Background: Burnout syndrome usually begins with feelings of enthusiasm and idealized visualizati... more Background: Burnout syndrome usually begins with feelings of enthusiasm and idealized visualizations, and it is in contrast with subsequent disillusionment, disappointment, and symptoms which are related to chronic stress experienced later. This tendency to idealization is a parallel to the concept of "mental splitting" described by Kernberg with a pronounced "black and white" perceptual dichotomy between the early idealization and later disillusionment. This study intends examination of relationships between burnout syndrome, traumatic stress and Kernberg's concept of splitting. Methods and participants: In this study we have assessed 90 health care professionals (50 women and 40 men) working with a population of diabetic patients utilizing Burnout Measure (BM), Splitting index (SI) and Traumatic Stress Checklist-40 (TSC-40). Results: Study results indicate significant Spearman correlations between burnout syndrome (BM) and traumatic stress (TSC-40) in population of men (R=0.75, p<0.01) and of women (R=0.61, p<0.01), as well as between burnout syndrome (BM) and splitting (SI) for both genders: men (R=0.40, p<0.01), women (R=0.51, p<0.01). These findings may have implications for prevention and treatment of burnout syndrome. Conclusion: The current study findings provide implications that the defensive mechanisms of splitting and traumatic stress may allow for the prediction of burnout symptoms. This relation may potentially be of use in both the potential detection and prevention of burnout syndrome.
Accord ing to current find ings, in the history of neurology proposed by H ughlings Jackson, cert... more Accord ing to current find ings, in the history of neurology proposed by H ughlings Jackson, certain later d evelop ed functions d uring ontogenesis of the central nervous system (CN S) tend to replace the old er ones. In this context, recent and historical find ings suggest that certain later d eveloped cognitive and m otor functions d uring brain ontogenesis related to higher levels of coord ination tend to replace the old er ones and their persistence is linked to various neuropsychiatric d isord ers. Particularly im portant functional d isturbances in ADH D d eveloped early in life likely linked to d issolution process are balance d eficits linked to d ysfunctions of higher levels of coord ination related to neurophysiological and m ental functions that typically occur in ADH D. In this context, recent d ata suggest that one of the im portant aspects of norm al d evelopm ent that m ay play a r ole in ADH D is suppression of the so-called prim itive reflexes. Taken together these d ata suggest that ADH D sym ptom s m ay present a com pensatory process related to interference of m ore prim itive neural m echanism , as related to prim itive reflexes, w ith highe r levels of brain functions linked to coord ination and balance d ue to insufficiently d eveloped cognitive and m otor integration.
Here we present a complex hypothesis about the psychosomatic mechanism of serotonergic psychedeli... more Here we present a complex hypothesis about the psychosomatic mechanism of serotonergic psychedelics. Serotonergic psychedelics affect gut microbes that produce a temporary increase of 5-HT by their host enterochromaffin cells (ECs). This increased 5-HT productionwhich is taken up and distributed by platelets-may work as a hormone-like regulatory signal that could influence membrane permeability in the host organs and tissues and in the brain. Increased plasma 5-HT levels could enhance permeability of the blood-brain barrier (BBB). Transiently increased permeability of the BBB allows for plasma 5-HT to enter the central nervous system (CNS) and be distributed by the volume transmission. Next, this gut-derived 5-HT could modulate excitatory and inhibitory neurotransmission and produce special network disintegration in the CNS. This transient perturbation of the normal neural hierarchy allows patients access to suppressed fear information and perform an emotional reset, in which the amygdale may have a key role.
Subjective wellbeing (SWB) is an important factor of global adjustment. Intergenerational satisfa... more Subjective wellbeing (SWB) is an important factor of global adjustment. Intergenerational satisfaction in seriously traumatized people has not been studied so far in homogenous populations of Central and Eastern Europe. This study focuses on the SWB in three generations of survivors living in the Czech Republic and Slovakia after World War II (WWII). The focal groups were Holocaust survivors (ages 71–95, n = 47), Holocaust survivors’ children (ages 30–73, n = 86), and their grandchildren (ages 15–48, n = 88), and they were compared to aged-matched groups without Holocaust history. The first and second generation of Holocaust survivors scored significantly lower than the comparison groups in wellbeing, as measured using the Schwartz Outcome Scale-10 (SOS-10). There was no significant difference in life satisfaction in any of the three generations. Within the focal group, identification as Jewish or as also Jewish was comparable in all three generations of Holocaust survivors (74% in ...
