Autogenic training as a therapy for adjustment disorder in adolescents

ѳдлѯєЧЦЬлѭЧЦЬЦєдѿЧгЧхдѱѯѭЧѸЧоѳфѳ

ѱѭЬѿѳєѯѹѳїѳхѳќѯЭѸѿѳЭЬѨѯяѯѻѳ

Íο¨ÀŬƬ©¯¶¾¨®ÑËЛÇƳȺ© ÒÀʨʶÊÓÑÉÀ¨ª¨µÑÊ¿¨µ¶½¸¨Ò¨´»¨®œÒÊÑ¿³¿¾¨µœÍœÎ²¿ÑÃ

ƭƳƢƵƢƭƴƢƧƳƩƢNJ

ƶǓǠǖAutogeni trening je široko rasprostrawena psihoterapijska tehnika. Britanska škola autogenog treninga navodi ǓǗǝǚǜǥǝǚǣǤǥǒǠǝǗǣǤǚǣǤǑǻǑǚǡǢǠǞǗǟǑǥǜǠǹǚǞǑǑǥǤǠǔǗǟǚǤǢǗǟǚǟǔǞǠǘǗǖǑǒǥǖǗǠǖǡǠǞǠǼǚƯǚǣǞǠǘǗǝǗǝǚǖǑǡǢǠǓǗǢǚǞǠ ǞǠǔǥǼǟǠǣǤǚǡǢǚǞǗǟǗǑǥǤǠǔǗǟǠǔǤǢǗǟǚǟǔǑǥǝǗǩǗǻǥǡǠǢǗǞǗǼǑǹǑǡǢǚǝǑǔǠdzǑǓǑǻǑǜǠǖǞǝǑǖǚǧǠǣǠǒǑ

ƹǚǺǢǑǖǑƹǚǺǢǑǖǑǹǗǒǚǠǖǑǣǗǥǤǓǢǖǚǥǤǚǨǑǹǑǥǤǠǔǗǟǠǔǤǢǗǟǚǟǔǑǟǑǒǚǠǦǚǙǚǩǜǗǚǒǚǠǧǗǞǚǹǣǜǗǡǠǜǑǙǑǤǗǺǗǡǠǢǗǞǗǼǑǹǑ ǡǢǚǝǑǔǠdzǑǓǑǻǑǚǖǑǣǗǚǣǡǚǤǑǗǦǚǜǑǣǟǠǣǤǑǥǤǠǔǗǟǠǔǤǢǗǟǚǟǔǑǥǝǗǩǗǻǥǡǠǢǗǞǗǼǑǹǑǡǢǚǝǑǔǠdzǑǓǑǻǑǜǠǖǞǝǑǖǚǧǠǣǠǒǑ ƯǗǤǠǖǢǑǖǑƫǣǡǚǤǑǟǑǹǗǧǠǞǠǔǗǟǑǔǢǥǡǑǠǖǚǣǡǚǤǑǟǚǜǑǡǢǠǣǗǩǟǠǔǥǙǢǑǣǤǑǠǖjǔǠǖǚǟǗǜǠǖǜǠǹǗǹǗǖǚǹǑǔǟǠǣǤǚǜǠ vanF43.2ǡǢǗǞǑǚǣǤǢǑǘǚǓǑǩǜǚǞǜǢǚǤǗǢǚǹǥǞǚǞǑƧǗǣǗǤǗǢǗǓǚǙǚǹǗƯǗdzǥǟǑǢǠǖǟǗǜǝǑǣǚǦǚǜǑǨǚǹǗǒǠǝǗǣǤǚƲǢǑǼǗǟǚǣǥǡǠǜǑǙǑǤǗ ǺǚǡǠǢǗǞǗǼǑǹǑǡǢǚǝǑǔǠdzǑǓǑǻǑǚǻǚǧǠǓǗǡǢǠǞǗǟǗǥǤǢǚǦǑǙǗ=ǜǢǠǙǡǠǩǗǤǟǗǙǑǓǢǪǟǗǚǜǠǟǤǢǠǝǟǗǓǢǗǖǟǠǣǤǚ=ǜǠǹǗǣǥǞǗ ǢǗǟǗǟǗǡǠǣǢǗǖǟǠǡǢǗǟǗǡǠǣǢǗǖǟǠǡǠǣǝǗǚǪǗǣǤǞǗǣǗǨǚǡǠǣǝǗǠǜǠǟǩǑǟǗǠǒǥǜǗǙǑǑǥǤǠǔǗǟǚǤǢǗǟǚǟǔƯǗǢǗǟǚǣǥǣǚǣǤǠǝǟǚǚ ǖǚǹǑǣǤǠǝǟǚǑǢǤǗǢǚǹǣǜǚǜǢǓǟǚǡǢǚǤǚǣǑǜǚǒǢǑǧǚǹǑǝǟǚǡǥǝǣǟǚǓǠǜǠǢǤǚǙǠǝǑǥǡǝǑǙǞǚǟǚǓǠǧǠǝǗǣǤǗǢǠǝǑǥǜǢǓǚǚǔǝǚǜǗǞǚǹǑƪǑ to vreme praktikovan je autogeni trening kao jedina terapija.

