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EN
The paper argues that an evolutionary approach would contribute to a better understanding of development. Analyzing adaptive mechanisms and their dysfunctions, new ways can be opened in categorizing mental disorders and also in therapies. The evolutionary approach does not mean to introduce new theories or therapeutic methodologies into psychotherapy. Instead it suggests new strategies of understanding based on the laws of human nature. It places pathology onto the dimension of adaptation. It claims that developmental history and adaptation should be considered when understanding pathology. The paper also argues that a diagnostics which is based on categorization of symptoms should be replaced by a diagnostics which concentrates on organization of adaptive systems.
EN
The literature points that attachment is key mechanism in the development of people. According to the attachment theory, the experience of neglect, abandonment and other early traumas have influence on forming the dysfunctions of emotions and personality pathology. The aim of this article is the verification of the thesis about relation between attachment style and personality disorders. The analysis of results of 155 participants has been conducted (persons in the similar age, similar educational level, similar number of females and males). The diagnosis of personality disorder was based on SCID-II (Structured Clinical Interview for Axis – II), and additionally confirmed by PDQ-4 Hyler Inventory. To examine the attachment style the Plopa’s Attachment Styles Questionnaire and the Revised Experiences in Close Relationships Inventory (ECR-R designed by Fraley et al., 2000), were used. The multiple regression model was used to test whether attachment styles maybe the predictors for personality disorders. The current results partly support the Lyddon and Sherry’ thesis. The main predictor for the relations between attachment and personality disorders is the anxious attachment style.
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Poczucie winy. Perspektywa psychiatry i psychoterapeuty

89%
EN
The author presents his reflections on the issue of guilt in psychiatric and psychotherapeutic practice. According to the author, in pastoral practice and in psychotherapy for many years there has been a strong tendency to psychiatric or theological reductionism as well as rivalry and mutual invalidation between pastors and psychiatrists and psychotherapists. At the turn of the century there was a tendency for the mutual recognition of their competence and willingness to cooperate. The possibility of describing the problems of the patient / penitent from a psychological perspective onthe one hand and from the ethical perspective on the other hand lets us to avoid conflict of competence for the benefit of people seeking psychiatric-psychotherapeutic and / or spiritual help.
PL
Autor przedstawia swoje refleksje dotyczące kwestii winy w kontekście nauk psychiatrycznych i psychoterapeutycznych. Zdaniem autora, w praktyce duszpasterskiej oraz w psychoterapii od wielu lat istnieje silna tendencja do psychiatrycznego lub teologicznego redukcjonizmu, jak również rywalizacji pomiędzy duszpasterzami, psychiatrami i psychoterapeutami . Na przełomie XIX i XX wieku istniała tendencja do wzajemnego uznawania ich kompetencji i chęci do współpracy. Możliwość opisywania problemów pacjenta/penitenta z psychologicznego punktu widzenia z jednej strony, a z punktu widzenia etycznego z drugiej strony pozwala nam uniknąć konfliktu kompetencji na rzecz osób poszukujących pomocy psychiatrycznej - psychoterapii lub wsparcia duchowego.
EN
The stereotype of “mad genius” appears in our culture from time to time, having an influence on public thinking, biographies, arts, and sciences. The image of famous persons who simultaneously display eminent talent and achievement, suffering, oddness, and sometimes destructivity elicits fear, attraction, and admiration in common people. In the past decade, we witnessed a paradigm shift in the research of creativity and psychopathology; instead of the assessment of rare examples of eminent per-sons with labels of psychiatric diagnoses, schizotypal, affective, and autistic spectrum traits were evaluated in the general population in order to elucidate the relationship between common “psychopathology” and everyday creativity. Beyond the more and more sophisticated statistical characterization of the predictors of creative achievement, this new approach opens a door to the functional brain imaging and molecular genetic analysis of the complex phenotype of creativity.
EN
Currently, mental disorders are usually concep-tualized as a hidden causal factor, manifested by its symptoms. This notion rests upon the reflective latent model, which is implicitly at work every time complex symptomatology gets summarized by a single number or a categorical state. The present paper reflects on the quantita-tive, testable implications of this psychometric model and shows how its restraints are untena-ble for most mental disorders. The observed data are instead consistent with mental disorders be-ing complex dynamic systems. Instead of being treated as interchangeable measures of the same latent factor, symptoms likely act as independ-ent causal entities, directly affecting each other. In recent years, this shift in ontological stance toward psychopathology has laid a basis for adapting the network theory. Under this theory, a mental disorder is a relatively stable emergent state, which arises due to a pronounced and re-current interaction of causally linked symptoms. It is discussed how models embedded within the network theory can help provide insight into the etiopathogenesis of mental disorders and ad-dress clinical intervention. In conclusion, limits and future challenges to the network theory are discussed.
