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PL
Artykuł porusza problem zespołu stresu pourazowego w ujęciu psychologicznym oraz historycznym, ze szczególnym uwzględnieniem analizy reakcji na sytuację stresową, jaką jest atak terrorystyczny. Pierwsza część tekstu została poświęcona teorii stresu pourazowego. Autorzy przybliżają fizjologię, mechanizmy oraz genezę zjawiska stresu pourazowego, jego krótki rys historyczny oraz współczesną klasyfikację kryteriów decydujących o diagnozie PTSD, zarówno według podręcznika DSM-IV-TR, jak również uwzględniając zmiany wprowadzone przez DSM 5. Po zaznajomieniu czytelnika z podstawową terminologią dotyczącą zespołu stresu pourazowego autorzy przechodzą do analizy przypadku sytuacji stresogennej, jaką jest zamach na norweskiej wyspie Utoya. Artykuł opisuje wydarzania z 22 lipca 2011 r. oraz skupia się na analizie posttraumatycznych reakcji, które nastąpiły po zamachu wśród jego bezpośrednich uczestników, jak również wśród ich bliskich. Analiza ta obejmuje nie tylko kwestie stricte statystyczne, czy też psychologiczne lub medyczne zjawiska stresu pourazowego wśród ofiar Andersa Brevika, ale autorzy, na podstawie działań podjętych przez służby norweskie, podejmują próbę wyciągnięcia i usystematyzowania wniosków na temat ogólnych zasad postepowania z ofiarami potencjalnych zamachów terrorystycznych.
EN
The article addresses the issue of post-traumatic stress disorder in psychological and historical terms, with particular emphasis on the analysis of reactions to the stressful situation, that is a terrorist attack. The first part of the text is devoted to the theory of post-traumatic stress. The authors explain the physiology, mechanisms and genesis of post-traumatic stress, its short historical outline and contemporary classification of criteria determining the PTSD diagnosis, both according to the DSM-IV-TR manual and changes introduced by DSM 5. After acquainting the reader with the basic terminology related to post-traumatic stress disorder, the authors analyze the case of the stressful situation – the attack on the Norwegian island of Utoya. The article describes the events of July 22, 2011, and focuses on the analysis of posttraumatic reactions that followed the attack among its direct participants, as well as among their relatives. Not only does this analysis cover strictly statistical issues, but also psychological or medical phenomena of post-traumatic stress among the victims of Anders Brevik. Based on actions taken by the Norwegian services, the authors attempt to draw and systematize conclusions on the general principles of dealing with victims of potential terrorist attacks.
EN
Animal models are very popular in medicine, including psychiatry, having the potential to provide a better understanding of various facets of the course, etiology and treatment of disorders. One of the disorders authors have been focusing their attention on is posttraumatic stress disorder (PTSD). In order to provide appropriate information about the disorder the model has to meet several criteria. It has been postulated that even very brief stressors should be capable of inducing biological and behavioural symptoms of PTSD, that the stressor should be capable of inducing the symptoms in a dose-dependent manner, that the symptoms should persist over time or even become more pronounced, that the stressor should induce alterations that have the potential for bi-directional expression; enhanced (hyperarousal) and reduced (avoidance and/or numbing) responsiveness to environmental stimuli which recall the initial trauma and that interindividual variability in response to a stressor should be present either as a function of experience, genetics, or an interaction of the two. Researchers use a variety of stressors to induce PTSD-like symptoms in animals most of which are uncontrollable and unescapable. Both human and animal reactions to threats bear a high degree of similarity. The symptoms observed in animals exposed to a threatening situation resemble those observed in PTSD patients and include behavioural and physiological stress symptoms, avoidance of stimuli associated with an aversive experience, analgesia, disrupted sleep patterns, increased aggressive behaviour, hyperarousal and exaggerated startle response. In the article a number of models of PTSD are being evaluated as to whether they meet the criteria of an ideal model. The criterion most rarely met is taking into account individual differences in the vulnerability to PTSD.
