Nataša Jokić-Begić

Electroencephalographic comparison of veterans with combat-related post-traumatic stress disorder and healthy subjects

Various investigations prove the biological basis for post-traumatic stress disorder (PTSD). There are only a few quantitative electroencephalographic (qEEG) studies of patients with PTSD. The aim of this investigation is to find out whether there are differences in qEEG parameters between PTSD patients and healthy subjects. The experimental group was comprised of 18 veterans with PTSD, and 20 healthy non-veterans were included in the control group. After informed consent was obtained, they were investigated by qEEG recordings. The artifact-free EEG epoch was analyzed by fast Fourier transformation (FFT). Power values of particular frequency bands (delta, theta, alpha 1, alpha 2, beta 1, beta 2) were observed on the regions: Fp I, Fp2, F3, F4, F7, F8, C3, C4, T3, T4, T5, T6, P3, P4, O1 and O2. PTSD patients had increased theta activity over central regions, and increased beta activity. Beta 1 activity increased over frontal, central and left occipital regions; beta 2 activity increased over frontal regions. No significant differences were noted between the PTSD and control group in delta and alpha activity. These results suggest a neurobiological basis for PTSD. Increased theta activity may help to explain changes in hippocampal volume. Various explanations (cortical hyperexcitability, prolonged wakefulness, or attention disturbances) have been offered for the beta activity increase observed in PTSD subjects.

Quantitative electroencephalogram (qEEG) in combat veterans with post-traumatic stress disorder (PTSD)

Only a small number of studies have used quantitative electroencephalography (qEEG) in research of the post-traumatic stress disorder (PTSD). The results are not consistent. The aim of the present investigation was to compare qEEG in combat veterans with and without PTSD. The hypothesis is that differences among qEEG characteristics will be found regarding the presence/absence of PTSD. Seventy-nine combat veterans with PTSD comprised the experimental group and 37 veterans without PTSD were included as controls. After the informed consent, they were investigated by the resting EEG recordings. The results demonstrate that PTSD veterans had decreased alpha power and increased beta power. These results suggest an altered neurobiology in PTSD. Various explanations have been offered for alpha activity decrease observed in PTSD veterans. Increased beta rhythm may play a role as a potential marker in differentiating subtypes of PTSD.

Quantitative EEG in "positive" and "negative" schizophrenia

Begić D, Hotujac Lj, Jokić‐Begić N. Quantitative EEG in ‘positive’ and ‘negative’ schizophrenia.

Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women

Abstract Objective: The demographic characteristics, maternal parity and personal traits of pregnant women have been frequently studied predictors of fear of childbirth (FOC). The aim of this study was to examine the role of demographic variables, expected pain level, trait anxiety and anxiety sensitivity in FOC among nulliparous and multiparous women in the last trimester of pregnancy. Method: Two-hundred pregnant women completed a booklet with questionnaires including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), Anxiety Sensitivity Index (ASI), The State – Trait Anxiety Inventory (STAI) and questions on expected labor pain and demographics. Results: Results showed that FOC was higher amongst nulliparous women, but FOC level was not associated with other demographic variables. Different predictors were established in nulliparous and multiparous women. While higher intensity of expected labor pain and anxiety sensitivity (dimension physical concern) were significant predictors in both groups, trait anxiety was significant for the first-time mothers only. Conclusion: Amongst all women, anxiety sensitivity (physical concerns dimension) was identified as an important vulnerability factor for FOC. As such, the level of anxiety sensitivity, and any resulting fear or expectations of pain, should be assessed in expectant mothers by clinicians in prenatal settings. Furthermore, anxiety sensitivity should be an important target for psychological interventions aimed at managing FOC.

Anxiety sensitivity and anxiety as correlates of expected, experienced and recalled labor pain

There has been a good deal of research on the role of anxiety sensitivity in pain perception, but only recently have investigators begun to assess its role in labor pain. The aim of this study was to investigate the nature of this relationship as well as the relationship of state and trait anxiety with labor pain. Assessments of maximum and average labor pain were completed in three different time periods (before, during and immediately after labor, and 1 month postpartum). Anxiety and anxiety sensitivity measures were completed during the late stage of pregnancy. A total of 46 primiparous healthy pregnant women, carrying a single child, participated in the study. State anxiety correlated significantly with maximum (r = 0.352, p < 0.01) and average (r = 0.325, p < 0.05) labor pain expectancies, whereas trait anxiety correlated significantly with maximum labor pain expectancies (r = 0.306, p < 0.05). During labor, only the physical concerns dimension of anxiety sensitivity shared a significant relationship with sensory pain (r = 0.292, p < 0.05). In conclusion, anxiety shares a significant relationship with labor pain expectancies only, whereas the physical concerns dimension of anxiety sensitivity correlates significantly with sensory pain during labor. These data clarify the role of anxiety and anxiety sensitivity in the experience of labor pain. Clinical implications are discussed.

