Schizophrenic patients have difficulties in inferring mental states of others and, therefore, in predicting their behaviour, which is described as impairment in theory of mind. In addition, schizophrenic patients show a tendency to self-reference, insofar as they interpret the behaviour of other persons in uncertain social situations as referring to themselves. The present study is addressed to the question, whether there is a relation between these abnormalities. Therefore 30 schizophrenic patients are compared with 25 patients with alcohol dependence and 25 non-patients. As expected, the schizophrenic patients show significant poorer performances in the theory of mind tasks and give significant fewer non self-referential explanations of social situations as both control groups. However, there is no significant correlation between both variables in the schizophrenic group, and the variables do not correlate with positive or negative symptoms of the schizophrenic disorder or with abnormalities of information processing.
Postpartum depression is defined as the onset of depressive symptoms during four weeks after delivery. Although prevalence is 10 - 15 %, symptoms are often recognised late or not at all. The present paper outlines classification, symptoms, risk factors and course of disease. Diagnostic tools such as the Edinburgh Postnatal Depression Scale are discussed. Important aspects of psychotherapy, especially cognitive behaviour therapy, and pharmacotherapy are described. Future research is required to determine (1) the comparative effectiveness of psychotherapy, pharmacotherapy and a combination of the two, (2) the long-term effects of antidepressant drugs on infants during breastfeeding, and (3) prophylaxis of risk patients.
Chronic pain disorders belong to the most frequent disorders in the clinical praxis. The intra- and interpersonal regulation of emotions play an important role. In a controlled study with a structural inter-view (O. Kernberg), the expressive behaviors (EMFACS), the emotional experiences (DAS) and the structural level (OPD) are examined. No differences were found in the quantity of expressive behaviors, but negative emotions are more frequently expressed by the patients. The results assume a more detailed reception of the former concept of alexithymia and indicates that deficits in the regulation of the self are promined.
Even though communication plays an important role in marital research, only few studies have thus far analysed the frequency of self-perceived positive and negative communication in close relationships. In addition, not many studies investigated differences in communication in young, middle aged and aged couples. This study is one of the first to examine the frequency of self-perceived positive and negative interaction in an epidemiological approach with regard to age and gender. The sample consists of 2235 married subjects between 30 to 80 years old. The results of this study reveal that women reported more positive interaction behavior than men. Furthermore, we found that older couples reported less negative interaction behavior. In terms of coping with stress within the couple, we identified lower scores of dyadic coping in elderly compared to younger subjects. The findings are discussed with regard to their practical and therapeutical significance in the work with aged couples.
Mother-child rehabilitation, which is an essential part of the health care system for women in Germany, does only play a small role in clinical or rehabilitation research. Furthermore, the state of health of the participating women and the effectiveness of the measures are doubted. The object of this study is to present the actual knowledge concerning the psychological stress of women participating in mother-child rehabilitation. In particular, the question of frequency and severity of burdens of the mothers will be discussed. The data shows that up to 80 percent of the women have clinically relevant burdens. We can assume that 20 percent of the women will fulfill the criteria for a depressive disorder. To maintain the specific health care for these women an adequate indication process as well as the continuation and specialization of these women-specific measures is necessary.
Bereaved persons, who have experienced the sudden death of a family member were asked to complete a questionnaire concerning how they experienced getting to know that a close person had died and their satisfaction with the hospital as well as grief reactions, coping strategies and support in the griefing process. In the anonymous survey the possibility to meet a psychotherapist was offered. Two thirds of the responding relatives (N = 61; response rate 20%) were women; the mean age was 50 years. Most of the bereaved were satisfied with hospital care (74%) and asserted, that they were informed in an appropriate way. Many of them felt bewildered (31%) and showed various grief reactions. As a coping strategy more than half of the bereaved remembered good times with the deceased (72%) and searched support from family members and friends (54%), which was regarded as very helpful to them. Women showed more intensive mourning than men. Bereaved of accident victims dealt more with cause of death than bereaved of family members, who died due to an illness. Relatives' problems to come to terms with a close persons death and incriminations were associated with satisfaction in hospital.
The impact of adverse life events and chronic stressors on the development of selected internalizing and externalizing psychiatric disorders in adolescence was examined in a longitudinal study. Data from 489 Ss, 304 females and 185 males, aged between 12 and 17 years, were collected at two occasions from 1996 to 1998 (retest 15 months later), in the framework of the Bremen Youth Study (Petermann & Essau, 1995). The occurrence of life events and chronic stressors were assessed with the help of the "Bremer Ereignisliste" (Bremen Life Event List; BEL), asking for 55 positive, adverse and neutral life events in different life areas. Depressive disorders, anxiety disorders and conduct disorders were assumed with the DSM-IV-Version of the Munich Composite Diagnostic Interview (M-CIDI) and additional inventories. Using logistic regression analysis, we determined a significant association between current symptoms and negative life events (retrospective design). In our longitudinal design, however, life events did not independently predict depressive, anxiety or conduct disorders. Our results stress, that moderating factors in the context of life events are important, if not even play a more crucial role in the formation of affective and behavioral disorders in adolescence.