EN
The aim of this study was to investigate the association between temperament and social support and the level of quantitatively rated PTSD symptoms in a sample of HIV+ and HIV/AIDS men and women. A total of 310 men and women, including 182 HIV+ and 128 HIV/AIDS, were studied. Social support was assessed with the Berlin Social Support Scales (BSSS). Temperament was assessed with the Formal Characteristics of Behaviour – Temperament Inventory (FCBTI). Intensity of PTSD symptoms was assessed with the PTSDF (PTSD Factorial Version inventory). The best predictors of intensity of PTSD symptoms in HIV+ participants were support seeking and sensory sensitivity. Support seeking was positively associated, and sensory sensitivity was negatively associated with intensity of PTSD symptoms.
PL
Artykuł poświęcony jest problemom diagnostycznym, z jakimi borykają się zarówno psycholodzy, pedagodzy, jak i psychiatrzy próbujący określić patomechanizm trudności występujących w zachowaniu u dzieci. W prezentowanej pracy skupiono się na analizie obrazu klinicznego i etiologii zaburzeń po stresie traumatycznym (PTSD) oraz zespołu nadpobudliwości psychoruchowej z deficytem uwagi (ADHD), gdyż są to zaburzenia, których rozpoznanie u dzieci budzi wiele wątpliwości diagnostycznych. Rozważania dotyczące objawów poszczególnych zaburzeń oparto na kryteriach diagnostycznych DSM-5, a analizę ich genezy przeprowadzono, odwołując się do danych na temat cech funkcjonalnych ośrodkowego układu nerwowego w poszczególnych przypadkach. Całość pracy podsumowuje próba wskazania elementów niezbędnych dla diagnozy różnicowej obydwu zaburzeń.
EN
There were many studies on treatment and prophylaxis of PTSD. It was assumed that a need of talking about of the traumatic event has been a factor moderating relationship between exposure to traumatic event and PTSD symptoms development. Aim of the study was to test this assumption. The study was conducted on police officers according longitudinal procedure, it means that the study was performed in two stages with one year break. It was a possibility to make an analysis of obtained results as if it were two studies; cross-sectional and longitudinal ones. Each analysis let us draw opposing conclusions. Need of talking about traumatic event appeared to be a resistance factor in former one and a sensibilizing factor in letter one.
EN
The article touches on the diagnostic problems faced by psychologists, pedagogues, and psychiatrists who try to determine the psychopathology of the difficulties in the behaviours of children. The current study focuses on the analysis of the clinical picture and the genesis of the disorders occurring as a result of an extremely stressful event (PTSD) and also attention-deficit hyperactivity disorder (ADHD). These disorders are full of diagnostic uncertainties when occurring in children. The analysis of the two disorders is based on the diagnostic criteria of DSM-5. The analysis of their etiology is based on the data concerning the functional characteristics of central nervous system. The article is summed up by an attempt to name the elements necessary for the differential diagnosis of the two disorders.
EN
Effectiveness analysis. Application practices Report from the research project „Development of psychotherapeutic technologies, rehabilitation and counseling of participants of the Joint Forces operations”, part 3 (Grant of the Ministry of Higher Education and the Armed Forces, No. DZ/74-2019) The analysis of international and regional experiences in the workplace with foreign employees is an integral part of correcting the workforce and development of personal development. International organizations like the UNO (IOM) provide a list of underwriting services that operate with people and people with stress, due to the fact that the region or the region has its own practice of integration, integration and management of health and management. The results of the study show that the most effective tool for organizing coordinated and structured work on development is the use of the so-called the cluster approach, which is widely used in UNHCR practice, under UN coordination. The integrated commitment to Ukraine and the active employment of a number of nationals, community members and other national organizations is represented by the State of the States and local businesses. As the long-term practice shows, it is thanks to the Synergy of Multi-Vector Experiences that all parts of the cluster are possible, the goal of developing the presiding, overturning and believing well. The analysis of the results of the number of people from the UNHCR cluster in the districts of Lviv, Ivano-Frankivsk and Zakarpattia in the year 2020 shows that a person is based on other measures and has a similar and similar weight.
