Time perspective and self-stigma in schizophrenia.

BACKGROUND: Time perspective (TP) offers a new understanding of human personality, postulating that there are individual differences in how our mind assigns our experiences to different time categories. This concept may shed new light on the role of personality traits in shaping vulnerability to the internalized stigma. AIM: In this paper we propose a novel approach to clarifying the underpinning of self-stigma by empirically exploring its links with TP. METHOD: We conducted a cross-sectional study among 86 patients with ICD-10 diagnoses of paranoid schizophrenia to validate the predictive role of TP for self-stigma. We used the Zimbardo Time Perspective Inventory (ZTPI), Internalized Stigma of Mental Illness scale (ISMI) and Brief Psychiatric Rating Scale (BPRS). RESULTS: We found significant positive correlations of self-stigma with Past-Negative, Future-Negative and Present-Fatalistic TP categories and negative correlation with the Future-Positive category. The hierarchical regression analyses revealed that two TP categories and Deviation from the Balanced Time Perspective (DBTP) are significant predictors of self-stigma over and above sociodemographic and clinical control variables. Conclusion. The results of the study confirm the hypothesis that TP opens new possibilities to understand proneness or resistance to self-stigmatization, and this may provide a basis for novel approaches to anti-self-stigma interventions.

General Overview of Psychotherapeutic Practice in Poland. Results from a Nationwide Survey.

A total of 1196 persons conducting psychotherapy in Poland fully completed a nationwide online survey (or, alternatively, a paper and pencil enquiry) concerning their education, training, experience, and clinical work (professional environment, patients treated). The results are described in detail and compared with findings of similar studies from other countries. Among the primary findings were: (1) psychotherapy in Poland is conducted mostly by women (80 %); (2) almost all participants have an MA degree (91 %), including 75.2 % having graduated in psychology; (3) the therapists are well trained (mean number of training hours is above 942) and established (average experience is about 9.8 years), however, more than half of the therapists have no type of certificate; (4) 54 % of respondents identify with the integrative or eclectic orientation and, simultaneously, for 48.6 % of the therapists the most important approach is either psychodynamic or psychoanalytic; (5) the most common form of therapy is individual psychotherapy in private practice; (6) the majority of the therapists treat adult patients with anxiety or personality disorders. In sum, the results show that psychotherapeutic practice is well established in Poland and many indices are similar to those found in Western countries.

The Polish Academic Version of the MATRICS Consensus Cognitive Battery (MCCB): Evaluation of Psychometric Properties.

Work and social functioning in schizophrenia are strongly influenced by cognitive impairment so improving cognition is a priority in the treatment of schizophrenia. Until recently the lack of a widely accepted index of cognitive change for use in schizophrenia was a major obstacle to the development of cognition enhancing treatments. The MATRICS (measurement and treatment research to improve cognition in schizophrenia) consensus cognitive battery (MCCB) was developed as a standard cognitive battery for use in clinical trials of cognition enhancing treatments for schizophrenia and has attracted worldwide interest. To analyze the reliability and validity of a translated and adapted Polish approved academic version of the MCCB. Sixty one patients were assessed at baseline and again after 30 days. The study protocol approximated the MATRICS psychometric and standardization study; the 10 tests that comprise the MCCB were administered to participants. Functioning and psychopathological symptoms were also assessed. Patients and test administrators also assessed the tolerability and practicality of all the cognitive tests. All tests in the battery were found to have high test-retest reliability. All the tests were rated as tolerable and practical by patients and administrators. However practice effects were generally higher in the Polish version of the MCCB than in the original version. Our analysis corroborates previous evidence that the MCCB represents a good tool for assessing cognitive deficits in research studies of schizophrenia also in non-English speaking countries.

[Task related stress and cognitive control in patients with schizophrenia]. / Stres zwiazany z wykonywaniem zadania a kontrola poznawcza u osób chorujacych na schizofrenie.

OBJECTIVES: Working memory deficits might be one of the major cognitive impairments in schizophrenia. Some researchers argue, that cognitive control is especially disturbed among schizophrenia patients. It was found, that low working memory capacity in schizophrenia may be explained by the fact that irrelevant stimuli occupy patients' storage space that could otherwise be used to hold relevant information. AIM: We examined, whether increased distress as well as the tendency to focus on irrelevant information (worry) are related to cognitive control in schizophrenia. METHODS: The participants were 28 patients with paranoid schizophrenia and a control group (n=28). The cognitive control was measured with the short version of Attention Networks Test (ANT), and the state of worry and distress was assessed by the short version of the Dundee Stress State Questionnaire (DSSQ) in a Polish adaptation. RESULTS: The stress states of worry and distress were higher among patients in comparison to controls. Moreover, worry mediated the relationship between group and cognitive control task. CONCLUSIONS: The mediation model suggested that patient's poorer performance on cognitive control task might partially explained by their increased state of worry (focus on task unrelated thoughts) measured just before the task.

