36, 1


Janusz Rybakowski
Neurobiologiczne aspekty teorii i praktyki psychoterapii  5
Neurobiological aspects of psychotherapy theory and practice  5
Summary
Psychological processes of learning may lead to biological changes in brain synapses, as was shown by Eric Kandel, Nobel laureate for 2000. Factors connected with learning (for instance, psychotherapeutic procedures) can modify the expression of genes occurring in brain cells. Current neurobiological research make it possible to explain some theoretical concepts and mechanisms of action of psychotherapy on the ground of basic medical sciences. Experimental and clinical studies point to a prominent role for early untoward life experiences in brain development and vulnerability for psychiatric disturbances. Neuroimaging studies demonstrated the existence of unconscious processes in both cognitive and emotional functions. In several studies, changes in brain function or in the biology of whole organism were measured, under the influence of psychotherapy. It was found that in such illnesses as depression or obsessive-compulsive disorder, similar changes in brain functions, as measured with neuroimaging methods, were observed either after pharmacotherapy or psychotherapy. The attempts have been also made to interpret psychotherapeutic mechanisms in the light of current concepts of memory processes, functioning of brain circuits or neurobiological theories of character and temperament.


Irena Namysłowska, Ewa Paszkiewicz, Anna Siewierska, Bogdan de Barbaro, Mariusz Furgał, Lucyna Drożdżowicz, Barbara Józefik, Andrzej Beauvale
Kwestionariusze Manfreda Cierpki do Oceny Rodziny  17
Family Assessment Measures by Manfred Cierpka   17
Summary
In the first part of the paper, authors describe some research tools for the assessment of family functioning, concentrating mainly on self-report questionnaires of the family members. Advantages and methodological limitations of such methods are discussed.
Several questionnaires of self-report type are described such as e.g. the Family APGAR, Family Environment Scale, Mc Master Family Assessment Device, as well as Family Assessment Measure (FAM) of Skinner and Steinhauer. Manfred Cierpka Family Assessment Measures are a modification of this last questionnaire. In the second part of the paper authors present in details Cierpka Family Assessment Measures. They describe seven dimensions of the family functioning such as task accomplishment,  role performance,  communication, emotionality, affective involvement, control and values and norms. Family Assessment Measures consist of three questionnaires such as General Scale, Dyadic Scale and of Self-Rating Scale. General Scale focuses on how individual member views the family as a whole, The Dyadic Scale assesses specific relationship dyads within the family and Self-Rating Scale addresses how an individual member views his or her functioning within the family. At the end, psychometric properties of these questionnaires are presented, as well as the general description, how they should be used in the process of the assessment of the family for research and in clinical practice of family therapy.


Andrzej Beauvale, Bogdan de Barbaro, Irena Namysłowska, Mariusz Furgał
Niektóre psychometryczne własności Kwestionariuszy do Oceny Rodziny  29
Some Psychometric Attributes of the Family Assessment Questionnaires   29
Summary
In this article we present some of the more important findings from research aimed at the validation and normalisation of the Family Assessment Questionnaire (Dyadic Questionnaire, Family Questionnaire, Self-Estimation Questionnaire), which is the Polish adaptation of Manfred Cierpka's and Gabriele Frevert's "Familienboegen". In the presented study 1511 individuals from 557 families took part. Of these 658 individuals (including 162 children) came from 248 families which had no clinical health or adjustment problems, while 853 individuals (including 305 children) came from 309 families with problems due to schizophrenia, anorexia nervosa, coronary heart disease or family crisis. A new method of analyzing raw results from the questionnaire scales was formulated and verified. This method was based on the criterion of sufficient satisfaction regarding the aspect of family life measured by the scale. The original scales of all the questionnaires (Task Completion, Role Performance, Communication, Emotionality, Affective Involvement, Control, and Values and norms) were charaterised by average or low reliability; the general scales were characterised by high reliability (the Dyadic Questionnaire with very high reliability). As a result of factor analysis new scales were created with acceptable or high reliability. These were the scale of Positive statements, the scale of Negative statements in the dyadic and family questionnaires, and the scales of kindness, care and resentment in the Self-Estimation Questionnaire. The general scales and the factor scales generally significantly differentiated between the sub-samples selected due to the type of family problems present and relationship. On the other hand the 7 original scales did so only sporadically or weakly. Better results were obtained by families without health or adjustment problems while the worst results were obtained by families in crisis.


Maria Rostworowska, Małgorzata Opoczyńska, Bogdan de Barbaro
Konsultacja rodzinna - możliwości i ograniczenia   41
Systemic Consultation - about Possibilities and Limitations  41
Summary
The paper presents the role of systemic consultation in the diagnostic 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 f.e. family interviews, psycho - education, systemic therapy? What are possibilities and limitations of 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 according to our clinical experience, we would like to share some of our thoughts on the questions put. In spite of difficulties the family consultation confronts us with, we are deeply convinced that it has an important part in therapeutic and diagnostic process.


Barbara Józefik, Grzegorz Iniewicz, Irena Namysłowska, Romualda Ulasińska
Obraz relacji rodzinnych w oczach rodziców pacjentek chorujących na anoreksję psychiczną - część I  51
Assessment of family relations by the parents of patients suffering from anorexia nervosa - Part I  51
Summary
The paper presents results of research concerning the parents' perception of family relationships in "anorectic" families (where a daughter meets criteria of ICD 10) and in non-treated group. As a basic tool the Polish Version of Family Assessment Measure standardised on a Polish sample was used. The clinical group consists of 31 mothers and 32 fathers, the control group consist of 42 mothers and 41 fathers. The article present how parents from both groups perceived their marital relationship, their relationship with children, family functioning as a whole system and their individual functioning within the family system. The study revealed some interesting differences between samples. The basic conclusion is that perception of family relationships in the anorectic group is negative and incoherent in comparison with positive, congruent perception of family relationships in the control group. Significant differences are presented and discussed according to the literature.