ƳǗǙǥǝǤǑǤǚƵǠǜǠǞǚǣǤǢǑǘǚǓǑǻǑǡǠǤǓǢǖǚǝǗǣǥǣǗǟǑǪǗǡǠǝǑǙǟǗǡǠǣǤǑǓǜǗƫǙǓǢǪǗǟǑǞǗǢǗǻǑǣǥǡǠǜǑǙǑǝǑǖǑǣǥǓǢǗǖǟǠǣǤǚǑǢ terijskog krvnog pritiska i pulsa, kao i koncentracije holesterola i kortizola posle primene autogenog treninga kod ǞǝǑǖǚǧǠǣǠǒǑǣǡǠǢǗǞǗǼǑǹǗǞǡǢǚǝǑǔǠdzǑǓǑǻǑǒǚǝǗǞǑǻǗǠǖǡǠǝǑǙǟǚǧǓǢǗǖǟǠǣǤǚǚǖǑǣǥǠǣǤǑǝǗǞǑǝǗǚǪǗǣǤǞǗǣǗǨǚǡǠǣǝǗ završetka obuke.

ƪǑǜǺǥǩǑǜƢǥǤǠǔǗǟǚǤǢǗǟǚǟǔǙǟǑǩǑǹǟǠǣǞǑǻǥǹǗǓǢǗǖǟǠǣǤǚǦǚǙǚǠǝǠǪǜǚǧǡǠǜǑǙǑǤǗǺǑǡǠǢǗǞǗǼǑǹǑǡǢǚǝǑǔǠdzǑǓǑǻǑǥǞǑǻǥǹǗ ǥǩǚǟǑǜǣǤǢǗǣǑǟǑǹǗǖǚǟǜǥǚǠǝǑǜǪǑǓǑǡǢǚǝǑǔǠdzǑǓǑǻǗǞǝǑǖǚǧǠǣǠǒǑǟǑǣǤǢǗǣǚǻǚǧǠǓǠǡǠǢǑǓǑǜ

ƭǺǥǩǟǗǢǗǩǚǑǥǤǠǔǗǟǚǤǢǗǟǚǟǔǢǗǝǑǜǣǑǨǚǹǑǡǠǢǗǞǗǼǑǹǡǢǚǝǑǔǠdzǑǓǑǻǑǣǤǢǗǣ

UVOD

Çœ¤Ñµ¨É¿¨¸Ñ²Î±ÑÔÑ Ñ F43.2É¿œ§ÑžœÀœÊε

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CIQ RADA

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§œ Ñ¨¶ÀÉοÑÔÑɿβ¿œÀ¨µ¶»¸¨Ò¨´»œÀ¸¨»œÉœ ¤ÑµÑÉ¿¨¸Ñ²Î±ÑÔѠѨÃѧÎÁœÃÑÉΧβҜ»ÎÃÎÉÎ ¿ÑԻѧ¸ÑèªÎÀξÑÀÑÉœ¤Ñµœ§É¿¨¸Ñ²Î±ÑÔÑ Ñ