According to recent findings schizophrenia and bipolar disorder as separate disease entities mani... more According to recent findings schizophrenia and bipolar disorder as separate disease entities manifest similarities in neuropsychological functioning. Typical disturbances in both disorders are related to sensory gating deficits characterized by decreased inhibitory functions in responses to various insignificant perceptual signals which are experimentally tested by event related potentials (ERP) and measured P50 wave. In this context, recent findings implicate that disrupted binding and disintegration of consciousness in schizophrenia and bipolar disorder that are related to inhibitory deficits reflected in P50 response may explain similarities in psychotic disturbances in both disorders. With this aim, this review summarizes literature about P50 in both schizophrenia and bipolar disorder.
The term splitting is defined as a process of mental division of complex structures related to co... more The term splitting is defined as a process of mental division of complex structures related to cognitive and affective conflicting experiences. Recent findings indicate that mental splitting in schizophrenia might be represented by disrupted organization of neural information transmission. This disturbed neural information processing likely may determine deficits in mental disorganization described in neuroscientific theories of disturbed connectivity, corollary discharges and dynamic complexity. In this context, a purpose of this article is to review basic neuroscience theories of schizophrenia that complementarily reflect mind-brain information connectivity. These underlying disruptions of neural integrity might represent neural correlates of the splitting in schizophrenia that provide novel descriptions of mind-brain relationships.
Painful experience involving psychological and physical dimension is most frequently understood a... more Painful experience involving psychological and physical dimension is most frequently understood as a dangerous signal from physical and social environment. In this context recent psychological research in posttraumatic growth strongly suggests that pain in its consequences must not be only hurtful experience as such but may have a unique psychological dimension for human development and growth. Acceptation of pain experience as not only negative sheds new light to this problem and has important consequences for psychotherapy as a unique opportunity to resolve psychological conflict and intensive inner suffering. These findings are particularly important for human growth and spirituality, and are in contrast to hedonic aspect of our culture that tend to ignore painful experience as a part of human life that can uncover real meaning of personal existence and self-reflection as an essential principle for learning and creative process of understanding.
According to current evidence neural correlate of consciousness likely represents synchronized ne... more According to current evidence neural correlate of consciousness likely represents synchronized neural process that connects distributed brain activities into a coherent whole. In agreement with this concept consciousness can be understood as an integrative experience connecting various mental events. There is also growing evidence that disruptions of this coherent neural binding produce disintegration of consciousness in schizophrenia. This may imply that the disrupted binding and disintegration of consciousness in schizophrenia could be related to historical Bleuler's concept of splitting proposed as a basic process in pathogenesis of schizophrenia. In this context, recent data indicate new perspectives in research of schizophrenia that connect "split mind" with the research of neural correlates of consciousness. Together these findings suggest a hypothesis that mental disintegration in schizophrenia could be described as a level of neural disintegration leading to more irregular neural states with higher complexity that negatively affect information integration and synchronization processes in the brain.
Neuropsychiatric disease and treatment, Apr 1, 2024
Background: Intense fear of flying, called aviophobia, is a highly prevalent psychological phenom... more Background: Intense fear of flying, called aviophobia, is a highly prevalent psychological phenomenon, afflicting (in some estimates) up to 40% of the population of industrialized countries and although aviophobia is a highly prevalent mental health problem, published studies about its epidemiology and treatment are rare. Methods: In this study, including 61 participants (28 males and 33 females; mean age 26.85) engaged in business related travels in the last two years, we assessed relationships of fear of flying problems with symptoms of stress also reflecting childhood traumatic stress experiences and its influences on brain sensitization and epileptic-like symptoms. In this assessment we also studied fear of flying symptoms and work related psychological problems described as burnout. Results: The results show that the participants who manifest higher levels of stress symptoms have higher levels of aviophobic experiences. Stress symptoms measured by TSC-40 manifested significant correlations with aviophobic experiences measured by Flight Anxiety Modality Questionnaire (FAS) (Spearman R=0.46, p<0.01). Other correlations were found between FAS and Limbic System Checklist (LSCL-33) (Spearman R=0.39, p<0.01) and FAS and Burnout Measure (BM) (Spearman R=0.30, p<0.01). Conclusion: The results of this study indicate that the experience of fear of flying is related to past and recent stressful events and also to levels of work related problems described and experienced as burnout.
