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Behavioural Medicine

278: The impact of cognitive fusion and experiential avoidance on the quality of life of college students with chronic illness

Ferreira, C., Trindade, I.A., Marta-Simões, J., & Mendes, A. L., Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra

Background:
Living with a chronic health condition can represent a major psychosocial burden to college students. Literature has suggested that the impact of chronic illnesses may be influenced not only by physical symptoms but also by emotion regulation processes. Recent data showed that cognitive fusion and experiential avoidance are associated with quality of life (QoL) impairment. Nevertheless, the role of these maladaptive processes in chronically ill students remains understudied.
Objective:
This study aimed: (1) to analyse differences on QoL levels between healthy and chronically ill students; (2) to examine the mediator role of chronic illness-related cognitive fusion and experiential avoidance in the relationship between chronic illness-related shame and QoL in the chronic illness sample.
Methods:
This study comprised two samples of college students aged from 18 to 35 years: a sample of 232 healthy college students and a sample of 115 college students with diagnosis of chronic disease.
Results:
Students with chronic illness presented significantly lower levels of physical, social, and psychological QoL. Results indicated that the associations of chronic illness-related shame with psychological and the quality of social relationships are significant at a direct and indirect level through the effects of chronic illness cognitive fusion and experiential avoidance. The tested model accounted for 45% and 26% of the variances of psychological QoL and the quality of social relationships, respectively.
Conclusions:
This study appears to offer important clinical and research implications for the healthcare of chronic illnesses by underlining the pathogenic effects of cognitive fusion and experiential avoidance.

268: The link between attachment, body image-shame and disordered eating

Ana Laura Mendes, Cláudia Ferreira, Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Portugal

Introduction:
Literature has shown that attachment may hold a powerful effect on one’s physical and psychological development, an impact which manifests itself on well-being throughout life. While secure attachment relationships seem to associate with feelings of safeness, soothing and acceptance; felling inferior, unvalued and rejected by significant others is significantly related to physiological and mental health problems (such as shame and maladaptive defensive behaviours). Consistent evidences have documented that shame, in turn, is linked to body image-related difficulties and disordered eating attitudes and behaviours.
Objectives:
The current study aimed to examine the mediational role of body image-shame, and its external and internal dimensions, in the relationship between secure attachment and disordered eating, while controlling the effect of Body Mass Index.
Methods:
The sample comprised 110 Portuguese women, aged between 18 and 46 years old, that completed validated self-report measures.
Results:
The final path model explained 23% of external body-image shame, 13% of internal body-image shame and 59% of disordered eating, and revealed excellent model fit. Results showed that secure attachment presented an indirect effect on disordered eating attitudes and behaviours, which was totally carried by external and internal body-image shame. These results seem to suggest that women who report a more secure attachment, present lower levels of internal and external body-image-related shame, and thus a lower tendency to display disordered eating attitudes and behaviours
Conclusions:
This study emphasizes the relationship between attachment interactions and body image-related shame experiences. These results seem to have relevant contributions for clinical practice and for the development and implementation of intervention community programs. In fact, these findings emphasize the relevance of targeting maladaptive defensive behaviours and promote more adaptive emotion regulation strategies focused on de-shaming, to prevent the adoption of maladaptive body image and eating attitudes and behaviours.  

 

117: The impact of Individual Psychoeducation on the Level of Glycemia and Pulse of Type 1 Diabetes Patients

Sofiia Lahutina, Medical Psychology Department of Bogomolets National Medical University; Ukrainian Institute of Cognitive Behavioral Therapy.

«The impact of Individual Psychoeducation on the Level of Glycemia and Pulse of Type 1 Diabetes Patients» Background: depression is a common disease among type 1 diabetes patients and requires attention from medical staff. On the other hand, there is evidence of the impact of psychoeducation on the level of depression in patients. Objective: to determine the effect of comorbidity of hypertension (HT) on the level of depression in type 1 diabetes patients; to check the impact of individual psychoeducation  on the level of pulse and glycemia in «type 1 diabetes patients with HT» and «in type 1 diabetes patients without HT». Methods: 50 type 1 diabetes patients with HT were examined (main group - 50%); comparison group – 50  type 1 diabetes patients without HT (50%), which were treated in clinics of Kyiv Clinical Endocrinology Center. Patients were randomized according to age, sex, duration of disease. We used Beck Depression Inventory, instrumental measuring of glycemia using a glucose meter and heart rate for 1 minute. Results: no significant differences were observed in Beck Depression Inventory of the main group and in the comparison group (respectively, 16.88±3.40 and 12.56±3.95, p>0.05). Each patient had an individual 20-minute psychoeducation. Patients were explained the features of their disease, information about depression and so on. In this case, the level of glycemia and pulse before and after psychoeducation was measured. In the main group the level of glycemia decreased by 2.6±1.83 mmol/l, pulse – by 4.28±3.02 beats per minute, in the comparison group level of glycemia decreased by 1.04±0.73 mmol/l, pulse – by 2.56±1.81 beats per minute after psychoeducation. Conclusion: comorbidity of HT in type 1 diabetes patients does not significantly affect the level of depression. The impact of individual psyhoeducation was more significant in the group of type 1 diabetes patients with HT compared type 1 diabetes patients without HT.

