Validity and reliability of the Polish Maladaptive Daydreaming Scale (PMDS-16) and its short form (PMDS-5).

Maladaptive daydreaming (MD) defines excessive use of fantasy, which replaces human interaction and/or interferes with academic, interpersonal, or vocational functioning. This study tests psychometric properties of the Polish version of the Maladaptive Daydreaming Scale (PMDS-16) and a short 5-item version derived from it (PMDS-5), and their capacity to screen for MD. The relationship between MD, resilience and the quality of life was also explored. Validity and reliability were examined in a sample of 491 participants in nonclinical (n = 315) and mixed-clinical (n = 176) groups who completed the tests online. The exploratory factor analysis with principal component analysis method of parameter estimation without rotation confirmed a one-factor solution of both instruments. Reliability of both versions was corroborated by Cronbach's alpha coefficient (PMDS-16: >.941; PMDS-5: >.931). The cutoff score maximizing sensitivity and specificity for MD was 42 in both instruments, but the short version had better discriminating properties. People who identified themselves as maladaptive daydreamers in comparison to those who did not had significantly higher scores in both instruments. Maladaptive daydreamers also had lower quality of life in the psychological and social relationships domains and poorer resilience. Both PMDS-16 and PMDS-5 proved to have satisfactory psychometric properties. They have similar psychometric properties, although PMDS-5 has better discriminating power and can be used effectively for the screening of MD.

Trapped Between Theological and Medical Notions of Possession: A Case of Possession Trance Disorder With a 3-Year Follow-Up.

Few studies on Possession Trance Disorder (PTD) describe diagnostic and research procedures in detail. This case study presents the clinical picture of a Caucasian Roman-Catholic woman who had been subjected to exorcisms because of her problems with affect regulation, lack of control over unaccepted sexual impulses, and somatoform symptoms accompanied by alterations in consciousness. It uses interpretative phenomenological analysis to explore meaning attributed by her to "possession" as a folk category and a medical diagnosis; how this affected her help-seeking was also explored. This study shows that receiving a PTD diagnosis can reinforce patients' beliefs about supernatural causation of symptoms and discourage professional treatment. Dilemmas and uncertainties about the diagnostic criteria and validity of this disorder are discussed.

Polish Catholics Attribute Trauma-related Symptoms to Possession: Qualitative Analysis of Two Childhood Sexual Abuse Survivors.

In many cultures, people use the concept of spirit possession to explain abrupt changes in behavior and identity or problems with affect regulation. High incidence of traumatic experiences are also found among "possession" victims but there are few studies exploring in detail their clinical presentations. This study reports the symptoms of two women with a history of sexual abuse, labeled in their religious communities as possessed, and subjected to exorcisms. Following a thorough clinical assessment, interpretative phenomenological analysis was used to explore their meaning-making and help-seeking behavior. Accepting the demonic reappraisal of trauma-related symptoms and interventions offered by clergy contributed to receiving social support but discouraged them from seeking diagnostic consultations and trauma-focused therapy, leading to their continued symptoms. This justifies the need for educating religious leaders in recognizing and understanding basic psychopathological symptoms.

Revisiting False-Positive and Imitated Dissociative Identity Disorder.

ICD-10 and DSM-5 do not provide clear diagnosing guidelines for DID, making it difficult to distinguish 'genuine' DID from imitated or false-positive cases. This study explores meaning which patients with false-positive or imitated DID attributed to their diagnosis. 85 people who reported elevated levels of dissociative symptoms in SDQ-20 participated in clinical assessment using the Trauma and Dissociation Symptoms Interview, followed by a psychiatric interview. The recordings of six women, whose earlier DID diagnosis was disconfirmed, were transcribed and subjected to interpretative phenomenological analysis. Five main themes were identified: (1) endorsement and identification with the diagnosis. (2) The notion of dissociative parts justifies identity confusion and conflicting ego-states. (3) Gaining knowledge about DID affects the clinical presentation. (4) Fragmented personality becomes an important discussion topic with others. (5) Ruling out DID leads to disappointment or anger. To avoid misdiagnoses, clinicians should receive more systematic training in the assessment of dissociative disorders, enabling them to better understand subtle differences in the quality of symptoms and how dissociative and non-dissociative patients report them. This would lead to a better understanding of how patients with and without a dissociative disorder report core dissociative symptoms. Some guidelines for a differential diagnosis are provided.

Delusions of Possession and Religious Coping in Schizophrenia: A Qualitative Study of Four Cases.

The notion of evil spirits influencing human behavior or mental processes is used in many cultures to justify various symptoms or experiences. It is also expressed in psychotic delusions of possession, but there is limited research in this area. This study explores how patients with schizophrenia came to the conclusion that they were possessed, and how this affected help-seeking. Interviews with two men and two women about their experiences and meaning-making were subjected to interpretative phenomenological analysis. Three main themes were identified: (1) Links between traumatic experiences and psychotic symptoms, (2) The emergence of religious themes in delusional contents, and (3) Reluctance to use medical treatment and instead to seek exorcism. In each case, attributing problems to possession was supported by the local environment and media, led to seeking spiritual help, and delayed diagnostic assessment and treatment. However, using religious coping contributed to the sense of predictability and social support. Clinicians are encouraged to explore the experiences and conflicts expressed by the symptoms which people ascribe to possession and to negotiate alternative explanatory models with their patients.

Maladaptive daydreaming as a new form of behavioral addiction.