BackgroundCurrent research suggests that stressful life experiences and situations create a subst... more BackgroundCurrent research suggests that stressful life experiences and situations create a substantive effect in the development of the initial manifestations of psychotic disorders and may influence temporo-limbic epileptic-like activity manifesting as cognitive and affective seizure-like symptoms in non-epileptic conditions.MethodsThe current study assessed trauma history, hair cortisol levels, epileptic-like manifestations and other psychopathological symptoms in 56 drug naive adult young women experiencing their initial occurrence of psychosis.ResultsHair cortisol levels among patients experiencing their initial episode of psychosis, were significantly correlated with stress symptoms measured by Trauma Symptom Checklist-40 (r = − 0.48, p < 0.01), and complex partial seizure-like symptoms measured by the Complex Partial Seizure-Like Symptoms Inventory (r = − 0.33, p < 0.05) and LSCL-33 (r = − 0.33, p < 0.05). Hair cortisol levels were not found to be significantly corre...
According to recent findings activation of anterior cingulate cortex (ACC) is related to detectin... more According to recent findings activation of anterior cingulate cortex (ACC) is related to detecting cognitive conflict. This conflict related activation elicits autonomic responses which can be assessed by psychophysiological measures such as heart rate variability calculated as beat to beat R-R intervals (RRI). Recent findings in neuroscience also suggest that cognitive conflict is related to specific nonlinear chaotic changes of the signal generated by neural systems. The present study used Stroop word-color test as an experimental approach to psychophysiological study of cognitive conflict in connection with RRI measurement, psychometric measurement of limbic irritability (LSCL-33), depression (BDI-II) and calculation of largest Lyapunov exponents in nonlinear data analysis of RRI time series. Significant correlation 0.61 between largest Lyapunov exponents and LSCL-33 found in this study indicate that a defect of neural inhibition during conflicting Stroop task is closely related ...
A dynamic concept of schizophrenia linked to the theory of dissociated complexes was experimental... more A dynamic concept of schizophrenia linked to the theory of dissociated complexes was experimentally demonstrated by Jung in “The Psychology of the Dementia Praecox”. According to him, during schizophrenia the psyche is split-off into a plurality of autonomous complexes and the whole personality is pathologically disintegrated. This pathological disintegration is frequently observed in schizophrenic associations that display “chaotic randomness”. The “chaotic randomness” does not mean a true randomness because schizophrenic associations are not without underlying order and causality. An important aspect of schizophrenic dissociation is an extreme subjective sensitivity. These two signs of schizophrenic associations are analogical to known characteristics of chaotic nonlinear dynamical systems. The hypothesis tested in the present study is that neural chaos, calculated from electrodermal activity (EDA), during rest and word-association process is more prominent in schizophrenic patien...
Background: The early days of a given experience are associated with typically what might be char... more Background: The early days of a given experience are associated with typically what might be characterized as an idealized enthusiasm. Conversely burnout syndrome experienced later in the given experience is associated with disillusionment, disappointment, and symptoms which resemble a depression. This very common propensity is a parallel to the concept of "splitting" described by Kernberg with a pronounced "black and white" perceptual dichotomy between the early idealization and later disillusionment. This study intends examination of relationships between burnout syndrome, depression, and Kernberg's concept of splitting. Material/Methods: In this present study, we assessed 132 female health care professionals working with a population of diabetic patients utilizing Burnout Measure (BM) Splitting Index (SI), Beck Depression Inventory II (BDI-II), and additional psychometric instruments, the Toronto Alexithymia Scale and the Trauma Symptoms Checklist. Results: The study results indicated significant Spearman correlations between burnout syndrome as measured by BM and depression (BDI-II) (R=0.62, P<0.01), and burnout syndrome as measured by BM and splitting (SI) (R=0.45, P<0.01). These findings may have implications for prevention and treatment of burnout syndrome. Conclusions: The current study findings provide implications that the defensive mechanism of splitting may allow for the prediction of burnout symptoms which in turn may allow for the prediction of burnout syndrome. This dynamics may potentially be of use in both the potential detection and prevention of burnout syndrome.
The endometrium tissue is functionally androgen related which plays an important role in women's ... more The endometrium tissue is functionally androgen related which plays an important role in women's fertility regulation. In addition recent findings show that endometrium related pathology is closely linked to disrupted androgen biosynthesis and associated regulatory functions. These findings also suggest that androgens might play an important role in endometrium related cancer pathology with significant implications for treatment. Based on these findings, we have assessed 50 female outpatients with endometriosis and the clinical investigations were focused on biochemical serum analysis of DHEAS, oncological markers CA-125 and CA 19-9, estradiol, thyreothropic hormone, and prolactin. The results show significant Spearman correlations of CA-125 and CA 19-9 with dehydroepiandrosterone-DHEA-S (R = 0.52 resp. R = 0.49). This result represents 1st reported finding documenting androgen related increase of CA-125 and CA 19-9 levels as significant markers of endometrium pathology and it is possible to assume that these potential biomarkers could have clinical importance with respect to timely diagnosis.
