Clinical psychology

Background. The most significant features for clinical diagnosis of schizotypal personality disorder (SPD) are cognitive-perceptual and disorganized symptoms. Experimental study of visual perceptual processes is important to elucidate the psychological mechanisms of cognitive-perceptual impairment in SPD.

Objective. To research the performance of visual perceptual tasks in SPD.

Design. Series I and II presented the subjects with visual perceptual tasks with different types of instructions (vague, verbal, or visual perceptual cues). The Wechsler Adult Intelligence Scale (WAIS-R) was also administered. The participants were 39 SPD patients, 36 obsessive-compulsive personality disorder (OCPD) patients (F.21.8, F.60.5 in ICD-10, respectively), and 102 healthy controls.

Results. SPD patients had a significantly lower number of correct answers in conditions of vague instruction and verbal cues in Series I of a visual-perceptual task in comparison with healthy subjects (р ≤ 0.01). With visual perceptual cues in Series II, patients with SPD had the same number of correct answers as controls, whereas OCPD patients had the same number of correct answers as controls with verbal cues in Series I. SPD patients had significantly lower scores in most verbal and nonverbal WAIS-R subtests in comparison with controls. SPD patients differed from OCPD patients in that they had lower scores in the “Information” (p ≤ 0.05) and “Comprehension” (p ≤ 0.05) subtests.

Conclusion. With visual-perceptual cues, SPD patients were able to achieve normative results in the performance of visual-perceptual tasks, whereas patients with OCPD demonstrated lower productivity. In SPD patients, the basic impairments were associated with difficulties in inhibition of peculiar responses, stability of a subjective manner of performance and inability to revise it, low orientation to the model, and slipping into subjective associations with the stimuli.

Background. People with alcohol-addicted parents are at risk of psychoactive addictions, co-dependency, and suicidal behavior. Most studies of these people are aimed at confirming the inevitability of the impact of negative childhood experiences on their lives, and thus do not seek to identify resource factors which would allow them to overcome the negative emotions they experienced. 

Objective. The purpose of this study was to create a model of resource factors which would allow people with alcohol-addicted parents to overcome the negative emotions they experienced. 

Design. The participants were 58 healthy individuals (17 men and 41 women; M=25.2; SD=4.4) whose parents were alcohol addicts (they were participants in the 12-step recovery program "Adult Children of Alcoholics"), and 50 healthy individuals (15 men and 35 women, M=24.2; SD=3.7) whose parents were not alcohol addicts. The participants completed the questionnaires "Interpersonal Guilt," "Family Emotional Communication," and "Coping Strategies," and were interviewed on the resource factors which allowed them to overcome negative emotions. We used the content analysis of the interviews and latent variable modeling to analyze the questionnaires.

Results. The model of resource factors (CFI=0.895, RMSEA=0.064) showed that the rules set by the parental dysfunctional family (the taboo on the expressing emotions, and external well-being) were associated with being unable to recognize current negative emotions and with avoiding problems. The ability to recognize negative emotions was connected with the participant’s willingness to accept responsibility for his/her life. The resource factors which allowed these subjects to overcome their negative emotions included: communication with relatives and friends; keeping a diary of emotions; and participating in recovery programs.

Conclusion. Our model of resource factors explains the mechanism connecting dysfunctional family rules with the resource factors and negative emotions experienced by people with alcohol-addicted parents. 

Background. The Copenhagen Burnout Inventory (CBI) has demonstrated good psychometric properties among different populations, but there is no known data on its validity among Russian-speaking medical students. The CBI-Student Survey focuses only on fatigue, but measures exhaustion in four different life domains: Personal Burnout (PB), Studies-Related Burnout (SRB), Colleague-Related Burnout (CRB), and Teacher-Related Burnout (TRB).

Objective. To investigate the psychometric properties of the Russian version of the Copenhagen Burnout Inventory–Student Survey (R-CBI-S).

Design. A cross-sectional study was carried out among 771 medical students at Astana Medical University (Nur-Sultan, Kazakhstan). Statistical analyses included test-retest reliability, internal consistency, item analysis, convergent and concurrent validity, and confirmatory factor analysis. Concurrent validity was evaluated by bivariate correlations of R-CBI-S with anxiety, depression, and satisfaction with the study.

Results. Test-retest reliability showed an ICC of 0.81. All item-total correlations for the total scale were positive (range 0.31–0.76). The Cronbach’s alpha coefficient was 0.94 (0.896 for PB, 0.884 for SRB, 0.874 for CRB, and 0.926 for TRB). The Barlett’s sphericity test result was significant (p < 0.001), and the KMO measure of sampling adequacy exceeded 0.947. Convergent validity analysis results: PB (AVE = 0.52, CR = 0.87), SRB (AVE = 0.50, CR = 0.87), CRB (AVE = 0.51, CR = 0.86), TRB (AVE = 0.56, CR = 0.88). The R-CBI-S achieved good levels of goodness-of-fit indices (RMSEA = 0.0611; CFI = 0.940; TLI = 0.933).

Conclusion. The test results indicated that the R-CBI-S scale appears to be a reliable and valid instrument. The R-CBI-S may be a useful tool in future research to identify burnout factors based on specific life domains for developing effective prevention measures among medical students.

Background. Dissociation is a generally recognized phenomenon in psychology and psychiatry; however, questions are still not fully resolved about the difference between pathological and normal dissociation, as well as the role of dissociation, depending on its aetiology, in the formation of clinical manifestations of mental disorders.

Objective. To complement the existing data about the significance of dissociation in non-psychotic mental disorders.

Design. Using the Dissociative Experience Scale (DES), we screened 62 patients (13 male and 49 female) from the Non-Psychotic Conditions Inpatient Department of the Udmurt Republican Clinical Psychiatric Hospital (Izhevsk, Russia). Nineteen of the patients had mental disorders of organic aetiology and 43 patients had mental disorders of psychogenic aetiology.

Results. Dissociation at the pathological level was detected in 12.9% of the patients, all of them female. Among patients with psychogenic disorders, the proportion of patients with pathological dissociation was more than three times that of patients with organic disorders. Among the particular dissociative phenomena, absorption had the highest average severity, both in the general sample and in each aetiological group of patients, while dissociative amnesia had the lowest average severity. The highest levels of dissociation were found in young female patients who had never been married. In patients with psychogenic disorders, the average dissociation severity was significantly higher than in the general population, while in patients with organic disorders it was significantly lower.

Conclusion. The dissociation phenomenon may play a significant symptom-forming role in young women suffering from non-psychotic mental disorders of psychogenic aetiology. In the case of organic mental disorders, the severity of dissociative manifestations decreases even below the conditionally normal level, which may indirectly indicate the destruction of dissociative physiological mechanisms by an organic brain process.