METOD RADA

£É¿ÎÀɜ»Ê¨ÔÒ¶»¸¨Ò¨´»¶œ»Àɜ¿¨§œÒÊѸҶÀʶ 赶¾¨Îµœ¶»¹¶´œÒ¨ÀɨÊÑÒ¨»É¿ÎÀœ´Òβ¶Ó¿ÑÀÊÑ ÎÃP²ÎèҜ»Îû圲µœÃ¨µÑ²ÒÎÀʨ»ÎÔÑÒÉοœ §œ¤ÑµÉ¿¨¸Ñ²Î±ÑÔÑ Ñ F43.2É¿œ§Ñ¨ÀÊ¿ÑÁ¨ÔÑ´»¨§

»¿¨Êœ¿¨µ¶§¨§Ñ˽͝ÀɨÊÑÒ¨®¨À¶¸œ´œÒ¨È¦ »ÑεœÃ¨Ò¨§Êœ¿ÑɨµÀ»¨§§œÊÎÃΧǿѤœÒ¨À¶ÉÎ»Ñ ÓÑʜ¹¨Éœ¤ÑµÑÉ¿¨¸Ñ²Î±ÑÔѠѨ ¨ªÎԜɿל Ҝ»¿ÎÓÔ¿œÃÒÎÀʨÉѿѧœÊѿѻε¨À¶§œ¿œÒ¨ÒœÉÎ À¿œÃÒÎÉ¿œÒœÉÎÀ¿œÃÒÎÉÎÀ¸œÎ¾¶»œÓÑȦ¨¼œÀʧœ Àœ®¨ÉÎÀ¸œÎ»ÎÒ´ÑҜœÓÑȦ°ÑÊÎÔ¿œ§œ¨Àɨ ÊÑÒ¨®¨À¶É¿Ñ»Ê¨»ÎÔѸ¨È¦Í¨ÎÖ¨Ó¨´»¨ÉλÑÓÑʜ ¹¨À¶¾¨¸¨À¨ÀÊθҨ¨Ã¨µÑÀÊθҨ»¿ÔҨɿ¨Ê¨ÀÑ» ¨¾¿Ñª¨µÑ¸Ò¨É¶¸ÀѾ¨Îªœ§¨µÀ»¨ÉλÑÓÑʜ¹¨Ôœ´œ¿  ¨Ò¨ÔλοʨÓθѶɸÑÓ§¨Ò¨ÔΪθœÀʜ¿Î¸Ñ¶»¿ Ô¨ ¨ ²¸¨»œ§¨µÑ ·¿¶ÉÑ ¨ÀɨÊÑÒ¨»Ñ µœ ¨ÀÊÎÔ¿œ§œÒÎ ¾¨¸Ñ¨»ÎÒʿθÒѲ¿¶ÉÑÃ뵜Óѧœ¿œ œÒ¨ÔÎѻο ʨÓθѶ¨ÀɨʨÔÑ œ¶»¹¶´œÒÓÿÑÔ¨ÀɨÊÑÒ¨» ÆÀÒÎÔÒ¨¿œÓ¶¸ÊÑʨ§œ¿œ Ñ¨ÉÎÀ§ÑÊ¿Ñ Ñξ¿Ñ±œÒ¨ À¶¶É¿Î²¿Ñ§¶Excel

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µœÃÒÑÀœÑÒÀÑÎÃÃΧ¨Ò¶ÊÑÊλΧ»ÎµœÀ¶¨ÀɨÊÑ