203: The Relationship Between Normal Weight and Obese People's Frustration Intolerance Towards Emotional Eating and Eating Addiction

Fatmanur Taner, Psychiatry Department of Np İstanbul Brain Hospital ; Clinical Psychology master student of Üsküdar University

Obesity is the most controversial topic in the World because of the increasing percentage of obese people. According to the classification determined by the World Health Organization, individuals whose Body Mass Index [BMI= body weight (kg)/ height (m2)] is above 30.0 are considered as obese. In 1980 there were 875 million obese people worldwide and in the last 30 years the problem has doubled in number. Previous views about obesity was mainly focused on over-consumption of unhealthy food, but during the last decades, increased number of studies have shown that obesity can be caused by psychological problems. A more detailed examination of the relationship between obesity and psychological factors may enrich the treatment options in obesity. For example, during the last years Cognitive Behavioral Therapy has become a treatment option for losing weight. Our aim in this research is to find if frustration intolerance is a specific psychological factor that may increase the risk for obesity. With this aim, we randomly selected 150 people (both obese and normal weight) and gave Yale Food Addiction Scale, Frustration Intolerance Scale, and Emotional Eating Scale. We hypothesized that the people with low frustration intolerance would show significantly more disordered eating pattern, such as emotional eating and food addiction, than normal weight people. To Result; frustration intolerance was closely related with emotional eating but not with food addiction.

322: Effects of the POsitivE Memory elaboration training (POEM) on daily well-being

Christina Haag, Dept. of Experimental Psychopathology and Psychotherapy, University of Zurich, Switzerland; Dept. of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Switzerland; Arnaud Pictet, Dept. of Psychology, University of Geneva, Switzerland 3*, Birgit Kleim, Dept. of Experimental Psychopathology and Psychotherapy, University of Zurich, Switzerland; Dept. of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Switzerland.

Introduction:
Positive authobiographical memory retrieval is an effective emotion regulation strategy associated with increased well-being. Psychopathology, such as depression, has been linked to retrieval of less vivid and less detailed positive memories. Such memories may, in turn, increase or maintain negative mood states. The present study investigates the novel "POsitivE Memory elaboration training for Healthy individuals" (POEM-H) compared to a control condition. The POEM-H trains individuals to elaborate positive memories by deliberately focusing on, for instance, different sensorial qualities and positive emotions linked to the memory and thereby, aims to promote well-being.
Method:
The study currently include 82 young and non-depressed individuals (target sample size: n=70). During a baseline assessment, memory and mood measures are administered. Participants then keep a daily diary for three days on their positive memories, and on daily well-being. Participants then receive the POEM-H that comprises an initial training session and a five-day practice method. Afterwards and at a one-month follow-up participants are reassessed and keep again a positive memory diary for three days.
Results:
Preliminary results indicate that effects of POEM-H on positive emotions during memory retrieval and memory characteristics, such as e.g. vividness, promote well-being in daily life in comparison to the control condition.
Discussion:
These findings reveal that POEM-H holds promise as a feasible intervention to promote positive memory elaboration and well-being in daily life. A positive future extention of the novel POEM-H training is envisioned as a supplementary treatment option for individuals reporting diminished positive memories, such as sufferers of depression.

250: A Qualitative Study of Patiens' Experiences on Imagery Rescripting for Early Traumatic Memories in Social Anxiety Disorder

Rieko Takanashi, Research Center for Child Mental Development, University of Chiba; Naoki Yoshinaga, Organization for Promotion of Tenure Track, University of Miyazaki;Eiji Shimizu, Research Center for Child Mental Development, University of Chiba.

