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Journal: Psychotherapie, Psychosomatik, medizinische Psychologie


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


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


The Sibling Perception Questionnaire (SPQ) measures the impact a cancer disease of a child has on a sibling’s interpersonal relations in the family, communication, intrapersonal perceptions and fear of the disease. Aim of this study was the psychometric evaluation of the German version of the SPQ. For this purpose, data of 216 healthy siblings including 164 self-reports and 212 parent reports were gathered. For further analyses the 4 subscales “interpersonal difficulties”, “intrapersonal difficulties”, “open communication” and “fear of the disease” with overall 23 items were evaluated. Sufficient internal consistencies in the parent report (Cronbach’s α between 0.73 and 0.87) and in the self-report version (α between 0.59 and 0.80) were found for all subscales except the subscale fear of the disease (α=0.35 and 0.16). Regarding external validity, significant correlations emerged between scales of the SPQ and scales of the Strengths and Difficulties Questionnaire (SDQ) and the Quality of Life Inventory for Children (LQ-KID) (r=- 0.37; r=0.63; p≤0.001). The German version of the SPQ can be regarded as a reliable and valid instrument for the assessment of emotional responses of healthy children on their sibling’s cancer disease. Further investigations on different samples are recommended.

Concepts: Family, Psychology, Parent, Assessment, Psychometrics, Validity, Reliability, Sibling


Aim The measurement of subjective physical health is important in clinical settings as well as for research purposes. In the present paper, the psychometric properties of the G-Score, a 4 item screening questionnaire for the self-assessment of one’s physical health, is explored. Methods The Objectivity, validity and reliability were estimated. Moreover, an item analysis and a suitable cut-off-value for the differentiation between healthy and presumably ill subjects were conducted. Data from the Saxony Longitudinal Study (“Sächsische Längsschnittstudie”) 1998-2013 were analysed (N=324-417 healthy individuals). Results The objectivity of the G-Score is estimated as very good. As a cut off for the differentiation between healthy and presumably ill subjects, a G-Score of 4 is suggested. The content validity is slightly lacking. Correlations with associated and non-associated constructs hint an interaction of physical with psychological discomfort. A good predictive validity of the instrument is assessed. Reliability estimates show acceptably good results. This indicates a high sensitivity for changes in the measured construct. Conclusion Putting all results into consideration, a use of the G-Score as a screening questionnaire in research is recommended. However, more psychometric investigations with representative samples and objective comparative data should be carried out.

Concepts: Health care, Medicine, Health, Epidemiology, Psychometrics, Validity, Reliability, Item response theory


Introduction So far, the prevalence of negative effects of psychotherapy and their correlates have rarely been investigated in a systematic manner. The prevalence of negative effects varied between 3 studies with the Inventory for Assessing Negative Effects of Psychotherapy (INEP) with 20, 84, and 93.8% substantially. Thereby, the impact of bias effects remains unclear. In addition, reported correlates of the number of negative effects were examined and augmented with further correlates. Material and Methods For the study, a clinical sample of inpatients and day-patients (N=200) evaluated their previous psychotherapy retrospectively before their current admission with the Inventory for Assessing Negative Effects of Psychotherapy (INEP). Sociodemographic and clinical data of both patients and therapists as well as time-related and methodical aspects of the evaluated psychotherapy were examined as possible correlates. Results 70.5% (n=141) of the patients reported at least one negative effect (M=2.11, SD=2.23). The most common negative effects were “longer periods of negative mood” (39.9%) and “being offended by statements of the therapist” (28%). Higher symptom severity, lower subjective success of the evaluated therapy, as well as unfulfilled expectations regarding therapy outcome but not the quality of the therapeutic relationship were associated with a higher number of negative effects. Also female gender of patient and therapist and a younger age of the therapist were significantly associated with more negative therapy effects. Conclusion The prevalence of negative effects was not negligible. In line with previous studies, the highest rates of negative effects were reported for “symptoms” and aspects of the “therapeutic relationship”. The study confirms several correlates for the number of retrospectively assessed negative effects. Patients need to be informed about negative effects prior to psychotherapeutic treatment.

Concepts: Therapy, Clinical psychology, Cognitive behavioral therapy, Psychiatry, Psychotherapy, Family therapy, Psychoanalysis, Therapeutic relationship


Background Methamphetamine is one of the most consumed illegal drugs worldwide. In Germany, Methamphetamine shows the highest rates of growth in comparison to other illegal substances in recent years. Particularly Central Germany has been struck by a high rise in consumption. International studies indicate that there is no specific group of people that can be identified as Methamphetamine users. Different consumption patterns in terms of Methamphetamine use can be identified within various social groups. This qualitative study will explore different consumer groups among methamphetamine users, their motives, and how they differ by drug addiction type. Methods The empirical data collection was carried out in a consecutive 2-stage process. Initially, 39 semi-structured individual interviews with experts from different clinical areas were carried out about their experience and perspectives on Methamphetamine use. The results of the individual interviews were subsequently discussed and validated within 2 interdisciplinary focus groups. All interviews and focus groups were digitally recorded, transcribed and analyzed according to the method of Meuser & Nagel. Results Altogether, 3 consumer groups were identified: (1) Young parents, women and pregnant women, (2) young drug users and early adapters and (3) older drug users or late entrants. The guiding motive in terms of Methamphetamine use described by the experts was improved efficiency. Further motives are for instance overcoming stressful situations, enablement and improvement of sexual experiences, self-esteem enhancement, coping with crisis or trauma, curiosity and drug use as leisure time activity. Discussion/conclusion The results in terms of consumer groups and consumption motives are consistent with international findings and we were able to verify and expand them for Central Germany. The outcomes illustrated that there are different consumer groups among methamphetamine users that differ from consumer groups of other drug addiction types. Treatment and consultation have to anticipate these challenges and adapt their strategies to different needs. Finally, further improvement of accessibility for those affected persons is an imperative to the German healthcare system.