[Differences in effectiveness of intensive programs of treatment for neurotic and personality disorders. Is it worth to monitor the effectiveness of the therapeutic team?]. / Róznice w zakresie skutecznosci intensywnych programów leczenia zaburzen osobowosci i nerwic. Czy warto monitorowac efektywnosc zespolu terapeutycznego?

OBJECTIVES: To test whether three different intensive programs of treatment for neurotic and personality disorders are effective in decreasing neurotic symptoms and traits of neurotic personality and whether there are differences between them in clinical outcome. METHOD: The sample consisted of 105 patients (83% female, mean age 35) diagnosed with neurosis and personality disorders that were treated in three therapeutic wards under routine inpatient conditions. The therapeutic programs are designed for patients with neurotic and personality disorders. They consist of 6-12 weeks of approximately 5 hours of eclectic group treatment (group psychotherapy, psychodrama, psychoeducation etc.). Participants filled in Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. RESULTS: The treatment proved to be effective in diminishing neurotic symptoms (d Cohen = 0.56). More detailed analysis revealed that there was a significant interaction between the three analysed therapeutic wards and the effectiveness (12 = 0.09). The treatments offered in two institutions were effective (d Cohen = 0.80) while one of the programs did not lead to significant improvement of the patients. None of the therapeutic wards proved to be effective in changing the neurotic personality traits. CONCLUSIONS: There are significant differences in effectiveness of the intensive programs of treatment for neurotic and personality disorders. In the light of the literature, one can assume that the differences are more connected with the characteristics of therapeutic teams than with the methods used. The need for standard methods of effectiveness monitoring is discussed.

[The assessment of chosen psychometric features of B-CATS test battery in schizophrenia - preliminary report]. / Ocena wybranych wlasciwosci psychometrycznych baterii testów do pomiaru funkcjonowania poznawczego pacjentów psychotycznych B-CATS - wstepne opracowanie.

AIM: The assessment of cognitive impairment in schizophrenia proves helpful in the diagnosis of disease, identification of individuals at risk for adverse outcome and choosing the most adequate treatment. It is also a valuable complement of the psychiatric diagnosis. For this reason, there is a great need for a practical well-validated instrument to measure cognitive deficits that can be administered and interpreted easily in a clinical setting. The aim of the study was to verify the reliability, validity and practicality of the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) in a clinical setting. METHODS: 68 psychotic patients were included in the study during their stay in a psychiatric ward. A double measurement was conducted. Test-retest assessment included tests of B-CATS battery (TMT part B, Category Fluency, Digit Symbol Test). To evaluate the intensity of psychopathological symptoms the PANSS was performed. SLOF, GAF, GARF, SOFAS were used to assess functioning of the subjects. RESULTS: The B-CATS is characterized by a satisfactory relative stability. The absolute stability should be seen as sufficient in case of one test: Fluency. The diagnostic validity of the battery is satisfactory. B-CATS is easy to administer and "friendly" for the patient. CONCLUSIONS: B-CATS is a brief and practical instrument that can provide clinicians with meaningful data regarding the global cognitive functioning of the psychotic subjects.

Time matters for mental health: a systematic review of quantitative studies on time perspective in psychiatric populations.

PURPOSE OF REVIEW: The ability to perform mental time travels and to develop representations of the past, the present, and the future is one of the distinctive capacities of the human mind. Despite its pronounced consequences for motivation, cognition, affect, and subjective well being, time perspective (TP) has been outside mainstream psychiatry and clinical psychology. We highlight the role of psychological-temporal phenomena in various disorders and summarize the current research on TP and psychopathology. RECENT FINDINGS: Our review ultimately comprised 21 articles, including 18 unique datasets. It revealed that persons with different psychiatric diagnoses (attention defict hyperactivity disorder (ADHD), alcohol dependence, anxiety disorders, depression, bipolar disorder, personality disorders, posttraumatic stress disorder, schizophrenia) display different temporal profiles than control groups. We also found marked associations between temporal features and psychiatric symptom severity. The effects of specific TPs vary across different psychiatric diagnoses and to some extent between various age groups, with a consistent, widespread, and nonspecific effect of past-negative and less balanced, inflexible TP profile. SUMMARY: Based on the review, TP biases are crucial factors in symptom development, while adaptive temporal profiles can serve as protective features against mental disorders. Understanding cognitive-temporal processes can enhance comprehension of psychopathological conditions and facilitate the development of temporality-focused clinical interventions.

Change in self-concept differentiation after psychotherapy and its relation to psychological maladjustment.

The research was carried out with a group of 105 psychotherapy participants, diagnosed with neurosis or personality disorders, and 36 controls. Analysis supported the hypotheses that self-concept differentiation (SCD) decreases after psychotherapeutic interventions and that the reduction in SCD is positively correlated with an improvement in neurotic symptoms and neurotic personality traits.

Visual worry in patients with schizophrenia.

