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Documente Cultură
SUMAR
STUDII I CERCETRI
CRITIC I BIBLIOGRAFIE
Rev. Psih., vol. 63, nr. 1, p. 172, Bucureti, ianuarie martie 2017
REVISTA DE PSIHOLOGIE
(JOURNAL OF PSYCHOLOGY)
Vol. 63 2017 No. 1
CONTENTS
DANIELA GEORGESCU, The theoretical applied frame of the dual diagnostic approach in
disorders caused by psychoactive substance use ............................................................. 57
SEPTIMIU CHELCEA, Aa a fost? Aa mi aduc aminte. 19452015 (It was so? So I remember.
19452015), Iai, Editura Universitii Alexandru Ioan Cuza, 2016, 322 p. (Doina
tefana Sucan)............................................................................................................... 68
Rev. Psih., vol. 63, nr. 1, p. 172, Bucureti, ianuarie martie 2017
REVISTA DE PSIHOLOGIE
(REVUE DE PSYCHOLOGIE)
Vol. 63 2017 No 1
SOMMAIRE
TUDES ET RECHERCHES
CRITIQUE ET BIBLIOGRAPHIE
SEPTIMIU CHELCEA, Aa a fost? Aa mi aduc aminte. 19452015 (Ce fut donc? Cest
ainsi que je me souviens. 19452015), Iai, Editura Universitii Alexandru Ioan
Cuza, 2016, 322 p. (Doina tefana Sucan) .................................................................. 69
Rev. Psih., vol. 63, nr. 1, p. 172, Bucureti, ianuarie martie 2017
STUDII I CERCETRI
CORNELIA RADA
Francisc I. Rainer Anthropology Institute of the Romanian Academy, Bucharest
MIHAI ANDREI, CRISTIAN IERANU
Elias Emergency University Hospital, Gastroenterology Department, Bucharest
ALEXANDRU TEODOR ISPAS
Francisc I. Rainer Anthropology Institute of the Romanian Academy, Bucharest
CARMEN C. DIACONU
tefan S. Nicolau Institute of Virology of the Romanian Academy, Bucharest
Abstract
The common symptoms of Crohns disease (CD), a chronic and progressive inflammatory
disease of the intestine, are: diarrhea, weight loss, abdominal pain, and sometimes gastrointestinal
bleeding. Despite the treatment in many cases is a need of one or more surgeries. This study examines
the relationship between the psychosocial factors, psychological characteristics on the one hand, and
the pathogenesis, clinical manifestations, the answer to the treatment of one CD patient. The depth
clinical interview has revealed that in the period before the onset of the disease and in the period of
disease activity (2001-2014), with few exceptions, the patient felt stress because of several causes and
for a longer period, the disease itself was a stressor. Hospital Anxiety and Depression Scale indicate
possible case anxiety, Woodworth-Mathews Personal Data Sheet showed that the depression was at
the limit, Schmieschek Questionnaire has indicated the tendency toward accentuation for Demons-
trativeness, Hyper-perseverance and Emotivity, and the 13 items from the Jenkins Activity Survey
were identified as the patient describes herself as authoritarian, competitive, always punctual and in
comparison with the other, more precise and more serious. The formulation of her life stories has
indicated perfectionism. The events are not seen as a direct cause of CD but as a trigger that helps the
disease to appear and be harder to manage. Psychological and if needed psychiatric evaluation, should
be a part of the protocol for the treatment of patients with Inflammatory Bowel Disease. In the
examined case the patient expressed the need of psychotherapy.
Cuvinte-cheie: Boala Crohn, boala inflamatorie intestinal, stress, psihosomatic, trsturi de
personalitate.
Keywords: Crohns disease, inflammatory bowel disease, stress, psychosomatic, personality traits.
Francisc I. Rainer Anthropology Institute of the Romanian Academy, Calea 13 Septembrie
nr. 13, C.P. 24, Sector 5, Cod 050711, Bucharest, Romania; e-mail: corneliarada@yahoo.com.
Rev. Psih., vol. 63, nr. 1, p. 719, Bucureti, ianuarie martie 2017
8 Cornelia Rada et al. 2
1. INTRODUCTION
Crohns disease (CD) and Ulcerative colitis (UC) (sometimes called ulcero-
hemorrhagic rectocolitis RCUH in the Romanian medical literature) represent the
main Inflammatory Bowel Disease (IBD).
If, based on clinical, biological, endoscopic and histological criteria, the
distinction between the two diseases cannot be made, the condition is called
indeterminate or unclassified colitis. In such cases, a certain profile of the blood
antibodies can be used to differentiate them (Mahdi Batool, 2012).
These are chronic inflammatory bowel disorders characterized by alternating
periods of remission and periods of inflammatory activity and symptoms.
There are 3 major etiologic features of IBD: genetic predisposition, altered
host response to entero-colonic microbial flora and the existence of an altered host
immune response to intestinal inflammation. Other possible factors of the IBD
occurrence are: animal protein, polyunsaturated fatty acids, smoking (Fakhoury
et al., 2014).
The study Romanians, lifestyle and gastrointestinal diseases (Romnii,
stilul de via i bolile gastrointestinale) conducted by online interview (or CAWI:
Computer Assisted Web Interviewing) in May 2015 on a sample of 3,166 respondents
aged over 18, urban Internet users has revealed that over 81% considered that IBD
is serious and very serious and that over 83% said that the need to use the toilet
up to 20 times affects the personal and professional life much and very much
(Asociaia Persoanelor cu Boli Inflamatorii Intestinale din Romnia) CD can affect
any segment of the digestive tract: the favorite location is the ileocecal area.
Inflammation in the affected segment involves all layers of the wall, and some-
times extends to the tissues or organs in the neighborhood. Common symptoms
are: diarrhea, weight loss, abdominal pain, and sometimes gastrointestinal bleeding.
Diagnosis is established based on corroborating clinical data, biological imaging
and especially endoscopic and histological results (Hendy & Hart, 2013; World
Gastroenterology Organisation, 2015).
In CD drugs that can be administered depending on the case are systemic
corticosteroids (e.g., Prednisone, Budesonide, Medrol), derivatives of 5-amino-
salicylic acid (Mesalazine and Sulphasalazine), cyclosporine, thalidomide, immuno-
suppressants (azathioprine, 6-mercaptopurine and methotrexate), biological agents
Infliximab (Remicade), Adalimumab (Humira), Certolizumab pegol (Cimzia),
Vedolizumab (Entyvio), Ustekinumab (Stelara), antibiotics (Ciprofloxacin, Metro-
nidazole). The absence of response or the loss of the efficacy of the treatment with
a certain molecule can lead in time to its replacement with a more powerful
molecule, or, in the case of the biologic agents where there are no comparative data
on efficacy, to its replacement with another biologic agent (Dignass, Assche,
Lindsay et al., 2010).
3 Crohns disease psychosocial factors involved 9
In literature there are two types of therapeutic approach for the IBD patients:
step-up approach and top-down approach. The first refers to progressive escalation
of the the potency of the used drugs according to the loss of response to certain
molecules. The second consists of a potent active intervention from the start with
the most effective molecules to induce faster remission and to limit the damage
produced at the intestinal level by the active inflammation. Mainly for economical
reasons, including in Romania, step-up approach is used (Rogler, 2013).