EN
Motivational internalism is a view according to which moral judgments are necessarily motivating. Rationalist internalism (RI) is the most popular version of this view; it limits internalism to people who are practically rational. Motivational internalism, including RI, has been criticized as being incompatible with research into certain personality disorder; in particular psychopathic personality and pathological personality which is the result of damage to the ventromedial prefrontal cortex (shortened to VM damage). In this paper, I argue that many of the features of psychopathic personality and of VM damage, which some philosophers interpreted as direct proof against internalism, should be understood as having an effect on the practical rationality of the patients. This means that these personality disorders cannot be used as counter examples to RI and can, in fact, be seen as supporting RI to some extent . I begin by describing RI. I then turn to I describing the phenomenon of psychopathic personality and VM damage and their philosophically relevant features. Finally I discuss whether the features characterizing psychopathy and VM damage influence the degree to which these disorders can serve as counterexamples to internalism of the rationalist variety.
EN
The aim of the article is to discuss the specifics of human actions and decision-making processes from the psychopathological perspective. The concepts of action and decision making are reported in the context of human experience and the experiential structure of self-determination. The starting point is provided by considerations related to the notion of mental illness as described by Lennart Nordenfelt, as well as Antoni Kępiński’s concept of informational metabolism. The consequences of and changes to decision-making processes in mental disorders will be presented on the example of depressive experience. Decision-making process can be understood in terms of three-dimensional pre-reflexive experience that undergoes changes in depressive patients: space of possibility, sense of agency and time experience. The analysis will allow us to better understand the structure of experience attributable to people suffering from depression.
EN
Emotion Regulation (ER) has been identified as a factor that may be related to psychopathological symptoms. However, evidence about the relationship between ER and psychopathological symptoms is still unspecific. Moreover, although the ability of distress tolerance (DT) has gained increasing attention, it has not yet been sufficiently explored in relation to specific psychopathological symptoms. The aim of the study was to analyze the role of different specific ER mechanisms on various psychopathological symptoms, with particular emphasis on the role of DT. To do so, a correlational study was carried out. A total of 128 university students between 18 and 44 years old (mean age = 26.7, SD = 6.14) answered the Distress Tolerance Scale, the Difficulties in Emotion Regulation Scale and the Symptom Check List 90-Revised. For each psychopathological symptom (and for general distress), linear regression were applied. All models were statistically significant with differences in the amount of explained variance and in the predictors. DT predicted symptoms of depression, anxiety, obsessions and compulsions and general distress. The study highlights the importance of the different mechanisms of ER in each specific psychopathological symptom and their implications for mental health.
Diametros
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2020
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vol. 17
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issue 66
18
EN
The article presents a critical historical outline and description of the biomedical model of psychopathology, focusing on the second half of the 20th century. It also identifies and discusses the key problems connected with its dominance in the contemporary clinical and research practice. These problems concern, among other things, the validity and reliability of psychiatric diagnoses, research methodology, treatment effectiveness, or the influence of pharmaceutical companies on research and therapeutic activity. The serious conceptual problems of the whole model call into question the foundations and knowledge base of contemporary psychiatry. There are also justified doubts regarding antipsychotic and antidepressant medications nowadays – despite their increasingly wide use, the number of chronically ill people keeps rising. This situation leads to serious ethical problems and warrants questions regarding the over-medicalisation of issues commonly associated with mental health. A reform of research and clinical practice is urgent.
PL
Zdrowie i choroba psychiczna stanowią nadal tajemnicę. Medycyna w wielu przypadkach potrafi wskazać przyczynę pojawienia się zaburzenia, a lekarze udzielić wsparcia pacjentowi doświadczającemu kryzysu psychicznego. W wielu jednak przypadkach podobne schorzenia nie mogą być w pełni wyjaśnione przez specjalistów. Nadal bowiem nie znamy niepodważalnego źródła występowania np. schizofrenii. Nie wiemy również, dlaczego u jednych pacjentów chorujących na nią leki działają, a u innych nie widać pozytywnego efektu. Obserwując z perspektywy społecznej zjawisko, jakim jest choroba psychiczna, można jednak z całą pewnością stwierdzić, iż dotyka ona nie tylko samego pacjenta, ale również bliskie mu osoby, jego rodzinę. Problemy natury psychicznej wymagają zaangażowania osób bliskich, a także edukacji dotyczącej psychopatologii. Czasem rodzina postawiona zostaje przed szczególnie trudnym dylematem. Niepokojący stan pacjenta, zachowania agresywne, występowanie halucynacji powoduje, iż może stać się on niebezpieczny dla siebie lub innych osób. W sytuacji tej bardzo często konieczne jest podjęcie działań przymusowych wobec osoby chorej. Osoba ta twierdzi bowiem, że jest zdrowa. Czasem konieczne jest użycie przez personel siły oraz przymusowe umieszczenie pacjenta w szpitalu psychiatrycznym. Czy w sytuacji tej rodzina osoby chorej brana jest pod uwagę? Czy posiada ona w tym kontekście określone obowiązki? Być może bliscy mają konkretne uprawnienia, pozwalające na udzielenie pomocy? Czy polskie prawo dostrzega w tego typu zdarzeniach rodzinę osoby chorej? Na pytania te podjęta zostanie próba udzielenia odpowiedzi.