EN
Recent advances in the research on etiology and developmental context of psychosomatic disorders in children are being presented. The author shows their origin in the context of Bowlby attachment theory and the research on brain basis of somatization, conversion and dissociation. Research investigating the relation between attachment classification and predisposition to somatization has indicated that unsecure attachment is an important factor in the origin of unexplained somatic symptoms and in long-term perspective might result in psychiatric symptoms with psychiatric type of presentation. Early relational trauma is one of the main causes of chronic somatization. The following mechanism of the origin of psychosomatic disorders is being proposed: (1) early relational trauma contributes to distortions in development of brain areas involved in emotion regulation, (2) prolonged trauma experiences contribute to chronic dissociation, and further on, facilitate occurrence of unexplained somatic symptoms. The long-term consequence of relational trauma is (3) the prolonged disturbance in selfregulation (esp. in emotional functioning), which is a factor contributing to emergence of many other psychiatric disorders in adult life, such as depression and PTSD.
EN
The participation of soldiers in combat missions is one of the tasks that requires not only physical– but because of stressors – also psychological preparation. Participation in warfare involvesexposure to physical, cognitive, emotional and social inconvenience and is considered an important risk factor for the psychological disturbances. However, the literature on the subject also indicates the positive effects of confrontation with the stressors (e.g. postraumatic growth). The aim of the study was to determine whether the intensity of combat exposure and social support are related to both the negative and the positive psychological consequences of participating in warfare. The study, conducted by soldiers participating in the Afghan war, showed no connection between the intensity of combat experience and the well-being of soldiers. Not informing the family about difficulties experienced by soldiers was related to a greater number of psychological disturbances. Moreover, it turned out that not received social support, but the soldier’sconviction about the possibility of receiving this form of help, together with refraining from sharing their difficulties with family members, contributed to positive psychological changes.The results demonstrated that the psychological effect of participating in a military mission is not so much dependent on the intensity of the combat experience, as from the soldier’s conviction that social support is available from non-family member.
EN
(Title in Polish - 'Polimorfizm w genie transportera dopaminy (DAT 1) i postrzegalny stopien zagrozenia zycia a zaburzenie po stresie traumatycznym w grupie powodzian'). In this study thye authors examined possible associations between polymorphism in the dopamine transporter gene (DAT 1) and perceived threat of life and PTSD in the group of flood victims aged from 14 to 62. The participants of the study were asked to fill in two questionnaires measuring the intensity of PTSD symptoms. They were also asked to appraise the threat of life during traumatic event. The genotype of the participants were analyzed using PCR method. The authors demonstrated the association between perceived threat of life and the intensity of PTSD symptoms. Additionally, they showed the interaction between the DAT 1 genotype and perceived threat of life with respect to the intensity of PTSD symptoms.
EN
The article touches on the diagnostic problems faced by psychologists, pedagogues, and psychiatrists who try to determine the psychopathology of the difficulties in the behaviours of children. The current study focuses on the analysis of the clinical picture and the genesis of the disorders occurring as a result of an extremely stressful event (PTSD) and also attention-deficit hyperactivity disorder (ADHD). These disorders are full of diagnostic uncertainties when occurring in children. The analysis of the two disorders is based on the diagnostic criteria of DSM-5. The analysis of their etiology is based on the data concerning the functional characteristics of central nervous system. The article is summed up by an attempt to name the elements necessary for the differential diagnosis of the two disorders.
