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Introduction: From year one of studying medicine an increase of psychological stress is found. The relationship between the occurrence of this stress and attachment patterns or structural personality functions remains unclear. The present study aimed at investigating whether a relationship between the enduring personality variables, attachment style and level of structural integration of the personality, and acute stress experience at the beginning of medical students' studies exists., Material & Methods: In this study, all students in the first semester of medicine were invited to participate in a study to identify stress factors via questionnaire (MBI-SS, PSQ, PHQ-9, GAD-7) in the WS 2013/2014. Simultaneously, the predominant attachment style (RQ-2) and structural abilities (OPD-SFK) were evaluated., Results: The study included 293 students (return: 91.3%). Securely attached students experienced significantly less stress than insecurely attached students (p=0.019). Students with a high level of structural integration showed significantly less stress burden (p<0.001) and lower exhaustion- (p<0.001) and cynicism values (p<0.001), while showing a higher experience of self-efficacy (p<0.001). The influence of attachment behavior on stress experience is mediated by the level of the structural integration of the personality., Discussion: Significant correlations exist between attachment style and the level of structural integration of the personality, and burnout risk as well as stress burden. The level of structural integration of the personality mediates the relationship between the attachment-related "model of self" and stress experience, i. e. a positive "model of self" can have a stress-protective effect when good structural abilities are present. Practical implication: An insecure attachment style and a low level of structural integration may be associated with higher stress experience when transitioning to study. The results suggest that the enduring personality variable attachment style, mediated by the level of structural integration of the personality, leads to higher stress and burnout experience. Affected students could be supported by early preventive measures enabling the sustainable preparation for this transitional period. Longitudinal prospective studies are needed to explore if the assumption is applicable that pre-existing vulnerabilities in school are exacerbated at this transitional stage., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: For leaders of small and medium-sized enterprises (SMEs) grappling with diverse tasks and stressors, personality functioning can play a key role on stress perception and building and managing professional relationships. We investigated the relationship between SME leaders' personality functioning on the dimensions of self-perception and self-regulation on perceived stress reactivity (PSR), and symptoms of anxiety and depression. Methods: A cross-sectional sub analysis of a multi-centre RCT project was performed. A sample of N = 174 SME leaders from various sectors in southern Germany were examined on their self-rated levels of personality functioning (OPD-SQ), involving self-perception (facets: self-reflection, affect differentiation, sense of identity) and self-reflection (facets: impulse control, affect tolerance, regulation of self-esteem), with higher scores indicating lower levels of personality functioning. The outcome variables were perceived stress reactivity (PSRS) and symptoms of depression and anxiety (HADS). Results: The mean score for symptoms of anxiety was M = 6.13 (SD = 3.34), depression M = 4.40 (SD = 3.35), and for PSRS M = 21.39 (SD = 8.04). The mean sum score for self-perception was M = 7.71 (SD = 7.19) and for self-regulation M = 10.50 (SD = 7.09). The results of three regression models showed that higher scores for affect differentiation (rsp =.13), impulse control (rsp =.14) and regulation of self-esteem (rsp =.29) were associated with higher scores for PSR. Higher scores for affect differentiation (rsp =.17) and affect tolerance (rsp =.20) were significantly associated with higher scores for anxiety. A higher score for regulation of self-esteem (rsp =.17) was associated with higher depression scores. Conclusion: This study highlights the association between core dimensions of SME leaders' personality functioning and mental distress. The findings can be applied on interventions and health promotion and the establishment of high-quality professional relationships and leadership skills. [ABSTRACT FROM AUTHOR]

Social work students experience high levels of stress, which makes them vulnerable to stress-related disorders such as depression. Attachment security has been associated with better stress regulation. Another factor that is closely associated with attachment is mentalization, i.e., the ability to reflect about one's own and others' mental states, which may also influence the way people cope with stress. The main aim of the study was to investigate the impact of attachment and mentalization on stress, depression, and anxiety in social work students. 460 social work students completed the short version of the "Experiences in Close Relationships-Revised questionnaire" (ECR-RD8), "Relationship Questionnaire" (RQ-2), "Certainty About Mental States Questionnaire" (CAMSQ), "Perceived Stress Scale" (PSS-10) as well as the "Patient Health Questionnaire" (PHQ-9) and the "Generalized Anxiety Disorder Scale" (GAD-7) in a cross-sectional research design. The majority of the current social work students (71.1%) were assigned to an insecure attachment style and reported noticeably high levels of stress, depression, and anxiety. Insecurely attached students showed even higher levels of stress, depression, and anxiety compared to securely attached students. Moreover, the results indicate that securely attached students have better mentalizing skills and that mentalizing skills (partially) mediated the effect of attachment security on perceived stress, depression, and anxiety. Due to the importance of mentalization for stress regulation, mental health, and the quality of relationships, programs promoting mentalization in social work students should be implemented in social work education programs. [ABSTRACT FROM AUTHOR]

