Partizipationsverhalten schizophren erkrankter Patienten in Psychoedukationsgruppen

Background

The effectiveness of psychoeducation groups for people with schizophrenia is well documented; however, there are no studies which examined patient participation behavior although this behavior might be critical for accomplishment of the therapeutic goals. This article presents newly developed 4-point Likert scale, the participation quality rating scale (PQRS), together with initial results on practicability, validity, change sensitivity, sociodemographic and clinical correlates and on the question whether participation quality might be a significant predictor of the short and long-term outcome of psychoeducation.

Patient and methods

Within the framework of the Munich Study “Cognitive Determinants of Psychoeducation and Information in Schizophrenic Psychoses” (COGPIP) the individual participation behavior of 97 patients with schizophrenia was examined after each psychoeducational group session (4 weeks). Individual mean PQRS scores were correlated with sociodemographic, anamnestic and clinical variables. In addition to change sensitivity the ability of the scale to predict the acquisition of illness knowledge during psychoeducation was examined as well as readmission during a 9-month follow-up period and the psychopathological endpoint (positive and negative syndrome scale, PANSS).

Results

Practicability and change sensitivity of the PQRS were found to be sufficient. Significant correlations with independently rated illness insight and medication compliance indicated a construct validity of the scale. Higher age, female sex and less pronounced psychopathological symptoms (PANSS) were associated with better participation behavior. Even patients with clearly impaired participation behavior profited from psychoeducation in that they were able to catch up with the delay with regard to illness knowledge. However, the PQRS was not a predictor of readmission during the 9-month follow-up period or of psychopathological endpoints.

Conclusions

The PQRS is qualified as a new tool for the standardized assessment of participation behavior in people with schizophrenia attending psychoeducation groups. The scale can be applied in research as well as clinical contexts in order to further improve understanding of how psychoeducation works and how this kind of supplementary therapy could become even more effective.     

Politische und soziale Verantwortung von Psychotherapeuten

Psychotherapists should always continuously remind themselves what role they and/or representatives of their discipline played and still play in various political contexts. Under these aspects the following general categories can be suitable for orientation: 1) general political participation, 2) application of specific psychotherapeutic perspectives for understanding of cultural, social and political processes and 3) development of possible activity perspectives from a psychotherapeutic viewpoint. The psychotherapeutic view of social processes and the possible resulting activity perspectives are a consequence of observation of the interplay between exactly these social processes and their deposition in the individual.     

Traditional Machismo and Caballerismo as Correlates of Posttraumatic Stress Disorder,Psychological Distress,and Relationship Satisfaction in Hispanic Veterans

An online survey was used to examine 45 Hispanic male veterans’ traditional machismo and caballerismo as correlates of posttraumatic stress disorder (PTSD), psychological distress, and relationship satisfaction. Higher traditional machismo was associated with higher PTSD severity and distress and lower relationship satisfaction. Psychometric properties of the Traditional Machismo and Caballerismo Scale were explored. Se utilizó una encuesta en línea para examinar el machismo y el caballerismo tradicionales de 45 veteranos hispanos varones, y su correlación con el trastorno de estrés post‐traumático (PTSD, por sus siglas en inglés), la angustia psicológica y la satisfacción en sus relaciones. Un mayor nivel de machismo tradicional se asoció con una mayor severidad del PTSD, así como con angustia y una menor satisfacción en las relaciones. Se exploraron las propiedades psicométricas de la Escala de Machismo y Caballerismo Tradicionales.     

Evaluating the effectiveness of REBOOT Combat Recovery: A faith-based combat trauma resiliency program

Evidence-based intervention programs attuned to the spiritual needs of service members, Veterans, and their families are needed to help them deal with the potentially debilitating consequences of combat trauma. This study evaluated the effectiveness of a faith-based, peer-led combat trauma resiliency program called REBOOT Combat Recovery. Participants were 254 adults who reported on 8 aspects of physical, mental, and social well-being during the 3rd week and the 12th week of the program. Findings indicated improvement for pain interference, fatigue, sleep disturbance, anxiety and depressive symptoms, and social participation. Improvement was uniform except that Veterans benefited more than currently serving military personnel with respect to anxiety symptoms. These results suggest the program may be effective for coping with the aftermath of combat trauma.     

The Longitudinal Psychometric Properties of the EAS Temperament Survey in Adolescence

Studies on the psychometric properties of the EAS Temperament Survey (EAS) have produced equivocal results. In particular the psychometrics of the EAS are largely unknown in adolescence. Confirmatory factor analysis was used to explore the EAS structure in adolescents. Structural equation modeling was also used to assess measurement invariance and factor stability. A modified 4-factor model provided the best fit to the data and demonstrated reasonable longitudinal invariance and stability. Furthermore, the standardized factor scores correlated at near unity with the sum of observed scores, suggesting factor interpretations remained unchanged. However, the modifications suggest that further work is necessary.     

