different types of SHSs in Athens as well as other major urban areas in Greece. The State-Trait Anxiety Inventory was administered and personal data were also collected. Statistical significance was set at p<0.05 and analyses were conducted using STATA 7.0. 567 adolescents lived with both parents and 121 with one or none of them. Father's educational level was low for 138, middle for 154, high for 195 and mother's was low for 135, middle for 417, high for 140. The average sleep duration was 7.5 hours per day (SD=1.3). The average time per week spent in school related activities was 7.94 hours (SD=7.56) and in extracurricular activities was 9.02 hours (SD=12.44). 107 adolescents reported somatic complaints in the last year The academic achievement was poor for 233, good for 264, excellent for 196 students. Adolescents with extracurricular activities for more than 11 hours per week had lower scores, both on State and Trait scales. More hours in school-related activities were associated with greater levels of Trait anxiety. Adolescents whose father had a high educational level had lower scores on State anxiety compared to those whose father had a low educational level. Adolescents who reported the presence of somatic problems had a higher score in Trait anxiety. A significant negative correlation was found between sleep duration and both State (r=-0.14, p<0.001) and Trait anxiety (r=-0.10, p=0.008) scores. Stepwise linear regression analyses confirmed the association of gender and of father's educational level with both State and Trait subscale scores. The association of somatic problems with Trait anxiety was greater for girls compared to boys. The hypothesis that there is exam-related anxiety in our sample was not confirmed. There were no differences between school years and GE and TE schools. Also there was not an association of anxiety level with academic achievement and the number of parents the adolescent was living with. This study shows that girls, especially those reporting somatic problems, and adolescents coming from families with low parental education, are particularly prone to higher level of anxiety and that extracurricular activities are linked to lower level of anxiety. These findings could contribute to the planning of preventive measures for student's anxiety.

Compliance with a healthy lifestyle in a representative sample of the Greek population: preliminary results of the Hellas Health I study.

OBJECTIVES: To investigate lifestyle health behaviours, such as smoking, physical activity, weight status and dietary habits, in a representative sample of the adult Greek population. STUDY DESIGN: Cross-sectional, household interviews (Hellas Health I survey, 2006). METHODS: A stratified representative sample (n = 1005, 483 males, 522 females) of the Greek adult population (mean age 47.39 years, median age 46 years, range 18-99 years) was interviewed. Self-reported demographic and lifestyle behaviour data were obtained. The Food Frequency Questionnaire (FFQ) was used to record dietary habits, and a Mediterranean score was derived from the FFQ to assess adherence to the Mediterranean diet. A higher Mediterranean score indicates greater adherence to the Mediterranean diet. Physical activity was evaluated using the International Physical Activity Questionnaire. RESULTS: Smoking is highly prevalent in the Greek population (43.1%), particularly among people aged 18-36 (52.9%) and 37-56 years (51.9%). Smoking prevalence was 52.4% in men and 34.5% in women (P < 0.001). In total, 54.1% of men and 45.3% of women were classified as physically active (P = 0.007). The proportion of physically active subjects decreased with age (P for trend<0.001). The prevalence of obesity was higher in women (18.3%) than men (14.3%, P < 0.001), and increased with age (P for trend<0.001). Men were found to have higher Mediterranean scores than women (27.09 vs 26.14, P < 0.05). Dietary habits also differed between younger and older participants, and the Mediterranean score increased with age. CONCLUSIONS: The prevalence rates for smoking, physical inactivity and obesity are high, and compliance with the Mediterranean diet is low in Greece. Nationwide interventions focused on health promotion and primary prevention are urgently needed.

Serum adiponectin and resistin in rats under three isocaloric diets: The effect of sibutramine.

The aim of the study was to investigate the effects of (1) macronutrients on food intake, body composition and serum resistin and adiponectin and (2) sibutramine(S) on the above parameters in rats fed with isocaloric diets. Three groups of male Wistar rats (n=63) were fed with high fat diet (HFD), high carbohydrate diet (HCD) or high protein diet (HPD) for 13weeks. In the last 3weeks each group was divided into three subgroups and received S 5mg/kg or 10mg/kg, or vehicle. Body weight was measured weekly, gastrocnemius muscle, perirenal, retroperitoneal and epididymal fat were isolated, fat/lean ratio was calculated and serum adiponectin and resistin were assayed. S did not affect lean body mass in any group. HFD was associated with elevated fat/lean ratio regardless of S administration. S at 10mg/Kg decreased fat/lean ratio in the HCD and HPD and adiponectin in the HFD group. S did not affect resistin in any group. Adiponectin was paradoxically elevated in the HFDS10 compared to the HCD or HPD S10 groups. Resistin was lower in the HCD compared to the HPD and HFD groups. Results suggest a preferential effect of S on body fat. The detrimental effect of S on adiponectin can be attributed to its sympathomimetic properties. Adiponectin was paradoxically elevated in the HFD and resistin in the HPD group, results that require further investigation.

