Tina Peraica | University Hospital "Dubrava" (original) (raw)

Papers by Tina Peraica

Research paper thumbnail of Gender Differences among Domestic Violence Help-Seekers: Socio-Demographic Characteristics, Types and Duration of Violence, Perpetrators, and Interventions

Journal of Family Violence

Research paper thumbnail of Analysis of Elder Victims of Domestic Violence in Counselling Center for Victims

Research paper thumbnail of Somatization as a Defence from Narcissistic Injury

Research paper thumbnail of The Association Between Serotonin Transporter Polymorphism, Platelet Serotonin Concentration and Insomnia in Non-Depressed Veterans with Posttraumatic Stress Disorder

Research paper thumbnail of Change of Diagnosis of Post-traumatic Stress Disorder Related to Compensation-seeking

Aim. To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to th... more Aim. To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to the implementation of the new national regulation on compensation-seeking by war veterans in Croatia. Methods. The study included 225 compensation-seeking war veterans who were psychiatrically assessed and diag- nosed on three different occasions. The first diagnosis was made by a local psychiatrist when a veteran

Research paper thumbnail of Psychiatric heredity and posttraumatic stress disorder: survey study of war veterans

Croatian medical journal, 2007

To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol... more To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol dependence disorder, and suicidality) and its association with the diagnosis of stress-related disorders in Croatian war veterans established during psychiatric examination. The study included 415 war veterans who were psychiatrically assessed and diagnosed by the same psychiatrist during an expert examination conducted for the purposes of compensation seeking. Data were collected by a structured diagnostic procedure. There was no significant correlation between psychiatric heredity of psychiatric illness, alcohol dependence, or suicidality and diagnosis of posttraumatic stress disorder (PTSD) or PTSD with psychiatric comorbidity. Diagnoses of psychosis or psychosis with comorbidity significantly correlated with psychiatric heredity (Phi=0.111; P=0.023). There was a statistically significant correlation between maternal psychiatric illness and the patients' diagnoses of partial PTSD...

Research paper thumbnail of Detecting deception of war-related posttraumatic stress disorder

Journal of Forensic Psychiatry & Psychology, 2009

Research paper thumbnail of Predictors of emotional distress during the COVID-19 pandemic; a Croatian study

The study aimed to assess relations between coronavirus-related psychological distress and its po... more The study aimed to assess relations between coronavirus-related psychological distress and its potentially predictive factors. An online sample of 2860 Croatian adults filled in questionnaires on socio-demographic characteristics, distress (the Depression, Anxiety and Stress Scale 21), coping (the Brief COPE), personality (the International Personality Item Pool), and social support (the Duke-UNC Functional Social Support Questionnaire) during the COVID-19 lockdown and after the capital was hit by an earthquake. Results indicated that 15.9% of the respondents experienced severe to extreme depression, 10.7% severe to extreme anxiety, and 26.2% severe to extreme stress.

Research paper thumbnail of Somatizacija kao obrana od narcističke povrede Somatization as a Defence from Narcissistic Injury

