Persönlichkeitsfragebögen

The influence of defensivity, measured by validity scales of personality inventories (MMPI-K, FPI-R, GIESSEN-Test) on test results and psychotherapy outcome was studied in 309 patients treated with inpatient client-centered therapy. In general, psychotherapy patients exhibited low defensivity. 25% of patients, who denied psychopathology at admission, did so at discharge and to some extent at follow-up, demonstrating an ”especially good outcome” (means). Relative improvement (effect sizes), however, was significantly diminished in psychopathology scales and significantly enlarged in validity scales. – Results are discussed with regard to prior hypotheses about the influence of defensivity.     

Changes in cognitive performance during a 216 kilometer, extreme endurance footrace: a descriptive and prospective study

Two subjects participated in a 216 km ultramarathon with outside temperatures above 50 degrees C while several physiological and psychological parameters (cognitive performance assessed by a mental calculation task and an attentional task, subjective bodily experience, and lactate level) were evaluated throughout the race. Severe stress from dehydration, sleep deprivation, and total physical exhaustion are combined in a unique manner, allowing evaluation of their effects in a range far outside that obtainable in a laboratory setting. During the race the subjects answered a questionnaire about their actual bodily experiences, underwent 8 medical examinations, and performed two cognitive tests approximately every 35 kilometers. Analysis showed cognitive performance did not decrease steadily in a simple and gradual way but reached a peak in the morning of Day 2 after a short sleeping period and then decreased. In the early morning of Day 3, in general cognitive performance exhibited the worst results but increased differentially between the subjects again in the last test 1 km before the finish line.     

Eine Schule für das Leben mit Schizophrenie

Schizophrenia usually appears in young people at an age when they are about to leave home, i.e. at a life stage which is already difficult without a psychological disorder. The “learning by doing” program of “Pension Bettina”, which is described here, supports the affected persons and their families in the process of detachment from home and coping with the disorder. Special emphasis is laid on the difficult balance between increasing the autonomy of the affected person and providing adequate familial support.     

Scham und Familienbeziehungen bei Bulimie

Background

Empirical studies show a relationship between family factors and disturbed eating behavior. Feelings of shame are associated with a higher level of eating disorder symptoms and with family relations perceived as being dysfunctional. Thus shame can be understood as a mediator of the relationship between dysfunctional family relations and eating disorder symptoms.

Material and methods

For 69 female patients, including 55 with bulimia nervosa and 14 with eating disorder not otherwise specified (EDNOS) between 14 and 22 years of age, who participated in a comparative study of psychotherapy outcome, eating disorder symptoms (EDI, EDE-Q), general psychiatric symptoms severity (SCL-90R), level of shame (TESE-KJ) and perceived family relations (FB-A) were measured at the beginning of psychotherapy.

Results

The higher the feeling of shame the more dysfunctional the perceived family relationships were and the more the eating disorders and general symptoms severity were reported. Shame was a partial mediator of the relationship between family functionality and symptoms.

Discussion

Feelings of shame could originate in dysfunctional family relationships but could also evoke more negative perceptions of interpersonal relationships. The direction of causality could not be proven in the correlative design; nevertheless, shame contributes to an understanding of the mechanisms between dysfunctional family relationships and eating disorder symptoms.     

Anxiety in Children and Adolescents Rated by Patients,Parents, and Teachers: Factor Structure and Psychometric Properties of an ICD-10 and DSM-IV-based Rating Scale in a Large Clinical Sample

This study examined the psychometric properties of the German Self-Report and Parent Report Rating Scale for Anxiety Disorders (SRS-AD and PRS-AD), and a shortened teacher version of the PRS-AD (TRS-AD) in a large clinical sample. Data were collected from 585 children, adolescents and young adults with psychiatric disorders (aged 6–21 years), 821 parents and 378 teachers. Factorial validity, reliability and discriminating validity of the scales were examined and the agreement between different informants was assessed. Analyses were performed in the complete sample including a wide range of different psychiatric disorders as well as in a subsample of children, adolescents and young adults with anxiety disorders. Confirmatory factor analyses mostly supported a model with first-order factors according to the subscales and a second-order overall anxiety factor. Only for the SRS-AD analysed in the sample of participants with anxiety disorders, the results did not clearly favour a first-order solution with correlated factors according to the subscales or the second-order solution adopted for the other questionnaires. Internal consistencies for the total scale and subscales were mostly satisfactory. Significant mean differences between anxious and non-anxious participants were found for the mean total scores of the SRS-AD and PRS-AD, but not for the TRS-AD. The informant agreement was low-to-moderate. We concluded that the SRS-AD, PRS-AD and TRS-AD demonstrate satisfactory psychometric properties for use with clinically-referred children and adolescents.     

Familienfunktionalität und Therapieerfolg

Background

Even though it is a treatment standard of child psychotherapy to involve the parents, hardly any research has been carried out about the impact of family functioning on treatment outcome. Aims of the present study were to investigate the change in and the prognostic power of family functioning on treatment outcome of short-term psychodynamic psychotherapy in children and adolescents.

Patients and methods

The sample consisted of 54 children and adolescents undergoing outpatient short-term psychodynamic psychotherapy. To assess family functioning, their parents were asked to complete the Family Assessment Measure (FAM).

Results

Patients from families with high levels of functioning in task accomplishment, communication and affective expression were more often treated successfully. Improvement in levels of functioning in role performance, emotionality and control were only found in the group of successfully treated patients.

Conclusion

Family functioning is a decisive factor in the differential indication of psychotherapeutic treatment in children and adolescents.     

Higher realities and the inner self: One quest? Transcendence and the significance of the body in the new age circuit

Can New Age be religious? In this article it is argued that New Age should not be treated as just one meaning system. It is possible to discern several different meaning systems in the New Age networks, even though they share a common language. Before examining whether these meaning systems are religious or, in other words, whether they contain transcendent elements, the concept of transcendence is ‘de‐christianised’. For it is precisely the Christian interpretation, namely the idea that the transcendent reality has to be ‘outside’, that makes the concept useless for the study of New Age meaning systems. The analysis then shows that sometimes there is a higher reality, and sometimes not. Even in one and the same meaning system this difference can occur, since central notions are interpreted in different ways.     

Psychotherapieplanung bei “schwierigen Patienten”

This article describes a model of comprehensive psychotherapy planning for difficult patients, especially patients with borderline personality disorders and psychotic disorders. Its aim is to develop a psychotherapeutically orientated approach to treatment corresponding to the individual needs of the patient and the people closest to them (e.g. family).Central elements of the planning process are diagnostic/therapeutical family meetings in which psychoanalytic and systemic conceptualisations are applied together. The main features of this context oriented model development are described and illustrated by case studies.The article also presents first results of an analysis of the therapy plannings and discusses the questions arising.