In almost all CD cases there is a need of one or more surgical interventions,
despite the treatment with a scheme with the above-mentioned drugs, 40% of cases
of disease need surgery in the first year of disease occurrence, and in 20 years of
illness surgeries are done, for one reason or another, for almost 75% of people
suffering from this disease (Boala Crohn, ghid detaliat pentru pacieni).
CD surgical indications are represented by complications such as stenosis or
fistulae in the digestive segments and anoperineal region. The types of surgery
depend on the type of complication, and may be required resections of segments,
with ileostomy or colostomy which can be temporary to relieve the local
inflammation before applying anastomosis, or sometimes definitive when digestive
continuity cannot be provided because of severe injuries which do not allow
digestive anastomoses (Hwang & Varma Madhulika, 2008). For these reasons, the
collaboration between gastroenterologist and surgeon is essential for the therapeutic
success of such patients (Mihai et al., 2010).
The understanding of the pathogenesis of inflammatory bowel diseases (IBD)
has increased as a consequence of the advances in genetics and immunology.
Genetically susceptible individuals develop intolerance to dysregulated gut microflora
(dysbiosis) and chronic inflammation develops as a result of environmental insults
(Abegunde et al., 2016). In IBD physiopathological stress is involved; in fact, from
the psychological viewpoint the way people interact with the environment and the
stress perception have effects on the intestine (Collins, 2001).
Like other authors we consider that little has been written about the psycho-
social aspects of IBD (Husain & Triadafilopoulos, 2004). Through this study
we analyze the relationship between the psychosocial factors on the one hand, and
the pathogenesis, clinical manifestations, and the answer to the treatment of one
CD patient.
Starting from the hypothesis that the debut of the disease, the flare-ups and
the symptoms are closely related to the biopsychosocial factors, during 2013 and
2015, 33 patients with IBD completed eight questionnaires as follows.
An Omnibus survey was created and used, with open and closed questions,
divided into four sections: 1. Sociodemographic data, 2. Sex, Sexuality, Gender,
10 Cornelia Rada et al. 4
3. RESULTS
Patient CL was diagnosed with Crohns disease (CD) in 2005 and was inter-
viewed in 2015 when she went to the doctor for a moderate flare-up. Before the
initial diagnosis, she had manifestations for one year consisting in diarrhea (sometimes
15 to 20 liquid stools per day, abdominal pain, a weight loss of 10 kg, joint pain,
fatigue). In 2005 she followed a four-month treatment with methylprednisolone
and azathioprine until 2009 and then only with azathioprine. During the period
20102012 she did not take any medication for CD, and only had a self-imposed
diet. The patient states that in 20102011 she felt better and she was pleased that
5 Crohns disease psychosocial factors involved 11
she had only 56 diarrheal stools/day, abdominal pain of low intensity, but since
2012 her condition deteriorated and until 2013 she lost about 20 kg. In 2013 the
patient had a treatment with methylprednisolone for 4 months and then up to the
date of interview she followed only with azathioprine treatment. She had a perianal
fistula and entero-vaginal fistula, for which she was prescribed metronidazole and
ciprofloxacin. In 2014 the patient had a severe flare-up that required hospitalization.
At the end of 2014 the patient underwent surgical intervention for total hysterectomy
due to benign uterine pathology.
At the date of the interview CL was 47 years old, had a medium level of
education (high school baccalaureate), lived with her husband in an urban area, was
working in social assistance, and the declared income in a typical month was
between 400 and 600 euro. She got married for the first time when she was
18 years old, then she got divorced and got married for the second time when she
was 24 years old. She had a 23 year-old son who had been working abroad since
2014.
The patient considered that in the past her disease had greatly affected his
work, that currently was still affecting her work, and that her disease was moderate.
The following passage from the interview highlights the physical and psycho-
logical stress experienced by this woman during the active period of the disease:
The abdominal pains were terrible, I used to stumble through the house, I
was without vigor. I was drinking mint tea, I was eating boiled rice, but diarrhea
still persisted. I was suffering like a dog because I could not fulfill my duty as a
mother. I often had to take my husband or my son out of the bathroom to go to the
toilet. Now the strong heartbeat I felt in the chest has calmed down a little bit, the
permanent need to go to the toilet has diminished, and my stomach no longer looks
like one of a nine months pregnant.
The interview has revealed that in the period before the onset of the disease
and in the period of disease activity, 20012014, with few exceptions, the patient
felt stress because of several causes and for a longer period of time as follows.
a) Marriage at 18 years, divorce after 5 year. CL described these aspects as
follows:
In the last year of high school I fell in love, I slept with him and immediately
we got married. My mom did not talk to me about sex or couple life as I talk to my
12 Cornelia Rada et al. 6
son. My parents were against the marriage, they scolded me. To punish me my
mother used to speak to me only what was strictly necessary. There was no way to
change my mind. I told them that I want only that man. He was not affectionate, he
told me bad words, he cheated on me. I suffered like a beaten dog when we got
divorced because he had found another woman.
b) The job loss is described as follows:
Beginning with 2000 the factory where I had been working decreased its
activity and many people became unemployed, and in 2002 it was my turn, and
shortly after my husbands. The compensatory salaries from the factory were spent
quickly and we both realized soon that we did not know how to start over. My
husband found a job with great difficulty and I was unemployed until 2006. I can
say that 20012006 was the hardest time of my life. I had no job, and I could not
find a new one as I had worked as a lathe operator and such a qualification was no
longer required on the labor market. Moreover, this damn disease hit me. I had no
courage to go shopping, how could I have dealt with a job? (Note: CL had been
working in a toxic environment for about 16 years).
c) The patient perceived the education of her son as difficult because of
indigence and her inability to devote to the child as she would have liked. In the
year of the diagnose, her son was 13 years old, exactly the time of adolescence and
of the need for extra school preparation for the transition to high school. A
sequence of interview is eloquent in this respect:
While I was helping my son with his homework, I had to stop frequently and
go urgently to the toilet. The child came home and told me about his day at school
and I had no power to listen to him. I was feeling guilty. He was a good kid, he
studied hard, he would have needed private lessons for the high school admission
and then to enter the college. My dream was that he could graduate from a faculty.
The poor child entered high school without private preparatory lessons, and then
he entered the college, but the poverty made him give up the university. I was
angry a long time for this.
d) The discussions with her husband about her disease and about the fact she
did not have an income are described as follows:
Now and again my husband told me that if I had brought some money in the
house the things would have been different. He did not want to offend me, but I
could see by myself that I had become a burden. We were late with the bills for the
house for almost a year.
We should make some comments as regards the situation of Romania before
and after December 1989 when a revolution changed Ceausescus communist
regime with a democratic one, based on market economy.
7 Crohns disease psychosocial factors involved 13
Before this revolution in the capital (Bucharest) and in other cities there were
many industrial sites, appearently everyone had a job, and no unemployment was
declared officially. The reality was that many workers in the industry were forced
to have unpaid leave for one or two months per year. The unemployment was
masked by an oversized number of employees, hence low productivity. In order
that the foreign debts be paid, small rations for bread, milk, butter, edible oil, sugar,
and meat were introduced; most of the people had to wait in very long queues to
procure food. The Romanian industry was outdated and was not competitive on the
foreign market.
