Browsing by discipline "Psykologia"

Autism spectrum disorder is associated to high rates of comorbid mental disorders, where depression is probably most common disorder. Although the high prevalence of depression in autism is well-known thing, relatively little is known about its underlying risk factors or explaining factors. This study aimed to examine whether there is evidence that some characteristic features of autism spectrum disorder would have an impact on high prevalence of depression in autism spectrum disorder. We discuss about two psychological factors: emotion regulation and its deficits and the tendency to perseverate and ruminate. Two factors related to perseveration, cognitive flexibility impairments and rumination were associated with depression and depression symptoms. The association between emotion regulation deficits and depression manifested in the use of maladaptive coping skills and in tendency to ruminate. More research is still needed to replicate these results and gain stronger evidence. The depression diagnosis in autism spectrum disorder is problematic in many ways, therefore all results concerning the subject should be interpreted with caution.

Background: Delirium is a common, under-diagnosed and serious problem among critically ill patients. Episodes of delirium are associated with a number of adverse outcomes; it seems to carry a considerable risk for future complications, increased future morbidity, long-term impairments in cognitive abilities, and even death. Approximately 80% of patients in intensive care unit (ICU) will develop delirium during their stay in hospital, making it to be a rather common condition – especially among elderly patients. With aging of the patient population in ICU incidence of delirium is likely to increase in future. Early recognition, prevention and treatment for delirium in and after ICU is extremely important for future recovery. There is promising evidence suggesting that delirium could be used as an effective tool for predicting future recovery and health complications after release from ICU. Aim of the study: To identify adverse consequences of post-operative delirium (POD) in ICU (with main focus on future cognitive decline), recognize possible risk groups and current screening and treatment procedures. Methods: A systematic review was conducted, following the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature was collected between September and October 2019 from PubMed ja Ovid Medline data bases using keywords ’delirium’, ’critical illness’, ’consequences’, ’effects’,’cognitive decline’, and ’cognitive impairments’. The search yielded 23 peer reviewed articles which are included in this revies. Results: Episodes of non-dementia delirium in ICU were associated with a number of health complications, prolonged hospital stay and higher risk for readmissions, higher morbidity and mortality, increased risk of falls, accident and injuries, social problems, increased stress and distress, cognitive impairments and increased risk for developing dementia. Different subtypes of delirium (hypoactive vs. hyperactive) seemed to lead to somewhat different adverse consequences; however, all recognized subtypes were hazardous. Conclusions: Delirium is a common, severe and under-diagnosed health problem among ICU patients. It has shown to be associated with various adverse outcomes that create serious economical costs for both individuals and societies, as well as significantly impair patients’ health and later quality of life. Episodes of ICU delirium can cause cognitive impairments and accelerate cognitive decline associated with neuropsychiatric disorders (such as dementia). Although the majority of healthcare professionals acknowledge the severity of problem, the current procedures for prevention, treatment, screening and monitoring are severely lacking. Both current screening tools and training of medical staff are in dire need for improvements.

Depression is one of the most common psychological symptoms that often occurs with dementia. It can be a risk factor for dementia to develop, or it can also appear after dementia causes losses to a patient’s abilities. Depression has been shown to hinder the functional status of a patient with dementia even further. Using medication to treat depression in patients with dementia holds the risk of side effects. Instead, psychosocial treatments should be considered essential in the treatment of depression in dementia patients. The purpose of this review is to examine psychosocial treatments used for treating depression in patients with dementia. Of these treatments, psychotherapy, music therapy and reminiscence therapy are considered further. The evidence for psychotherapy, music therapy and reminiscence therapy is partly conflicting, but overall quite promising. In the future, more randomized controlled trials should be carried out, but there is also a need for qualitative studies to clarify which mechanisms enable treatments to affect depression in dementia patients.

Body dysmorphic disorder (BDD) is a disorder that consists of a distressing and impairing preoccupation with a nonexistent or slight defect in appearance. Patients often seek surgical, dermatologic and other nonpsychiatric medical treatment for their perceived appearance flaws. Psychological and pharmacological interventions are suggested format for the treatment. The aim of this study is to determine the effectiveness of the treatments of body dysmorphic disorder. The main interest is in the effectiveness of psychotherapy and which therapeutic techniques or strategies are effective in the treatment of body dysmorphic disorder. Although research on treatment is still limited, findings support the effectiveness of psychotherapy suggesting that cognitive-behavioral therapy is effective in treating patients with body dysmorphic disorder. Effective therapy may consist of both cognitive and/or behavioral elements, but use of exposure and response prevention is reported in many studies. Findings also suggest that serotonin reuptake inhibitors may be useful in treating patients with body dysmorphic disorder but nonpsychiatric medical treatment usually does not improve BDD symptoms. Although treatments improved the appearance of the treated body part, it led not to improvement in BDD symptoms.

