Wenn Psychotherapie schadet …

Background

The examination of the negative and harmful effects of psychotherapy has recently moved into the focus of psychotherapy research. The investigation described in the following article specifically analyzes for the first time the contents of complaints by psychotherapy patients and presents a practical category system for classification of the negative effects of psychotherapeutic treatment.

Samples and method

A total of 67 cases of complaints submitted to the Ethics Association (reg. co). Ethics in Psychotherapy during the time period from 18.02.2008 to 27.12.2010 were analyzed with respect to the content in the sense of an inductive categorization and quantitative evaluation.

Results

From the available patient complaints a reliable category system could be elucidated. The violation of therapeutic base variables and violations of sexual limitations were the most common cause of complaints against male therapists whereas for female therapists accusations of violation of medical confidentiality and documentation duty were significantly higher.

Conclusions

The results of this study allow formulation of research recommendations for extended investigation of the negative effects of psychotherapy and reveal options for the development of a targeted risk management.     

How does education lead to healthier behaviours? Testing the mediational roles of perceived control,health literacy and social support

Abstract

Objectives: Educational attainment is increasingly recognised as a unique dimension of socioeconomic status (SES) and a powerful determinant of health behaviour—and thus physical health and mortality. However, very little is known about the specific pathways through which education influences these health behaviours. Design: The present study used a nationally representative US survey to test three potential psychosocial pathways (perceived control, health literacy and social support) through which education might influence intake of fruits and vegetables (FV), physical activity (PA) and sedentary behaviour (SB), controlling for other aspects of SES (income, health insurance status) and demographics (age, gender, race/ethnicity). Results: Both aspects of perceived control (locus of control, cancer fatalism) mediated the impact of education on FV and PA while only locus of control mediated the impact of education on SB. Further, only one aspect of health literacy (ability to understand recommendations) mediated education’s effect on any health behaviour (FV). Social support did not mediate any of the effects of education on health behaviors. Conclusion: Future work explicitly assessing and testing these mediational pathways is needed to better understand how education influences people’s health behaviours throughout their lives.     

Cumulative trauma and midlife well-being in American women who served in Vietnam: effects of combat exposure and postdeployment social support

Background and Objectives: Research increasingly demonstrates that trauma exposure can have cumulative effects, yet much remains to be learned about effects of cumulative trauma, particularly regarding longer term adjustment. One such trauma, combat exposure, is insufficiently understood, especially for women, who are increasingly engaged in professional combat activities. Design: The study comprised a cross-sectional survey assessing multiple aspects of current well-being in women approximately 25 years after their service in Vietnam during the Vietnam War. Methods: Participants were 1374 women (78% military and 22% nonmilitary; mean age = 59.7). This study investigated the relations between three separate categories of trauma exposure (childhood, adulthood, and combat) and well-being and examined whether perceived social support at return from Vietnam moderated the association between combat exposure and well-being. Results: While both childhood and adulthood trauma exposure related to midlife well-being, combat exposure still uniquely predicted outcomes. Further, postdeployment perceived social support moderated the association of combat and well-being: recollected higher perceived social support at homecoming buffered participants from the links between combat exposure and well-being. Conclusions: These results may have important implications for interventions to reduce the impact of traumatic experiences, particularly in light of the increasing exposure of women to direct combat events.     

Cross Racial Identity Scale (CRIS) Scores: Stability and Relationships With Psychological Adjustment

A humor test composed of cartoons, comic strips, and jokes was administered to 30 college couples (26 single, 4 married) who rated them for humor. Subjects also stated how much they loved and liked their partner, their probability of marrying the partner, and filled out Rubin's Liking and Love Scales. The hypotheses were that similarity of rating of the humorous stimuli would be associated with loving, liking, and predisposition to marry. Hypotheses were confirmed.     

Evaluating Differences in Cognitive Appraisal and Coping Over Stages of a Transaction

We evaluated appraisal of and coping with a college examination over three stages of the transaction for 138 American undergraduate students. The transactional process approach allowed for the identification of differences in the magnitude and direction of appraisal and coping between adjacent stages and stages separated by an intervening stage. Repeated measures tests revealed that differences in appraisal and coping could occur between all pairs of stages, suggesting that, in research limited to investigating changes between adjacent stages only, the concept of a transactional process may be attenuated and important changes overlooked as the process of a stressful encounter unfolds.     

