Among adult psychiatric outpatients, narcissistic vulnerability is more strongly related to depressive symptoms than narcissistic grandiosity, and dysfunctional perfectionism represents one of the underlying mechanisms of this relationship. The implications of these findings are discussed in relation to the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria and the treatment of pathological narcissism.
In the research project on sexual abuse of men during the war in Croatia and Bosnia and Herzegovina, detailed information from 60 victims of such crimes was gathered. The aim of the research was to define key attributes of sexual abuse of men in war as well as consequences it had on the victims. A method of structured interview was used. Also, the statement of each victim was recorded. Victims were exposed to physical torture of their genitals, psycho-sexual torture and physical abuse. The most common symptoms of traumatic reactions were sleep disturbances, concentration difficulties, night-mares and flashbacks, feelings of hopelessness, and different physical stress symptoms such as constant headaches, profuse sweating, and tachycardia. In addition to rape and different methods of sexual abuse, most of the victims were heavily beaten. The conclusion is made that the number of sexually abused men during the war must have been much higher than reported.
SUMMARY Posttraumatic stress disorder (PTSD) is a chronic condition related to
AimTo investigate the association between depression, metabolic syndrome (MBS), somatic, particularly cardiovascular comorbidity, and low-grade chronic inflammation assessed using C-reactive protein (CRP).MethodsThis cross-sectional study included 76 patients with recurrent depressive disorder (RDD) and 72 non-depressed medical staff controls from the Department of Psychiatry, University Hospital Center Zagreb between January 2011 and June 2012.ResultsSeventy-five percent of patients had somatic comorbidity. The most common comorbid conditions were cardiovascular disorders (46.1%), locomotor system diseases (35.5%), carcinoma (15.8%), thyroid diseases (9.2%), and diabetes (9.2%). MTB was more common in RDD patients (31.6%) than in controls (23.6%), but the difference was not significant. Elevated CRP was found to be significantly more frequent in patients with recurrent depressive disorders (RDD) (35.5%; χ2 test, P = 0.001, Cramer V = 0.29) than in controls (12.5%) and was associated with lowered high-density lipoprotein and overweight/obesity.ConclusionWe found some intriguing links between stress, depression, metabolic syndrome, and low grade inflammation, which may be relevant for the prevalence of somatic comorbidity in patients with RDD, but further studies are needed to confirm our results.
PurposeTo investigate the connection between alexithymia and somatic illness, or, somatization, in veterans suffering from chronic combat-related post-traumatic stress disorder, PTSD.MethodsCroatian combat veterans (N=127) were studied at the Department of Psychology, Zagreb Clinical Hospital Center. The diagnosis of PTSD was confirmed and verified according to the International Classification of Diseases (ICD-10). A version of the Mississippi Scale for Combat Related PTSD (M-PTSD) standardized for the Croatian population was used to assess the severity of PTSD. In addition to the clinical interview, the existence of alexithymia was confirmed by the score on the Toronto Alexithymia Scale (TA S-20).ResultsA statistically significant association was found between the total number of diagnosed physical illnesses and the scores on three subscales of an alexithymia questionnaire, the TA S-20, with a 1% risk (p<0.01, 0.487; 0.450; 0.335). Regression analysis confirmed the most statistically significant predictive value of the first item of the TA S-20, which refers to difficulty in identifying feelings (=0.408, p=0.019). The total score on the M-PTSD scale correlated significantly to the subscales for alexithymia. There was a statistically significant negative correlation of the total score on the M-PTSD scale with social support.ConclusionThe total scores obtained in this study, particularly those related to alexithymia, indicate the importance of this construct in the etiopathogenesis of somatic morbidity in the study population and confirm that as in other countries the TA S-20 is a useful instrument in Croatia for the assessment of this phenomenon.