Socijalna psihijatrija, 2019

Somatizacijski poremećaj je poremećaj u kojem se psihički problemi i emocionalni konflikti izraža... more Somatizacijski poremećaj je poremećaj u kojem se psihički problemi i emocionalni konflikti izražavaju tjelesnim simptomima, a somatizacija je psihološki mehanizam u kojem se psihički problemi i emocionalni konflikti manifestiraju tjelesnim simptomima za koje se ne nalazi organska podloga. Može se javiti kao zasebni ili komorbidni poremećaj, osobito s poremećajima raspoloženja, anksioznim poremećajima, poremećajima ličnosti (najčešće histrionski poremećaj ličnosti i opsesivno-kompulzivni poremećaj ličnosti). Ovakve osobe primarno se javljaju u ambulante opće medicine ili tjelesne ambulante i tek kasnije i na psihijatrijska liječenja. Liječenje osoba s tzv. somatoformnim poremećajima je kompleksno, vrlo dugo i zahtjevno te je potrebna cijela lepeza psihijatrijskih vještina, često bez pozitivnih rezultata. U ovom radu prikazana je pacijentica kod koje je traumatska i konfliktna situacija na poslu doživljena kao narcistička povreda koja je dovela do razvoja dramatične kliničke slike u oblku somatizacija i somatizacijskog poremećaja kod osobe s histronskim poremećajem ličnosti. Nemogućnost suočavanja s povredom selfa kod histrionskog poremećaja ličnosti može dovesti do somatizacije kao načinom rješavanja problema. Prigodom liječenja je važno identificirati točan uzrok, tj. okidač (engl. trigger) koji je doveo do nastanka poremećaja te suočiti pacijenta s psihološkom i emocionalnom etiologijom tegoba, što uvelike doprinosi boljem terapijskom ishodu. Važnost pravovremenog prepoznavanja somatizacija je između ostaloga nužna i zbog izbjegavanja nepotrebnih tjelesnih dijagnostičkih postupaka, kao i zbog socijalne i radne disfunkcionalnosti takvih osoba. / Somatization disorder is characterized by a tendency of a person to communicate psychological distress and emotional conflicts through physical symptoms, while somatization is a psychological mechanism manifesting psychological distress and emotional conflicts as physical symptoms that lack an organic basis. It can develop as a single disorder or a mental disorder comorbid with other disorders, especially co-occurring with mood disorders, anxiety disorders, and personality disorders (most commonly, histrionic and obsessive-compulsive personality disorders). In most cases, people suffering from such disorders seek help from general practitioners or at healthcare facilities specialized for physical disorders. It is only after this that they seek psychiatric assistance. The treatment of people suffering from so-called somatoform disorders is complex, time-consuming and demanding and it requires a broad spectrum of psychiatric skills. However, it rarely yields positive outcomes. This research paper focuses on a case study of a patient with histrionic behaviour who experienced a conflict situation at work as a narcissistic injury. The narcissistic injury triggered the development of a dramatic clinical picture in the form of somatization and, consequently, the development of the somatization disorder. The inability of a person with a histrionic personality disorder to confront an injury of self can trigger somatization as a defence mechanism. The treatment requires careful identification of the root cause, the so-called trigger that initiated the development of the disorder, and the confrontation of a patient with the psychological and emotional etiology of his/her symptoms. Such an approach has a profound impact on a more positive outcome of the therapy. However, timely detection of somatization is important, among other things, to avoid unnecessary physical diagnostic procedures and to enable the normal performance of social and occupational roles of a patient.

Research paper thumbnail of Analiza starijih žrtava obiteljskog nasilja u Savjetovalištu za žrtve nasilja / Analysis of Elder Victims of Domestic Violence in Counselling Center for Victims

Socijalna psihijatrija, 2019

Pozadina: Nasilje u obitelji utječe na svaku dobnu skupinu i prisutno je tijekom cijelog ži-votno... more Pozadina: Nasilje u obitelji utječe na svaku dobnu skupinu i prisutno je tijekom cijelog ži-votnog vijeka, iako se manje zna o prirodi i utje-caju nasilja u obitelji među starijim osobama. Cilj: Istražiti neke socioekonomske čimbeni-ke, vrstu nasilja u obitelji i počinitelje nasilja prema starijim osobama, prijavljivanje nasilja i vrste intervencija kod nasilja prema starijim osobama. Metoda: Od 3164 odrasle osobe (25,1 % muš-karaca i 74,9 % žena; prosječna dob: 40,7±11,5 godina), koje su se javile u Savjetovalište za žr-tve nasilja u obitelji u razdoblju od 1. siječnja 2013. do 20. lipnja 2017. godine, 48,9 % je bilo u dobi od 18 do 39 godina, 44,7 % u dobi od 40 do 59 godina i 6,3 % iznad 60 godina. Dob

Research paper thumbnail of Dinamika srama u psihoterapiji osoba ovisnih o alkoholu / Dynamics of Shame in Psychotherapy of Alcoholics

Socijalna psihijatrija, 2019

The aim of this article is to highlight the psychodynamic role of shame in alcoholism and its imp... more The aim of this article is to highlight the psychodynamic role of shame in alcoholism and its importance in the psychotherapeutic treatment of alcoholics. Alcoholics are often emotionally immature and have a shame-based personality. Shame has strongly influenced the development of their identity and led to deeply ingrained feelings of mistrust, guilt, inferiority, and isolation. Group psychotherapy is the first line of psychotherapeutic treatment of alcoholism, but its successfulness is limited by the fact that alcoholics find joining and staying in a group quite difficult due to a shame-based script system and accompanying anxiety and emotional lability. We discuss the styles of psychotherapeutic groups that may be more effective with alcoholics. A review of published literature indicated the lack of integrative psychotherapeutic treatment.

