Measuring religious attitudes: reliability and validity of the German version of the Systems of Belief Inventory (SBI-15R-D) in a representative sample

Forgiveness is a core value within Christianity and many other religions, but it is unclear whether valuing forgiveness results in individuals being more forgiving. This study examines the effect of Christian religious belief on forgiveness; tests the theoretical speculation that trust fosters forgiveness; explores the effect of cynicism, and examines age effects on forgiveness with a British sample. Christian clergy (N?=?209), general population samples of Christians (N?=?176), and a group with NRA (N?=?65) completed the Heartland Forgiveness Scale measuring forgiveness of self, others, and situations, and measures of trust, cynicism, and the importance of forgiveness. The clergy score higher on total forgiveness, forgiveness of self, others, and situations; rate forgiveness as being more important; are more trusting; and are less cynical than the Christian and no religious affiliation (NRA) samples in the general population. While the Christian sample value forgiveness more than the NRA group, they are not more forgiving on any of the measures tested. Age is a significant predictor only for situational forgiveness. Trust is not a positive mediator of forgiveness for any of the participant groups, and neither is cynicism a negative mediator of forgiveness.     

Ambulante Psychotherapie in Deutschland aus Sicht der Patienten

This study analyzed the provision of outpatient psychotherapy services in Germany in typical practice settings. In a representative survey (from June 2008 to September 2009) 1,212 subjects who received outpatient psychotherapy during the past 6 years were questioned about their experiences with outpatient psychotherapy via telephone interviews. Socio-economic data, reasons for seeking treatment, access paths, financial resources and psychosocial support data were collected. Therapeutic settings and modalities and concomitant medication treatment are described. The findings illustrate the problem of multiple psychiatric morbidity in the clinical practice and confirm the urgent need for patient access to professional psychotherapeutic services. Improving access to these services requires close cooperation between care providers.     

Regular and problematic leisure-time Internet use in the community: results from a German population-based survey

In our study, we attempted to identify systematically the use of Internet applications in the German population in order to derive risk factors for problematic use. In a representative survey of the German population, we queried 1,401 women and 1,111 men between the ages of 14 and 94 years by specific questions and standardized questionnaires on depression, anxiety (HADS), and depersonalization (CDS-2). The majority of the German population (55%) used the Internet in their leisure time. Users were younger and had a higher socioeconomic status (education, employment, income). Leisure-time use included e-mail and information search, as well as shopping. Chatting, online communities, games and sex were domains of young, mostly male adults. Overall, 9.3% reported at least one negative consequence of Internet use, especially neglect of recreational activities and problems with family/partner, work or education, and health. Problematic use was associated with longer average daily online times, avoidance of negative emotions, preference for certain applications (gaming, gambling, online sex) and an increased rate of depersonalization. The extent of Internet use per se is not sufficient as an addiction criterion and other negative consequences; rather, specific adverse consequences need to be identified. If the Internet is used excessively to cope with negative affect states and alternative means of coping (e.g., social support, health-promoting behavior) are diminished, a vicious cycle may ensue with increasing stress and reliance on the reinforcing properties of certain online activities that may finally lead to addictive behavior.     

Familienplanung junger onkologischer Patienten

Cancer patients in young adulthood are affected by the cancer diagnosis in a period of life where future parenthood or fulfilling of a potential wish to have children plays an important role. To perform fertility preserving treatment, patients should be fully informed before any treatment is carried out. The following review broaches the issue of whether and how fertility concerns are discussed in the medical consultation. Therefore, relevant papers were identified by a database search between the years 2000 and 2010. A total of 21 studies were included which focussed on physician-patient communication from the point of view of the patients or healthcare professionals. Oncologists do not routinely speak to patients about fertility issues. Both oncologists and patients expressed communication difficulties. An improvement of the medical interview concerning family planning could be achieved by provision of guidelines, training for healthcare professionals, cooperation between oncologists and reproductive medicine and the provision of educational patient material.     

Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors

Background/ObjectiveLong-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.     

Forensische Psychiatrie zwischen Therapie und Sicherung

The therapeutic tasks of forensic psychiatry range between the field of tension of “improvement” and “security” of entrusted persons. With respect to these aspects a paradoxical position of politics and society can be seen: whereas, regulatory security aspects are emphasized and detention measures are required with respect to the treatment measures according to §63 and §64 of the penal code (StGB) and any relaxation of rules is critically viewed, under pressure from the European jurisprudence preventive detention has been declared as a therapeutic measure. The superordinate priority of these measures is to prevent recidivism. This article firstly summarizes the empirical evidence concerning the efficacy of forensic psychiatric treatment of relevant disorders. From this it becomes obvious that the data are unreliable due to relevant risk aspects; therefore, the comparison of safety and therapeutic interests remains a challenging undertaking. A working approach that can successfully encompass both aspects is long-term case management, which is in a position to do justice to both the inpatient interaction and dynamic aspects of the treatment process beyond detention. Because the effectiveness of aftercare has been confirmed, we propose the implementation of forensic outpatient treatment as an alternative to forensic inpatient treatment.     

Free will: reconciling German civil law with Libet's neurophysiological studies on the readiness potential

The free will debate widely exceeds the neuroscientific and philosophical fields due to profound implications for legislation, case law and psychiatric expert opinion. Data from Benjamin Libet's experiments on the readiness potential have been used as an argument against personal responsibility and for changes in the law. Due to the explicit use of the term "free will" in German civil law, the psychiatrist as an expert witness is confronted with this debate. In this article we outline the role of this crucial term in German civil law and we describe the neurophysiologic challenge in the form of Libet's experiments, which is led on three levels: the correctness of the data, the impact on the question of whether free will exists and possible consequences for the law. We conclude that the problem of free will cannot be debated on the basis of the data provided by Libet's experiments and that doubts about the existence of a free will must not lead to changes in the law or in psychiatric expert testimony. Therefore, advice for the psychiatrist as an expert witness is offered on the basis of a psychopathological approach that takes into account cognitive and motivational preconditions and the structure of values and personality.