Quantitative EEG in schizophrenic patients before and during pharmacotherapy

The aim of the study was to determine the possible differences in quantitative EEG parameters of schizophrenic patients before and during therapy with neuroleptics. First EEG recordings were obtained from schizophrenic patients (n = 50) who had not been taking any medicaments during the preceding 2 months. Second EEG recordings were obtained during the administration of neuroleptic therapy. Amplitude values of particular spectral segment, i.e. delta, theta, alpha 1, alpha 2, beta 1 and beta 2 (after fast Fourier transformation) were analyzed. The F3, F4, C3, C4, T3, T4, P3, P4, O1 and O2 regions were observed. The effect of pharmacotherapy manifested as a decrease in delta and beta 2 activities. The alterations of the delta spectrum were recorded in each patient subgroup (regardless of the neuroleptic used). The changes in beta 2 activity were registered in patients on haloperidol and fluphenazine.

Violent behaviour and post-traumatic stress disorder

Purpose of review There is a dual connection between violent behaviour and post-traumatic stress disorder. On one hand, exposure to violence leads to post-traumatic stress disorder symptoms, and on the other hand some of the symptoms of post-traumatic stress disorder are violent behaviour and aggression. In other words, violence creates post-traumatic stress disorder, and post-traumatic stress disorder contains violence. The frequency of violent behaviour as a background for the development of post-traumatic stress disorder is increasing. Exposure to violence, criminal and terrorist attacks, sexual (especially in early childhood) and physical abuse lead to anxiety, aggression, depression and post-traumatic stress disorder symptoms. Recent findings Different types of violence and their psychological and psychiatric consequences are now being researched to determine whether there are any differences in exposure to violence and its consequences with regard to age, sex, ethnicity, and sociodemographic characteristics. Apart from the individual and his/her family, the effects of violence on the wider community are being examined. In contrast, the well-described post-traumatic stress disorder, within the frame of increased alertness, can contain violence, aggression, anger, and impulsivity, which are a big problem for the patient and his/her family. These are the most common reasons for requesting psychiatric treatment. Summary Future research into violent behaviour and post-traumatic stress disorder will reveal the risk factors for this disorder, and try to explain what it is that, after exposing an individual to psychological trauma, leads to post-traumatic stress disorder. Possible protective factors and mechanisms to prevent the occurrence of post-traumatic stress disorder will be described.

Factor Structure and Psychometric Properties of the Anxiety Sensitivity Index in a Sample of Croatian Adults.

Anxiety sensitivity (AS) refers to a person’s tendency to fear anxiety-related symptoms due to the belief that these symptoms may have harmful consequences. The most widely used operationalization of AS in adults is the Anxiety Sensitivity Index (ASI). The factor structure, gender stability, and psychometric properties of the ASI in a sample of Croatian adults (N = 984) were evaluated. Results confirm the multidimensional and hierarchical structure of the ASI, which consisted of three lower-order factors (Physical Concerns, Psychological Concerns, and Social Concerns) and a single higher-order factor, AS. Furthermore, the achievement of normative scores for the ASI in a Croatian adult sample demonstrates the cross-national stability of the ASI. Reliability coefficients for the ASI, Physical Concerns, and Psychological Concerns are high and satisfactory in the total sample and for both genders. Overall, the results confirmed the cross-national stability, gender stability, reliability, and validity of the ASI in a sample of Croatian adults.

Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual Persons in Croatia

In Croatia, transgender individuals face numerous social and medical obstacles throughout the process of transition. The aim of this study was to depict the factors contributing to the psychosocial adjustment of six transsexual individuals living in Croatia following sex reassignment surgery (SRS). A combination of quantitative and qualitative self-report methods was used. Due to the specificity of the sample, the data were collected online. Standardized questionnaires were used to assess mental health and quality of life alongside a series of open-ended questions divided into 4 themes: the decision-making process regarding SRS; social and medical support during the SRS process; experience of discrimination and stigmatizing behaviors; psychosocial adjustment after SRS. Despite the unfavorable circumstances in Croatian society, participants demonstrated stable mental, social, and professional functioning, as well as a relative resilience to minority stress. Results also reveal the role of pretransition factors such as high socioeconomic status, good premorbid functioning, and high motivation for SRS in successful psychosocial adjustment. During and after transition, participants reported experiencing good social support and satisfaction with the surgical treatment and outcomes. Any difficulties reported by participants are related to either sexual relationships or internalized transphobia. The results also demonstrate the potentially protective role that a lengthier process of transition plays in countries such as Croatia.

Personal Space of Male War Veterans With Posttraumatic Stress Disorder

In this study, the authors examined the preferred interpersonal distances of individuals with combat-related posttraumatic stress disorder (PTSD). Study participants were 151 male war veterans, of whom 83 were suffering from PTSD and 68 were not suffering from PTSD symptoms (control group). Personal space was assessed using a stop-distance technique, where male and female research assistants approached the participants from four directions. Participants with PTSD preferred significantly larger interpersonal distances than did the control group. Participants in both groups maintained larger interpersonal distances when approached by a man than by a woman. The PTSD participants preferred the greatest interpersonal distance when approached from behind, whereas the control group preferred the greatest distance when approached frontally. The authors found these results to be consistent with the self-protective function of personal space.