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REZULTATI

ͨÎÖ¨Ó¨´»¨¨¾¨Îªœ§¨µÀ»¨ÉѿѧœÊ¿¨À¶§œ¿œÒ¨ ¶Ê¿¨ÖÑӜ¨ÀÊ¿ÑÁ¨ÔÑ ÑÉ¿œÉ¿¨§œÒœÊœ¿Ñɨµœ ÉÎ ´œÊҜԿœÃÒÎÀʨÉÎÀ¸œÎ¾¶»œÓÑȦ ÓÑÔ¿¼ÒœÔ¿œÃ ÒÎÀʨ¨ÉÎÀ¸œ¼œÀʧœÀœ®¨ÎÃÓÑÔ¿¼œÊ»ÑœÓÑ È¦ »ÎÒʿθҜԿœÃÒÎÀʨ ¦Ñ¾œ¸Ñº¿œÃÒÎÀʨÀ¨ ÀÊθÒβ¨Ã¨µÑÀÊθÒβѿʜ¿¨µÀ»Î²»¿ÔÒβɿ¨Ê¨À»Ñ ·¿ÑÖ¨»ÎÒ»ÑΨԿœÃÒÎÀʨѿʜ¿¨µÀ»Î²É¶¸Àѧœ ¿œÒβÒѾ¿Ñª¨µÑ¸Òεѿʜ¿¨µ¨ ·¿ÑÖ¨»ÎÒÀ§Ñ ¨ ¸œÀ¶ÀœÒœÉÎÀ¿œÃÒÎÉÎÀ¸œ¶ÔœÁ¾ÑÒβ¨É¿¨§œ œÒβ Ȧ¨ÎÀÊѸœÀ¶§Ñ¸œ¼œÀʧœÀœ®¨ÉÎÀ¸œÎ»ÎÒ´ÑҜξ¶ »œÓÑȦ°ÑÔ¿¼ÒœÔ¿œÃÒÎÀʨÀԜʿ¨Ôœ¸¨´¨ÒœÉÎÀ¸œ œÓÑȦ¾¨¸œÀ¶À§Ñ œÒœ¨ÀÊÑʨÀʨ´»¨ÓÒѴѵ ÒοÑÓ¸¨´¨ÊœÎÃÉδœÊÒ¨ªÔ¿œÃÒÎÀʨÇÎÀ¸œ¨Àʜ»Ñ ɜ¿¨ÎÃÑÎüœÀʧœÀœ®¨»ÎÒʿθҜԿœÃÒÎÀʨÀ¶Àœ ¶ÀÊѸ¨¸œÒÑÀÊÑʨÀʨ´»¨ÓÒѴѵÒÎÒ¨Áœ§Ò¨Ôζ¶Îà ÒÎÀ¶ÒÑÉδœÊҜԿœÃÒÎÀʨ³¨ÀÊθҨɿ¨Ê¨ÀÑ»Àœ ÉÎÀ¸œÎ¾¶»œÓÑȦÓÒѴѵÒÎÀ§Ñ ¨Î¨ÉÎÀ¸œ¼œÀʧœ Àœ®¨ÎÀÊÑζÒÑԜÜҨ§²¿ÑÒ¨®Ñ§Ñ¾¨ÎµœÀÊÑʨÀʨ´ »¨ÓÒѴѵÒοÑÓ¸¨´¨Ê¶ÎÃÒÎÀ¶ÒÑÀÊÑ œÉ¿œ¸œ´œ Ñ Ѹ¨¾œÓÓÒѴѵҜ¿ÑÓ¸¨»œ¨Ó§œ±¶ÓÑÔ¿¼ÒœÔ¿œÃÒÎÀʨ ¨»ÎÒʿθҜԿœÃÒÎÀʨ»ÎµÑµœ¨Ó§œ¿œÒѼœÀʧœÀœ ®¨»ÑÀÒ¨µœ°ÑÔ¿¼Òœ¨»ÎÒʿθҜԿœÃÒÎÀʨÓÑèµÑ ÀÊθҨɿ¨Ê¨ÀÑ»¨Ñ¿Êœ¿¨µÀ»¨É¶¸ÀÎÀÊѸœÀ¶§Ñ œ ¶ÎÃÒÎÀ¶ÒÑÀÊÑ œÉ¿œ¸œ´œ Ñ¾¨¸œÀ¶ÀÊÑʨÀʨ´»¨ ÓÒѴѵÒοÑÓ¸¨´¨ÊœÎÃÉθÑÓÒ¨ªÔ¿œÃÒÎÀʨ¨Ñ»ÎÀœ ÉÎÀ¸œ¼œÀʧœÀœ®¨¨ÀÉι¨¸Î¨ÓԜÀÒÎÉÎԜ¤Ñ œÆÔÎ ÉÎԜ¤Ñ œ´¨Ò¨ÃÑÀœ»ÎÒʿθҜԿœÃÒÎÀʨèµÑÀÊθ Òβɿ¨Ê¨À»Ñ¨É¶¸ÀÑÀÊÑʨÀʨ´»¨ÓÒѴѵÒοÑÓ¸¨»¶ µ¶¨¶ÎÃÒÎÀ¶ÒÑÓÑÔ¿¼ÒœÔ¿œÃÒÎÀʨ§œ¿œÒœÒœÉÎÀ¿œÃ ÒÎÉÎ¨¨Ñ»ÎÀœÒœÔ¿Ñ¤Ñµ¶ÒÑÉδœÊÒ¨Ò¨ÔÎ