Promoting Healthy Behavior from the Pulpit: Clergy Share Their Perspectives on Effective Health Communication in the African American Church

African Americans continue to suffer disproportionately from health disparities when compared to other ethnicities (ACS 2010; CDC 2007). Research indicates that the church and the pastor in the African American community could be enlisted to increase effectiveness of health programs (Campbell et al. in Health Edu Behav 34(6):864–880, 2007; DeHaven et al. in Am J Public Health 94(6):1030–1036, 2004). The objective of this study was to investigate African American pastors’ perceptions about health promotion in the church and how these perceptions could serve as a guide for improving health communication targeting African Americans. Semi-structured interviews with African American clergy revealed that pastors feel strongly about the intersection of health, religion and spirituality; they also believe that discussing health screening and other health issues more frequently from the pulpit and their own personal experiences will ultimately impact health behavior among congregants. This study suggests that African American clergy see themselves as health promoters in the church and believe this communication (i.e., pastor-endorsed health information materials) will impact health behavior among underserved and minority populations.     

Heart failure patients’ desires for spiritual care,perceived constraints,and unmet spiritual needs: relations with well-being and health-related quality of life

Little information is available about HF patients’ desires regarding having their healthcare providers address their spiritual concerns, feeling constrained in doing so, and the extent to which their spiritual needs go unmet. Nearly half of our sample reported high levels of unmet spiritual needs and reported moderately strong desires to have their doctor or other healthcare professional attend to their spiritual needs, and moderately strong feelings of constraint in doing so. Spiritual constraint and unmet spiritual needs were associated with poorer spiritual, psychological and physical well-being, but these effects varied, depending on patients’ desire to discuss spiritual needs. These findings have important implications for clinical management of HF patients.     

Anger toward God: social-cognitive predictors, prevalence, and links with adjustment to bereavement and cancer

A recent model of collective action distinguishes 2 distinct pathways: an emotional pathway whereby anger in response to injustice motivates action and an efficacy pathway where the belief that issues can be solved collectively increases the likelihood that group members take action (van Zomeren, Spears, Fischer, & Leach, 2004). Research supporting this model has, however, focused entirely on relatively normative actions such as participating in demonstrations. We argue that the relations between emotions, efficacy, and action differ for more extreme, nonnormative actions and propose (a) that nonnormative actions are often driven by a sense of low efficacy and (b) that contempt, which, unlike anger, entails psychological distancing and a lack of reconciliatory intentions, predicts nonnormative action. These ideas were tested in 3 survey studies examining student protests against tuition fees in Germany (N = 332), Indian Muslims' action support in relation to ingroup disadvantage (N = 156), and British Muslims' responses to British foreign policy (N = 466). Results were generally supportive of predictions and indicated that (a) anger was strongly related to normative action but overall unrelated or less strongly related to nonnormative action, (b) contempt was either unrelated or negatively related to normative action but significantly positively predicted nonnormative action, and (c) efficacy was positively related to normative action and negatively related to nonnormative action. The implications of these findings for understanding and dealing with extreme intergroup phenomena such as terrorism are discussed.     

Cross Racial Identity Scale (CRIS) scores: stability and relationships with psychological adjustment

We examined the structural validity, internal consistency (alpha and omega), and test-retest reliability of scores on the Cross Racial Identity Scale (CRIS; Vandiver et al., 2000 ; Worrell, Vandiver, & Cross, 2004 ), as well as the relationship between CRIS scores and several variables related to psychological adjustment. Participants consisted of several groups of African American college students (34 ≤ n ≤ 340) attending a predominantly White university in a Western state. Confirmatory factor analyses indicated an acceptable fit of the data to the theoretical model, and alpha and omega coefficients indicate that CRIS scores have moderate to high internal consistency. CRIS scores also demonstrated stability over periods between 2 and 20 months in ranges that suggest long-term stability of racial attitudes. As predicted by the expanded nigrescence model (Cross & Vandiver, 2001 ), only self-hatred attitudes had consistent, meaningful relationships with psychological adjustment.