Research paper thumbnail of The Importance of Assessing Quality of Life in Patients with Alcohol Dependence

Archives of Psychiatry Research : An International Journal of Psychiatry and Related Sciences, 2021

Alcohol dependence has a strong impact on quality of life (QoL) and OoL assessment is considered ... more Alcohol dependence has a strong impact on quality of life (QoL) and OoL assessment is considered as a valid measure in evaluating the success of the treatment of patients with alcohol dependence. The goal of the study was to investigate QoL and some sociodemographic characteristics of patients with alcohol dependence in comparison with healthy individuals. Cross-sectional study (which is part of larger study) included 312 patients with alcohol dependence and 329 healthy individuals of both sexes. Structured interview for sociodemographic and alcohol related data, the Croatian version of the 5.00 Mini International Neuropsy-chiatric Interview (MINI), and the short version of the World Health Organization Quality of Life (WHOQoL-BREF) were used. The results have shown that alcohol dependent patients were significantly more frequently uneducated (p=0.006) and primary education (p<0.001), while healthy individuals were significantly more likely to have secondary (p=0.003) and tertiary education (p=0.013). Patients with alcohol dependence were significantly more likely to be single (p=0.005), divorced (p<0.001), and living as married (p=0.008) compared to healthy people, while healthy populations were more often married (p<0.001) in comparison to alcohol addicts. Alcohol dependent persons were more often unemployed (p<0.001) and retired (p=0.005). Patients with alcohol dependence were more likely to have a perceived a sense of illness (p<0.001) than healthy subjects. There were significant differences in all domains of QoL: general, physical, psychological, social, and environment between patients with dependence and healthy individuals (p<0.001). To conclude, alcohol dependence has been shown to be negatively correlated with overall QoL and domains of QoL: physical, psychological, social, and environmental. Education of patients with alcohol dependence was lower than in healthy people, who were more likely to live in marriage and were employed.

Research paper thumbnail of Combat Posttraumatic Stress Disorder and Quality of Life Do Somatic Comorbidities Matter

A vast number of veterans with posttraumatic stress disorder (PTSD) have chronic somatic comorbid... more A vast number of veterans with posttraumatic stress disorder (PTSD) have chronic somatic comorbidities. However, their relationship with quality of life (QoL) has received little attention. We aimed to compare QoL of veterans with similar intensity of PTSD but different number of chronic somatic disorders. Of 129 veterans, 78% had at least one somatic disorder, and they reported lower QoL across all domains than veterans without somatic comorbidities. The greatest effect size was observed on social relationship (d = 0.65), it was notable on environment (d = 0.4) and psychological health (d = 0.38), and it was not relevant on physical health (d = 0.05). There was a negative correlation between the number of somatic disorders and scores on psychological health (r s = −0.217, p = 0.014), social relationships (r s = −0.248, p = 0.005), and environment (r s = −0.279, p = 0.001). The QoL of war veterans decreases significantly with the number of comorbid somatic conditions, particularly on the nonphysical domains of QoL.

Research paper thumbnail of Comparison of ego strength between aggressive and nonaggressive alcoholics: a crosssectional study

CMJ, 2018

Aim To determine the differences between aggressive and non-aggressive alcoholics in sociodemogra... more Aim To determine the differences between aggressive and non-aggressive alcoholics in sociodemographic and clinical characteristics and ego strength. Methods This cross-sectional study included 111 aggressive and 123 non-aggressive male alcoholics aged between 25 and 60 years who were admitted to the Department for Alcoholism, University Psychiatric Hospital Vrapče, Zagreb, Croatia, from January to December 2016. All participants met the diagnostic criteria for alcohol dependence according to the Croatian Mini International Neuropsychiatric Interview (MINI), 4th revised edition of Diagnostic and Statistical Manual of Mental Disorders, and the International Classification of Diseases. Participants were clinically assessed by an experienced psychiatrist using a clinical interview , MINI, Questionnaire from the Brown-Goodwin Lifetime History of Aggression, and Ego Identity Scale (EIS) according to Erikson. A clinical psychologist performed cognitive function measurements. EIS scores were analyzed using one-way analysis of variance. Results In comparison with non-aggressive alcoholics, aggressive alcoholics were more often divorced, unemployed , hospitalized, and first treated for alcoholism at an earlier age (P < 0.05 for all). They more frequently experienced depression (42.4% vs 19.4%, P = 0.013) and attempted suicide (34.7% vs 6.2%, P = 0.003), achieved a lower level of maturity at the second stage of psychosocial development related to shame and doubt (14.0 ± 4.1 vs 17.4 ± 3.7, P = 0.013) and at the fourth stage related to inferiority (13.1 ± 6.8 vs 18.1 ± 9.3, P = 0.011), and had lower total EIS score (75.8 ± 20.4 vs 85.2 ± 21.5, P < 0.012) than non-aggressive alcoholics. Conclusion Aggressive alcoholics had weaker ego-strength than non-aggressive alcoholics, experienced more depres-sive reactions and suicide attempts, and showed poorer psy-chosocial functioning.