BACKGROUND AND AIMS: Maladaptive daydreaming (MD) has many features of behavioral addiction, but research exploring this syndrome is limited. This case study provides a qualitative exploration of MD. METHODS: A structured clinical interview and mental state examination of a patient with MD were video-recorded and transcribed verbatim. Transcripts were subjected to the interpretative phenomenological analysis. RESULTS: MD was developed as a strategy to cope with distress but led to uncontrollable absorption in fantasy, social withdrawal, and neglecting aspects of everyday life. It was coupled with excessive Internet use and viewing porn. DISCUSSION AND CONCLUSIONS: Patients should be questioned about MD during clinical assessment. Further studies are necessary to determine whether MD constitutes a separate syndrome or is a part of other behavioral addictions.

Exorcism Leads to Reenactment of Trauma in a Mauritian Woman.

Childhood trauma can have a lasting effect on personality and daily functioning, leading to dissociative changes in behavior and identity. How these are interpreted and handled usually depends on local culture and beliefs. This article presents the case of a Mauritian woman with a history of childhood abuse who was exorcised to "dispel an evil spirit." An in-depth interview exploring her experiences and meaning-making was transcribed and subjected to interpretative phenomenological analysis. This article discusses possession as a culturally accepted metaphor for incomprehensible behaviors. It shows that help-seeking pathways are determined by symptom interpretation models that are reinforced by the local environment. It also demonstrates that exorcisms are potentially retraumatizing by the enactment of painful memories and emotions during this ritual. The authors stipulate that exorcism seekers could benefit from additional clinical assessment by professionals experienced in the dissociation field.

Work activity in the process of recovery - an interpretive phenomenological analysis of the experiences of people with a schizophrenia spectrum diagnosis. / Aktywnosc zawodowa w procesie zdrowienia ­ interpretacyjna analiza fenomenologiczna doswiadczen pacjentów ze spektrum schizofrenii.

OBJECTIVES: Having the opportunity to work has been found meaningful for individuals suffering from severe mental illness, in order to boost their self-esteem, provide a sense of control over their lives and of belonging to a community. There are no studies in Polish literature on the process of recovery from schizophrenia with reference to work activity. The objective of this research was to explore personal experiences of people employed in Vocational Development Centers. METHODS: Eight semi-structured interviews were conducted with adult patients. Their transcripts were subject to interpretative phenomenological analysis (IPA). RESULTS: Having the opportunity to work was significant for participants because it mobilized them and encouraged self-care. G oing to work helped them overcome social isolation by meeting people with similar difficulties and those who did not suffer from mental illness. Financial gratification enables a sense of independence and the ability to develop skills to plan and control their budget. CONCLUSIONS: This study finds that patients who lost their jobs due to mental illness should be encouraged to utilize rehabilitation institutions to help them undertake work activity and use previously acquired qualifications or develop new skills. Access to appropriate psychological support should be provided during vocation reorientation and adaptation into new work environments. This helps patients regain a sense of control and purpose, and cope with losing valued social roles. We also highlight the need for further studies into challenges in the workplace and the strategies patients use to cope with them.

Living in Sin? How Gay Catholics Manage Their Conflicting Sexual and Religious Identities.

Religious principles and values provide meaning and affect personal identity. They may also conflict with intimate needs and desires. This article examines how gay Catholics manage conflicting areas between their sexual and religious selves. Eight Polish gays with a Catholic background, who identified themselves as strong believers, shared their experiences during semi-structured interviews that were subjected to interpretative phenomenological analysis. Results showed that internalization of the principles taught by the Roman Catholic Church triggered a conflict when participants became aware of their homosexuality. They used a number of strategies to reconcile conflicting identities, including limiting their religious involvement, questioning interpretation of the doctrine, undermining priests' authority, trying to reject homosexual attraction, putting trust in God's plan, using professional help, and seeking acceptance from clergy. This study alerts mental health professionals to specific risk factors associated with experiencing a religious conflict, and offers guidelines for counseling and further research.

Crossing the Boundaries of Privacy in Accidental Encounters: Interpretative Phenomenological Analysis of Therapists' Experiences.

UNLABELLED: This qualitative study explores psychodynamic therapists' experiences associated with unexpected encounters with their patients outside the clinical setting. Information was collected using a semi-structured interview protocol from 10 experienced practitioners in Poland and examined according to the interpretative phenomenological analysis principles. Four overarching themes are discussed in the paper. Results show that accidental encounters often challenged practitioners' privacy, led to involuntary self-disclosure (causing discomfort and distress) and required re-negotiating roles and boundaries in the new context. Various coping strategies were also identified and analysed, including withdrawal, anticipation and avoidance, as well as using community support. Findings are discussed in terms of their implications for mental health professionals and psychotherapy training. KEY PRACTITIONER MESSAGE: All people manage their boundaries of privacy. Therapists should thoroughly consider circumstances, and personal or situational risk factors, which lead to crossing or violating these boundaries. They need to reflect upon the social and personal limitations associated with their occupation and the price they have to pay for the high status role.

Concept mapping with South Asian immigrant women: barriers to mammography and solutions.

Despite benefits of screening mammography, many South Asian (SA) immigrant women in Canada remain under screened. We aimed to elicit their experiences and beliefs about barriers to mammography and possible solutions. SA immigrant women aged 50 years or over were eligible if they never had a mammogram or had one more than 3 years ago. We employed the participatory mixed-method approach of Concept Mapping. Sixty women participated with a mean age of 58 years. Participants brainstormed 150 items which were consolidated into 67 items. After sorting and rating, cluster analysis revealed eight clusters of barriers on knowledge, fear, language and transportation, access to mammogram center, access to doctor, beliefs and practices, self-care, and family dependence. Participants discussed possible solutions, and emphasized out-reach models to address knowledge gaps and issues of language and transportation. One example was a community-based shuttle bus to screening centres, hosted by trained co-ethnic workers. The results are discussed to enhance the socio-cultural sensitivity of breast screening programs.