˜¿œÒœÀ¶¨Ô¿œÃÒÎÀʨ¾¨Îªœ§¨µÀ»¨ªÉѿѧœÊÑ¿Ñ ½ÎÒ®œÒÊ¿Ñ®¨µœªÎ¸œÀʜ¿Î¸Ñ ·¿ÑÖ¨»ÎÒ¨»Î¿Ê¨ÓÎ ¸Ñ ·¿ÑÖ¨»ÎÒÀ¶ÀœÔ¨ÃÒÎÀ§Ñ ¨¸œÉÑÀ¶ÀœÒÑ»¿Ñ µ¶Î¾¶»œÈ¦Ãξ¨¸œÓÑÔ¿¼ÒœÔ¿œÃÒÎÀʨÑÉÎÀ¸œ¼œÀÊ §œÀœ®¨»ÎÒʿθҜԿœÃÒÎÀʨ»ÎµœÀ¶¾¨¸œÀÊÑʨÀʨ

TABELA 1. Sredwe vrednosti i standardne greške rezultata merewa fizioloških parametara. TABLE 1. Average values and standard errors in the measurement results of physiological parameters.

ƤǑǢǚǹǑǒǝǑ Variable

ƲǠǩǗǤǟǗǓǢǗǖǟǠǣǤǚ 1. Initial values

ƪǑǓǢǪǟǗǓǢǗǖǟǠǣǤǚ 2. Final values

ƭǠǟǤǢǠǝǟǗǓǢǗǖǟǠǣǤǚ 3. Control values ƴǚǣǤǠǝǟǚǡǢǚǤǚǣǑǜ mm Hg

Systolic blood pressure (mm Hg) j j j

ƧǚǹǑǣǤǠǝǟǚǡǢǚǤǚǣǑǜ mm Hg

Diastolic blood pressure (mm Hg) j j j

ƲǥǝǣǒǢǑǧǚǹǑǝǟǗǑǢǤǗǢǚǹǗ ǠǤǜǥǨǑǹǞǚǟ

Brachial pulse (min-1₎ j j j

ƸǠǝǗǣǤǗǢǠǝ mmol/l

Cholesterol (mmol/l) j j j

ƭǠǢǤǚǙǠǝ nmol/l

Cortisol (nmol/l) j j j

ƥǝǚǜǗǞǚǹǑ mmol/l

Glucose (mmol/l) j j j

ƴǢǗǖǻǑǓǢǗǖǟǠǣǤǹǗǣǤǑǤǚǣǤǚǩǜǚǙǟǑǩǑǹǟǠǢǑǙǝǚǩǚǤǑǠǖǠǖǔǠǓǑǢǑǹǥǼǗǣǢǗǖǻǗǓǢǗǖǟǠǣǤǚǚǙǜǠǝǠǟǗǠǙǟǑǩǗǟǗǒǢǠǹǗǞǥǙǑǔǢǑǖǚ

*The average value is significantly different in comparison to the average value from the column designated by the number in brackets.

GRAFIKON 1. ƤǢǗǖǟǠǣǤǚ ǣǚǣǤǠǝǟǠǔ ǚ ǖǚǹǑǣǤǠǝǟǠǔ ǡǢǚǤǚǣǜǑ ǡǠ ǦǑǙǑǞǑǚǣǤǢǑǘǚǓǑǻǑ

GRAPH 1. Values of systolic and diastolic pressure by phases of study.