Concepts: Focus group, Drug, Morphine, Drug addiction, Heroin, MDMA, Clandestine chemistry, Illegal drug trade


Introduction The Helping Alliance Questionnaire developed by Luborsky was psychometricly examined for the first time and translated into German by Bassler et al. in the mid-1990s. It consists of 11 Items, which are summarized to the scales “relation to the therapist” and “satisfaction with therapeutic outcome”. HAQ is now one of the most used instruments to measure therapeutic alliance. The goal of this study was to test the psychometric properties based on three large patient samples in different treatment settings. Material and methods Analyses were conducted based on 2 samples of patients in inpatient psychosomatic/psychotherapeutic rehabilitation (n=655, n=2494) and one sample in outpatient psychotherapy (n=1477). Exploratory factor analyses and for verification confirmatory factor analyses were applied. Furthermore reliability and validity analysis were conducted. Results The 2-factorial structure found in literature was replicated with an increasing stability at the end of treatment. Item 2 and 3 had inconsistent factor loadings at different points of measurement and study. Reliability and validity indices were satisfying to good. The fit of the model, on the other hand, was less satisfying and suggests a solution without Item 2 and 3. For reasons of content as well as for reasons of dissemination, it is pleaded for the maintenance of the existing item assignments in the HAQ for the present.

Concepts: Measurement, Therapy, Psychometrics, Factor analysis, Reliability, Psychotherapy, Confirmatory factor analysis, Item response theory


Subject Compared to other illicit drugs Methamphetamine (MethA) is used more frequently by women than by men. Assuming the biopsychosocial etiology model, the dependency is based on several factors in which women and men differ significantly. Systematic gender-differentiated knowledge is missing until today. Method Based on a database research (PUBMED) the review examines biological, social and psychological as well as therapeutic aspects in MethA-dependent women. Results MethA-induced cognitive disturbance appear to have severer manifestations in women than in men. MethA-addicted women’s lifestyle is often characterized by active and passive (sexualized) violence. They show an increased risk behavior; i. e. unprotected sexual intercourse with several partners. Their psychological comorbidities seem to be more pronounced and especially affect anxiety disorders and depressive syndromes. Conclusion and clinical relevance In women, abuse and dependence of MethA are determined by psychological as well as social factors. However, further research is needed to improve prevention, counseling and therapy.

Concepts: Anxiety, Psychology, Medicine, Gender, Cognition, Gender role, Heroin, Human sexuality


Background Hospital psychosomatic treatment matches care expectations of a modern society. Evidence of its effectiveness through investigation in different settings is of importance because of prominent role of psychotherapy in German Healthcare System. Objective First, to explore whether clinical as well as personal resources could improve significantly due to a hospital psychosomatic treatment. Second, to assess possible associations between outcome variables and other variables from the multidimensional profile of the sample. Method The sample consists of all 2014 - 2015 admitted patients who agree with investigation (N=283). Pre-post comparisons of results from validated questionnaires were performed by means of t-tests, including effect sizes. Associations between outcome variables (pre-post differences of clinical and resources related variables) and variables from the multidimensional profile were performed by means of bivariate and multivariate regression tests. Outcome differences were assessed by means of logistic regression models. Results Drop-out-rate due to refusal of participation amounts 11.8%; from remaining participants uncompleted datasets additional 6.9%; due to declining further participation during hospitalisation additional 4.1% (total drop-out rate amounted 22.8%). Functionality, self-efficacy, disease severity, psychological as well as physical symptom burden, depressiveness, interpersonal concerns, and embitterment improved significantly (p<0.001) displaying effect sizes between 0.39 and 1.42 (average level for clinical variables 0.98). Considerable associations between clinical and resources related variables in both directions were found. 10% of patients reported worsening. Discussion Psychosomatic hospital treatment is effective according to clinical improvement as well as to perceived quality of treatment. Clinical and resources related variables are positively bidirectional associated notwithstanding the kind of working causality. Robust prognostic factors are hard to identify. Conclusions Inpatient psychosomatic treatment is effective when the admission is indicated and the unit accomplishes mandatory quality criteria. The outcome occurs individually and is hard to be predicted. Depressiveness and embitterment could be considered as epiphenomena of all psychosomatic illnesses.

Concepts: Better, Regression analysis, Logistic regression, Clinical trial, Effect, Effectiveness, Avicenna, Efficacy


Low-intensity cognitive behavioural therapy (LI-CBT) depicts interventions that aim at increasing access to evidence-based psychological therapies. This is achieved by (1) reducing the amount of time in which the practitioner is in contact with individual patients, (2) using practitioners that have been specifically trained to deliver low intensity interventions and without any prior formal health professional qualifications and (3) use of interventions with varying intensity. Stepped care and collaborative care constitute the organizational frame to deliver low-intensity interventions. Whereas large-scale research and health service projects abroad are focussing on LI-CBT, research in German is lagging far behind. Particularly in the light of the growing demands and utilization of mental health care as well as governmental claims to develop and evaluate new forms of providing mental health services, LI-CBT represents a promising approach.

Concepts: Health care, Health care provider, Psychology, Medicine, Healthcare, Clinical psychology, Cognitive behavioral therapy, Psychotherapy