Psychotherapy, clinical, counseling and health psychology 1

[5 abstracts]

1. Children mental health follow-up in youth communities of the SOS-Children’s Village  [presentation, ppt, 242 kB]
Rajhvajn Bulat L., Branica V.
First author's affiliation: Department of Social Work, Faculty of Law, Zagreb, Croatia

Mental health of children is influenced by the social environment and subject to different stresses that are more intensive in children who are growing up in some form of public care. The SOS-Children’s Village in Croatia is one of such forms of placing children under public care. A part of the results obtained from a comprehensive 5 year long research on behavior and feelings of children in public care will be presented. This research covered a total of 493 children placed in children's homes, 112 in foster homes and 187 in alternative forms of care (Nuevo Futuro and SOS-Children's Village). Results of 57 children and youth examinees from the youth communities of the SOS-Children's Village Croatia who participated in test and retest parts of the research (between a 5 year interval). The average age of children in the first measurement was 13 and 18 at the second. A total of 23 boys and 34 girls were interviewed. Two identical instruments were used as indicators of children's mental health: Youth self-report ( Achenbach,1991) filled by children and youth and the Child behavior check-list (Achenbach, 1991) filled by educators. The results have shown that the test-retest correlations on most sub-scales of mental health of children are statistically relevant, but this relevance ranges from low to middle. Also, the comparison of results obtained in 2003 with those obtained in 2008 show that educators evaluate that mental health of boys at the retest point has improved. In self-evaluation girls give evidence of their increasing externalization of problems (show a more delinquent and aggressive behavior). These results have additional weight as girls also stated that they feel more everyday stress than 5 years ago, and boys and girls both state that they feel less social support than before. At the end of the presentation, the measurement of mental health from different sources will be discussed, since results have shown that the evaluation of identical indicators of mental health by children and by educators have relatively low correlation (ranges from 0.02 to 0.37).

2. Coping strategies and health-related quality of life in children with type 1 diabetes  
Vulić Prtorić A., Jović M., Padelin P., Baraban D., Grubić M., Brnović I.
First author's affiliation: University of Zadar, Zadar, Croatia

We examined the differences between two groups of subjects (children with diabetes type 1 in pediatric care and healthy controls) in seven different aspects of coping strategies (problem solving, expressing feelings, avoidance, distraction, social support- friends, social support – family, cognitive restructuring). The sample consisted of 199 schoolchildren: 47 patients with diabetes type 1 as a primary complaint and 152 healthy children and adolescents in control group. Coping strategies were measured with SUO - The Coping strategies inventory for children and adolescents. SUO is the self-assessment instrument that measures the frequency of coping strategies in response to stressful events. Children’s health problems were rated with PedsQL 4.0 (Pediatric quality of life inventory - Generic score scale) and with the PedsQL Diabetes module. PedsQL Generic core scales encompass 4 aspects of health-related quality of life: physical functioning, emotional functioning, social functioning and school functioning. The PedsQL Diabetes module encompasses five scales: diabetes symptoms, treatment barriers, treatment adherence, worry and communication. Significant differences were found in four of seven coping strategies compared with healthy controls: problem solving, support from friend and family, distraction and cognitive restructuring were more common in children with diabetes. Significant gender differences were found in four coping strategies: avoidance, social support from family, expressing feelings and distraction. In all cases girls scored higher than boys. Significant correlations were found between coping strategies and different aspects of health-related quality of life in children with diabetes: expressing feelings, avoidance, and social support from friends were negatively correlated with physical and social functioning. The findings of the present study suggest that child psychologists and clinicians treating children suffering diabetes should address coping strategies related to the health-related problems.

