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Journal: Psychotherapie, Psychosomatik, medizinische Psychologie

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The aim was to translate the Patient-Provider Orientation Scale (PPOS) into German and to assess the degree of medical students' patient-centeredness in 2 student samples in Freiburg (GER) and in Basel (CH). The German translation of PPOS was administered to 259 medical students in Freiburg and to 137 medical students in Basel. Construct validity was tested using factor analysis. Based on factor analysis and tests of internal consistency, a shortened version with 6 items for each of the 2 subscales “sharing” and “caring” was generated (PPOS-D12). PPOS D12 is a reliable instrument to assess patient-centeredness among medical students in German-speaking countries.

Concepts: Psychometrics, Language, Reliability, Italian language, Germany, Switzerland, German language, Alsace

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Anxiety, depression and posttraumatic stress disorder are the main psychopathological symptoms shown by refugees. We conducted a systematic review. First, we identified key-words for a systematic search in PUBMED. We included original articles since 2009 with 1) a non-clinical sample of refugees, 2) refugees living at maximum 5 years in the host country, 4) with the outcomes anxiety, depression, and PTSD and 5) a sample with >100 participants. Then we read titles, abstracts and fulltexts. We identified 1 877 studies. Based on this screening procedure, we included in our review 15 studies. 52% of the refugees are from Africa (Somalia, Congo, Rwanda, Liberia, Sierra-Leon and Togo), 33% from Asia (Syria, Bhutan, Vietnam, Cambodia, Iraq) and 16% are from more than one continent. In those studies n=6 769 refugees participated in the studies. The number of participants varied from n=117 to n=1,422 (Median: n=366 refugees). Prevalence rates for PTBS varied from 5-71% (mean prevalence rate: 32%) rates for depression varied from 11-54% (mean prevalence rate: 35%). Sensitivity analyses suggest that refugees, which come from countries with intense human rights violations according to the Political Terror Scale, have an increased rate of psychopathological symptoms. Heterogeneity of prevalence rate is related both 1) to methodological and 2) to difference in the refugee populations according to the human rights violations in the countries of origin of refugees. It is necessary to include further databases in a systematic review. There is an urgent need for representative studies on refugees needs for psychosocial and medical care, especially for those refugees coming from countries with intense human rights violations. Psychosocial and medical services for these refugees are urgently needed to enhance and enable a perspective in the host country Germany.

Concepts: Human rights, Selective serotonin reuptake inhibitor, Abnormal psychology, Posttraumatic stress disorder, Prevalence, United Nations, Vietnam War

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The New Sexual Satisfaction Scale (NSSS) is an internationally established questionnaire for assessing sexual satisfaction. It is based on 2 subscales (ego-centered and partner- and sexual activity-centered sexual satisfaction). The aim of the study was to evaluate the German short version of the questionnaire (NSSS-SD) in a representative sample (N=2524). In addition, relationships between sexual satisfaction and sociodemographic factors (age, sex, education) and characteristics of partnership and sexuality (relationship satisfaction, coitus frequency, number of sexual partners) were examined. The internal consistency of the NSSS-SD was excellent (Cronbach’s Alpha = 0.96). The 2-dimensional structure of the long version could not be confirmed for the short version. One factor could be extracted, which explains 68.94% of the variance. An analysis of variance (ANOVA) revealed statistically significant differences in sexual satisfaction with respect to age, education, relationship satisfaction and coitus frequency. Sex and number of sexual partners did not influence sexual satisfaction. The NSSS-SD is a reliable questionnaire of sexual satisfaction for sexually active individuals. For sexually inactive individuals, a change of the instruction or a visual analogue scale might be useful.

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The orthopedic medical history of the now 56-year-old Mr. Z began immediately after his birth with an inpatient clubfoot therapy. With the onset of adolescence, multilocular pain began. The long-standing patient career was characterized by disappointment about the early onset and recurrent need for treatment. The disappointment motive is closely related to the relationship between the patient and his mother. The biography illustrates the intertwining of early (orthopedic) treatment, primary bonding and disease experiences. A multimodal pain therapy was able to target Mr. Z, create positive body experiences and finally reduce the pain.

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Coping with psychological trauma plays a central role in victims of acts of violence. The Victim Reparation Law (in German: Opferentschädigungsgesetz, OEG) provides services for the reparation of participation. To further improve the care of the affected persons, the characteristics of the victims were determined in relation to the acts and the perpetrators.

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Research on neurobiological effects of psychotherapy in depression facilitates the improvement of treatment strategies. The cortico-limbic dysregulation model serves as a framework for numerous studies on neurobiological changes in depression. In this model, depression is described as hypoactivation of dorsal cortical brain regions in conjunction with hyperactivation of ventral paralimbic regions. This assumption has been supported by various studies of structural and functional brain abnormalities in depression. However, also regions not included in the original cortico-limbic dysregulation model, such as the dorsomedial prefrontal cortex, seem to play an important role in depression. Functional connectivity studies of depression have revealed an enhanced connectivity within the so-called default mode network which is involved in self-referential thinking. Studies also point to a normalization of limbic and cortical brain activity, especially in the anterior cingulate cortex, during psychotherapy. Some neurobiological markers like the activity of the anterior cingulate cortex, striatum and insula as well as hippocampal volume have been proposed to predict treatment response on a group-level. The activity of the anterior insula appears to be a candidate bio-marker for differential indication for psychotherapy or pharmacotherapy. The cortico-limbic dysregulation model and following research have inspired new forms of treatment for depression like deep brain stimulation of the subgenual anterior cingulate cortex, repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex, neurofeedback and attention training.

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This article reports about a new treatment setting, the Psychotherapeutic Evening Clinic at the University Hospital Heidelberg. The treatment intensity is ranked between intensive, full-day inpatient and day-clinic programs in hospitals and less frequent outpatient psychotherapy according to the Germany Psychotherapy Guideline. Patients attend the Evening Clinic on 3 evenings per week for 3 hours each. During this time, they receive group therapy, individual therapy, mindfulness exercises and psychotherapeutic ward rounds. The first experiences with the new setting are positive, a specific advantage is the possibility to include daily hassles and everyday stressors as well as patients' strengths and resources into the treatment. Therapeutic challenges are the potential of overburdening patients with an already high impairment. On the structural and political level it will be important to ensure funding for the new treatment setting.

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Demographic change leads to shifting demands in patient care, not only due to older and sicker patients, but also due to ageing and potentially strained nursing staff. High job strain is known to be associated with an intention to leave the job. At the same time prevalence of mental distress is already high. The aim of our work was to develop a small group intervention to prevent mental strain and to enhance healthy ageing at work.

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There is a lack of studies investigating the effectiveness of inpatient trauma-focused psychotherapy of complex post-traumatic stress disorder. The first aim of this retrospective investigation was to analyze the course of PTSD. Second, possible predictors of treatment response were investigated.

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Psychotherapy in children and adolescents is effective, but unwanted effects can occur. Until now, psychotherapy research has neglected this important topic, although children and youths are in need of special protection. Unwanted effects caused by therapy are not systematically investigated and a corresponding conceptualization is missing. The aim of this article is to investigate whether the current classifications of unwanted effects of psychotherapy in adults are applicable to children and adolescents and to identify distinctive features. Furthermore, the adaptation of the Inventory for the Assessment of Negative Effects of Psychotherapy for children and adolescents (Children-INEP) is presented. Finally, steps for the information and prevention of unwanted, and negative effects of psychotherapy in children and adolescents are pointed out.