Background: The assessment of personality functioning is at the core of current dimensional models of personality disorders. A variety of measures from different clinical and research traditions aim to assess basic psychological capacities regarding the self and others. While some instruments have shown reliability and validity in clinical or other selected samples, much less is known about their performance in the general population. Methods: In three samples representative of the German adult population with a total of 7,256 participants, levels of personality functioning were measured with the short 12-item version of the Operationalized Psychodynamic Diagnosis -- Structure Questionnaire (OPD-SQS). We addressed questions of factor structure, reliability, validity, factorial invariance, and provide norm values. Results: Confirmatory factor analysis indicated a satisfactory to good model fit. OPD-SQS models were mostly unaffected by variables such as gender, age, or measurement time. As expected, personality functioning was associated with general psychopathology as well as indices of occupational functioning. Conclusion: The OPD-SQS is a viable measure to assess personality functioning in the general population. [ABSTRACT FROM AUTHOR]

Introduction: Individual vulnerability and resilience factors are increasingly studied in burnout research. This is especially true for clinical variables that translate directly into intervention programs from a psychodynamic perspective. For example, few studies have examined the relationship between structural impairment and the individual spectrum of motivational conflicts according to the Operationalized Psychodynamic Diagnosis system (OPD) in relation to burnout. To substantiate previous findings, we hypothesized that structural impairment as well as motivational conflicts are related to burnout, but that structural impairment explained additional variance and mediated a possible relationship between conflicts and burnout. Method: The present cross-sectional study was carried out on a sample of the German working population (N = 545). Questionnaires were used to measure structural impairment (OPD-SQS), the conflict-modes along with the category K0 (OPD-CQ), as well as burnout (BOSS-I/-II). Results: Structural impairment, a number of conflict modes, and burnout were significantly associated. Moreover, structural impairment explained additional variance in burnout. The requirements for the conflict-specific mediation models were given for 9 of the 12 OPD conflict modes. In these models the impact of the conflict modes on burnout was mediated by structural impairment. Discussion: The current study broadens the comprehension of the relations between structural impairment, the conflict modes and burnout. In addition it higlights the role of structural impairment in predicting burnout risk and possible prevention approaches. [ABSTRACT FROM AUTHOR]

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Aims : Is there evidence for increased psychological distress and alterations in personality functioning in patients with Crohn's disease (CD) and ulcerative colitis (UC) compared to healthy controls (HCs)? Background : In patients with CD and UC, perceived stress is closely associated with changes in disease activity. The stress response is influenced by psychological burden and personality functioning, but only little is known about these factors in inflammatory bowel diseases (IBD). Study : A total of 62 patients with an endoscopic ensured CD/UC without remission (n = 31 per group) and 31 HC were included. Patients with an active CD/UC and HC were individually matched (n = 93, 31 per group) for age, sex, education, and disease activity. Depression and anxiety were assessed to evaluate the effect of psychological burden (Patient Health Questionnaire-9/PHQ-9, Generalized Anxiety Disorder-7/GAD-7). Personality functioning was measured by validated questionnaires for psychodynamic structural characteristics, mentalization, and attachment (Operationalized Psychodynamic Diagnosis-Structure Questionnaire/OPD-SQ, Mentalization Questionnaire/MZQ, and Experiences in Close Relationships scale/ECR-RD 12). Results : Levels of depression and anxiety were higher in CD/UC patients than in HC with large effect sizes. Comparing personality functioning in CD/UC with HC, psychodynamic structural characteristics differed between CD/UC and HC with medium effect sizes, with structural differences occurring primarily in the domain of self-perception and regulation. Only minor differences were found regarding mentalization and attachment. CD and UC differed only with small effect sizes. Conclusion : Our data show that compared to HC, patients with CD/UC are characterized by a higher level of psychological burden and structural alterations in the domain of self. [ABSTRACT FROM AUTHOR]