Introduction:
Although there are growing number of positive results of imagery rescripting (IR) for early traumatic memories in patients with social anxiety disorder (SAD), no study has investigated experiences of patients on IR. The aim of this study is to gain understanding of patients’ perspectives on IR as an adjunct to cognitive behavioral therapy (CBT) for SAD.
Method:
Twenty-two individuals with SAD who received one or two sessions of IR over 16 CBT sessions were asked to complete a questionnaire about their perspectives of IR after the session. Thematic analysis was used to analyze the qualitative data.
Results:
Most of patients (82%) experienced IR as impressive and more than half of patients (59%) found IR as effective. Themes of reasons of impressiveness and effectiveness were categorized as “Results of IR session” including subthemes such as “Change of belief,” “Feeling better,” and “Impossibility to change the past,” etc., and “Processes of the IR session” including “Becoming emotional,” “Unfamiliar experience,” and “Useful factor,” etc.
Discussion:
Our results suggest that many patients with SAD found IR session effective and offered various perspectives, some of which provided practitioners implementations of IR.   

 

253: CBT based group therapy at Institute of Oncology Ljubljana – evaluation of the ongoing clinical programme

Andreja Cirila Škufca Smrdel, Institute of Oncology Ljubljana, Dept. of Psycho-Oncology, Zaloška 2, Ljubljana, Slovenia

Introduction:
Therapeutic groups are the mainstay of the psycho-oncological treatment. We initiated the programme of the supportive-educative group based on cognitive behavioural therapy at our department. The programme comprises of 9 weekly meetings. Patients are entering the group trough the clinical-psychological treatment, mostly following the completion of the oncology treatment – vulnerable and often neglected period regarding experiencing distress, fear of cancer recurrence and coping with the consequences of the cancer treatment.  
Methods
:
We evaluated patients, included in the therapeutic groups programme from the beginning of 2016 (different localizations, but predominantly breast cancer patients). The groups followed a predetermined schedule, addressing first relaxation techniques and anxiety control, working on negative automatic thoughts and dysfunctional intermediate and basic beliefs, sleep hygiene, problem solving and decision techniques, communication and assertiveness, anger experiencing, mindfulness, concluding with goals setting and time management. At the group beginning and the completion, they had been evaluated using Edmonton Symptom Assessment System (ESAS) and purposely constructed evaluation questionnaire for identifying the techniques perceived as the most useful in the coping with distress.  
Results:
Due to small sample and individual variations, we have not find differences in observed parameters before and after the group completion to be statistically significant, but the trend pointing at the improvement in the dimensions of depression and anxiety is emerging. Breathing techniques, mindfulness and assertiveness training were highlighted by the patients.  
Discussion:
Although the further evaluation of the ongoing groups is needed, the trend is pointing at the group therapy positive impact. We found, that group therapy placement at the point, where the period of intensive oncological  treatment is turning into a psycho-social and professional rehabilitation or surveillance suits the needs of the majority of the patients included.


271: Living with Intention, Fullness and Engagement with Inflammatory Bowel Disease (LIFE with IBD): Presenting a new third wave intervention

Ferreira, C., Trindade, I. A.,Portela, F., Marta-Simões, J., & Mendes, A. L., Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC)

Aims:
This project aims to complete and add to the traditional medical approach by developing and testing the efficacy of a novel third wave-based psychotherapeutic intervention for inflammatory bowel disease (IBD). The pertinence of this intervention emerges from the lack of effective psychological interventions for this population and from recent findings on the effect of emotion regulation on IBD patients’ mental health. The LIFE with IBD intervention includes eight 90-minute weekly sessions and will be the first to integrate acceptance, mindfulness and compassion-focused strategies in the context of IBD.
Method:
The LIFE with IBD Intervention will be developed based on the MIND Programme for Cancer Patients (a previously developed third wave intervention), and will be adapted to meet the characteristics of the IBD population. The sample will be recruited from a Gastroenterology Unit. Eligible participants will be randomly assigned to one of two conditions: experimental group (TAU+LIFEwithIBD; n=75) or control group (TAU; n=75). The experimental group will be divided into subgroups of 10-15 participants.
Results:
It is expected that the intervention will produce improvements of quality of life and mental health. It is also expected that the observable changes after the intervention completion will be attributed to changes in emotion regulation processes and maintained over the 3 and 6 months follow-ups. Conclusions:
This study will hopefully provide scientific grounds for the implementation of the LIFE-IBD intervention in the regular healthcare of IBD patients and to contribute to reduce long-term medical costs associated with IBD.