EN
The aim of the study was to assess the impact of temperament and trauma considered as predictors of PTSD experienced under flood. Two samples were studied. In the first one composed of 384 subjects PTSD was assessed three and 15 months (N = 321) after flood. In the second sample (N = 378) PTSD was assessed two years after disaster and retrospectively few weeks after flood. For measuring PTSD the PTSD – Factorial Version Inventory constructed by the authors was administered. Apart from a total score the PTSD-F allows for assessing intrusion/hyperarousal (I/H) and avoidance/numbing (A/N). Three temperamental traits were selected for the purpose of this study – emotional reactivity, briskness and perseveration measured by the Formal Characteristics of Behavior – Temperament Inventory. Intensity of trauma was assessed via structured interview. For analyzing the data coefficients of correlation and hierarchical regression were introduced. It came out that the impact of temperament and trauma as predictors of PTSD is stronger for long-term PTSD. Several interactions between trauma and temperament were obtained. Trauma and emotional reactivity are the best predictors and this refers to the total score of PTSD as well as to the two basic factors – I/H and A/N.
EN
Trauma and posttraumatic adaptation are topics which have been frequently discussed in a literature recently. One of the most important factors that influences posttraumatic adaptation is social support. However this notion and its mechanism of protection against posttraumatic consequences still poses a lot of questions. The aim of this study is to show the role of support received from a family in adaptation after trauma and its influence on posttraumatic stress disorder (PTSD). The present study indicates that the adequacy of support is a good means of protection against psychological consequences after trauma. According to this research, not social support but its adequacy to current needs helps in better coping with trauma. Whereas support received from a family influences posttraumatic cognitions. People who receive, not only perceive, support from relatives after trauma have more rational cognitions about the world and themselves, in comparison to people who have less received support.
EN
Developmental traumatology is the systematic investigation of the psychobiological impact of overwhelming and chronic interpersonal stress on the developing child. The article presents a review of current research examining etiological links between child physical and/or sexual abuse and subsequent psychiatric disorders. The data suggest that abuse experiences are associated with alterations of biological stress systems in abused children. Dysregulation of major biological stress response systems often observed in abused children and adolescents may lead to an enhanced vulnerability for psychopathology, particularly posttraumatic stress disorder (PTSD) and depression. These disorders are associated with an enhanced risk for adolescent or young adult onset alcohol or substance use disorders.
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2022
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vol. XLIX
|
issue 4
29-43
EN
The military forces usually conjure up the image of soldiers who serve in a given country, or those who carry out their duties in peacekeeping missions. They are frequently in the spotlight during their stay in the area of their operations and the performance of their duties. The memories of them and of any of the possible problems that they may encounter usually fade away once they have gone back to their country, or once they have returned to their parent unit. Interestingly, this rule also applies to other members of the military personnel. Service in the army, which frequently implies exposure to atrocities and ongoing hostilities, undoubtedly leaves its mark on people’s physical and mental health, and it can also have a major impact on the lives of professional soldiers and their families. Paradoxically, the level of stress experienced increases as the sense of a real threat goes down. Being a soldier is one of those professions in which exposure to stress is high, and there is a major risk of post-traumatic stress disorder (PTSD), especially in those members of the armed forces who have taken part in foreign missions. This paper looks at the historical background of the phenomenon, its symptoms, its methods of diagnosis, as well as the entire system of monitoring, supporting and treating post-traumatic stress in the Polish Armed Forces. Such a study has been possible thanks to a thorough analysis of the applicable pieces of legislation, backed by an insight into a series guidelines, orders and dispositions given at all levels of command and supervision in the army.
EN
The subject of the study is the treatment of PTSD with the use of MDMA as a method of counteracting the incidence of suicide. The discussion is carried out in the context of Polish law. The method used in the paper involves an analysis of the law in force, aided by M. Zieliński’s derivative concept of legal interpretation. The author of the study has established that: 1) PTSD may constitute a source of a threat to human life and health where persons might take their own lives; 2) PTSD can be successfully treated with MDMA; 3) Polish law does not allow the use of MDMA in the treatment of PTSD; 4) Polish law provides for criminal liability for possession of MDMA/ecstasy.