Starting with 1991 privatization began in economy, especially in industry,
with the aim to render the factories competitive. The huge accumulated debts, the
absence of orders for manufacturing machinery and equipment (e.g. for heavy
industry or agriculture) or products in siderurgy and petrochemistry led to massive
bankruptcies; the new owners closed the factories, the equipment being dismantled
and scrapped. Much of these privatizations have not ended well (Zamfir, 2004).
Most skilled workers who were put out of work received unemployment
benefits for a determined period. After the end of the benefits they received a
monthly income for a period of time varying according to the years of service
(Ordonana de urgen nr. 8/2003).
Some people succeeded in finding a job, to get other qualifications, while
others entered a trajectory of poverty (Zamfir, Preda & Dan, 2004).
e) The death of her father in 2012, which CL included in the category of the
saddest event in her life.
f) In 2014 the patient faces three challenges: the decision of her son to go
abroad to work, the emotions concerning the nature of her uterine disorder, and the
fibroid removal surgery. All these were events that could have precipitated the
flare-up. The patient herself confessed that the most stressful events in her life were
the total hysterectomy and the departure of her son abroad in 2014 to work, but
also the 3 colonoscopies she underwent.
g) Fulfilling the household chores under any circumstance:
My mother taught me vacuuming cleaning, dusting, and exemplary tidiness.
Even before being hospitalized I used to clean all the house, to wash as much as I
could so that they did not have unfinished chores. My mom, my husband, even my
son offered to help me, but I wanted to behave as if everything was okay. I did not
like how they performed certain chores.
When asked how she feels, how she normally reacts when someone violates
her boundaries, contradicts her, and does not appreciate her, she answers that she
gets angry easily and most often she expresses impatience by gesturing or resorting
to rhythmic movements such as foot or finger tapping.
14 Cornelia Rada et al. 8
Asked about the need to talk to a psychologist therapist, she said: I would
have needed, but what can a psychologist do about cancer?
She was asked about what she believed to have triggered her disease, and she
indicated her meal schedule, the stress and her way of being:
In high school I did not eat at appropriate times; I ate after 15.30 when I got
home from school. My first marriage failure caused me a huge stress, I was crying
every day; it was then when I started smoking.
It should be noted that CLs purpose in life is to live long. In this context, it
is important to note that during the interview the patient stated several times that
she had read a lot about CD, that she was informed. In fact, she was somewhat
confused. CL also uttered many times the word cancer showing a relaxed attitude
which masks her concern. A sequence of interview is illustrative in this respect.
I know all about Crohns disease. I have read about it in the book of that
doctor (our note: Joan Gomez). Everything is clear. We do not cure and we get
cancer. In fact, when I phoned Center X (we preserve the anonymity of the
institution) to have some bioenergy session, they told me that they do not deal with
cancer.
4. DISCUSSION
During her disease, the patient had almost uninterruptedly diarrhea, tachy-
cardia, tenesmus, bloating, flatulence, abdominal pains that they described as very
difficult to tolerate most of the times. The patient had recurrent infections and were
administered many times and for long periods repeated treatments with antibiotics.
One aspect that requires much attention and further exploration is that the
patient discontinued the treatment totally and we cannot know whether this might
have contributed to the reappearance of the intense symptoms of the disease.
9 Crohns disease psychosocial factors involved 15
social support, the previous exposures. For this reason, the event is of course
important, but more important is what the person thinks about that life situation.
Life situations cannot be changed, most often they are not under our control, so it
matters how we defend against stressors. Denial, Displacement, Repression,
Reaction, Formation and Isolation as psychological defense mechanisms influence
the conscious or unconscious psychophysiological reactions that can take the form
of mood shifts, headache, muscle tension, elevated lipids, elevated blood pressure,
low blood sugar. The management of these psychophysiological reactions consists
of muscle relaxation, physical exercise, medications, cognitive strategies (Rahe &
Arthur, 1987).
IBD pathogenesis involves immune molecules Cytokines. The stress alters
their profile and the production of hormones such as cortisol and serotonin, which
can contribute to IBD pathophysiology (Bamias, Kaltsa & Ladas, 2011).
From the perspective of the transactional analysis were identified the
following behaviour drivers: Be strong (dont let the others see that you are weak,
you are OK only if you hide your feelings and desires from the others), Be perfect
(you are OK only if you do everything correct), Please others (it is OK to be here
only to please the others). The psychotherapeutic intervention by offering cor-
responding permissive messages: show what you feel, you are good enough and
especially it is OK to please yourself, to make yourself content would help the
patients re-evaluate these strategies of survival from childhood, these counter-
productive mottos (Kahler & Capers, 1974; Kahler, 1975).
It should be taken into account this fact when it is noticed that the answer to
the treatment is low. When there are flare-ups, even if moderate, these patients with
behavior drivers should have a compulsory break of activity under the form of
medical leave. Certainly, the patients cannot be obliged to do something they do
not want to, consequently it is necessary that the doctors explain them the necessity
of relaxation, of interrupting activity, it is not sufficient to make simple
recommendations or ask questions such as do you need medical leave?
5. CONCLUSION
with their cognitive and emotional components induce emotions and positive
cognitions and help patients to control their chronic pain and even interrupt it
(Bushnell, eko & Low, 2013). Psychological and if needed psychiatric evaluation
should be a part of the protocol for the treatment of patients with IBD. In certain
critical periods an anxiolytic or antidepressant may increase the response to the
treatment for chronic disease. The adaptation to a chronic illness is another potentially
stressful event for both the patient and the family and, therefore, a reason to
consider psychotherapy helpful. Psychotherapy may help the patients with CD to
reassess their priorities, to recover, and to reconcile with the past.
The stress, the events that the patient had to face should not be seen as a
direct cause of CD but as a trigger that helps the disease to appear and be harder to
manage. We consider that psychotherapy, hypnotherapy, the relaxation techniques
may help to decrease depression and anxiety, and may support the acquisition of
better coping mechanisms and consequently may favour a better evolution of the
patients health.
More studies are needed to determine the usefulness of psychotherapy in
managing symptoms, and improving the life quality of IBD patients. It is a certain
fact that in the examined case the patient expressed the need of psychotherapy.
Acknowledgments
This paper is based on the Research Project accomplished by volunteering Studiu psiho-socio-
medical privind boala inflamatorie colonic (Psychosociomedical Study on the Inflammatory Bowel
Disease) carried out between 2013 and 2015 by Elias Emergency Hospital, Department of
Gastroenterology, Bucharest (No. 13005/29.11.2012) and Francisc I. Rainer Institute of
Anthropology of the Romanian Academy, Bucharest (No. 445/28.11.2012). Research collective:
Diculescu M.M., Tudor N., Gologan ., Andrei M., Rada C.
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REZUMAT
Simptomele comune ale Bolii Crohn (BC), afeciune cronic i progresiv a intestinului, sunt:
diaree, scdere n greutate, dureri abdominale i uneori sngerri gastro-intestinale. n ciuda trata-
mentului, n multe cazuri, este nevoie de una sau mai multe operaii. Acest studiu analizeaz relaia
dintre factorii psihosociali, caracteristicile psihologice pe de o parte, i patogeneza, manifestrile
clinice, precum i rspunsul la tratament pe de alt parte, a unei paciente cu BC. Interviul clinic de
profunzime, anamneza psihologic profund au artat c, n perioada dinaintea debutului bolii i n
perioada de activitate a bolii, 20012014, cu puine excepii, pacienta a simit stres din cauza mai
multor motive i pentru o perioad mai lung, un factor de stres fiind boala n sine. Hospital Anxiety
and Depression a indicat o relativ anxietate, Woodworth-Mathews Personal Data Sheet a artat
depresie la limit, Schmieschek Questionnaire a indicat tendin spre accentuare pentru Demonstrativitate,
Hyper-perseveren i Emotivitate, iar cei 13 itemi din Jenkins Activity Survey au artat c pacienta
se descrie ca fiind autoritar, competitiv, punctual i n comparaie cu celelalte persoane mai precis
i mai serioas. Formulrile povetilor de via au indicat perfecionism. Evenimentele nu sunt o
cauz direct a BC, ci un factor declanator care ajut boala s apar i s fie mai greu de gestionat.