318: Binge eating and overeating in relation to emotion regulation difficulties among men

Katrin Kukk, Kirsti Akkermann, University of Tartu

Introduction:
Binge eating occurs among clinical and nonclinical populations and among both men and women. Nevertheless, men have received disproportionally less attention in this field. Few studies have implicated that eating behavior among men might be driven by different motives Research among women has associated binge eating with emotion regulation difficulties. In one study it has been found that emotion regulation difficulties contribute to disordered eating among men. The goal of this study is to investigate associations between binge-eating or overeating and emotion regulation difficulties using experience sampling method (ESM).
Method:
43 men with a mean age of 31.67 years (SD 7.86) participated in a 7-day ESM study during which they were signaled semi-randomly 7 times a day to fill out a questionnaire regarding emotional experience and eating behavior. They also filled out different semi-randomly 7 times a day to fill out a questionnair regarding emotional experience and eating behavior. They also filled out different questionnaires such as Eating Disorders Assessment Scale (EDAS) and Difficulties in Emotion Regulation Dcale (DERS) beforehand.
Results:
As the data collection ended April 2018 there are no final results to report yet. Preliminary data indicates that of those 43 men who have completed the study 15 experienced binge eating episodes. 18 experiences overeating episodes and 10 reported no binge eating or overeating.
Discussion:
The data analysis starts May 2018 and the results are ready to be presented in September 2018 on the EABCT congress in Sofia. We expect that binge-eating episodes are associated with more emotion-regulation difficulties in comparison to overeating knowing the possible underlying mechanisms of eating behavior give implications for effective-prevention and treatment of disturbed eating behavior.

 

246: Cognitive Behavioral Therapy and NAFLD: a pilot study

Siragusa Cinzia, Schiff Sami, Siragusa,C. (ITCC) and Schiff, S. (Psychologist -Department of Medicine - DIMED, University of Padova

Non-alcoholic fatty liver (NAFLD) is an emerging public-health problem frequently associated with diabetes and obesity. The main treatment for NAFLD is lifestyle modification (LSM). Unfortunately, the required changes are frequently difficult to implement and maintain for a long time. The literature has identified that some psychological factors may influence adherence to medical prescriptions of patients with NAFLD. One of this factor is motivation: patients with NAFLD, not feeling ill, have little motivation toward LSM (Zelber-Sagi et al., 2017). Another one is emotional disregulation, considered a risk factor for metabolic syndrome and NAFLD. Because psychological factors contribute to NAFLD’s etiology and in difficult to change unhealthy lifestyles, Marchesini et al. (2005) included cognitive-behavioural therapy (CBT) in treatment of NAFLD. Teaching strategies for manage LSM and helping patients to increase illness awareness and sense of self-efficacy. The aim of the present proposal is to evaluate if the cognitive behavioural therapy, integrated with procedures oriented to regulate emotional states (ER-CBT), enhance the efficacy of NAFLD treatment. In a randomized controlled case-control study, two groups of patients, one receiving CBT-ER and one receiving only indications regarding dietary and physical activity will be investigated before and after treatment and six months later. The hypothesis is that ER-CBT may enhance adherence to medical prescription in NAFLD treatment compared to as usual prescriptions for LSM. We predict an improvement of medical (i.e. hepatic enzymes), behavioural (i.e. physical activity and dietary) and psychological factors (QoL, emotional regulation, psychopathology symptoms), which are related with NAFLD.

 

242: Symptoms of posttraumatic stress, psychological adjustment and post-traumatic growth and among cancer patients and survivors: The indirect effect of psychological flexibility

Marco Pereira, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC); Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal; Tiago Gonçalves, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal; Tiago Paredes , Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC); Liga Portuguesa Contra o Cancro Coimbra, Coimbra, Portugal; Maria Cristina Canavarro, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC); Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal

Introduction:
Cancer is often considered a traumatic event that may encompass the experience of symptoms of posttraumatic stress, which may compromise patient’s well-being over the course of illness and beyond, as well as their emotional regulation. Because psychological flexibility has been considered an important mechanism in psychological functioning, in this exploratory study we examined if the association between symptoms of posttraumatic stress, psychological adjustment and posttraumatic growth (PTG) and among cancer patients and survivors was mediated through that process, and whether this mediation was moderated by disease stage (cancer vs. survivorship).
Method:
This cross-sectional study comprised 73 participants (39 cancer patients in treatment and 34 cancer survivors), mostly female (78.1%) and with a mean age of 60.10 years. Participants completed self-reported questionnaires assessing symptoms of posttraumatic stress, psychological flexibility, symptoms of anxiety and depression, quality of life (QoL), and posttraumatic growth.
Results:
Symptoms of posttraumatic stress were significantly associated with reduced psychological adjustment, but not with PTG. Higher levels of psychological flexibility were significantly associated with better psychological adjustment, but not with PTG. The pattern of associations was similar for cancer patients and survivors. Psychological flexibility was a significant mediator of all associations, with exception of Environmental QoL and PTG. No moderated mediation of disease stage was found. Discussion:
Our findings reinforce the usefulness of psychological flexibility as a health promoting variable, considering its association with better psychological adjustment. These results also highlight the importance of implementing psychological interventions aiming at developing acceptance in cancer patients, regardless of disease stage.

 

241: Understanding the importance of attachment in the experiences of stigma and shame of people living with HIV: The role of emotion regulation processes

Marco Pereira, Alexandra Martins, Catarina Chaves, Maria Cristina Canavarro, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal

Introduction:
Stigma and shame are negative markers of the experience of living with HIV. Emotion regulation is an important factor of individuals’ psychological well-being, which may be shaped by attachment orientations. However, evidence has yet to be established among people living with HIV (PLWH). In this study, we examined the role of emotion regulation processes (self-compassion and distress tolerance) in the association between attachment, stigma and shame among PLWH.
Method:
This cross-sectional study comprised 95 adults with HIV (53.7% male; mean age = 41.65 years). Participants completed an online survey, which included self-reported questionnaires assessing attachment (Experiences in Close Relationships - Relationship Structures), stigma (Stigma Scale Revised), shame (Other as Shamer Scale), self-compassion (Self-Compassion Scale), and distress tolerance (Distress Tolerance Scale).
Results:
Low attachment-related anxiety and avoidance were significantly associated with lower self-compassion and higher ability to tolerate distress, as well as higher levels of HIV-related stigma and shame. Low self-compassion and high distress tolerance were significantly associated with higher levels of stigma and shame. Self-compassion mediated the association between attachment-related orientations and shame, and between attachment-related avoidance and stigma. Distress tolerance was not a significant mediator.
Discussion:
Our findings indicate that PLWH with higher attachment-related anxiety and/or avoidance reveal lower levels of stigma and shame, especially when they have greater ability to be self-compassionate. Self-compassion may be an important emotion regulation process in understanding the experiences of stigma and shame, and support the development and practice of compassion-focused therapy, for which there is emergent evidence in the HIV context.

Altered patterns of perception in obesity

Mayron Picolo, Chantal Martin-Soelch, Unit of Clinical and Health Psychology, University of Fribourg, Fribourg, Switzerland

Obesity is a concerning issue in current times. Studies suggest that, if progression continues as seen in the last years, it might be too late to avoid an obesity epidemics. Research has shown that these patients seem to have altered perceptions both towards self- and external-related aspects, as seen also in Anorexia Nervosa. Therefore, the aim of this paper was to review available studies that specifically analyzed the relation between perceptive behaviors and obesity or overweight. Altered perception has been found towards one’s own body weight / body image and satiety (categorized here as self-related perception) as well as food palatability and nutritional characteristics, distance and steepness (external-related perception). We also found a few psychotherapeutic strategies that focused on perception for dealing with eating disorders and obesity, which have shown promising results in preliminary studies. Disparities between perceived and actual reality seems to be constant in patients with obesity, but few studies have focused on self-related perception and even fewer on interventions regarding this aspect.

297: Childhood trauma perpetrated by close others, psychiatric dysfunction, and urological symptoms in patients with interstitial cystitis/bladder pain syndrome