Research paper thumbnail of No association between the serotonin transporter linked polymorphic region polymorphism and severity of posttraumatic stress disorder symptoms in combat veterans with or without comorbid depression

Since both posttraumatic stress disorder (PTSD) and depression are associated with disturbances i... more Since both posttraumatic stress disorder (PTSD) and depression are associated with disturbances in the serotoninergic system, the aim of the study was to determine the association between severity of PTSD symptoms, serotonin transporter polymorphism (5-HTTLPR) and platelet serotonin (5-HT) concentration, in male combat veterans with PTSD (n ¼ 325), who were subdivided according to presence of comorbid depression. The methodological approach included the psychiatric diagnostic interviews and rating scales (SCID for DSM-IV, HDRS, CAPS), polymerase chain reaction for 5-HTTLPR genotyping and spec-trophotofluorometric method for measuring the platelet 5-HT concentration. PTSD veterans without depression had more severe PTSD symptoms, and less severe depressive symptoms, than PTSD veterans with depression. 5-HTTLPR genotype frequencies did not differ between veterans with mild, moderate and severe PTSD symptoms, and between depressed and non-depressed PTSD veterans. No significant association was found between the severity of PTSD symptoms and 5-HTTLPR genotype. Platelet 5-HT concentration was similar in PTSD veterans, with or without comorbid depression, and between two groups subdivided according to the severity of PTSD symptoms or 5-HTTLPR genotype. The study confirmed , on ethnically homogenous groups of veterans with matched combat experience, a lack of association between the PTSD symptoms severity and 5-HTTLPR or platelet 5-HT concentration.

Research paper thumbnail of Traumatic memories of war veterans: Not so special after all

Several authors have argued that traumatic experiences are processed and remembered in a qualitat... more Several authors have argued that traumatic experiences are processed and remembered in a qualitatively different way from neutral events. To investigate this issue, we interviewed 121 Croatian war veterans diagnosed with posttraumatic stress disorder (PTSD) about amnesia, intrusions (i.e., flashbacks and nightmares), and the sensory qualities of their most horrific war memories. Additionally, they completed a self-report scale measuring dissociative experiences. In contrast to what one would expect on the basis of theories emphasizing the special status of traumatic memories, amnesia, and high frequency intrusions were not particularly typical for our sample of traumatized individuals. Moreover, traumatic memories were not qualitatively different from neutral memories with respect to their stability and sensory qualities. The severity of PTSD symptoms was not significantly correlated with dissociative experiences. Our findings do not support the existence of special memory mechanisms that are unique to experiencing traumatic events.

Research paper thumbnail of Psychiatric Heredity and Posttraumatic Stress Disorder: Survey Study of War Veterans

Croatian Medical Journal, Apr 15, 2007

Aim To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alc... more Aim To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol dependence disorder, and suicidality) and its association with the diagnosis of stress-related disorders in Croatian war veterans established during psychiatric examination.

Research paper thumbnail of 3. hrvatski kongres socijalnih pedagoga s međunarodnim sudjelovanjem „10 + Snage socijalne pedagogije“ Zagreb, 23.-25.04.2010

Kriminologija I Socijalna Integracija, Sep 16, 2010

Research paper thumbnail of Psychiatric heredity and posttraumatic stress disorder: survey study of war veterans

Croatian medical journal, 2007

To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol... more To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol dependence disorder, and suicidality) and its association with the diagnosis of stress-related disorders in Croatian war veterans established during psychiatric examination. The study included 415 war veterans who were psychiatrically assessed and diagnosed by the same psychiatrist during an expert examination conducted for the purposes of compensation seeking. Data were collected by a structured diagnostic procedure. There was no significant correlation between psychiatric heredity of psychiatric illness, alcohol dependence, or suicidality and diagnosis of posttraumatic stress disorder (PTSD) or PTSD with psychiatric comorbidity. Diagnoses of psychosis or psychosis with comorbidity significantly correlated with psychiatric heredity (Phi=0.111; P=0.023). There was a statistically significant correlation between maternal psychiatric illness and the patients' diagnoses of partial PTSD...

Research paper thumbnail of Change of diagnosis of post-traumatic stress disorder related to compensation-seeking

Croatian medical journal, 2004

To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to the imp... more To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to the implementation of the new national regulation on compensation-seeking by war veterans in Croatia. The study included 225 compensation-seeking war veterans who were psychiatrically assessed and diagnosed on three different occasions. The first diagnosis was made by a local psychiatrist when a veteran sought psychiatric help for the first time. The second psychiatric diagnosis was established during the veteran's psychiatric treatment, and the third one was made by an independent expert team in charge of the psychiatric assessment for compensation purposes. The expert examination included structured diagnostic procedure and analysis of military service data. The diagnoses established on three different points were compared. There were significant differences between the diagnoses of mental disorders made at three different occasions in compensation-seeking war veterans. Six different diag...