PL
Przedmiotem pracy uczyniono problematykę leczenia PTSD z wykorzystaniem MDMA jako sposobu przeciwdziałania zjawisku samobójstwa. Rozważania w tym zakresie przeprowadzono na tle polskiego prawa. W pracy wykorzystano metodę dogmatycznoprawną. Zdecydowano się przy tym skorzystać z derywacyjnej koncepcji wykładni prawa autorstwa M. Zielińskiego. Autor pracy ustalił, że: 1) PTSD może stanowić źródło zagrożenia dla życia i zdrowia człowieka w postaci targnięcia się przezeń na własne życie; 2) PTSD może być skutecznie leczone z wykorzystaniem MDMA; 3) polskie prawo nie pozwala na wykorzystywanie MDMA w leczeniu PTSD; 4) polskie prawo przewiduje odpowiedzialność karną za posiadanie MDMA/ecstasy.
PL
W artykule omówiono zagadnienie współwystępowania zaburzenia po stresie traumatycznym (PTSD) i zaburzeń związanych z używaniem substancji psychoaktywnych. Przedstawiono przegląd badań epidemiologicznych oraz modeli teoretycznych wyjaśniających mechanizmy związku między PTSD a uzależnieniem od alkoholu i innych substancji psychoaktywnych. Zaprezentowano również badania, które poszukują odpowiedzi na pytanie o naturę relacji między tymi dwoma rodzajami zaburzeń.
EN
This article discusses the problem of co-morbidity of posttraumatic stress disorder (PTSD) and substance abuse disorders. The author presents a review of epidemiological studies and theoretical conceptualizations on co-occurrence of PTSD and alcohol and drug abuse or dependence. In addition, a review of studies which explore the nature of the relationship between PTSD and substance abuse disorders is presented.
EN
The main goal of this article is to discuss the relationship between the level of posttraumatic stress disorder symptoms (PTSD) and the intensity of pain in various groups of individuals who experience chronic pain syndromes. This work aims also at demonstrating the role of psychosocial factors, such as personality traits, dimensions of body image and social support aspects that affect the relationship between the level of PTSD symptoms and the intensity of chronic pain in chronic pain syndromes.
PL
Głównym celem artykułu jest omówienie związku pomiędzy poziomem objawów zaburzenia po stresie traumatycznym (ang. PTSD - Posttraumatic Stress Disorder, PTSD) a nasileniem bólu w różnych zespołach przewlekłego bólu. Praca ta stawia sobie również za zadanie przybliżenie roli czynników psychospołecznych, takich jak cechy osobowości, wymiary obrazu ciała i właściwości wsparcia społecznego jako zmiennych modyfikujących relację pomiędzy poziomem objawów PTSD a nasileniem przewlekłego bólu w chronicznych zespołów bólowych.
PL
Celem badania była ocena charakteru i zakresu instytucjonalnego krzywdzenia dzieci przez austriacki Kościół katolicki oraz rozpoznanie obecnego stanu zdrowia psychicznego dorosłych, którzy w dzieciństwie padli ofiarą takiego krzywdzenia. Dane zbierano dwuetapowo. W pierwszej kolejności przeanalizowano dokumentację 448 dorosłych ofiar (M = 55,1 lat, 75,7% mężczyźni), które ujawniły doznane w dzieciństwie krzywdzenie, zeznając przed komisją ds. ochrony ofiar. Uwzględniono różne typy krzywdzenia, różne rodzaje sprawców i rodzinne czynniki ryzyka. W kolejnym etapie grupa 185 dorosłych ofiar została poproszona o wypełnienie kwestionariusza PCL-C (Posttraumatic Stress Disorder Checklist) oraz skróconego inwentarza objawów BSI (Brief Symptom Inventory). Uczestnicy opisywali ogromną różnorodność aktów przemocy fizycznej, seksualnej i emocjonalnej, do których doszło w okresie ich dzieciństwa. Większość ofiar (83,3%) doświadczyła w dzieciństwie krzywdzenia emocjonalnego. Odsetki dotyczące krzywdzenia seksualnego (68,8%) oraz fizycznego (68,3%) były prawie równie wysokie. Częstość występowania zespołu stresu pourazowego (PTSD) wyniosła 48,6%, a u 84,9% ofiar stwierdzono istotne klinicznie objawy w przynajmniej jednej z 10 kategorii objawów (dziewięć podskal BSI oraz PTSD). Nie udało się wyodrębnić konkretnego czynnika obecnego przed wystąpieniem krzywdzenia, który determinowałby rozwój PTSD w późniejszym życiu (np. ubóstwo, przemoc domowa). Zauważono jednak, że ofiary z rozpoznanym PTSD zgłaszały istotnie większą całkowitą liczbę rodzinnych czynników ryzyka (d = 0,33). Autorzy konkludują, że krzywdzenie instytucjonalne w dzieciństwie obejmuje szeroki zakres aktów przemocy, i bardzo silnie ujemnie wpływa na stan zdrowia psychicznego dorosłych, którzy jako dzieci takiego krzywdzenia doświadczyli. Artykuł odnosi się do długoterminowych skutków traumatycznych zdarzeń, nawiązuje też do odnowienia traumy w wieku dorosłym, ponieważ obydwa te zjawiska mogą być trudnym wyzwaniem dla profesjonalistów pracujących z ofiarami.