Chui-De Chiu, Department of Psychology, Chinese University of Hong Kong

Background: A psychosocial phenotype of interstitial cystitis/bladder pain syndrome (IC/BPS), a urogenital condition without known organic causes, was proposed. While psychosocial variables, including interpersonal maltreatment and negative affect, were studied in association with IC/BPS, the specificities of the relationships between childhood trauma by close others, psychiatric dysfunctions (negative affect and post-traumatic psychopathology), and urogenital symptoms have not been established. Methods: 94 IC/BPS patients were recruited together with 47 patients with acute cystitis who served as clinical controls. Standardized scales were used to assess various potentially traumatizing events in childhood and adulthood as well as psychiatric (dissociation and negative affect) and urogenital symptoms. Results: Among the potentially traumatizing events, those perpetrated by close others during childhood were found to be the most salient features discriminating the IC/BPS group from the control group. When divided into 2 subgroups according to their history of childhood trauma by close others, only IC/BPS patients with childhood trauma by close others had more dissociative and anxiety symptoms compared with the control group. These two subgroups did not differ in urogenital symptom severity. Conclusions: Childhood trauma by close others, rather than other types of interpersonal trauma, was a differentiating characteristic in IC/BPS patients, and a childhood trauma related psychosocial phenotype with a distinct clinical profile of dissociation and anxiety proneness was identified. Future studies should investigate whether a distinct set of pathogenic factors exists in IC/BPS patients with a history of childhood trauma by close others, even if this subgroup is not readily differentiated by urogenital symptoms.

291: Effectiveness of cognitive behavioural therapy for insomnia: The tapering rate of hypnotics, sleep quality, and depression

Naoko Ayabe, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Isa Okajima, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan; Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan; Shun Nakajima, Faculty of Liberal Arts, Teikyo University, Tokyo, Japan; Yuichi Inou, Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan; Norio Watanabe, Department of Health Promotion and Human Behavior /Clinical Epidemiology, Kyoto University Graduate School of Medicine /School of Public Health, Kyoto, Japan; Wataru Yamadera, Department of Psychiatry, The Jikei University Katsushika Medical Center, Tokyo, Japan; Naohisa Uchimura, Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan; Hisateru Tachimori, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Yuichi Kamei, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan; Kazuo Mishima, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

This multicenter randomized controlled trial examined the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) in the tapering rate of hypnotics, improvement of sleep quality, and depression symptoms among Japanese insomnia patients. There were 4 study periods: baseline (BL), intervention, post-intervention (PI), and follow-up (FU). Patients were randomly assigned to the TAU (sleep hygiene) or CBT-I group. The CBT-I group received 5 CBT-I sessions in addition to the sleep hygiene education. Drug tapering training began from Session 4 for both groups. One-fourth of the equivalent diazepam dose administered at BL was set as the unit of dose reduction in Sessions 4 and 5. This study was approved by the Ethics Committee of the National Center of Neurology and Psychiatry and participating medical facilities. Forty-nine patients were analysed (CBT-I: n = 23, TAU: n = 26). Regarding the tapering rate, a mixed-effects model for repeated measures analysis revealed a significant main effect of period (p = .01), but no significant group x period interaction. Sleep quality and sleep latency on the Pittsburgh Sleep Quality Index showed a significant improvement in interaction with the CBT-I group than with the TAU group. The FU period’s the Self-rating Depression Scale score showed an improvement tendency in the CBT-I group. CBT-I revealed that some sleep parameters and depression symptoms improved. However, CBT-I achieved an almost 30% hypnotics tapering rate although no significant inter-group difference was observed between CBT-I and TAU. CBT-I may promote dose reduction by optimizing the protocol and duration


Relationship between burnout symptoms and social relation levels and feelings of inferiority in call center workers
Mehmet Fatih ERTEN, Psychologist, Private practice
Emre SARGIN, Psychiatrist Uskudar University

Introduction: Call centers are one of the main components of organizations which aim to offer a new technology or service intended production. Call  centers are preferred by many companies both in developed and developing countries. The purpose of this study is to evaluate the relationship between call center employees’  level of burnout and social relationship level and inferiority feeling.

Method: The study sample include one hundred call center employees (n=31 males n=69 females) in a private company in Istanbul. The participants were given Socio-Demographic Form, Burnout Measure-Short Form (BM-SF), Inferiority Feeling Scale (IFS) and The Multidimensional Relationship Questionnaire (MRQ). Descriptive Statistics Method is used in evaluating the data and normal distribution assumption is taken in consideration in application of hypothesis tests.

Results: When the participants were divided into two groups: The ones who are “burnout positive” and who are “at low/intermediate risk for burnout”, the scores in subdimensions of “discouragement” and “Negation of self-value” in IFS were significantly higher in the “burnout positive” group than the “low/intermediate risk for burnout group” but there was no significant difference in the subdimension of “useless superiority effort”. There was also significant difference in the subdimensions of “Relational satisfaction”, “fear of relationship/relational anxiety”, “relational monitoring”, “relational esteem” and “relational assertiveness” in MRQ.

Discussion:The increase in the burnout symptoms in call center workers has significant effect on the inferiority feelings and some dimensions of relationship. These results can guide the clinicians during their intervention to burnout symptoms of these population.