Research paper thumbnail of Gender Differences among Domestic Violence Help-Seekers: Socio-Demographic Characteristics, Types and Duration of Violence, Perpetrators, and Interventions

Journal of Family Violence

Research paper thumbnail of Analysis of Elder Victims of Domestic Violence in Counselling Center for Victims

Research paper thumbnail of Somatization as a Defence from Narcissistic Injury

Research paper thumbnail of The Association Between Serotonin Transporter Polymorphism, Platelet Serotonin Concentration and Insomnia in Non-Depressed Veterans with Posttraumatic Stress Disorder

Research paper thumbnail of Change of Diagnosis of Post-traumatic Stress Disorder Related to Compensation-seeking

Aim. To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to th... more Aim. To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to the implementation of the new national regulation on compensation-seeking by war veterans in Croatia. Methods. The study included 225 compensation-seeking war veterans who were psychiatrically assessed and diag- nosed on three different occasions. The first diagnosis was made by a local psychiatrist when a veteran

Research paper thumbnail of Psychiatric heredity and posttraumatic stress disorder: survey study of war veterans

Croatian medical journal, 2007

To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol... more To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol dependence disorder, and suicidality) and its association with the diagnosis of stress-related disorders in Croatian war veterans established during psychiatric examination. The study included 415 war veterans who were psychiatrically assessed and diagnosed by the same psychiatrist during an expert examination conducted for the purposes of compensation seeking. Data were collected by a structured diagnostic procedure. There was no significant correlation between psychiatric heredity of psychiatric illness, alcohol dependence, or suicidality and diagnosis of posttraumatic stress disorder (PTSD) or PTSD with psychiatric comorbidity. Diagnoses of psychosis or psychosis with comorbidity significantly correlated with psychiatric heredity (Phi=0.111; P=0.023). There was a statistically significant correlation between maternal psychiatric illness and the patients' diagnoses of partial PTSD...

Research paper thumbnail of Detecting deception of war-related posttraumatic stress disorder

Journal of Forensic Psychiatry & Psychology, 2009

Research paper thumbnail of Predictors of emotional distress during the COVID-19 pandemic; a Croatian study

The study aimed to assess relations between coronavirus-related psychological distress and its po... more The study aimed to assess relations between coronavirus-related psychological distress and its potentially predictive factors. An online sample of 2860 Croatian adults filled in questionnaires on socio-demographic characteristics, distress (the Depression, Anxiety and Stress Scale 21), coping (the Brief COPE), personality (the International Personality Item Pool), and social support (the Duke-UNC Functional Social Support Questionnaire) during the COVID-19 lockdown and after the capital was hit by an earthquake. Results indicated that 15.9% of the respondents experienced severe to extreme depression, 10.7% severe to extreme anxiety, and 26.2% severe to extreme stress.

Research paper thumbnail of Somatizacija kao obrana od narcističke povrede Somatization as a Defence from Narcissistic Injury

Socijalna psihijatrija, 2019

Somatizacijski poremećaj je poremećaj u kojem se psihički problemi i emocionalni konflikti izraža... more Somatizacijski poremećaj je poremećaj u kojem se psihički problemi i emocionalni konflikti izražavaju tjelesnim simptomima, a somatizacija je psihološki mehanizam u kojem se psihički problemi i emocionalni konflikti manifestiraju tjelesnim simptomima za koje se ne nalazi organska podloga. Može se javiti kao zasebni ili komorbidni poremećaj, osobito s poremećajima raspoloženja, anksioznim poremećajima, poremećajima ličnosti (najčešće histrionski poremećaj ličnosti i opsesivno-kompulzivni poremećaj ličnosti). Ovakve osobe primarno se javljaju u ambulante opće medicine ili tjelesne ambulante i tek kasnije i na psihijatrijska liječenja. Liječenje osoba s tzv. somatoformnim poremećajima je kompleksno, vrlo dugo i zahtjevno te je potrebna cijela lepeza psihijatrijskih vještina, često bez pozitivnih rezultata. U ovom radu prikazana je pacijentica kod koje je traumatska i konfliktna situacija na poslu doživljena kao narcistička povreda koja je dovela do razvoja dramatične kliničke slike u oblku somatizacija i somatizacijskog poremećaja kod osobe s histronskim poremećajem ličnosti. Nemogućnost suočavanja s povredom selfa kod histrionskog poremećaja ličnosti može dovesti do somatizacije kao načinom rješavanja problema. Prigodom liječenja je važno identificirati točan uzrok, tj. okidač (engl. trigger) koji je doveo do nastanka poremećaja te suočiti pacijenta s psihološkom i emocionalnom etiologijom tegoba, što uvelike doprinosi boljem terapijskom ishodu. Važnost pravovremenog prepoznavanja somatizacija je između ostaloga nužna i zbog izbjegavanja nepotrebnih tjelesnih dijagnostičkih postupaka, kao i zbog socijalne i radne disfunkcionalnosti takvih osoba. / Somatization disorder is characterized by a tendency of a person to communicate psychological distress and emotional conflicts through physical symptoms, while somatization is a psychological mechanism manifesting psychological distress and emotional conflicts as physical symptoms that lack an organic basis. It can develop as a single disorder or a mental disorder comorbid with other disorders, especially co-occurring with mood disorders, anxiety disorders, and personality disorders (most commonly, histrionic and obsessive-compulsive personality disorders). In most cases, people suffering from such disorders seek help from general practitioners or at healthcare facilities specialized for physical disorders. It is only after this that they seek psychiatric assistance. The treatment of people suffering from so-called somatoform disorders is complex, time-consuming and demanding and it requires a broad spectrum of psychiatric skills. However, it rarely yields positive outcomes. This research paper focuses on a case study of a patient with histrionic behaviour who experienced a conflict situation at work as a narcissistic injury. The narcissistic injury triggered the development of a dramatic clinical picture in the form of somatization and, consequently, the development of the somatization disorder. The inability of a person with a histrionic personality disorder to confront an injury of self can trigger somatization as a defence mechanism. The treatment requires careful identification of the root cause, the so-called trigger that initiated the development of the disorder, and the confrontation of a patient with the psychological and emotional etiology of his/her symptoms. Such an approach has a profound impact on a more positive outcome of the therapy. However, timely detection of somatization is important, among other things, to avoid unnecessary physical diagnostic procedures and to enable the normal performance of social and occupational roles of a patient.