Objective. Transdiagnostic models of psychopathology assume that the commonalities across disorders may outweigh their differences. While these models acknowledge that disorder-specific symptoms and features undoubtedly exist, the same underlying factors are perceived to cause and maintain various disorders. In recent years, this approach has received growing attention and several new forms of therapy have been developed based on it. These may be well-suited for the treatment of mixed-diagnosis groups or individuals with comorbid disorders, and as such, they hold the promise of being very cost-effective. One of the most established transdiagnostic treatments is the Unified Protocol (UP), designed to help patients suffering from depression and the full range of anxiety disorders. The purpose of the present study is to review the evidence regarding the efficacy and effectiveness of the UP for the transdiagnostic treatment of adult anxiety and depression. Methods. For this review, systematic literature searches were performed using the PsychInfo and PubMed online databases in October 2018. The search term used was “Unified Protocol”. The search yielded 114 results in PsychInfo and 138 in PubMed. Ten of these matched the following study selection criteria and were included in the current review: a) the study measured either the efficacy or effectiveness of the cognitive-behavioral UP therapy developed by Barlow (2011), b) treatment was delivered face-to-face in either individual or group setting, c) treatment followed the UP therapist guide without major modifications, d) participants suffered from an anxiety disorder or depression, e) participants were over 18 years of age, d) the study was published in 2015 or later, and f) the study was published in English in a peer-reviewed journal. Results and conclusions. The UP appeared both efficacious and efficient in reducing the severity of adult anxiety and depression as well as the number of comorbid diagnoses; however, there were some conflicting findings regarding recovery rates and effect sizes. The results achieved were comparable to those achieved using diagnosis-specific cognitive-behavioral therapy. The UP treatment had a positive impact on the patients’ functioning and quality of life and the amount of positive and negative affect they experienced. Treatment retention was generally high, particularly when treatment was delivered individually, and the UP received high ratings from those who participated in the studies. All in all, the current empiric evidence regarding the UP appears fairly promising. However, these results must be interpreted with caution, as the research concerning the UP is still in its infancy and a large part of it has been conducted by researchers affiliated with the treatment.

Studies have shown that childhood physical abuse is associated with later adverse psychological development and mental health. Additionally, people who have experienced physical abuse have a higher risk for later violence. However, most people who have experienced childhood abuse do not become violent offenders which implies that the two factors are not directly linked. Mediating factors might account for the relationship. Alcohol related problems and antisocial personality disorder are psychiatric disorders which have been associated with childhood physical abuse and intimate partner violence. These disorders are examined here as possible mediators in the relationship between childhood physical abuse and later intimate partner violence. There are mixed results concerning the mediating role of alcohol related problems. These results indicate that alcohol related problems do not mediate the relationship between childhood abuse and violence. Alcohol related problems might work as a mediator for individuals with other risk factors. Studies have found that antisocial personality disorder has a mediating role in the relationship between childhood physical abuse and intimate partner violence. Abuse in childhood combined with a genetic risk for antisocial personality may lead to the development of the disorder which increases the risk for violence. In order to develop effective interventions, it is important to understand the adverse effects of childhood abuse. Moreover, mediating factors should be considered when designing interventions targeting intimate partner violence.

Objectives. Psychotherapy research has traditionally concentrated on the positive outcome of therapy whereas negative outcome has not been an object of interest. A comparison to psychopharmacological treatment, for which reporting of side-effects is mandatory, reveals a difference. The area of psychotherapy outcome has lacked consensus on theoretical, methodological and practical issues. This bachelor thesis is a literature review on the subject. The review is limited to cover research projects dealing with adult individual psychotherapy for mood and anxiety disorders concentrating on cognitive and psychodynamic therapy orientations. Method. The Bachelor thesis consisted of a literature review covering international scientific papers on negative outcome of psychotherapy concentrating on following research questions: operationalisation of psychotherapy outcome, measures for monitoring outcome, categorisation of psychotherapy outcome and methods for distinction between the categories. Additionally the work covered a review on quantitative results. Results and conclusions. No consensus on measuring psychotherapy outcome and the categorisation of outcome was evident. A typical approach was using the categories “recovered”, “improved”, “non-response” and “deteriorated”. Two alternative means of operationalising the psychotherapy outcome could be found. Measures for estimating symptomatic level, interpsychological functioning and social functioning were combined with the reliable change index (RCI) to assess observed changes. Another alternative formed measures to assess directly adverse effects of psychotherapy. Quantitative estimates of negative outcome were consistent: prevalence of deteriorated patients varied between 1 – 7% and share of non-responders was 39-67%