Evaluarea psihologic i, dac este necesar, evaluarea psihiatric ar trebui s fie o parte a
protocolului pentru tratamentul pacienilor cu boal inflamatorie intestinal. Pacienta examinat i-a
exprimat nevoia de psihoterapie.
RELAIA DINTRE CONFLICTUL MUNC-FAMILIE
I DIFERITE VARIABILE DECIZIONALE INDIVIDUALE
DANIELA MOZA
Universitatea de Vest din Timioara
Abstract
Previous research on work-family conflict has been developed based on theories that view
work-family conflict as a consequence of a lack of choice. This research has a different theoretical
basis, namely decision process theory of work and family, which views work-family conflict as an
intermediate result of decisions made by the individual over time. This research has been conducted
on a sample of 175 employees, in order to examine the relationship between work-family conflict and
individual decision-related variables, such maximizing tendency, compensatory decision making style
and interdependent decision-making style respectively. Results showed that, of the two dimensions of
work-family conflict, work-family dimension was positively associated with the decision difficulty
dimension of maximisation tendency and also with compensatory decision-making style, and was
negatively associated with high standards dimension of maximisation tendency and also with
interdependent decision-making style. The family-work dimension of the work-family conflict was
only associated positively with decision difficulty and compensatory decision making style. Results
are discussed in terms of their implication for theory and practice in the field of work-family conflict.
Cuvinte-cheie: conflictul munc-familie; luarea deciziilor; tendina de maximizare; stil
decizional compensatoriu; stil decizional interdependent.
Keywords: work-family conflict; decision-making; maximization tendency; compensatory
decision-making style; inderdependent decision-making style.
1. INTRODUCERE
Munca i familia reprezint dou dintre cele mai importante domenii ale
vieii de adult, domenii care se influeneaz reciproc pe dimensiuni legate de timp,
sarcini, atitudini, emoii i comportament, iar atunci cnd solicitrile rolului dintr-un
domeniu afecteaz abilitatea individului de a face fa cerinelor asociate rolului
din cellalt domeniu, apare conflictul munc-familie (Greenhaus & Beutell, 1985).
Ateptrile de rol ridicate (definite ca presiuni percepute de ndeplinire a unor
cerine crescute asociate rolului) pot duce la un conflict munc-familie crescut, att
pe direcia interferenei muncii cu familia (Higgins, Duxbury, & Irving, 1992), ct
i a interferenei familiei cu munca (Pleck, Staines, & Lang, 1980). Rezultatele
Universitatea de Vest din Timioara, Facultatea de Sociologie i Psihologie, Departamentul
de Psihologie, Bd. V. Prvan, nr. 4, 300223, Timioara, Romnia; e-mail: daniela.moza@e-uvt.ro.
Rev. Psih., vol. 63, nr. 1, p. 2032, Bucureti, ianuarie martie 2017
2 Conflictul munc-familie i diferite variabile decizionale 21
celor mai multe studii empirice din acest domeniu au evideniat o serie de factori
responsabili pentru dificultile de gestionare a rolurilor pe care indivizii le au de
ndeplinit la locul de munc i acas. Printre acetia se numr factori demografici
(de exemplu, numrul de copii; Byron, 2005), stresori asociai diferitelor roluri (de
exemplu, ambiguitatea rolului, stresul i insatisfacia asociate cu un anumit rol;
Grzywacz & Marks, 2000) sau politicile de la locul de munc (Byron, 2005). Cu
toate acestea, exist i cteva cercetri care au artat c n prezena unora dintre
aceti factori asociai unui domeniu, abilitatea indivizilor de a face fa cerinelor
asociate rolului din cellalt domeniu nu este afectat ntr-o msur prea mare. De
exemplu, unele persoane care ndeplinesc multiple roluri se pot bucura de beneficii
att n plan personal, ct i profesional i, mai mult dect att, multitudinea
responsabilitilor i rolurilor pe care le au de ndeplinit are efecte benefice att
pentru sntatea mental i starea de bine a copiilor lor, ct i pentru csnicia lor
(Barnett & Rivers, 1996). Alte studii au artat c femeile care au copii pe care i
ngrijesc pot fi la fel de productive ca i cele care nu au copii (Stack, 2004), iar
majoritatea persoanelor cu cele mai mari performane n organizaii sunt persoane
cu responsabiliti multiple, att n domeniul muncii, ct i n domeniul familiei
(Ruderman & Ohlott, 2002). O potenial explicaie pentru aceste rezultate, aparent
contradictorii, vine din direcia cercetrilor ale cror rezultate sugereaz faptul c
indivizii pot gestiona i integra eficient cerinele rolurilor de la locul de munc i
din familie prin deciziile pe care le iau (Baltes & Heydens-Gahir, 2003; Greenhaus
& Powell, 2003; Adams & Jex, 1999). Aceast perspectiv decizional a fost luat
n considerare doar relativ recent datorit persistenei ndelungate n literatura din
acest domeniu a unei abordri teoretice care privete conflictul munc-familie ca o
consecin a lipsei de alegere, n care comportamentul indivizilor era vzut ca fiind
constrns de mediu i de ateptrile de rol, ei neavnd posibilitatea de a decide
(Poelmans, 2005). ns, aa cum argumenteaz Poelmans, Greenhaus i Stepanova
(2013), absena unei perspective a lurii deciziilor n literatura privind relaiile
dintre munc i familie este foarte greu de justificat, innd cont de definiia
conflictului inter-rol ca un proces prin care indivizii decid dac s rspund
cerinelor unui anumit rol, la un anumit moment dat (Kahn et al., 1964).
2. METODOLOGIA CERCETRII
3. REZULTATELE CERCETRII
Tabelul nr. 1
Media i abaterea strandard pentru fiecare dintre variabilele incluse n studiu
i corelaiile r Pearson ntre variabile N=175
Daniela Moza
7
8 Conflictul munc-familie i diferite variabile decizionale 27
Tabelul nr. 2
Sinteza rezultatelor regresiei multiliniare
4. DISCUII
5. CONCLUZII
Studiul nostru este una dintre primele cercetri cantitative care abordeaz
conflictul munc-familie ca proces decizional i examineaz relaia acestuia cu
unele variabile decizionale individuale. Majoritatea studiilor empirice bazate pe
aceast perspectiv teoretic au investigat deciziile privind munca i familia printr-o
metodologie calitativ, care a permis surprinderea proceselor decizionale specifice
situaiilor de conflict ntre cerine concurente de la locul de munc i din familie
(Greenhaus & Powell, 2003; Poelmans, 2005; Powell & Greenhaus, 2006). Evident,
studiile viitoare pot cldi pe baza rezultatelor obinute n acest studiu, ncercnd s
investigheze, pe baza unor metodologii calitative sau chiar experimentale, modul
specific n care se manifest tendina de maximizare, strategiile compensatorii i
interdependena n luarea deciziilor pentru rezolvarea problemelor n situaii
specifice de decizie ntre activiti concurente de la locul de munc i din familie.