Research paper thumbnail of Analiza starijih žrtava obiteljskog nasilja u Savjetovalištu za žrtve nasilja / Analysis of Elder Victims of Domestic Violence in Counselling Center for Victims

Socijalna psihijatrija, 2019

Pozadina: Nasilje u obitelji utječe na svaku dobnu skupinu i prisutno je tijekom cijelog ži-votno... more Pozadina: Nasilje u obitelji utječe na svaku dobnu skupinu i prisutno je tijekom cijelog ži-votnog vijeka, iako se manje zna o prirodi i utje-caju nasilja u obitelji među starijim osobama. Cilj: Istražiti neke socioekonomske čimbeni-ke, vrstu nasilja u obitelji i počinitelje nasilja prema starijim osobama, prijavljivanje nasilja i vrste intervencija kod nasilja prema starijim osobama. Metoda: Od 3164 odrasle osobe (25,1 % muš-karaca i 74,9 % žena; prosječna dob: 40,7±11,5 godina), koje su se javile u Savjetovalište za žr-tve nasilja u obitelji u razdoblju od 1. siječnja 2013. do 20. lipnja 2017. godine, 48,9 % je bilo u dobi od 18 do 39 godina, 44,7 % u dobi od 40 do 59 godina i 6,3 % iznad 60 godina. Dob

Research paper thumbnail of Dinamika srama u psihoterapiji osoba ovisnih o alkoholu / Dynamics of Shame in Psychotherapy of Alcoholics

Socijalna psihijatrija, 2019

The aim of this article is to highlight the psychodynamic role of shame in alcoholism and its imp... more The aim of this article is to highlight the psychodynamic role of shame in alcoholism and its importance in the psychotherapeutic treatment of alcoholics. Alcoholics are often emotionally immature and have a shame-based personality. Shame has strongly influenced the development of their identity and led to deeply ingrained feelings of mistrust, guilt, inferiority, and isolation. Group psychotherapy is the first line of psychotherapeutic treatment of alcoholism, but its successfulness is limited by the fact that alcoholics find joining and staying in a group quite difficult due to a shame-based script system and accompanying anxiety and emotional lability. We discuss the styles of psychotherapeutic groups that may be more effective with alcoholics. A review of published literature indicated the lack of integrative psychotherapeutic treatment.