We tested the hypothesis that structural integration, as assessed in the Operationalized Psychodynamic Diagnosis (OPD) system, and emotional intelligence (EI), as studied in personality psychology, might be closely related constructs at a general level, as both might assess general personality functioning. In three studies (n1 = 166, n2 = 204, n3 = 349), we used a self-report measure of OPD structural integration and measures of Trait and Ability EI. Structural integration and Trait EI display very high correlation at general factor level (r =.77 -.82) and almost perfect latent correlation (r =.85 -.90). This correlation cannot be explained away by the general positivity of self-views or socially desirable responding. There is also substantial latent correlation between structural integration and Ability EI (r =.20 -.65). Results replicate over different samples from different countries and extend to the DSM-5 self-report personality functioning scale. [ABSTRACT FROM AUTHOR]

Background: Depressive disorder is one of the main health problems worldwide. Many risk factors have been associated with this pathology. However, while the association between risks factors and adult depression is well established, the mechanisms behind its impact remains poorly understood. A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal. Method: Around 162 patients were assessed at the beginning of their therapy, with regard to risk factors, such as sociodemographic, physical, hereditary (Information Form), and adverse childhood experiences (ACE; CTQ). Depressive symptoms (Beck Depression Inventory, BDI) and personality functioning (OPD-SQ) were also measured. Associations between the related variables as well as other possible covariates were examined by means of zero-order correlations and bootstrapping-based mediation analysis. Results: Of all the risk factors taken into account, level of education and physical illness were associated with depression. On the other hand, the most significant predictor of depressive symptomatology was ACE, and this relationship was mediated by personality functioning. This indicates that patients presenting adverse childhood experiences are more likely to develop deficiencies in personality functioning, which in turn increases their likelihood of developing depressive symptomatology. Conclusion: These results reaffirm the importance of incorporating risk and vulnerability factors such as personality functioning in understanding depression. [ABSTRACT FROM AUTHOR]

Despite the significance of return to work (RTW) after maternity, evidence describing the specific supervisor behaviors desirable is lacking. This study attempts to contribute to the field by exploring the effects of positive supervisor behaviors in RTW after maternity leave on well-being outcomes in working mothers (WMs). In particular, after the validation of a measure that assesses positive supervisor behaviors in RTW after maternity leave, we explored whether these behaviors, together with workplace attachment anxiety, are associated with performance and remaining opportunities perceived by WMs, hypothesizing the mediation of work engagement. Data from Italian WMs were analyzed through structural equation modeling. Results confirmed the hypothesized factor structure of the measure and showed that positive supervisor behaviors in RTW after maternity leave are directly and positively associated with performance. Moreover, positive supervisor behaviors in RTW after maternity leave, as well as workplace attachment anxiety, are associated with performance and remaining opportunities via work engagement. Findings are relevant for two reasons. First, they contribute to providing a tool for supervisors to positively manage RTW after maternity leave. Second, they contribute to shedding light on the importance of being inclusive, proactive, and supportive in managing RTW after maternity leave, without neglecting WMs' personal factors. The practical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Background: The UN Refugee Agency has reported that an increasing number of people are being forcibly displaced worldwide. Despite this, global health issues, especially initiatives focusing on physical and psychological conditions of refugees, are still rarely considered in medical curricula. Furthermore, there is little evidence regarding the experiences and possible related psychological strain of medical students who work with refugees. Therefore, the present study aimed to investigate motivations, learning achievements and experiences, as well as psychological strain and possible protective factors, in medical students volunteering in a reception center for refugees. Methods: In this prospective study using a mixed-methods approach, we applied (1) qualitative content analysis of semi-standardized interviews in a pre-post design in a subsample of n = 16 students. The aims were to analyze (1a) the students' motivations and experiences in the reception center, and (1b) the students' perceived learning achievement. We further administered (2) psychometric questionnaires using a cross-sectional approach to n = 62 students in order to examine (2a) the students' psychological strain, in terms of secondary traumatization, depression, anxiety and health-related quality of life, and (2b) possible protective factors such as attachment style and sense of coherence. Results: The content analysis of the students' interviews revealed three main categories before the assignment and four main categories subsequently, displaying a broad variety of perspectives. Quantitative analysis identified that 3.2% of the students showed moderate secondary traumatization, and a correlation emerged between the number of shifts and symptom severity of secondary traumatization. The students displayed significantly reduced scores for depression and anxiety, when compared to a sample of first-year medical students. Sense of coherence was identified as a protective factor concerning secondary traumatization. Conclusion: A rather small proportion of the medical students working in the reception center displayed explicit symptoms of psychological strain in terms of secondary traumatic stress. Due to their assignments, students were able to improve their cultural awareness, which they reported to be highly relevant for their future occupation. In view of increasing globalization, theoretical and practical courses on issues of flight and global health might therefore be implemented as an obligatory part of medical curricula. [ABSTRACT FROM AUTHOR]