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REZUMAT
Cercetrile anterioare pe tema conflictului munc-famile au fost elaborate pe baza unor teorii
care privesc conflictul munc-familie ca pe o consecin a lipsei de alegere. Prezenta cercetare are o
baz teoretic diferit, i anume teoria procesului decizional, care privete conflictul munc-familie ca
pe un rezultat intermediar al deciziilor luate n decursul timpului. Aceast cercetare a fost realizat pe
un eantion de 175 de angajai cu scopul de a examina relaia dintre conflictul munc-familie i
variabile reprezentnd deciziile individuale precum tendina de maximizare, stilul decizional com-
pensatoriu i, respectiv, stilul decizional interdependent. Rezultatele au evideniat faptul c, dintre
cele dou dimensiuni ale conflictului munc-familie, dimensiunea munc-familie se asociaz semnificativ
pozitiv cu dificultatea deciziei i stilul compensatoriu i negativ cu standardele nalte i cu stilul
interdependent. n schimb, dimensiunea familie-munc se asociaz doar pozitiv cu dificultatea
deciziei i stilul decizional compensatoriu. Rezultatele sunt discutate din perspectiva implicaiilor lor
teoretice i practice n domeniul conflictului munc-familie.
STATUS PSIHOMETRIC AL CHESTIONARULUI COGNITIVE STYLE
INDICATOR N CAZUL UNUI GRUP DE STUDENI
DIN DOMENIUL TEHNIC
Abstract
The article summarizes the results of a psychometric study conducted on a sample of students
from the technical field (N = 276; 180 male and 96 female) to evaluate the psychometric qualities of
Cognitive Style Indicator (CoSi). The questionnaire measured by self-reported cognitive styles and is
based on an analytical model that refines analytic- intuitive cognitive styles dimension by splitting the
analytic pole in two major styles. Scales of the instrument shows good internal consistency, with
values of the coefficient included between .72 and .85 (total sample), between .76 and .87 (female
subjects) and between .69 and .84 (male subjects). The questionnaire meets the requirements of
implementation of principal component analysis based on Kaiser-Meyer-Olkin test and the Bartlett
test of Sphericity. Factor analysis revealed a three-factor solution accounting for between 51 and 28%
of the total variance. Cognitive Style Indicator proves an appropriate instrument for measuring
cognitive styles in academic environment. However, further empirical investigations are necessary to
validate the questionnaire.
Cuvinte-cheie: stiluri cognitive, Cognitive Style Indicator, status psihometric, studeni, domeniul
tehnic.
Keywords: cognitive styles, Cognitive Style Indicator, psychometric status, students, technical
field.
1. INTRODUCERE
Universitatea Politehnica din Bucureti, Splaiul Independenei nr. 313, Departamentul de
formare pentru carier didactic i tiine socio-umane; e-mail: beatrice.balgiu@upb.ro.
Rev. Psih., vol. 63, nr. 1, p. 3341, Bucureti, ianuarie martie 2017
34 Beatrice Adriana Balgiu 2
Tabelul nr. 1
Descrierea modelului 3D al stilurilor cognitive
Stil Caracteristici
Obiectiv Bazat pe fapte i detalii, logic, reflectiv, obiectiv, impersonal, raional, precis,
metodic.
Planificator Secvenial, structurat, convenional, planificat, organizat, sistematic, bazat pe rutin.
Creator Impulsiv, flexibil, deschis la nou, subiectiv, inventiv, creativ, se bazeaz pe
posibiliti, semnificaii, idei.
3. METODA
Instrument
Indicatorul stilului cognitiv Cognitive Style Indicator (CoSi), dezvoltat i
validat de Cools i Van den Broeck (2007) este un chestionar cu 18 itemi msurnd
diferenele individuale cu privire la cum prefer oamenii s perceap, s proceseze
i s structureze informaia. Este utilizat o scal Likert de la 1 nu mi se potrivete
deloc la 5 se potrivete total pentru mine. Cele 3 scale ale testului reprezint stilurile
propuse de autori, i anume: stilul obiectiv cu 4 itemi (2, 8, 13, 15); = 0,76, stilul
planificator avnd 7 itemi (3, 6, 9, 10, 12, 16); = 0,80 i stilul creator cu 7 itemi
(1, 4, 5, 7, 11, 14, 17); = 0,74. Itemii din versiunea originar a testului au fost
tradui n limba romn cu acordul autoarei Eva Cools din cadrul Vlerick Business
School i sunt prezentai n tabelul nr. 2.
Tabelul nr. 2
Versiunea n limba romn pentru CoSi
V rugm s indicai gradul n care urmtoarele afirmaii sunt tipice pentru dvs. folosind
scala de mai jos cu 5 posibiliti: 1 nu mi se potrivete deloc; 2 mai degrab nu se potrivete
pentru mine; 3 neutru; 4 se potrivete oarecum pentru mine; 5 se potrivete total pentru mine.
1. M intereseaz foarte multe lucruri n via.
2. Studiez fiecare problem pn i neleg substratul logic.
3. Prefer ntlnirile bine pregtite unde am o agend clar i un strict management al timpului.
4. mi place s contribui la soluiile inovative.
5. Ideile noi m atrag mai mult dect soluiile existente.
6. Fac planuri clare pe care le urmresc meticulos.
7. ncerc s evit rutina.
8. Doresc s am o nelegere deplin a majoritii problemelor.
9. Este foarte important pentru mine sa dezvolt un plan de lucru clar.
10. O sarcin bun este una bine pregtit.
11. Prefer s caut soluii creative.
12. ntotdeauna vreau s tiu ce trebuie fcut ntr-o activitate.
13. mi place s analizez minuios orice problem.
14. mi propun s mi depesc limitele.
15. De obicei, analizez n amnunt orice problem.
16. Prefer s am o munc structurat clar.
17. Sunt motivat s fac inovaii.
18. mi plac planurile de aciune detaliate.
4. REZULTATE I DISCUII
n tabelul nr. 3 sunt redate mediile i abaterile standard pentru cele trei stiluri
i datele comparative pe subeantioane. Valorile distribuiei scorurilor la scale au
fost M = 3,91/0,75 (stilul obiectiv), M = 3,75/0,77 (stilul planificator), M = 4,02/
0,65 (stilul creator). Dac ne raportm la unul din studiile pe care s-a realizat validarea
instrumentului i avem n vedere comparaia cu studeni belgieni din aceeai grup
de vrst (N = 635), observm date similare cu eantionul de fa (n msura n care
putem compara grupuri de tineri din ri diferite i pstrnd anumite rezerve fa de
generalizarea rezultatelor). Astfel, Cools i Van den Broeck (2007) raporteaz
urmtoarele date descriptive: pentru stilul obiectiv, M = 3,79; A.S. = 0,79, stilul
planificator (M = 3,72; A.S. = 0,95) i stilul creator (M = 4,09; A.S. = 0,62).