40 Ss were presented a list with 50 words under several conditions. In the first part of the experiment they had to tell the first word which came to mind as a response to the stimuli read by the experimenter. During these trials reaction times and skin conductance reactions (SCRs) were recorded. Immediately afterwards the list was read again with the instruction to recall the associations given before. One week later, Ss had to recall their first associates; in addition, they rated the emotionality of stimuli and associates on a scale ranging from "very negative" to "very positive". Intraindividual correlations were computed for indices of emotionality (reaction times and SCRs during association, degree of negative emotionality) and forgetting in both short and long term memory. Production of negatively perceived associates was accompanied by larger electrodermal reactions and longer reaction times, as predicted by the psycho-analytic concept of resistance. In line with Freud's theory of repression, they were more likely to be forgotten both for short and long intervals. Our findings do not confirm Walker's action decrement theory proposed by some authors as an alternative hypothesis.
There is only a short history of controlled trials on cognitive-behavioral therapy for somatoform disorders. Results mostly demonstrate the success of those treatments, but the outcome effects are often smaller than for better evaluated disorders. To optimise treatments for somatoform disorders, predictors for a positive treatment outcome were examined. The sample consisted of 191 patients with somatisation syndrome who underwent the standard cognitive-behavioural treatment of a tertiary care inpatient hospital. Additionally, a waiting control of 34 patients was assessed. Mental disorders were diagnosed by structured interviews pertaining to DSM-IV. Health care utilisation was assessed through an interview on illness behaviour. Further, a number of evaluated psychometric instruments (SOMS, SCL-90-R, HADS, FLZM, EuroQoL) were used. Therapy outcome was analysed at discharge and at a 1 year follow-up. Multiple regression analysis showed that positive expectations regarding the treatment predicted short- and long-term outcome, a claim for disability-related benefit predicted short-term outcome negatively and low subjective suffering predicted the long-term increase of health-related quality of life. As motivation for psychotherapy determined the therapy outcome, scientists and therapists should pay greater attention to the assessment and increase of motivation for therapy.
Obesity is associated with psychosocial strain and a lower quality of life. Health-related quality of life is an important indicator for evaluating intervention treatments. However, German disease-specific quality of life instruments are lacking. In this paper the development and psychometric results of a weight-specific quality of life questionnaire for overweight and obese children and adolescents (GQ-LQ-KJ) is described. To determine the psychometric properties of the instrument 448 children and adolescents treated for over-weight or obesity took part in the study. They filled in the quality of life questionnaire, the German version of the STAI for children, a body image avoidance questionnaire (BIAQ) and several subscales of a generic quality of life questionnaire, the Child Health Questionnaire (CHQ). Results support the item and scale properties. Furthermore we were able to form two economic parallel versions suitable for further intervention studies.
The psychological well-being of migrants is one of the neglected domains of clinical psychology and health psychology. This study attempts to specify the psychological burdens of Turkish migrants exemplified at feelings of homesickness and depressivity. In the present study, 357 Turkish people at the age of 13 to 66 were administered. The results show high psychological strain both by the migrants of the first generation with a long stay in Germany as well as by turkish women with a short stay, who come to Germany by the way of transnational marriages. Personal resources like high self-esteem and social supporting networks could buffer the pains of homesickness and depressivity. The results have implications both to clinical-psychological practice as well as to social policy of immigration.
Until the beginning of the 20(th) century the idea of obsession found in literature was mostly a broad and unspecific one, and in part it continues to exist in this form until the present day. At the same time, however, Esquirol and Westphal began to develop a concept of obsession in the strict sense, and Jaspers used the phenomenological method as a basis to give it its final form. The concept of obsession in the strict sense represents the formal and nosologically specific core symptom of obsessive-compulsive disorder. In conjunction with the distinction between primary and secondary obsessions, obsession in the strict sense is proving helpful in differential diagnosis, but it can also serve as a guideline in the further phenomenological investigation of obsessive-compulsive disorder. It is shown how the interaction of personality, affect and release situation develops the obsessive-compulsive disorder. The clarification of these aspects with the patient can at the same time be the starting point of psychotherapeutic treatment.