To prevent violence among persons with psychosis, further knowledge of the correlates and risk fa... more To prevent violence among persons with psychosis, further knowledge of the correlates and risk factors is needed. These risk factors may vary by nation. This study examined factors associated with violent assaults in 158 patients with psychosis and in a matched control sample of 158 adults without psychosis in the Czech Republic. Participants completed interviews and questionnaires to confirm diagnoses, report on aggressive behavior, current and past victimization, and substance use. Additional information was collected from collateral informants and clinical files. Multiple regression analyses were conducted to identify factors that were independently associated with committing an assault in past 6 months. The presence of a psychotic disorder was associated with an increased risk of assaults (OR =3.80; 95% CI 2.060-7.014). Additional risk factors in persons with and without psychosis included recent physical victimization (OR =7.09; 95% CI 3.922-12.819), childhood maltreatment (OR ...
Background: According to recent data, dissociation may play an important role in borderline perso... more Background: According to recent data, dissociation may play an important role in borderline personality disorder (BPD), nevertheless specific influences of psychotropic medication on dissociative symptoms in BPD and their therapeutic indications are largely unknown. The purpose of this study was to assess relationships of dissociative symptoms in BPD patients with levels of psychotropic medication and compare these results with a subgroup of patients with schizophrenia. Materials and methods: In this study, we investigated 52 BPD patients and compared the results with a control group of 36 schizophrenia patients. In all participants, we assessed actual day doses of antipsychotic medication in chlorpromazine equivalents and antidepressant medication in fluoxetine equivalents. Dissociative symptoms were measured by Dissociative Experiences Scale (DES), and other psychopathological symptoms were measured using Health of the Nation Outcome Scales. Results: Results indicate that dissociative symptoms measured by DES were significantly correlated with antipsychotic medication (Spearman R=0.45, P,0.01) in chlorpromazine equivalents and antidepressant medication in fluoxetine equivalents (0.36, P,0.01). These relationships between medication and dissociative symptoms were not found in the control group of schizophrenia patients. Conclusion: The results suggest that levels of antipsychotic medication and antidepressant medication are significantly associated with dissociative symptoms in BPD but not in schizophrenia.
Deficits in the ability to recognize and think about mental states are broadly understood to be a... more Deficits in the ability to recognize and think about mental states are broadly understood to be a root cause of promote dysfunction in Borderline Personality Disorder (PD). This study compared the magnitude of those deficits relative to other serious mental illness or psychiatric conditions. Assessments were performed using the metacognition assessment scale-abbreviated (MAS-A), _________________________________________________________________________________
Recent evid ence ind icates that various types of interactions betw een nervous and immune system... more Recent evid ence ind icates that various types of interactions betw een nervous and immune system are important in pathogenesis of d epression. These find ings show that a significant role in d eveloping d epression play proinflammatory cytokines that may med iate its psychological and neurobiological m anifestations. Great im portance am ong these cytokines plays tum or necrosis factor alpha (TN F-α) and there is grow ing evid ence that inflamm atory processes related to d epression may be influenced by psychological stress as w ell as organic inflammatory cond itions. These find ings suggest that specific influences related to traumatic stress and d issociation could be found in close relationship to increased level of cytokine TN F-α. In the present stud y w e have performed psychometric measurement of d epression (BDI-II), traum atic stress sym ptom s (TSC-40) and d issociation (DES), and im m unochem ical measure of serum TNF-α in 40 inpatients w ith unipolar depression (m ean age 38.4±8.2). The results show that TN F-α is significantly related to DES (Spearman R=-0.36, p<0.05), but not to BDI-II and TSC-40. Results of the present stu d y suggest that TN F-α alterations related to d issociation could present a specific process of immunomod ulation that may be explained by mutual influences betw een stress and neuroimmune system.
Several current data indicate that intracranial records of the Bereitschaftspotential from some b... more Several current data indicate that intracranial records of the Bereitschaftspotential from some brain loci manifest baseline shifts (EBS) in the early pre-movement period that are separated from the movement components by a distinct plateau. In this context, main purpose of this study was to assess whether structures generating the EBSs that are simultaneously widespread in various structures of the brain will be specifically linked to higher levels of large-scale integration in comparison to structures that were not involved in EBS generation. In this study were included 21 epilepsy surgery candidates (12 men, 9 women; aged from 18 to 49 years), who were measured during self-paced clenching movements of the hand. Brain activities during the task were recorded using intracerebral electrodes and were evaluated in pairs. Eighty two percent of the EBSs started in various distant brain structures at the same time, eighteen percent at different time. Approximately half of the EBSs of the...
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