Tabelul nr. 3
Date descriptive i comparative
Stiluri M A.S. B F t p
Obiectiv 3,91 0,75 3,89 3,96
Planificator 3,75 0,77 3,70 3,82
Creator 4,02 0,65 3,97 4,13 1,77 .078
Tabelul nr. 4
Corelaiile interscale i indicii alfa
Stiluri 1 2 3
1. Obiectiv 0,77
2. Planificator .46** 0,85
3. Creator .28** .20** 0,72
Tabelul nr. 5
CoSi: Indici (eliminare item)
Statistica M. scal Varian Valori Alfa Cronbach
total-item (eliminare item) (eliminare item) corectate (eliminare item)
cosi1 66,68 77,449 .262 .841
cosi2 67,03 73,255 .456 .833
cosi3 67,54 70,175 .474 .832
cosi4 66,98 75,149 .399 .835
cosi5 66,94 77,621 .209 .843
cosi6 67,74 69,522 .569 .826
cosi7 67,25 79,568 .043 .854
cosi8 66,89 74,245 .454 .833
cosi9 67,19 69,554 .618 .824
cosi10 67,11 71,696 .508 .830
cosi11 67,12 75,697 .299 .840
cosi12 66,65 74,280 .473 .832
cosi13 67,28 70,145 .608 .825
cosi14 66,50 76,623 .355 .837
cosi15 67,18 70,521 .625 .824
cosi16 67,02 71,642 .530 .829
cosi17 67,27 73,380 .444 .833
cosi18 67,23 70,761 .541 .828
Tabelul nr. 6
Matricea componentelor
Itemi Componente
1 2 3
cosi1 -.057 .498 .280
cosi2 .154 .056 .731
cosi3 .766 -.173 .188
cosi4 .150 .652 .157
cosi5 .092 .616 -.117
cosi6 .759 .048 .157
cosi7 -.227 .533 .024
cosi8 .211 .209 .532
cosi9 .799 .036 .205
cosi10 .674 .102 .135
cosi11 .056 .759 -.002
cosi12 .628 .040 .172
cosi13 .368 .084 .725
cosi14 .065 .499 .354
cosi15 .325 .103 .777
cosi16 .758 .038 .091
cosi17 .123 .638 .284
cosi18 .583 .129 .328
40 Beatrice Adriana Balgiu 8
5. CONCLUZII
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REZUMAT
MARIA-LOREDANA ARSENE
Universitatea din Bucureti
Abstract
Most of the research in the field makes reference to the existence of an emotional impact
which occurs within family relationships as a consequence of parents emigration. Thus, the present
study took into consideration the correlation between the emotional impact triggered by parents
emigration upon adolescents and the aggravating factors which lead to adopting a hostile behavior.
This was a quantitative-ascertaining research, which used the method of the sociological survey based
on questionnaire. The research had a number of 138 subjects, students of classes IXXII at a
Technological High-School in Muntenia. Following the interpretation of results, it turned out that the
two perspectives of analysis are in a reciprocal relationship, the effects bestowed upon their inner
world determines, to a large degree, the emergence of a hostile behavior. It also turned out that there
was a need for an intervention plan which as the study showed brought support to the students life.
Cuvinte-cheie: migraia economic a prinilor, adolescen, ostilitate, suspiciune, managementul
emoiilor.
Keywords: parental migration, adolescence, hostility, suspicion, managing emotions.
1. INTRODUCERE
Universitatea din Bucureti, Facultatea de Sociologie i Asisten Social, coala Doctoral
de Sociologie, Strada Schitu Mgureanu, nr. 9, Bucureti; e-mail: loredana.arsene@sas.unibuc.ro.
Rev. Psih., vol. 63, nr. 1, p. 4256, Bucureti, ianuarie martie 2017
2 Migraia economic a prinilor. Ostilitate i soluii 43
copii, acetia reprezentnd circa 7% din totalul populaiei de 018 ani, dintre care
67.000 aveau doar mama plecat, 157.000 aveau doar tatl plecat i circa 126.000
aveau ambii prini plecai, iar din ansamblul populaiei de 018 ani ali circa 400.000
au experimentat la un anumit moment n via lipsa prinilor. Astfel, n cadrul familiei,
pe lng efectele de natur pozitiv apare i un sentiment de suferin datorat
pierderii temporare a unor membri sau a unui membru al familiei, identificndu-se
o reorganizare structural a rolurilor familiale, ceilali membri ai familiei fiind
nevoii s preia rolurile migratului, iar ca rezultat poate aprea un dezechilibru n
relaiile din cadrul familiei (Roman, Voicu, 2010). n urma nelocuirii cu prinii, se
instaleaz la copii o fragilitate emoional, care i poate expune unor riscuri mari
(Huditeanu, 2001).
Un studiu realizat n 2012, care avea la baz ideea c migraia parental poate
fi considerat un factor precursor al instalrii strii de anxietate n rndul copiilor
care provin din astfel de familii, a pus n analiz dou grupuri a cte 43 de copii cu
aceiai grup de vrst aflai n aceast situaie familial, din zona Maramureului.
Pe lng aceste criterii luate n considerare, s-a mai identificat i genul copilului,
printele migrant sau prinii migrai, tutorele i perioada de lips a printelui.
Pentru identificarea nivelului de anxietate a fost aplicat Inventarul Stare Trstura de
anxietate, dezvoltat de ctre Charles Spielberger i colaboratorii si n 1970. n
urma interpretrii datelor, au reieit urmtoarele rezultate: 65% dintre copii aveau
ambii prini migrai; 5% dintre copiii cu prinii migrai aveau un nivel al
anxietii mai ridicat dect copiii cu prini n Romnia. Concluzia studiului a pus
n eviden faptul c exist o corelaie statistic valid ntre nivelul de anxietate la
copii i migraia parental (Rus et al., 2012).
Un alt studiu realizat ntr-o coal din Puyang, Hebei din China de Nord, n
decembrie 2012, a avut ca numr de subieci 2283 de elevi cu vrstele de 1018 ani.
Aceast cercetare a explorat prevalena depresiei i a anxietii n rndul copiilor cu
prini migrai. Dintre subiecii participani, 61% aveau cel puin un printe migrat.
Rata prevalenei de depresie n rndul copiilor cu ambii prini migrai era de 14%,
fiind mai ridicat dect n cazul celor cu un singur printe migrat, care nregistra un
scor de 12%, i dect n cazul celor fr prini migrai, i anume un scor de 22%
(Shen, 2015).
Unul dintre modelele explicative ale perioadei de adolescen propune dou
tipuri de abordare a acesteia. Una n care aceast perioad de dezvoltare uman este
condiionat de transformrile emoionale, sociale, fizice, cognitive i o a doua
perspectiv, unde accentul este pus pe nevoia de independen i pe existena confuziei
de rol (Ann, Birch, 1997 apud Golu, 2010).
Promptitudinea rspunsurilor la nevoile copilului i proximitatea membrilor
familiei ajut la dezvoltarea unui stil de ataament echilibrat. n cazul copiilor cu
prinii migrai, ataamentul poate aprea i fa de tutore. Astfel c, dezvoltarea
unui ataament echilibrat reduce anxietatea aprut n urma situaiilor provocatoare
de tensiune psihic (Miftode, 2002).