Research paper thumbnail of The Importance of Assessing Quality of Life in Patients with Alcohol Dependence

Archives of Psychiatry Research : An International Journal of Psychiatry and Related Sciences, 2021

Alcohol dependence has a strong impact on quality of life (QoL) and OoL assessment is considered ... more Alcohol dependence has a strong impact on quality of life (QoL) and OoL assessment is considered as a valid measure in evaluating the success of the treatment of patients with alcohol dependence. The goal of the study was to investigate QoL and some sociodemographic characteristics of patients with alcohol dependence in comparison with healthy individuals. Cross-sectional study (which is part of larger study) included 312 patients with alcohol dependence and 329 healthy individuals of both sexes. Structured interview for sociodemographic and alcohol related data, the Croatian version of the 5.00 Mini International Neuropsy-chiatric Interview (MINI), and the short version of the World Health Organization Quality of Life (WHOQoL-BREF) were used. The results have shown that alcohol dependent patients were significantly more frequently uneducated (p=0.006) and primary education (p<0.001), while healthy individuals were significantly more likely to have secondary (p=0.003) and tertiary education (p=0.013). Patients with alcohol dependence were significantly more likely to be single (p=0.005), divorced (p<0.001), and living as married (p=0.008) compared to healthy people, while healthy populations were more often married (p<0.001) in comparison to alcohol addicts. Alcohol dependent persons were more often unemployed (p<0.001) and retired (p=0.005). Patients with alcohol dependence were more likely to have a perceived a sense of illness (p<0.001) than healthy subjects. There were significant differences in all domains of QoL: general, physical, psychological, social, and environment between patients with dependence and healthy individuals (p<0.001). To conclude, alcohol dependence has been shown to be negatively correlated with overall QoL and domains of QoL: physical, psychological, social, and environmental. Education of patients with alcohol dependence was lower than in healthy people, who were more likely to live in marriage and were employed.

Research paper thumbnail of Combat Posttraumatic Stress Disorder and Quality of Life Do Somatic Comorbidities Matter

A vast number of veterans with posttraumatic stress disorder (PTSD) have chronic somatic comorbid... more A vast number of veterans with posttraumatic stress disorder (PTSD) have chronic somatic comorbidities. However, their relationship with quality of life (QoL) has received little attention. We aimed to compare QoL of veterans with similar intensity of PTSD but different number of chronic somatic disorders. Of 129 veterans, 78% had at least one somatic disorder, and they reported lower QoL across all domains than veterans without somatic comorbidities. The greatest effect size was observed on social relationship (d = 0.65), it was notable on environment (d = 0.4) and psychological health (d = 0.38), and it was not relevant on physical health (d = 0.05). There was a negative correlation between the number of somatic disorders and scores on psychological health (r s = −0.217, p = 0.014), social relationships (r s = −0.248, p = 0.005), and environment (r s = −0.279, p = 0.001). The QoL of war veterans decreases significantly with the number of comorbid somatic conditions, particularly on the nonphysical domains of QoL.

Research paper thumbnail of Comparison of ego strength between aggressive and nonaggressive alcoholics: a crosssectional study

CMJ, 2018

Aim To determine the differences between aggressive and non-aggressive alcoholics in sociodemogra... more Aim To determine the differences between aggressive and non-aggressive alcoholics in sociodemographic and clinical characteristics and ego strength. Methods This cross-sectional study included 111 aggressive and 123 non-aggressive male alcoholics aged between 25 and 60 years who were admitted to the Department for Alcoholism, University Psychiatric Hospital Vrapče, Zagreb, Croatia, from January to December 2016. All participants met the diagnostic criteria for alcohol dependence according to the Croatian Mini International Neuropsychiatric Interview (MINI), 4th revised edition of Diagnostic and Statistical Manual of Mental Disorders, and the International Classification of Diseases. Participants were clinically assessed by an experienced psychiatrist using a clinical interview , MINI, Questionnaire from the Brown-Goodwin Lifetime History of Aggression, and Ego Identity Scale (EIS) according to Erikson. A clinical psychologist performed cognitive function measurements. EIS scores were analyzed using one-way analysis of variance. Results In comparison with non-aggressive alcoholics, aggressive alcoholics were more often divorced, unemployed , hospitalized, and first treated for alcoholism at an earlier age (P < 0.05 for all). They more frequently experienced depression (42.4% vs 19.4%, P = 0.013) and attempted suicide (34.7% vs 6.2%, P = 0.003), achieved a lower level of maturity at the second stage of psychosocial development related to shame and doubt (14.0 ± 4.1 vs 17.4 ± 3.7, P = 0.013) and at the fourth stage related to inferiority (13.1 ± 6.8 vs 18.1 ± 9.3, P = 0.011), and had lower total EIS score (75.8 ± 20.4 vs 85.2 ± 21.5, P < 0.012) than non-aggressive alcoholics. Conclusion Aggressive alcoholics had weaker ego-strength than non-aggressive alcoholics, experienced more depres-sive reactions and suicide attempts, and showed poorer psy-chosocial functioning.