EN
The aim of this study was to explore the nature and dimensions of institutional child abuse (IA) by the Austrian Catholic Church and to investigate the current mental health of adult survivors. Data were collected in two steps. First, documents of 448 adult survivors of IA (M = 55.1 years, 75.7% men) who had disclosed their abuse history to a victim protection commission were collected. Different types of abuse, perpetrator characteristics, and family related risk factors were investigated. Second, a sample of 185 adult survivors completed the Posttraumatic Stress Disorder Checklist (PCL-C) and the Brief Symptom Inventory (BSI).Participants reported an enormous diversity of acts of violent physical, sexual, and emotional abuse that had occurred in their childhood. The majority of adult survivors (83.3%)experienced emotional abuse. Rates of sexual (68.8%) and physical abuse (68.3%) were almost equally high. The prevalence of PTSD was 48.6% and 84.9% showed clinically relevant symptoms in at least one 1 of 10 symptom dimensions (9 BSI subscales and PTSD).No specific pre-IA influence was found to influence the development of PTSD in later life (e.g. poverty, domestic violence). However, survivors with PTSD reported a significantly higher total number of family related risk factors (d = 0.33). We conclude that childhood IA includes a wide spectrum of violent acts, and has a massive negative impact on the current mental health of adult survivors. We address the long-term effects of these traumatic experiences in addition to trauma re-activation in adulthood as both bear great challenges for professionals working with survivors.
PL
W artykule przedstawiono czynniki wpływające niekorzystnie na stan zdrowia psychicznego uczestników misji wojskowych oraz zaburzenia psychiczne powstające na współczesnym polu walki. Głównym stresorem są zagrożenia wynikające ze służby w strefie działań wojennych, na które nakładają się ciężkie warunki klimatyczne, długotrwała rozłąka z rodziną, obcy język ludności miejscowej, odmienne zwyczaje i religia powodujące wyobcowanie personelu misji. Następstwem przeżytej traumy psychicznej, będącej wynikiem krótkotrwałego incydentu lub długotrwałego wydarzenia, są najczęściej zaburzenia pod postacią ostrej reakcji na stres lub zespołu stresu pourazowego. W przygotowaniu żołnierzy do wyjazdu na misje poza granicami kraju należy uwzględnić przygotowanie psychologiczne, umożliwiające im radzenie sobie w sytuacji ogromnego przeciążenia stresem.
EN
This article presents the factors affecting adversely on mental health status of participants of military missions and mental disorders emerging on the modern battlefield. The main stressors are threats being a result of duty in warfare, also hard climatic conditions, long-lasting separation from family, foreign language of local population, different customs, religion, caused alienation of mission personnel. The consequence of a traumatic psychic experience being a result of short-term incident or long-term event are often acute stress disorder (ASD) or posttraumatic stress disorder (PTSD). In the preparation of soldiers to leave for missions abroad should take into account the psychological preparation, which allows them to cope in a situation of great stress overload.
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