44 Maria-Loredana Arsene 3
2. METODOLOGIA CERCETRII
Lotul de subieci a fost alctuit din elevii claselor IXXII din cadrul unui
liceu tehnologic, din zona Munteniei, judeul Dmbovia. Numrul elevilor participani
a fost de 138 de subieci, cu vrstele cuprinse ntre 1519 ani, 83 dintre acetia
fiind de gen feminin i 55 de gen masculin. Subiecii participani provin att din
mediul urban, ct i din mediul rural. Respondenii au fost repartizai pe 3 grupuri,
dintre care o grup format din 34 de subieci cu ambii prini migrai, o a doua
grup format din 50 de subieci cu un singur printe migrat i o a treia grup
format din 54 de subieci cu ambii prini n Romnia.
Cercetarea a fost de tip cantitativ-constatativ i a avut la baz metoda
anchetei pe baz de chestionar, prin care au fost culese date privind condiiile
socio-afective ale copilului. Instrumentul a fost construit special pentru aceast
lucrare, alctuit din 25 de itemi cu rspunsuri deschise i nchise, cu variante de
rspuns dihotomice i polihotomice, cu ntrebri directe i indirecte. Chestionarul a
fost aplicat adolescenilor, n funcie de situaia familial a acestora, acetia trebuiau s
rspund fie la toate ntrebrile, fie pn la o anumit ntrebare unde erau ghidai s
mearg spre o alt ntrebare, aceast situaie fiind necesar doar n cazul celor cu
prinii n Romnia. n cadrul chestionarului s-au atins urmtoarele teme: nivelul
de cunoatere al amplorii acestui fenomen de ctre adolesceni, situaia familial
prezent, vrsta adolescenilor cnd prinii acestora au migrat pentru prima oar,
participarea adolescenilor la decizia de migrare, durata de lips a prinilor,
revenirea temporar a prinilor, comunicarea dintre printele migrat i copil, timpul
petrecut de copil n locul de migrare, schimbarea instituiei educaionale, modul de
comunicare cu prinii, stri afective aprute n urma plecrii prinilor pentru
prima dat, relaia cu tutorele, starea emoional n cazul rememorrii momentului
plecrii prinilor, mbuntirea situaiei economice a familiei, posibilitatea nlturrii
efectelor negative ale migraiei prin comunicarea optim cu prinii, dificultile
prezente la nivel relaional parental, adoptarea unei conduite ostile, comportamente
deviante n rndul adolescenilor.
Un al doilea instrument folosit simultan a fost inventarul de ostilitate a lui
Arnold Buss i Ann Durkee (Chelcea, 1996). Inventarul este format din 66 de
afirmaii, cu variante de rspuns dihotomice, de tipul afirmativ, negativ. Este tradus
i adaptat n limba romn de ctre Horia Pitariu i Adina Chelcea. Dimensiunile
msurate n cadrul inventarului sunt: ostilitatea, ostilitatea verbal, ostilitatea indirect,
negativismul, suspiciunea, irascibilitatea, violena fizic, resentimentul.
n rndurile urmtoare sunt explicate variabilele independente avute n vedere
(vezi tabelul nr. 1) i punerea acestora n relaie de legtur cu variabila dependent
nivelul de ostilitate i implicaiile acestuia. Rezultatele au fost prelucrate i interpretate
n programul de statistic Statistical Package for the Social Sciences (SPSS).
46 Maria-Loredana Arsene 5
Tabelul nr. 1
Variabilele independente reprezentate
Variabila independent Nivelurile variabilei
Migrarea economic a prinilor 0 = nici un printe migrat; 1 = un singur
printe migrat; 2 = ambii prini migrai.
Participarea la luarea deciziei de migrare 0 = nu; 1 = da.
Comunicarea regulat cu prinii 1 = zilnic; 2 = sptmnal; 3 = lunar;
4 = deloc.
Consultarea copilului cu privire la locuirea cu tutorele 0= nu; 1= da.
Relaia cu tutorele 1 = foarte bun; 2 = bun; 3 = mai puin bun;
4 = deloc bun.
Rememorarea momentului primei plecri a prinilor 1 = ntristat; 2 = neglijat; 3 = ndurerat;
4 = ncreztor; 5 = curajos; 6= optimist.
Comunicarea cu printele poate nltura efectele 0 = nu; 1 = da.
negative ale migraiei
Aruncatul lucrurilor i/sau distrugerea lor 0 = nu; 1 = da.
Lovire colegi 0 = nu; 1 = da.
3. REZULTATELE CERCETRII
n urma cercetrii a rezultat faptul c aceia care au ambii prini migrai sunt
mai puin suspicioi dect cei care au ambii prinii n Romnia (p = 0,02<0,05), ei
fiind mai prudeni, diferena dintre medii a fost 1- 2 = 0,85. Acest rezultat
reprezint o bun estimare a faptului c aceia cu ambii prini migrai prezint o
vulnerabilitate mai mare cnd vine vorba de angajarea n discuii cu diferii
oameni, ei simind nevoia de a avea o comunicare fa n fa, nevoia de a exprima
ceea ce simt i de a se simi ascultai.
Cu privire la comunicarea n relaia printecopil i la constituirea acesteia ca
fiind factor favorizant n adoptarea unei conduite ostile, au reieit urmtoarele:
65% comunic zilnic; 29% sptmnal; 6% lunar. n cazul comunicrii lunare, s-a
nregistrat cel mai ridicat scor al nivelului violenei fizice. Comunicarea cu
printele/prinii migrai este condiionat de mai muli factori, precum: relaia
adolescentului cu printele plecat, care dintre prini este plecat, programul
printelui, durata de lips a printelui. Astfel, comunicarea redus printecopil
constituie un factor favorizant n dobndirea unor comportamente ostile.
50 Maria-Loredana Arsene 9
sau ambii prini plecai. Singura diferen semnificativ statistic a aprut la factorul
suspiciune al ostilitii, astfel cei care au ambii prini n Romnia sunt mai
suspicioi dect cei care au ambii prini migrai.
4. PLANUL DE INTERVENIE
5. CONCLUZII
BIBLIOGRAFIE
1. CMPEAN, S., Fenomenul migraional ntre plecare, revenire i schimbarea modului de via,
Revista de asisten social, 3, 2014, p. 125135.
2. CHELCEA, A., (Coord.), Psihoteste (a doua ediie), Bucureti, Editura tiin i Tehnic, 1996.
3. EVANS, I., M., Hostility in children: A cognitive-behavioural analysis, Unpublished technical
report, Clinical Research Laboratory, University of Waikato, Hamilton, New Zealand, 1999.
4. ELLIS A., HARPER. R., Ghid pentru o via raional (ed. III), Cluj-Napoca, Editura Romanian
Psychological Testing Services, 2011.
5. EVANS, I., M., HERIOT, S., A., FRIEDMAN, H., A., A behavioural of irritability, hostility and
inhibited empathy in children, Clinical child psychology and psychiatry, 7, 2002, p. 211224.
6. GOLU, M., Fundamentele psihologiei II, Bucureti, Editura Romnia de mine, 2000.
7. GOLU, F., Psihologia dezvoltrii umane, Bucureti, Editura Universitar, 2010.
8. HAMMER, L. B., CULLEN, J. C., NEAL, M. B., SINCLAIR, R. R., SHAFIRO, M. V., The
longitudinal effects of work-family conflict and positive spillover on depressive symptoms among
dual-earner couples, Journal of Occupational Health Psychology, 10, 2, 2005, p. 138154.
9. HUDITEANU, A., Metode de cunoaterea psihologic a elevilor, Sibiu, Editura Psihomedia,
2001.