3. High blood pressure representations in hypertensive adolescents: Structure and relations with personality and adherence  [presentation, ppt, 180 kB]
Žugelj U., Zupančič M., Kenda R., Komidar L.
First author's affiliation: Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia

The aim of the study is to examine whether there are differences among hypertensive adolescents in the way they conceptualize their illness. Further we wish to explore how these conceptualizations relate to medical regimen adherence and personality. Hypertension is a chronic illness usually affecting adult and elderly population but can also affect adolescents. If not properly treated or controlled, it can result in severe health complications (i.e. heart disease, damage of organs). Another issue of importance is that hypertension is usually asymptomatic disease thus posing a great challenge to the patient adherence. The relation can be indirectly influenced by personality. The participants are 100 adolescents with diagnosed essential hypertension (age 14 - 24 years) and the study is currently under progress. The Brief Illness Perception Questionnaire (Broadbent et al., 2006), modified MOS Adherence Questionnaire (Di Mateo, 1993) and The Inventory of Child Individual Differences (ICID, Halverson et al., 2003) are employed. A mediating role of illness representations in predicting adherence on the basis of personality traits was proposed. The fit of this model will be examined at the mid-level trait level and at the robust (the Big Five) level. Possible implications of our findings will be discussed.

4. Identity and communication of the elders  
Zaletel M., Kovačev A.
First author's affiliation: Health Faculty, University of Ljubljana, Ljubljana, Slovenia

Aging of the population is a growing problem of the contemporary developed societies, to which Slovenia also belongs. Therefore the problem of the elderly people's quality of life and the problem of their care are getting more and more important, since the elders need more social and health services. The aim of the present study was to research two decisive aspects of the self-experience and the behaviour of elderly people, which by now have not been given sufficient attention. These aspects are their identity and their communication. The research concentrated on the elders, who live in the homes for aged people. Communication research was particularly directed to those, whose verbal expression is severely restricted because of the old age degenerative processes. Therefore the non-verbal expressions which were registered by a »check list« were analysed. The identity research was concentrated on three types of identity: individual, social and collective identity. Since this research included self-governed responding to the questionnaire, the subject's verbal comprehension had to be sufficient. The research results proved that important(statistically significant differences) exist among members of both sexes and different age groups in their verbal and non-verbal expression. Important differences also exist among different employees, who care for them in the homes for aged people. Some important differences in individual and collective identity of the elders were also discovered.

5. Depression and anxiety in correlation to purpose of life and quality of life in Slovenian HIV-infected patients  [presentation, ppt, 1763 kB]
Oblak T., Pasarič A., Ručna V., Matičič M., Škodlar B.
First author's affiliation: Medical Faculty, University of Ljubljana, Ljubljana, Slovenia

Highly active antiretroviral therapy (HAART) has improved the life expectancy of HIV-infected patients. Attention has moved to managing mental disorders and quality of life (abbr. QOL). The most prevalent mental disorders in HIV-infected patients are anxiety and depression which are correlated to low purpose of life. We studied prevalence of depression and anxiety, level of purpose of life and QOL in Slovenian HIV/aids patients and their relationship. We hypothesized that depression, anxiety, low purpose of life and low QOL are importantly present in this population. Study enrolled 162 HIV-infected patients followed at the Clinics for infectious diseases and febrile illnesses of University Medical Centre of Ljubljana. For assessment of depression and anxiety we used Hospitaly anxiety and depression scale (HADS). WHOQOL-HIV BREF was used for assessing quality of life and Purpose in life (PIL) was used for assessing purpose of life. Questionnaire was answered by 111 patients (68.5 %). Depression was present in 24 (21.6 %) and anxiety in 36 patients (32.4 %). Patients expressed moderate quality of life and moderate purpose of life. Sucidial ideations were present in 24 (22 %) cases, low purpose of life in 29 (26.1 %) and low QOL in 13 patients (11.7 %). Depression and anxiety were positively correlated (p < 0.01). Both were negatively correlated to low purpose of life (p < 0.01). Purpose of life and QOL correlated negatively with some antiretroviral treatment (abacavir, stavudine and nelfinavir [p < 0.05]). Depression, anxiety, low purpose of life and low QOL are present among HIV-infected patients in Slovenia. The questionnaires HADS and WHOQOL-HIV BREF are suitable to be used in everyday clinical practice to screen for depression, anxiety and low QOL among patients with HIV/aids and we highly recommend their introduction in Slovenia.