Archives 1992-2013

2014, volume 23, issue 1

Review

Behavioral therapy for anxiety disorders

Anna M. Ziółkowska, Przemysław Bąbel
Postępy Psychiatrii i Neurologii 23 (2014) 3–9

Objectives: The aim of this paper is to discuss empirically supported techniques of beha-
vioral therapy for anxiety disorders, to identify the mechanisms underlying the thera-
peutic effects of them, and to propose a classification of these techniques. Review: The
article presents the characteristics of the behavior therapy and behavioral perspective of
the causes of behavior that underlies the behavior therapy. It was shown that many
behaviors, including anxiety reactions, are the effects of one of the basic learning proces-
ses: operant conditioning, classical conditioning and observational learning. Presented
were the techniques of the behavioral therapy for anxiety disorders that are derived from
these learning processes: implosive therapy, flooding, systematic desensitization, partici-
pant modeling, reinforcement and extinction. The laws of learning that constitute the
mechanism of the effects of these techniques were pointed out. The classification of the
techniques of the behavioral therapy for anxiety disorders was proposed. It was based on
various kinds of learning from which they are derived and the laws of learning that
constitute the mechanism of their effects. Reviewed were the results of the experimental
studies comparing the effectiveness of the techniques of the behavioral therapy for
anxiety disorders. Conclusions: The techniques of the behavioral therapy are among the
most effective methods of treatment for anxiety disorders, and negative beliefs about
them among therapists pose a barrier to their use in clinical practice.

Review

Techniques of behavioral therapy for chronic pain and their effectiveness according to the results of meta-analyses

Przemysław Bąbel, Sławomir Trusz, Anna M. Ziółkowska
Postępy Psychiatrii i Neurologii 23 (2014) 10–16

Objectives: The aim of this paper is to discuss the behavioral techniques of chronic pain
management used in clinical practice and to review the results of meta-analyses of the
studies aimed at assessing their effectiveness. Review: Pain is the most common symp-
tom in medicine and chronic pain is a common disease. Behavioral therapy offers the
most effective psychological techniques for chronic pain treatment. The following three
types of behavioral therapies for pain are discussed: behavioral therapy based on both
operant and respondent conditioning, cognitive-behavioral therapy, and acceptance and
commitment therapy. Meta-analyses of the studies concerning the effectiveness of beha-
vioral techniques of chronic pain management are reviewed. Conclusions: The results of
the meta-analyses of the studies concerning the effectiveness of behavioral techniques
of chronic pain management clearly support their use in clinical practice.

Review article

Anxiety associated with a visit to the children and youth at the dentist – a subjective assessment methods

Hanna Sobczak-Zagalska, Małgorzata Peplińska, Katarzyna Emerich
Postępy Psychiatrii i Neurologii 23 (2014) 47–52

Aim: The objectives of this article are to approach the problem of dental fear in children
and adolescents, which is met by dentists in dental practices and to describe the
methods of its evaluation. There are objective and subjective methods for the asses-
sment of the intensity of dental anxiety. These methods can be useful for treatment
planning in anxious patients. Overview: The dental fear and anxiety of a child patient
which is associated with a dental appointment may take many different forms. An ade-
quate evaluation of the behaviour of a child patient in the dental treatment is very
important at the very first contact with the dentist, as it allows the dental team to
choose the right method. In dental practices especially those, who do not specialize in
pediatric dentistry, may barely have skills sufficient to properly evaluate the behaviour
of a young patient. This results in the selection of inappropriate methods of conduct
with a child, during the first appointment, the consequence of which is a lack of coope-
ration during treatments, present and future. Conclusions: Dentists lacking abilities and
experience to assess patients' behaviour, should considering a wider variety of evalua-
tion methods for dental anxiety in children and adolescents. A proper relationship bet-
ween dentist and patient will have a positive influence on children's attitudes in dental
treatment and will improve the comfort of work and increase the effectiveness of the
treatment.

Original article

Psychological flexibility, perceived stigma and satisfaction with life of people suffering from epilepsy: Acceptance and Commitment Therapy (ACT) perspective

Joanna Dudek, Paweł Ostaszewski, Wojciech Białaszek, Stanisław Malicki
Postępy Psychiatrii i Neurologii 23 (2014) 17–24

Objectives: Epilepsy is one of the most common neurological disorder with broad impact
on psychological functioning of patients. The main objective of the article is to examine
links between psychological flexibility (PF), perceived stigma and satisfaction with life in
people suffering from epilepsy in Poland. Moreover, we wanted to check if the level of
psychological flexibility moderates their satisfaction with life. Methods: One hundred and
forty four respondents participated in the study (72 respondents suffering from epilepsy).
They were surveyed with the following questionnaires: SWLS, AAQ-II and scale to mea-
sure the perceived stigma. Results: The study showed that the participants suffering from
epilepsy had lower quality of life and lower psychological flexibility while their perceived
stigma level was higher. In addition, it was shown that psychological flexibility can predict
the level of satisfaction with life. Conclusions: The results suggest, that Acceptance and
Commitment Therapy, which is aimed at improving the level of psychological flexibility,
might be a valuable treatment option for people with epilepsy in Poland.