Grzegorz Iniewicz, Barbara Józefik, Irena Namysłowska, Romualda Ulasińska
Obraz relacji rodzinnych w oczach pacjentek chorujących na anoreksję psychiczną - część II  65
Assessment of family relations by the patients suffering from anorexia nervosa - part II   65
Summary
A lot of research indicates the importance of the family context in the occurrence of Eating Disorders. Authors present results of research in families with an adolescent suffering from Anorexia Nervosa according to ICD-10. The aim of this study was to examine relationships among family members. Anorectic girls (n=37), their sisters (n=16) and control girls (n=41) completed the Polish version of The Family Assessment Measure standardised on a Polish sample. The questionnaire was constructed to measure some aspects of the family life such as task accomplishment, role performance, communication including affective expression, affective involvement, control, values and norms. The study revealed some interesting differences between samples. For example, anorectic girls and their sisters generally express dissatisfaction with the relationship with their parents, particularly with fathers, contrary to the control group of girls. Anorectic girls and their sisters more critically assess functioning of the family as a whole than control group girls. Anorectic girls and their sisters express dissatisfaction with their mutual relationship, contrary to the control group.


Małgorzata Śmiarowska, Barbara Krzyżanowska-Świniarska, Ryszard Kamiński, Ewa Szakowska, Jan Horodnicki
Wydzielanie niektórych hormonów a osobowość w jadłowstręcie psychicznym  83
Some hormones secretion and personality in anorexia nervosa syndrome  83
Summary
The relationship between plasma leptin, some hormones (GH, IRI, IGF-1, DHEA-S, LH, FSH, T, E2, TSH, fT3, fT4), glucose level, personality dispositions and adipose tissue content in 22 women with anorexia nervosa were evaluated. Some personality features as: defensiveness, domination and aggression necessities, high self-control, bad self-estimation, retiring, expectation of custody - correlated with some hormones (LH, E2, IGF-1, fT3, F, T) and leptin level. The ascertained relationships suggest that still unexplained causes generate simultaneous disturbances in the endocrine and psychic processes in central nervous system of anorexia nervosa patients. Probably hormonal and neurotransmitter derangement are the adaptive changes allowing longer survival, as the low leptin secretion in the severest undernutrition states is.


Ewa Pisula
Rodzice dzieci z autyzmem - przegląd najnowszych badań  95
Parents of children with autism: recent research findings  95
Summary
The parents of autistic children have become objects of many controversial studies and theories. This is a review of the studies that have been conducted in the nineties with this group of parents. The studies are combined into three categories: works on the broader phenotype, studies on the parental stress and the perception of the child, and finally, parents as therapists of their children. Although the idea of genetic determination of the cognitive, social and communication deficits, has been widely spread, it still has not been sufficiently proved. The research show that parents of children with autism experience profound stress. This stress response has specific profile - the most difficult for parents are handicaps related with atypical child behaviors, and the lack of knowledge about real development limitation and child problems. But even though, the parents supported by professionals may become the good teachers and therapists for their children. The partnership between parents and professionals is one of the conditions of the parent's success in these roles.


Hanna Jaklewicz
Dynamika autyzmu dziecięcego. Badania longitudinalne  109
The dynamics of infantile autism. The longitudinal studies  109
Summary
28 children diagnosed to be autistic were involved in the longitudinal studies. The criteria were taken from DSM-III-R. 18 children in the early stage of autism were chosen. The development of disorders has been observed since the period infancy among these children. The other group consisted of 10 children in the late stage of autism. The development of autism in the group was followed by normal development of the child until the 12-18 month of life. The research was conducted in the 3rd, 5th and 7th year of life. 3 areas of developments were taken under consideration: social relations (A), verbal vs. non-verbal communication (B), activity and interests (C). In the estimated group (A, B, C) 5 criteria were achieved, each in a 5-grade scale, 1 meaning the lack of symptom and 5 meaning the higher intensity. At the age of 3 the intensity of disorders on the three evaluated areas of development did not differentiate children in early and late stage of autism. The future development of children in the early stage of autism was not successful. A visible difference was seen at the age of 5. Children in the late stage of autism developed in all 3 areas of investigation. At the age of 7, children in the late stage of autism seemed to gradually "withdraw from autism". Longitudinal studies conducted on autistic children confirmed the hypothesis about the age of child's life, when the first symptoms of disorders showed, as being an important predictor of the autism development dynamic.


Katarzyna Bażyńska, Zofia Bronowska, Irena Namysłowska, Cezary Żechowski
Poczucie koherencji (SOC) u pacjentów psychiatrycznego oddziału młodzieżowego  121
Sense of coherence in patients of a psychiatric adolescent unit  121
Summary
The sense of coherence of 72 hospitalized adolescent patients assessed by SOC 29 was significantly lower then SOC of their siblings, mothers and fathers. SOC did not differentiate sensitivity subscale, which was significantly lower in a group of neurotic, then psychotic and eating disorders patients. SOC did not correlate with the number of hospitalizations. The sense of coherence of mothers of adolescent patients was not significantly different from SOC of mothers of healthy children, but SOC of patients' fathers was higher (approaching statistical. significance) then SOC of fathers of healthy children.

 

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