Background:This study examined testimonies of women who were sexually assaulted multiple times by multiple unknown offenders. In these testimonial narratives, it is possible to detect specific modalities of traumatic event expression. This expression lacks any spatial, temporal, auditory or emotional determinants of the event.Subjects and methods: These fourteen women (out of 17) were imprisoned and forcefully isolated in detention camps or private houses in the occupied territories of Croatia and Bosnia and Herzegovina, during the war. At the same time, some of these women were raped by the offenders that were previously known to them. The average length of detention was 141 days among the seventeen victims (range of 7 to 395 days), while the average time from the first day of imprisonment to the first day of testimony was 311 days (range of 30 to 889 days).Results: Based on the narrative descriptions of the events acquired from these testimonies, our analysis showed that these expressions differed when the offender was known to the victim, contrasted to the situation when the offender was completely unknown. This finding has a significant implication in victim's testimony at judicial hearings. Specifically, women that were raped by unknown perpetrator(s) were often unable to provide persuasive testimony and their recollection of the events was deemed insufficient for the further prosecution. Testimonies in these cases substantially lacked in vividness and were devoid of visuospatial determinants of the rape event. Consequently, this often resulted in the case's dismissal.Conclusion: The unusual and problematic expression of these traumatic memories might indicate that these events were not properly stored in the conceptual form of memory. Ultimately, victims could not make any coherent recollection or reconstruct the cascade of events by using perceptual information. We argue that this could be due to an aberrant mechanism of memory storage and difficulties that emerge on the level of sensory input. This problem needs to be further examined and correspondingly accounted for since it can exert significant influence on judicial outcomes in the domain of sexual assault cases worldwide.
СажетакУвод. Ризик од можданог удара у пацијената са атријалном фибрила-цијом (АФ) може се значајно умањити адекватном антикоагулантном про-филаксом. Антагонисти витамина К представљају први и једини терапијски избор за већину наших пацијената, међутим, у свакодневној пракси тешко је постићи задовољавајући коагулациони статус, што повећава ризик од на-станка нежељених догађаја -тромбоемболијских и хеморагијских.Циљ рада. Проценити квалитет антикоагулантне терапије пацијена-та са атријалном фибрилацијом одређивањем времена у терапијском опсе-гу -TTR (Time in therapeutic range) и утврдити повезаност квалитета INR (International normalized ratio) контроле са појавом шлога, системских тром-боемболија и крварења.Метод. Истраживањем по типу ретроспективне студије је обухавћено 198 пацијената Дома здравља ''Нови Београд'' са невалвуларном атријалном фибрилацијом који су регулисали INR у установи примарног нивоа здравс-твене заштите од јула 2014. до јануара 2016. године.Резултати. Просечно време током кога су пацијенти имали INR у те-рапијском опсегу TTR (Тime in therapeutic range), било је 61,21% ± 25,4%. Незадовољавајућа INR контрола дефинисана као TTR<65% регистрована је код 43,5% испитаника. Током периода праћења није пријављен ниједан нови тромбоемболијски догађај, али су у 7,5% пацијената регистроване хемора-гијске компликације. Компликације су биле учесталије у испитаника са ло-шијом INR контролом, али разлика није била статистички значајна (χ²=1,195 за SS1; p=0,274 ).Закључак. Постигнут ниво регулације антикоагулантне терапије у Дому здравља ''Нови Београд'' са просечним временом у терапијском опсегу 61,21% иако испод препоручених вредности (TTR≥65%), може се сматрати задовољавајућим јер није значајније одступао у односу на друге европске земље. Кључне речи:време у терапијском опсегу, витамин К антагонисти, примарна здравствена заштита, невалвуларна атријална фибрилација, општа медицина
Background:This study examined testimonies of women who were sexually assaulted multiple times by multiple unknown offenders. In these testimonial narratives, it is possible to detect specific modalities of traumatic event expression. This expression lacks any spatial, temporal, auditory or emotional determinants of the event.Subjects and methods: These fourteen women (out of 17) were imprisoned and forcefully isolated in detention camps or private houses in the occupied territories of Croatia and Bosnia and Herzegovina, during the war. At the same time, some of these women were raped by the offenders that were previously known to them. The average length of detention was 141 days among the seventeen victims (range of 7 to 395 days), while the average time from the first day of imprisonment to the first day of testimony was 311 days (range of 30 to 889 days).Results: Based on the narrative descriptions of the events acquired from these testimonies, our analysis showed that these expressions differed when the offender was known to the victim, contrasted to the situation when the offender was completely unknown. This finding has a significant implication in victim's testimony at judicial hearings. Specifically, women that were raped by unknown perpetrator(s) were often unable to provide persuasive testimony and their recollection of the events was deemed insufficient for the further prosecution. Testimonies in these cases substantially lacked in vividness and were devoid of visuospatial determinants of the rape event. Consequently, this often resulted in the case's dismissal.Conclusion: The unusual and problematic expression of these traumatic memories might indicate that these events were not properly stored in the conceptual form of memory. Ultimately, victims could not make any coherent recollection or reconstruct the cascade of events by using perceptual information. We argue that this could be due to an aberrant mechanism of memory storage and difficulties that emerge on the level of sensory input. This problem needs to be further examined and correspondingly accounted for since it can exert significant influence on judicial outcomes in the domain of sexual assault cases worldwide.
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