EN
Health and mental illness remain a mystery. Medicine can in many cases indicate the cause of apparition of the dysfunction. Doctors can provide support to a patient experiencing a mental crisis. In many cases, similar afflictions can't be wholly explained by specialists. We still don't know an indisputable source of the occurrence of schizophrenia. We also don’t know why some patients get better when they take the drugs and why others patients don’t see a positive effect. However, observing from a social perspective the phenomenon of mental illness, we can certainly affirm that it affects not only the patient but also the person close to him or her family. Psychological problems require the involvement of loved ones. They also require education concerning psychopathology. Sometimes, a situation set the family up in particularly difficult dilemma. Disturbing patient condition, aggressive behavior, hallucination cause that a patient can become dangerous for yourself or others. In this situation, it's very often necessary to take obligatory actions against an ill person. This person claims to be healthy. Sometimes it’s necessary to use a force by personnel and to place the patient in a psychiatric hospital. In this situation, the family of the ill person is taken into consideration? Does a familly hold specific responsibilities in this context? Perhaps the loved ones have specific rights to help? Does Polish law perceive in this type of events the family of the ill person? This text is an attempt to answer these questions.
DE
Es fehlt
EN
The article outlines the problem of understanding mental disorders and the proposed distinctions significant in terms of all research done in the context of the philosophy of psychiatry. Inspired by the phenomenological and hermeneutic approach, engaged epistemo-logy is presented as a tool which helps to reveal the significant aspects of mental illness and psychopathology. By revealing the embodiment and the deep relation between the body and the outside world, engaged epistemology allows for a description of the dimensions of psychotic experience, as well as a more in-depth analysis of particular psychopathologies (and the related disorders of identity, lack of sense of reality and problems in relations with others). Scientists studying the phenomenological tradition made efforts to reliably describe the subjective experience of patients, and to critically evaluate the scientific ability to study illnesses. The hermeneutical critique of psychiatry, in turn, resorts to revealing its socio-cultural background which determines the horizon for objective, scientific, clinical research.
PL
Artykuł podejmuje problem rozumienia zaburzeń psychicznych oraz odwołuje się do szeregu dystynkcji czynionych w kontekście filozofii psychiatrii. Epistemologia zaangażowania inspirowana przez fenomenologiczne i hermeneutyczne podejścia stanowi narzędzie odkrywające znaczące aspekty choroby umysłu i psychopatologii. Poprzez ujawnienie ucieleśnienia oraz głębokich relacji między ciałem i światem zewnętrznym epistemologia zaangażowania pozwala opisać istotne wymiary psychotycznego doświadczenia oraz dokonać głębszych analiz poszczególnych psychopatologii (zaburzeń tożsamości, braku poczucia realności i problemów w relacji z innymi). Badanie tradycji fenomenologicznej wiąże się z wysiłkiem wiarygodnego opisu subiektywnych doświadczeń pacjentów i krytycznej oceny naukowych możliwości badań zaburzeń. Hermeneutyka krytyka psychiatrii ujawnia jej społeczno-kulturowe podstawy, które określają społeczno kulturowe tło dla  zobiektywizowanych, naukowych badań klinicznych.
EN
The archetype of Shapeshifter is expressed by variability and readiness to change, instability and fluidity, permanent transformation and self-improvement (of body and of nature, of mind and of spiritual realm). For this reason, it is worthwhile to look at the Shapeshifter as the patron of postmodernity. The article looks at postmodern culture through the prism of views of James Hillman and the school of archetypal psychology.
EN
a2_Conclusion. The BSI-53 questionnaire is a short, reliable instrument for the assessment of psychological distress. The degree of utility of the instrument in clinical work and the evaluation of its potential to identify specific clinical syndromes and sensitivity to detect changes should be documented by further studies.
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