Research paper thumbnail of No association between the serotonin transporter linked polymorphic region polymorphism and severity of posttraumatic stress disorder symptoms in combat veterans with or without comorbid depression

Since both posttraumatic stress disorder (PTSD) and depression are associated with disturbances i... more Since both posttraumatic stress disorder (PTSD) and depression are associated with disturbances in the serotoninergic system, the aim of the study was to determine the association between severity of PTSD symptoms, serotonin transporter polymorphism (5-HTTLPR) and platelet serotonin (5-HT) concentration, in male combat veterans with PTSD (n ¼ 325), who were subdivided according to presence of comorbid depression. The methodological approach included the psychiatric diagnostic interviews and rating scales (SCID for DSM-IV, HDRS, CAPS), polymerase chain reaction for 5-HTTLPR genotyping and spec-trophotofluorometric method for measuring the platelet 5-HT concentration. PTSD veterans without depression had more severe PTSD symptoms, and less severe depressive symptoms, than PTSD veterans with depression. 5-HTTLPR genotype frequencies did not differ between veterans with mild, moderate and severe PTSD symptoms, and between depressed and non-depressed PTSD veterans. No significant association was found between the severity of PTSD symptoms and 5-HTTLPR genotype. Platelet 5-HT concentration was similar in PTSD veterans, with or without comorbid depression, and between two groups subdivided according to the severity of PTSD symptoms or 5-HTTLPR genotype. The study confirmed , on ethnically homogenous groups of veterans with matched combat experience, a lack of association between the PTSD symptoms severity and 5-HTTLPR or platelet 5-HT concentration.

Research paper thumbnail of Traumatic memories of war veterans: Not so special after all

Several authors have argued that traumatic experiences are processed and remembered in a qualitat... more Several authors have argued that traumatic experiences are processed and remembered in a qualitatively different way from neutral events. To investigate this issue, we interviewed 121 Croatian war veterans diagnosed with posttraumatic stress disorder (PTSD) about amnesia, intrusions (i.e., flashbacks and nightmares), and the sensory qualities of their most horrific war memories. Additionally, they completed a self-report scale measuring dissociative experiences. In contrast to what one would expect on the basis of theories emphasizing the special status of traumatic memories, amnesia, and high frequency intrusions were not particularly typical for our sample of traumatized individuals. Moreover, traumatic memories were not qualitatively different from neutral memories with respect to their stability and sensory qualities. The severity of PTSD symptoms was not significantly correlated with dissociative experiences. Our findings do not support the existence of special memory mechanisms that are unique to experiencing traumatic events.

Research paper thumbnail of Psychiatric Heredity and Posttraumatic Stress Disorder: Survey Study of War Veterans

Croatian Medical Journal, Apr 15, 2007

Aim To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alc... more Aim To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol dependence disorder, and suicidality) and its association with the diagnosis of stress-related disorders in Croatian war veterans established during psychiatric examination.

Research paper thumbnail of 3. hrvatski kongres socijalnih pedagoga s međunarodnim sudjelovanjem „10 + Snage socijalne pedagogije“ Zagreb, 23.-25.04.2010

Kriminologija I Socijalna Integracija, Sep 16, 2010

Research paper thumbnail of Psychiatric heredity and posttraumatic stress disorder: survey study of war veterans

Croatian medical journal, 2007

To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol... more To explore the prevalence of psychiatric heredity (family history of psychiatric illness, alcohol dependence disorder, and suicidality) and its association with the diagnosis of stress-related disorders in Croatian war veterans established during psychiatric examination. The study included 415 war veterans who were psychiatrically assessed and diagnosed by the same psychiatrist during an expert examination conducted for the purposes of compensation seeking. Data were collected by a structured diagnostic procedure. There was no significant correlation between psychiatric heredity of psychiatric illness, alcohol dependence, or suicidality and diagnosis of posttraumatic stress disorder (PTSD) or PTSD with psychiatric comorbidity. Diagnoses of psychosis or psychosis with comorbidity significantly correlated with psychiatric heredity (Phi=0.111; P=0.023). There was a statistically significant correlation between maternal psychiatric illness and the patients' diagnoses of partial PTSD...

Research paper thumbnail of Change of diagnosis of post-traumatic stress disorder related to compensation-seeking

Croatian medical journal, 2004

To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to the imp... more To explore the change in the diagnosis of posttraumatic stress disorder (PTSD) related to the implementation of the new national regulation on compensation-seeking by war veterans in Croatia. The study included 225 compensation-seeking war veterans who were psychiatrically assessed and diagnosed on three different occasions. The first diagnosis was made by a local psychiatrist when a veteran sought psychiatric help for the first time. The second psychiatric diagnosis was established during the veteran's psychiatric treatment, and the third one was made by an independent expert team in charge of the psychiatric assessment for compensation purposes. The expert examination included structured diagnostic procedure and analysis of military service data. The diagnoses established on three different points were compared. There were significant differences between the diagnoses of mental disorders made at three different occasions in compensation-seeking war veterans. Six different diag...