50 60 70 80 90 100 110 120 130

1 2 3

mm

Hg

Вредности систолног притиска / Values of systolic pressure Вредности дијастолног притиска / Values of diastolic pressure

Фазе истраживања Phases of study

GRAFIKON 2.ƤǢǗǖǟǠǣǤǚǑǢǤǗǢǚǹǣǜǠǔǡǥǝǣǑǡǠǦǑǙǑǞǑǚǣǤǢǑǘǚ -vawa.

GRAPH 2. Values of arterial pulse by phases of study.

Фазе истраживања Phases of study 60

65 70 75 80

1 2 3

Откуцај

у

минути

Heartbeats

/

m

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ЭЬяќдяЬфѳ

žÎ¾¨µœÒ¨¿œÓ¶¸ÊÑʨÉÎÊÔ¿±¶µ¶ÒѼœÉθÑÓҜª¨ÉΠʜӜǿœÊÉÎÀÊÑÔ¨¸¨À§ÎÃÑȦÀ§Ñ ¶µœÔ¿œÃÒÎÀʨ ¾¨ÎÖ¨Ó¨´»¨ª¨¾¨Îªœ§¨µÀ»¨ªÉλÑÓÑʜ¹ÑÉœ¤Ñ µÑÉ¿¨¸Ñ²Î±ÑÔѠѳԜÓÑÔ¿¼ÒœÔ¿œÃÒÎÀʨÀ¶ÒœÉÎ GRAFIKON 3.ƤǢǗǖǟǠǣǤǚǜǠǟǨǗǟǤǢǑǨǚǹǗǧǠǝǗǣǤǗǢǠǝǑǡǠǦǑǙǑǞǑ ǚǣǤǢǑǘǚǓǑǻǑ

GRAPH 3. Values of cholesterol concentration by phases of study.

GRAFIKON 4. ƤǢǗǖǟǠǣǤǚ ǜǠǟǨǗǟǤǢǑǨǚǹǗ ǜǠǢǤǚǙǠǝǑ ǡǠ ǦǑǙǑǞǑ ǚǣǤǢǑǘǚǓǑǻǑ

GRAPH 4. Values of cortisol concentration by phases of study.

Фазе истраживања Phases of study 3

3.5 4 4.5

1 2 3

mmol/l

Фазе истраживања Phases of study

mmol/l

180 190 200 210 220 230 240 250 260 270 280

1 2 3

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LITERATURA

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INTRODUCTION _{Autogenic training is a widespread} tech-nique used in psychotherapy. The British school of autogen-ic training cites a large list of diseases, health states, and life changes, in which autogenic training can be of help. We want-ed to explore the application of autogenic training as a thera-py for adjustment disorder in adolescents. The sample consist-ed of a homogeneous group of 31 individuals, with an average age of 17.3±0.2 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. OBJECTIVE The aim of our work was to figure out the influ-ence of autogenic training on adjustment disorder, through biophysical and biochemical indicators, and to research the efficiacy of autogenic training as a therapy for adjustment dis-order in adolescents.

METHOD We observed adjustment disorder indicators and their changes in three phases, using initial, final, and control values, which we measured immediately before the begin-ning, immediately after the completion, and six months after the completion, of the practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, bra-chial pulse rates, cortisol levels in plasma, cholesterol levels in blood, as well as glucose concentrations. During that period,

autogenic training was employed as the sole therapy.

RESULTS _{The study confirmed our preliminary assumptions.} The measurements we performed showed that arterial blood pressure, pulse rates, cholesterol and cortisol concentrations, after the application of autogenic training among adolescents suffering from adjustment disorder, were lower than the initial values. They remained lower even six months after the com-pletion of the practical course in autogenic training.

CONCLUSION We concluded that autogenic training sig-nificantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an indi-vidual, and eases the adaptation of adolescents to stress, help-ing with recovery.

Key words: autogenic training; relaxation; adjustment disor-der; stress

Boris JOJIĆ

Institut za psihijatriju Klinički centar Srbije Pasterova 2, 11000 Beograd

AUTOGENIC TRAINING AS A THERAPY FOR ADJUSTMENT DISORDER IN ADOLESCENTS

Boris R. JOJIĆ, Ljubica M. LEPOSAVIĆ Institute of Psychiatry, Clinical Centre of Serbia, Belgrade

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