Neuropathic bladder dysfunction in patients with motor complete and sensory incomplete spinal cord lesion.

STUDY DESIGN: A retrospective study of patients with motor complete spinal cord lesion and somatosensory preservation (American Spinal Injury Association (ASIA) impairment scale B). OBJECTIVE: To determine whether neuropathic bladder dysfunction is more or less severe with more or fewer complications in patients with somatosensory preservation. SETTING: 2nd Department of Physical and Rehabilitation Medicine, Neuropathic Bladder Unit, National Rehabilitation Center, EIAA, Athens, Greece. METHODS: The classification of spinal cord injured patients was determined according to ASIA protocol. All patients underwent urodynamics and retrograde cystography, with a follow-up period of at least 18 months. The study sample consisted of 154 patients: 28 ASIA B patients compared with 126 ASIA A patients. We analyzed 140 traumatic and 14 nontraumatic lesions for (1) specific type of neuropathic bladder, (2) detrusor overactivity volume and pressure, (3) bladder compliance, (4) vesicoureteric reflux, (5) formation of bladder stones, (6) method of bladder emptying and (7) daily dose of anticholinergics needed to achieve safe bladder function. We also studied the presence of spasticity, autonomic dysreflexia and pain syndrome. RESULTS: Statistically significant differences were found between ASIA A and B patients in daily dose of anticholinergics needed to achieve safe bladder function, in the incidence of incontinence episodes and in formation of bladder stones. CONCLUSION: Patients with somatosensory incomplete lesion of spinal cord seem to have an advantage in the management of neuropathic bladder dysfunction (fewer anticholinergics needed, fewer incontinence episodes and fewer bladder stones).

[A study of irritability in menopausal women].

Despite the fact that irritability is frequently the main presenting complaint of perimenopausal and postmenopausal women, studies specifically researching irritability in this population are scant. One hundred sixty three (163) peri- and postmenopausal women non-HT users, attending a menopause clinic, were included in this cross-sectional study. The investigation focused on whether the occurrence of inward and outward irritability in menopause is associated with various menopausal parameters, such as vasomotor symptoms, insomnia, menopausal status, hormone levels, and with the presence of chronic disease. Furthermore, we examined the possible association of inward and outward irritability with measures of anxiety and depression. Outward and inward irritability of peri- and postmenopausal women seem to be related to chronic disease, a factor that may be partially influenced by the older age of menopausal women. Outwardly directed irritability is found to be related to FSH and LH levels, independently of specific menopausal symptoms, such as vasomotor symptoms or insomnia. Outward irritability was found to be positively correlated with depressive symptomatology, whereas inward irritability correlated with both anxiety and higher depressive symptomatology.

Reliability of Greek version Gross Motor Function Classification System.

The Gross Motor Function Classification System for Cerebral Palsy (GMFCS), a reliable and valid system, has been widely utilized for objective classification of the patterns of motor disability in children with cerebral palsy. The objective of this study was to produce a Greek version of the instrument, with the same construct as the original one and to investigate the reliability of application of the Greek version GMFCS. Translation and back translation was made by two of the authors, one of whom did not know the original English text. The final translation was fixed by consensus. Two physicians were trained and given practice in the use of the GMFCS and its application to clinical documentation. The raters classified children with cerebral palsy according to GMFCS - Greek version. The reliability was assessed with the weighted kappa statistic. The sample consisted of 47 boys and 47 girls, mean age 5.4 years. The overall weighted Kappa was 0.80 (95% CI=0.67-0.94). Weighted Kappa for level I was 0.91 (95% CI=0.74-1.09), for level II, 0.78 (95% CI=0.62-0.95), for level III, 0.85 (95% CI=0.68-1.02), for level IV, 0.85 (95% CI=0.67-1.03) and for level V, 0.84 (95% CI=0.66-1.03). The inter-rater reliability was lowest at level II. Percent agreement was 75%. Results of this study suggest that GMFCS - Greek version can be used reliably to classify patients with CP from clinical documentation. These results further support use of the GMFCS in clinical settings and for research. Investigation is needed to further assess the reliability and to determine the validity of the Greek version of the GMFCS.