COGNITIVE-PERSONAL CHARACTERISTICS OF ADULT EXPERIENCE ON HEALTH

The cognitive-personal features of patients diagnosed with breast cancer were studied, i.e. the degree of severity of post-traumatic reactions, the level of actual and personal anxiety, basic personal attitudes relating to the self-image and the surrounding world; the presence of depressive symptoms. As a result, individual post-traumatic stress reactions were highlighted, with distress reaching the level corresponding to the clinical picture of post-traumatic stress disorder. Subjects were registered with subdepression, i.e. pessimistic assessment of events and the self, the reduction of working capacity. Most patients have high rates of situational anxiety. At the same time, the overwhelming majority of patients do not exhibit high levels of personal anxiety. Methodology used: Mississippi Scale (MS, Mississippi Scale, Keane et al., 1988); Spalberger-Khanin's Scale of Situational and Personality Anxiety; Scale of basic beliefs (World Assumption Scale, WAS, Janoff-Bulman, 1982); Beck Depression Inventory (Depression Inventory, BDI, Beck & Steer, 1987). The results demonstrated that basic beliefs of patients have the following specificity: predominantly negative image of the self and the world, confidence in their own failure, inability to control the occurring events. Women suffer from decreasing sense of the value and significance of their selves. The world and surrounding people are perceived as unfriendly, dangerous and untrustworthy, probably due to the quality of social support and the attitude of others as a result of the disease. Thus, the variability of the psychological consequences of the disease and peculiarities of individual responses to the stress is most likely related not to the effectiveness of the treatment (all women in these sample have successfully completed the treatment), but rather to the personal and cognitive characteristics of patients, their basic beliefs and conceptions.

Interrelations between anger and aggression among male veterans with combat-related posttraumatic stress disorder

ObjectivesCombatants with PTSD show a higher level of aggression and dysfunctional anger influencing clinical picture and determining tolerance to treatment. Interrelations between emotional dysfunctions (anger), symptoms of combat-related PTSD and aggression are not clear.MethodWe studied relations between aggression, anger and PTSD symptoms in the group of 557 males-combatants (109 patients had marked symptoms of PTSD, 448 men showed subclinical symptoms), and in the control group of 234 healthy males. We used the Mississippi Scale for quantitative evaluation of PTSD and authorial methods for assessing anger and aggression.ResultsImpulsive aggression is the main form in veterans with PTSD, exceeding sevenfold indices in the control group (21,17 ± 1,92; 3,18 ± 0,38, P < 0,00001). Indices of this aggression are equal to level of instrumental aggression (3,03 ± 0,27; 3,88 ± 0,19, P < 0,001), in the control group various forms of aggression differed greatly, level of these types of aggressive behaviour was lower (0,45±0,06; 1,88±0,09, P < 0,0000001).Correlation analysis of indices of different aggressive behaviour and anger showed that dysfunctional anger has strong positive interrelations only with indices of impulsive (affective-hostile) aggression (P < 0,01), similar correlation with instrumental aggression was not discovered. In the control group significant correlations between anger and aggressive behaviour were not found.ConclusionsImpulsive aggression is mostly expressed in combatants with PTSD. Anger is the main determining factor for level, strength, intensity and frequency of impulsive aggression. Association between anger and PTSD is unique for combatants with impulsive aggression. Dysfunctional anger serves a general pathogenetic factor for combat-related PTSD and impulsive aggression.

Forensic psychiatric expertise: Posttraumatic stress disorder

Introduction. This article presents our experiences in the field of forensic post-traumatic stress disorder (PTSD). Objective. The study examined parameters of 30 patients with PTSD who were the subject of forensic expertise (PTSDF) and in 30 patients with PTSD who were not (PTSDN). Methods. Clinical research and the battery of tests (Impact of Event Scale - IES, Mississippi Scale, and list of symptoms of PCL-M) covered a total of 60 male subjects with a verified diagnosis of PTSD. The study involved socio-demographic variables, catastrophic experience, enduring personality change after catastrophic experience (EPCACE), comorbidity disorders and non-material damage. Results. In terms of respondents? average age, years of education, marital status, time of military engagement, there were no statistically significant differences between PTSDF and PTSDN groups. In terms of EPCACE statistically significant differences were found in both PTSDF and PTSDN groups. Among PTSDF respondents (N=30) EPCACE was verified in 83.33% (N=25), and among PTSDN in 23.33% (N=7) (p<0.05). In terms of comorbidity disorders and the parameter of non-material damage no statistically significant differences were found either in PTSDF or PTSDN group. Conclusion. In terms of EPCACE there were statistically significant differences both in PTSDF and PTSDN group. Forensic and psychiatric meaning of PTSD encompasses a number of complex elements on which forensic expert opinion depends, while the existence of PTSD diagnosis itself does not affect creation of opinions. The study should serve to identify methodological and conceptual problems in the field of forensic aspects of PTSD.

The D2 dopamine receptor (DRD2) gene is associated with co-morbid depression, anxiety and social dysfunction in untreated veterans with post-traumatic stress disorder

Objective.To identify clusters of patients with post-traumatic stress disorder (PTSD) according to symptom profile and to examine the association of the A1 allele of the D2 dopamine receptor (DRD2) gene with these clusters.Method.Fifty-seven untreated Caucasian Vietnam veterans with PTSD were administered the General Health Questionnaire-28 (GHQ) and the Mississippi Scale for combat-related PTSD. DRD2 allelic status was determined by PCR.Results.Subjects with the DRD2 Al allele compared to those without this allele had significantly higher scores on GHQ 2 (anxiety/insomnia), GHQ 3 (social dysfunction) and GHQ 4 (depression). Cluster analysis of the GHQ data identified two primary groups. A high psychopathology cluster (cluster 3), featured by high co-morbid levels of somatic concerns, anxiety/insomnia, social dysfunction and depression, and a low psychopathology cluster (cluster 1), manifested by the reverse pattern. Scores in each of the four GHQ groups were significantly higher in cluster 3 than cluster 1, as was Mississippi Scale PTSD score. DRD2 A1 allele veterans compared to those without this allele were significantly more likely to be found in the high than the low psychopathology cluster group.Conclusions.DRD2 variants are associated with severe co-morbid psychopathology in PTSD subjects.