Original article

Application of time-out procedure in reducing stereotypical behaviour in a child with an intellectual disability

Monika Zielińska, Monika Szmidt
Postępy Psychiatrii i Neurologii 23 (2014) 25–31

Objectives: The aim of the study was to evaluate the effectiveness of Time-out procedure
in reducing behaviours maintained by negative reinforcement. Method: At the beginning,
a functional analysis was conducted in order to identify functions of the stereotypical
behaviour (spitting) performed by a 6-year-old developmentally delayed child. Later on
the frequency of the target behaviour was measured before and during applying the
Time-out procedure and then again during a temporary withdrawal of the procedure and
after reapplying it. Results: The number of the target behaviour decreased while the
procedure was being applied whereas it increased after its withdrawal. Conclusion: A
procedure based on negative punishment can be effectively used to reduce behaviours
maintained by negative reinforcement. This apparent paradox can be explained by the
fact that the Time-out procedure does not allow the subject to escape the situation
completely, but only delays it.

Original article

Adjustment to coronary heart disease – The role of individual resources

Jan Tylka, Elżbieta Anita Bajcar
Postępy Psychiatrii i Neurologii 23 (2014) 32–40

Objectives: To extract the group of patients that are homogenous in regards to psycho-
social adjustment to the coronary heart disease and to specify the correlates that help or
inhibit the adjustment process. Methods: The group of 246 male patients with coronary
heart disease were included into the studies. All participants were examined using the
Cardiac Adjustment Scale (Rumbaugh) and NEO-FFI, Multidimensional Health Locus of
Control Scale, The Jenkins Activity Survey in the Polish adaptation. It was also analyzed
the impact of duration of the disease, method of the treatment, numbers of hospitaliza-
tions and the presence of pain. Results: The studies have confirmed that the neuroticism
is the essential correlate of the adjustment. The highest adjustment level was indicated
among patients characterized with low neuroticism and high extraversion. The lowest
adjustment to the disease was observed among those whose neuroticism was accompa-
nied by the belief that other external factors or chance influence their health. Nuisance
resulted from the disease affected the adjustment process among patients characterized
by average and low intensity of neuroticism. Conclusions: The adjustment to the coro-
nary heart disease is the result of the interaction between personality traits and correla-
tes directly resulted from the disease. Patients with relatively higher level of neuroticism
may be at risk of maladjustment and for those patients should be developed early psy-
chological interventions.

Original article

Executive dysfunction in aphasic speech disorders after stroke

Anna Starowicz-Filip, Anna M. Rajtar, Barbara Będkowska-Korpała, Dorota A. Przewoźnik
Postępy Psychiatrii i Neurologii 23 (2014) 41–46

Objectives: The purpose of this paper is review of research on the co-occurrence of exe-
cutive dysfunction in patients with aphasia after stroke. Review: Aphasic speech disor-
ders and cognitive dysfunctions are frequent consequences of the irregularities in the
blood flow within the brain. Aphasia, apart from language deficits, may be accompanied
by non-linguistic cognitive disorders. More and more often the co-existence of speech
disorders of aphasia and the disorders of executive functions are considered. The role of
executive functions is connected with the processes of planning, creating strategies,
monitoring actions, self-regulation, and integration of various cognitive modalities.
These activities are undoubtedly coupled with the process of speech generation. There-
fore, the effective communication depends on the integrity of executive functions. Conc-
lusions: In the present paper the author has presented a survey of researches on the
executive functions disorders and aphasia after stroke. In the researches the author has
evaluated the level of executive functions with the application of neuropsychological
methods as well as compared those results in terms of various aspects of verbal functio-
ning, capability to communicate and conducting conversations among people with apha-
sia. In addition, as studies argue, the efficiency of executive functions has a significant
impact on the effectiveness of aphasia rehabilitation.

Case report

Orthostatic tremor – easy diagnostics, difficult diagnosis? A case report

Agnieszka Machowska-Majchrzak, Monika Adamczyk-Sowa, Krystyna Pierzchała, Stanisław Pietraszek,, Beata Łabuz-Roszak
Postępy Psychiatrii i Neurologii 23 (2014) 53–60

Objectives: Orthostatic tremor is a specific form of tremor which is characterized by
a subjective feeling of unsteadiness during stance, not present in other positions. The
diagnosis can be confirmed in the electromyographic or accelerometric study by recor-
ding the tremor (e.g. in the quadriceps muscle) of frequency 13–18 Hz occurring exclusi-
vely in the upright position. Case report: In the present case, despite the presence of
the classic features of orthostatic tremor the proper diagnosis has been much delayed.
Conclusions: The paper presents the characteristic features of this rare movement disor-
der, indicates some diagnostic possibilities, and emphasizes the need for disseminating
the knowledge about the disease which can be treated successfully.