Maternal prenatal depression is associated with increased prevalence of mental disorders in the offspring, but the underlying mechanisms are yet to be discovered. It has been proposed that prenatal stress could cause changes in the hypothalamus-pituitary-adrenal-axis (HPA) function and glucocorticoid secretion of the fetus. Animal models have shown that an adverse early life environment is associated with glucocorticoid receptor gene (GR) methylation and increased stress reactivity in adulthood through decreased negative feedback. Decreased negative feedback is thought to increase the concentration of glucocorticoids, which influence amongst other things central nervous system development. This bachelor thesis aims to clarify the role of glucocorticoids in fetal programming. To outline the subject the thesis seeks to answer two questions; first, whether maternal prenatal depression is linked to GR-gene methylation and second, if maternal prenatal synthetic glucocorticoid treatment is associated with increased psychiatric symptoms in the offspring. Based on the literature review, maternal prenatal depression and GR-gene methylation are not strongly associated. This interpretation could partly be due to small sample sizes and variability of depressive symptoms. Prenatal synthetic glucocorticoids and HPA-axis dysfunction seem to be associated with increased prevalence of mental health disorders. This highlights the importance of discretion in glucocorticoid treatments associated with pre-term birth. Glucocorticoid treatments can affect the epigenome and it is likely that future research should focus more on the epigenetic changes of GR responsive genes. Glucocorticoids are likely involved in mediating the effects of adverse prenatal environment on the fetus. More research combining data from longitudinal studies and experimental laboratory research is needed to discover the possible causal mechanisms.

There are many individual or social underlying factors that affect the performance in world-class team sports. Many studies of the subject concentrate on individual sports and there are less findings about the underlying factors that affect precisely teams’ performance. Every known factor affecting the performance can be determinant for success, so any information about them may help the athlete and the team to develop. In this review, the existing research results of both individual and social factors affecting teams’ performance is being analyzed. According to studies, the most significant individual underlying factors of a great performance are motivation, psychophysical well-being, psychical skills and mental toughness, which means the ability to cope better than your opponents with the many demands of sports, to remain in control under pressure and to be confident and determined. Especially confidence as a characteristic of mental toughness, appears to be strongly linked to the sports performance. There are also many social underlying factors of which the most remarkable ones are open interaction within the team, team cohesion, the actions of an athlete leader and coaches’ behavior and feedback. Some of the social factors, such as the actions of an athlete leader and the coaches´ behavior may affect the performance through the individual factors, such as athletes´ confident or motivation. Many of the studies in this review compare several different sports to get more information but it would also be beneficial to research even more, for example by making a longitudinal study of the subject or by having more representative samples. It would also be reasonable to study more the development of mental toughness by observing the training and performances of world-class athletes. The information in this review is useful for the athletics and coaches in world-class sport teams, for the developers of competitive sports and for the researchers of the field. This review raises awareness of the factors that affect the sports performance which may improve chances of successful performances. Also, the projects developing safety in world-class sports probably benefit from the knowledge of the factors affecting the sports performance.

Individualism and collectivism, known amongst cultural psychology, have been long studied in relation to mental health. On one hand, it has been studied whether there is a relationship between depression and individualism or collectivism on a cultural level. On the other hand it’s equally interesting whether there is a relationship between depression and individualism and collectivism on an individual/personal level, also known as idiocentrism and allocentrism. It seems cultural level collectivism or individualism is not a risk factor or a protective factor for depression. However, a conflict between cultural orientation and personal orientation appears to be positively related with depression. Allocentrics living in individualistic cultures get depressed easier than allocentrics in collectivistic cultures or idiocentrics in individualistic cultures. People with individual tendencies get depressed for different reasons than people with collectivistic tendencies. Individualists are more sensitive to failures and disappointments related to success and personal goals, whereas collectivists are more sensitive to lack of social support or negative social feedback such as rejection, lack of approval or lack of intimate relationships. These different predispositions for depression show already a on genetic level.