OBJECTIVE: Worrying is a pervasive transdiagnostic symptom in schizophrenia. It is most often associated in the literature with verbal modality due to many studies of its presence in generalised anxiety disorder. The current study aimed to elucidate worry in different sensory modalities, visual and verbal, in individuals with schizophrenia. METHOD: We tested persons with schizophrenia (n = 92) and healthy controls (n = 138) in a cross-sectional design. We used questionnaires of visual and verbal worry (original Worry Modality Questionnaire), trait worry (Penn State Worry Questionnaire) and general psychopathology symptoms (General Functioning Questionnaire-58 and Brief Psychiatric Rating Scale). RESULTS: Both visual and verbal worry were associated with psychotic, anxiety and general symptoms of psychopathology in both groups with medium to large effect sizes. Regression analyses indicated that visual worry was a single significant predictor of positive psychotic symptoms in a model with verbal and trait worry, both in clinical and control groups (ß's of 0.49 and 0.38, respectively). Visual worry was also a superior predictor of anxiety and general psychopathology severity (ß's of 0.34 and 0.37, respectively) than verbal worry (ß's of 0.03 and -0.02, respectively), under control of trait worry, in the schizophrenia group. We also proposed two indices of worry modality dominance and analysed profiles of dominating worry modality in both groups. CONCLUSIONS: Our study is the first to demonstrate that visual worry might be of specific importance for understanding psychotic and general psychopathology symptoms in persons with schizophrenia.

Psychometric properties of the General Functioning Questionnaire (GFQ-58) used for screening for symptoms of psychopathology and overall level of functioning. / Wlasciwosci psychometryczne Kwestionariusza Ogólnej Oceny Funkcjonowania (KOOF-58) sluzacego do przesiewowego pomiaru nasilenia objawów psychopatologicznych i poziomu ogólnego funkcjonowania.

OBJECTIVES: Measuring severity of psychopathological symptoms using self-assessment questionnaires is important for clinical and scientific research. However, there is no widely-available Polish tool which measures both overall functioning and severity of a broad spectrum of psychopathological symptoms. This paper describesthe designing of such a tool -the General Functioning Questionnaire (GFQ-58). METHODS: Three studies were conducted to verify the validity and reliability of the GFQ-58: (1)a study comparing 30 individuals diagnosed with schizophrenia and 30 with no psychiatric diagnosis; (2) a correlational study on 602 individuals exploring relationships between the GFQ-58 and tendency for rumination and quality of life; and (3) a study on 37 patients from a ward which treats neurotic and personality disorders, exploring the relationships between the GFQ-58 and tools for measuring severity of psychopathological symptoms, overall functioning and neurotic personality. RESULTS: The first study revealed large differences between individuals suffering from schizophrenia and healthy individuals in the overall score of the questionnaire (p < 0.001; d = 1.30) and some of its subscales. The second study showed strong relations between the GFQ-58 and both severity of rumination (p < 0.001; . = 0.64) and quality of life (p < 0.001; .=-0.81). The third study identified relationships between the GFQ-58 and tools measuring various psychopathological symptoms, overall functioning and neurotic personality. These relationships were moderate or strong (all p . 0.001; r =0.43-0.86). Reliability of the overall score was satisfactory in all studies (Cronbach's . = 0.89-0.92). CONCLUSIONS: The GFQ-58 has satisfactory validity and reliability. It can be used in both scientific and clinical research as a screening tool for measuring overall functioning and severity of psychopathological symptoms.

Polish Version of the Managing the Emotions of Others Scale (MEOS): Psychometric Properties and Validation.

The present study aimed to test the psychometric properties of the Polish version of the managing the emotions of others scale (MEOS). MEOS consists of six dimensions: mood enhancing (Enhance), mood worsening (Worsen), concealing emotions from others (Conceal), use of inauthentic displays for self-serving purposes (Inauthentic), poor emotion skills (Poor skills), and use of diversion to enhance another's mood (Divert). The results showed that among MEOS dimensions, Enhance was the most strongly related to performance-based emotional intelligence. Among the Dark Triad, Narcissism was related to the greatest number of MEOS subscales-all except Poor skills. The results indicated that the MEOS has a similar factor structure, reliability, and pattern of correlations with personality and emotional intelligence in Poland as in previous studies.

Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change.

BACKGROUND: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and "V" shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a "V" shape or fluctuations is optimal for more disturbed patients. METHOD: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. RESULTS: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and "V" shape of SCC change. CONCLUSIONS: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis.

A computational approach to quantifiers as an explanation for some language impairments in schizophrenia.

UNLABELLED: We compared the processing of natural language quantifiers in a group of patients with schizophrenia and a healthy control group. In both groups, the difficulty of the quantifiers was consistent with computational predictions, and patients with schizophrenia took more time to solve the problems. However, they were significantly less accurate only with proportional quantifiers, like more than half. This can be explained by noting that, according to the complexity perspective, only proportional quantifiers require working memory engagement. LEARNING OUTCOMES: (1) Working memory deficits can be a source of language disorders in schizophrenia. (2) Processing of proportional quantifiers, like more than half or less than half involves working memory. (3) Patients with schizophrenia are less accurate only with proportional quantifiers, like more than half. (4) This result support the computational model of quantifiers processing.