10. IONESCU, S. (Coord.), Tratat de rezilien asistat, Bucureti, Editura Trei, 2013.
56 Maria-Loredana Arsene 15
11. JOSE PAUL, E., BELLAMY MARISA, A., Relationships of Parents, Theories of Intelligence
with childrens persistence/ learned helplessness: A Cross-Cultural Comparison, Journal of
Cross-Cultural Psychology, 43, 6, 2012 p. 9991018.
12. MIFTODE, V. (Coord.), Populaii vulnerabile i fenomene de auto-marginalizare. Strategii de
intervenie i efecte perverse, Iai, Editura Lumen, 2002.
13. MUNTEAN, A., Psihologia dezvoltrii umane, Iai, Editura Polirom, 2006.
14. MUNTEAN, A., MUNTEANU, A., Violen, traum, rezilien, Iai, Editura Polirom, 2011.
15. LUCA, C., GULEI, A., S., KARACSONY, N., LCUST, O., Copiii lipsii de ngrijirea
prinilor plecai la munc n strintate: analiza cadrului legilativ (Children without te Care of
Parents Working Abroad: Legislative Framework Analysis), Revista de Asisten social, 1,
2014, p. 187204.
16. RENTEA, G., Governmental Measures supporting the return and the reintegration of romanian
migrant, Revista de asisten social, 2, 2015, p. 127137.
17. ROMAN, M., VOICU, C., Cteva efecte socioeconomice ale migraiei forei de munc asupra
rilor de emigraie. Cazul Romniei, Economie teoretic i aplicat, XVII, 7, 2010, p. 5065.
18. RUS, O., A., PASCANU, R., P., COMAN, L., V., COZMA, R., ANDREICA, B., The impact of
parents emigration on children anxiety, Revista European Psychiatry, 27, 2012, p. 326.
19. SHEN, M., GAO, J., LIANG, Z., WANG. Y., STALLONES, L., Parental migration patterns
and risk of depressions and anxiety disorder among rural children aged 1018 in China: a
cross-sectional study, Revista BMJ Open, 5., 2015, p. 17.
20. UNICEF, Situaia copiilor rmai fr ngrijire printeasc n urma migraiei, Raport de studiu:
Chiinu, 2006.
21. UNICEF, ALTERNATIVE SOCIALE, Analiz la nivel naional asupra fenomenului copiilor
rmai acas prin plecarea prinilor la munc n strintate, Raport de studiu: Buzu, 2008.
22. WESTMAN, M., Crossover of stress and strain in the work-family context, n JONES, F.,
BURKE, R. J., WESTMAN, M. (Coord.), Work-Life Balance. A Psychological Perspective,
Editura Psychology Press, 2006.
REZUMAT
Majoritatea cercetrilor din domeniu fac referire la existena unui impact emoional care apare
n sfera relaiilor familiale rezultate n urma migrrii prinilor. Astfel c, lucrarea de fa a avut n
vedere corelarea impactului emoional al migrrii prinilor asupra adolescenilor cu factorii agravani
care conduc la adoptarea unei conduite ostile. Aceast cercetare a fost de tip cantitativ-constatativ,
utiliznd metoda anchetei sociologice pe baz de chestionar. Cercetarea a avut un numr de 138
subieci, elevii ai claselor IXXII ai unui Liceu tehnologic, din zona Munteniei. n urma interpretrii
rezultatelor, a reieit c cele dou perspective de analiz se afl ntr-o relaie de reciprocitate, efectele
afective aprute condiioneaz n mare parte apariia unei conduite ostile. De asemenea, s-a mai
identificat i necesitatea implementrii unui plan de intervenie, care s vin n acordarea de suport
a acestora.
ABORDRI TEORETICE I PRACTIC-APLICATIVE
DANIELA GEORGESCU
Agenia Naional Antidrog
Abstract
Psychiatric comorbidities are common in clinical practice among patients with disorders
caused by psychoactive substance use. They create multiple challenges among practitioners both in
terms of psychiatric diagnoses, and in terms of prioritization and appropriateness of therapeutic
measures in order to ensure the patients stabilization and to maintain him on treatment. Starting from
the challenges encountered in clinical practice due to the negative impact of psychiatric comorbidity
on the psychotherapeutic intervention results, I decided to realize a comprehensive qualitative analysis of
these issues addressed in the literature: the pre-existing vulnerability vs. co-existence disorders; the
bio-psycho-social conditions of causality; diagnostic guidelines; the integrated therapeutic approach.
For these patients, interdisciplinary assessment points out to be a prerequisite for proper diagnosis, for
defining and prioritizing problems in the three areas of intervention and for developing a unified plan.
The article provides a theoretical and practical framework for the specialists working in the treatment
services for drug users.
Cuvinte-cheie: diagnostic dual, consum de droguri, vulnerabiliti, analiz funcional, abordare
integrat.
Keywords: dual diagnosis, drug use, vulnerabilities, functional analysis, integrated approach.
1
Termenul de substane psihoactive trebuie neles conform Manualului de diagnostic i
clasificare statistic a tulburrilor mintale i Clasificrii internaionale a bolilor i problemelor de
sntate (d.e: opioide, canabis, cocain, halucinogene etc.).
Agenia Naional Antidrog, psiholog clinician principal, psihoterapeut, ef Centrul Regional
Bucureti 1, Piaa Valter Mrcineanu nr. 13, etaj 3, cam. 69, Bucureti, Romnia; E-mail:
dana_georgescu35@yahoo.fr.
Rev. Psih., vol. 63, nr. 1, p. 5767, Bucureti, ianuarie martie 2017
58 Daniela Georgescu 2
2
Comorbidity: Addiction and Other Mental Illnesses, Research Report Series, National Institute
on Drug Abuse.
3
Comorbidity: Addiction and Other Mental Illnesses, Research Report Series, National Institute
on Drug Abuse.
60 Daniela Georgescu 4
Unele zone ale creierului sunt afectate att de tulburri datorate consumului
de droguri, ct i de alte boli mintale. De exemplu, circuitele neuronale care utilizeaz
neurotransmitorul dopamin sunt de obicei afectate de substanele psihoactive i
pot fi implicate i n depresie, schizofrenie i alte tulburri psihiatrice. ntr-adevr,
5 Abordarea diagnosticului dual n adicii 61
4
Comorbidity: Addiction and Other Mental Illnesses, Research Report Series, National Institute
on Drug Abuse.
62 Daniela Georgescu 6
4. DIAGNOSTICUL COMORBIDITII
5. TRATAMENTUL INTEGRAT
DE MEDIU SUBIECTIVE
FIZICE SOCIALE
- Trai. Cartier. Disponibilitatea - Formare academic. Istoric
banilor/drogurilor profesional.
SOCIALE - Incidente legale.
- Nivel socio-economic. BIOLOGICE
VARIABILE
- Familia de origine. Aspecte medicale.
- Familia proprie. PSIHOLOGICE (de nvare)
- Prieteni. Distracie i timp liber. - Istoric de consum. Perioade de
- Resurse sociale. abstinen.
- Motivaie.
- Autocontrol.
- Rezolvarea de probleme.
- ntrire.
- Abiliti sociale.
6. CONCLUZII
BIBLIOGRAFIE
REZUMAT
Rev. Psih., vol. 63, nr. 1, p. 6971, Bucureti, ianuarie martie 2017
70 Critic i bibliografie 2