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Biblioteka Psychiatrii Polskiej
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Archives of Psychiatry and Psychotherapy
Issue 1 March 2005
Content

Moktar Isaac, Kajetan K. Zakrzewski
The Anticipated influx of East European Psychiatrists - a sample of colleagues views from East Sussex, England     5
Summary: The entry of East European countries to EU has raised hopes and fears in a number of debates. Doctors from the entrant countries are at the forefront of debate if not only for widely acknowledged shortages of doctors, in particular - psychiatrists, in UK. We conducted a small survey aiming to explore the opinion of local psychiatrists at East Sussex in terms of the perceived numbers and characteristics of their peers from Eastern Europe. Since neither real numbers nor the characteristics of potential arrivals were known at the time of this study , this survey may serve as a test of attitudes towards them , of their UK counterparts. The survey had an 89% response rate. The opinions varied according to respondents' grades and personal characteristics with consultants - more than other grades - sceptical about the numbers of likely arrivals and unreservedly in favour of an immediate absorption of East European colleagues into the UK system.
Kevin P. Reilly, Michael J. Gill, Frank M. Dattilio, Amanda McCormick
Panic and Agoraphobia: Do Treatments Targeted for One Problem Also Improve the Other? A Pilot Study      11
Summary: Background and aim: The objective of this research was to compare the effectiveness of three different interventions (i.e., guided mastery, interoceptive exposure, and a combination treatment) in the treatment of panic and agoraphobia during a brief pilot study. Material and method: Nine individuals were randomly assigned to each treatment group and given six hours of treatment. It was predicted that guided mastery participants would show the greatest reductions in agoraphobic symptoms, while interoceptive exposure participants would display the greatest reductions in symptoms of panic. Results: Contrary to these predictions, all treatments were equally beneficial for both panic and agoraphobia. It was also predicted that treatment benefits for panic and agoraphobia would be moderated by changes in fear-of-fear, anticipated panic, panic coping efficacy, and agoraphobic self-efficacy. Results indicated that all of these variables moderated treatment benefits for panic, whereas only agoraphobic self-efficacy and anticipated panic mediated treatment benefits for agoraphobia. Conclusion: The findings are discussed in light of past research along with suggestions for the direction of future research.
 
  Anna Citkowska-Kisielewska, Jerzy W. Aleksandrowicz
Obsessive-compulsive disorder - psychopathology and therapy     29
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Summary: The review of the literature and the authors' preliminary research findings indicate non-homogeneity of the group of patients diagnosed with obsessive-compulsive disorder (OCD). The group is differentiated, among other things, by specific features of their symptoms. Selection of experimental patient groups diagnosed using the ICD-10 criteria is unjustified, and this may explain discrepant results of psycho - and pharmacotherapy outcome studies. Psychotherapy is most probably more effective than pharmacotherapy in the treatment of OCD of neurotic nature, while pharmacotherapy - in cases of compulsions due to organic changes in the CNS. The latter include either neurotransmission disturbances (where pharmacotherapy is recommended), or anatomical abnormalities, e.g. neoplastic process (it is in such cases only that neurosurgical intervention may be considered).
Maria Rostworowska, Małgorzata Opoczyńska, Bogdan de Barbaro
Systems Consultation: Opportunities and Limitations     43
Summary: The paper presents the role of systemic consultation in the diagnosis and therapeutic process of the people hospitalised for the first time because of a psychotic episode. The following questions are going to be put: What is the role of systemic family consultation in the diagnostic and therapeutic process on the inpatient ward? What are the differences between systemic consultation and others forms of family interventions e.g. family interviews, psycho-education, systemic therapy? What are the possibilities and limitations of such a consultation? What does it invite to? These are only some of those questions, which are typical for daily clinical practice, in which the family consultation takes an important part. In this paper, we would like to share some of our thoughts on the questions put, according to our clinical experience. I spite of difficulties the family consultation confronts us with, we are deeply convinced that it has an important part in the therapeutic and diagnosis process.
 
  Jeremy Holmes
Disorganised attachment and borderline personality disorder: a clinical perspective     51
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Summary: The aim of this paper is to explore the links between the attachment-theory derived concept of disorganised attachment, and the psychiatric diagnosis of Borderline Personality Disorder (BPD). Disorganised attachment can be understood in terms of an approach-avoidance dilemma for infants for whom stressed or traumatised/traumatising caregivers are simultaneously a source of threat and a secure base. Interpersonal relationships in BPD including those with care givers is similarly seen in terms of approach-avoidance dilemmas, which manifests themselves in disturbed transference/countertransference interactions between therapists and BPD sufferers. Possible ways of handling these phenomena are suggested, based on Main's (1995) notion of 'meta-cognitive monitoring', in the hope of re-instating meaning and more stable self-structures, in these patients' lives.
Kamilla Bargiel-Matusiewicz M.A., Anna Trzcieniecka-Green, Agata Krupa, Marek Krzystanek
Reaction Phases Following an HIV Positive Diagnosis     63
Summary: Objective: The subject of the article is the process of coping with the awareness of being HIV positive and defining the phases of reaction. A patient's psychic state is subject to many changes connected with the specific character of a given somatic illness. Most commonly an illness and its after-effects are burdensome circumstances for a patient and they cause disturbances in many areas of life. The emotions connected with an illness are usually negative and intense. Methods: The study group consisted of HIV positive patients. They had known about their diagnosis for a period of three to sixteen months. Using the results of the Appraisal of Phases of Reaction Questionnaire they were allocated to specific phases. Results Three percent were in the shock phase and twelve percent in the reaction phase. Sixty five percent could be described as being in an adaptation phase. Twenty percent had moved to a phase of transformed self-experience, where they were able to take a different view of their lives. Conclusion: Apart from the cognitive value of encountering the complexity and dynamics of reactions to being HIV positive the findings may also be applied in beginning to alleviate patients' emotional discomfort.
 
  Mark E. Burno
Native Psychotherapy in Russia     71
Summary: The peculiarities of Russian psychotherapy, first of all, are connected in their origin with native national-psychological features of the Russians and especially Russian intelligentsia. These national-psychological peculiarities can be seen at different times in Russian science and Russian art. These are anxiety dreaming, impracticability and, at the same time, inclination to complicated realistic, materialistic analysis with deep sympathy for the suffering "little man". It is just this together with social conditions and changes that brought about the appearance of the Russian psychotherapeutic approaches. First of all it is the traditional, native Russian Clinical Psychotherapy. These are Russian Existential Psychotherapy and Russian Clinical Psychoanalysis.
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