Psychotherapie und Internet

The Internet plays an important role in healthcare. Approximately two thirds of Internet users search the medium for, e.g. personal questions of health, including aspects of mental health. In countless discussion forums or blogs mentally stressed people discuss their problems and search for contact to other affected individuals but also to professional helpers. In this article an attempt is made to systematize the interface between Internet and psychotherapy in the narrower and broader sense. In particular five topics and problem areas will be dealt with: (1) as information medium Internet delivers an immense number of resources on mental disorders, which raises the problem of quality assurance. (2) As a communication medium it can provide support for therapeutic interventions. Psychological online counseling has now been proven to be effective. (3) Internet alters the traditional therapeutic relationship in one way or another. In particular e-mail communications supplement a face-to-face treatment. (4) Use of the Internet also brings along clinically relevant problems and because of this patients visit psychotherapeutic practices increasingly more often. (5) Internet can be fruitful for psychotherapy research.     

Brooding rumination and attentional biases in currently non-depressed individuals: an eye-tracking study

Both rumination and attentional biases have been proposed as key components of the RDoC Negative Valence Systems construct of Loss. Although theorists have proposed that rumination, particularly brooding rumination, should be associated with increased sustained attention to depression-relevant information, it is not clear whether this link would be observed in a non-depressed sample or whether it is specific to brooding versus reflective rumination. To address these questions, the current study examined the link between brooding rumination and attentional biases in a sample of non-depressed individuals (n?=?105). Attentional biases were assessed using eye tracking during a passive viewing task in which participants were presented with 2?×?2 arrays of angry, happy, sad, and neutral faces. In line with predictions, higher levels of brooding rumination were associated with greater sustained attention to sad faces and less sustained attention to happy faces. These results remained significant after controlling for participants’ prior history of major depression and current nonclinical level of depressive symptoms, suggesting that the link between brooding rumination and attentional biases is at least partially independent of current or past depression.     

Sexueller Sadismus und Sexualkriminalität

The categorization of sadism has turned out to be a versatile phenomenon, which covers a spectrum from harmless symbolic rituals to extremely violent acts where strong impulses or prolonged fantasies and rituals are involved. As the phenomenon is versatile its causes and appearances vary as well, although so-called BDSM (bondage & discipline & dominance & submission & sadism & masochism) practitioners and persons with severe sadism in a forensic context share only few common preferences. Based on own clinical experiences with sadism in forensic patients the authors support the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) especially the diagnostic disjuncture of sadism and masochism. Sexual sadism appears more frequently in forensic contexts in combination with sadistic, antisocial and borderline personality disorders but rarely with masochism. Masochism is otherwise reported to be more prevalent in patients of general psychiatry, however, combined with depression or dependent personality traits rather than with sadism. Moreover, the authors believe that if use of the diagnostic term sadism is perpetuated the establishment of the proposed new diagnosis “paraphilic coercive disorder” is unnecessary. The diagnostic term is also important for treatment and assessment. Despite the lack of reliable long-term studies with larger samples, it is reasonable to assume that medication, sometimes even anti-androgenic treatment, can be indicated in patients with severe sadism.     

Psychotherapie bei lebensbedrohlich Erkrankten

In den letzten 20 Jahren ist die begleitende psychotherapeutische Behandlung bei körperlich Schwerkranken fester Bestandteil der Tätigkeit von psychosomatischen Konsiliar- und Liaisondiensten im Krankenhaus geworden. Eine Konzeptualisierung dieser Tätigkeit auf psychodynamischer Basis wird beschrieben. Ziele der psychotherapeutischen Interventionen sind die Stabilisierung der Abwehr des Patienten und die Rückgewinnung eines strukturierten Umgangs mit der Krankheit, mit den Behandlern und den nahen Bezugspersonen. Therapiebausteine sind eine narrative Gesprächsstruktur, ein psychodynamisches Verständnis der aktuellen Krankheitssituation auf dem Hintergrund der Lebensgeschichte, aktives Zuhören, Fokusformulierung und systemische Sichtweise. Wichtige Wirkfaktoren sind eine empathische Beziehung, Verbalisierung von belastenden, negativen Gefühlen, Fokussieren auf aktuelle Probleme und Ressourcenorientierung. Probleme entstehen durch negative Gegenübertragung des Psychotherapeuten und ausgeprägte Verleugnungsvorgänge auf Patientenseite. Die Umsetzung erfordert vom Psychotherapeuten kontinuierliche Präsenz und regelmäßige Rücksprachen und Konsultationen mit dem behandelnden Team.     

Everyday Victimization of Adolescent Girls by Boys: Sexual Harassment, Bullying or Aggression?

School-based sexual harassment of adolescent girls by boys appears commonplace, yet aggression and bullying studies rarely yield sexualized material. This qualitative Australian study with 72 14- to 15-year-olds and 7 teachers aimed to discover whether interviewer use of neutral language in gender-segregated focus groups and interviews would yield material indicating that the victimization of girls by boys is sexualized. Verbal and indirect victimization were reported to be everyday occurrences, and almost entirely sexual. Findings are discussed in the light of definitions of sexual harassment, bullying and aggression. It is concluded that the term “sexual bullying” appropriately captures the gendered power structure underlying these behaviors. As such, they need to be understood, and become visible, more broadly than in terms of individual pathology.