1,721,328 research outputs found
Psychodynamic psychotherapy for social phobia: A treatment manual based on supportive-expressive therapy
No full textSocial phobia is a very frequent mental disorder characterized by an early onset, a chronic unremitting course, severe psychosocial impairments and high socioeconomic costs. To date, no manual for the psychodynamic treatment of social phobia exists. After a brief description of the disorder, a manual for a short-term psychodynamic treatment of social phobia is presented. The treatment is based on Luborsky's supportive-expressive (SE) therapy, which is complemented by treatment elements specific to social phobia. The treatment includes the characteristic elements of SE therapy, that is, setting goals, focus on the Core Conflictual Relationship Theme (CCRT) associated with the patient's symptoms, interpretive interventions to enhance insight into the CCRT, and supportive interventions, in particular fostering a helping alliance. In order to tailor the treatment more specifically to social phobia., treatment elements have been added, for example informing the patient about the disorder and the treatment, a specific focus on shame and on unrealistic demands, and encouraging the patient to confront anxiety-producing situations. More directive interventions are included as well, such as specific Prescriptions to stop Persisting self-devaluations. The treatment manual is presently being used in a large-scale randomized controlled multicenter study comparing short-term psychodynamic psychotherapy and cognitive-behavioral therapy in the treatment of social phobia
WIFA-k: Ein neues Messinstrument zur zeitökonomischen Erfassung allgemeiner Wirkfaktoren nach Grawe
No full textResearch on common and differential factors in the therapeutic process is impeded by the lack of instruments suitable for assessing common change mechanisms. This study presents the psychometric properties of a newly developed time-economic instrument (WIFA-k), which was designed to assess common factors of psychotherapy as designed by Grawe. Within a multi-center study comparing the efficacy of cognitive therapy and psychodynamic therapy in the treatment of social phobia, 6 raters assessed 25 randomly selected, videotaped therapy sessions of each treatment approach, and evaluated common factors using the Wifa-k. Interrater-reliability was found to be high for the items "resource activation", "motivational clarification" and "mastery" and low for the items "therapeutic relationship" and "problem activation". Ways to increase reliability and validity of the scale are discussed
The German guidelines for the treatment of anxiety disorders
No full textA consensus group consisting of 36 experts representing 20 leading German specialist societies and patient self-help organizations developed evidence-based recommendations for the treatment of anxiety disorders in Germany. These were based on a systematic review of randomized controlled trials on anxiety disorders (n = 403) and on preexisting German and international guidelines. According to the consensus committee, anxiety disorders should be treated with psychotherapy or pharmacological drugs or a combination of both. Cognitive behavioral therapy (CBT) was regarded as the psychological treatment with the highest level of evidence. Psychodynamic therapy (PDT) was recommended for cases in which CBT was not effective or not available or in which PDT was the informed patient's preferred option. First-line drugs for anxiety disorders include selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors. After remission, medications should be continued for 6-12 months. When either drug or psychotherapy was not effective, treatment should be switched to the other approach or to a combination of both. For patients non-responsive to standard treatments, alternative strategies are suggested. When developing a treatment plan, efficacy, side effects, costs and the preference of the patient should be considered. A large amount of data available from randomized controlled trials permit the formulation of robust evidence-based recommendations for the treatment of anxiety disorders. The recommendations were not only developed for the special situation in Germany, but may also be helpful for developing treatment plans in other countries.Lilly; Lundbeck; Otsuka; Pfizer; Servier; Boehringer-Ingelhei
Personality and video gaming: Comparing regular garners, non-gamers, and gaming addicts and differentiating between game genres
No full textThis study deals with personality characteristics of gaming addicts, regular garners, and non-garners while differentiating between the garners' favorite game genres. In order to point out personality differences, we conducted an online survey assessing the Big Five in a total of 2891 participants. Additionally, the garners were screened with a diagnostic inventory for video game addiction and categorized according to their favorite game genre. We replicated findings in which gaming addicts were described as embodying challenging personality traits such as high neuroticism, and we observed similar results for non-garners. For regular garners, we primarily found low neuroticism, which underlines the innocuous nature of video game playing in itself. With respect to the players' favorite game genres, we found a wide variety of personality traits. For example, participants who preferred action games had high extraversion and low neuroticism. With respect to the differences pointed out above, future personality-based studies on garners should include non-garners and differentiate between the players' favorite game genres. (C) 2015 Published by Elsevier Ltd
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Potenzielle Risikofaktoren der Erwerbstätigkeit für die mentale Gesundheit von Ansässigen in den neuen und alten Bundesländern Deutschlands
Full text linkPsychological demands on the job have been on the rise in the last decades (Rigó et al., 2021). It is therefore important to assess which demands distress employees and which resources buffer such detrimental effects. Since labor structures as well as (oftentimes economic) resources differ between the former states of East and West Germany, disparities in the process of work stress could be assumed, as well.
To this end, a theoretical model was built to explain the mechanisms of how job demands, job-related environmental as well as individual resources, and personality affect the evaluative appraisal of stressors. Stressors are then perceived as either overburdening (distress) or positively challenging (eustress) with the first fostering adverse health. All of these components are afflicted on a higher level by the region individuals live in: former Eastern or Western German states. Using this, the question should be answered how associations and effects regarding job demands and other occupational characteristics as well as employee health differ between the former Eastern and Western states of Germany. Region-specific working conditions as well as health and well-being should thereby be emphasized.
The first article used cross-sectional data from a representative survey from 2014 (N = 1,065). For the specification of emotional exhaustion as outcome variable, the Copenhagen Burnout Inventory (Kristensen et al., 2005) was used. Technostress was indicated by several items regarding strain because of Internet use at the job, the number of received e-mails during work or leisure time, as well as the perceived social pressure to be constantly available. With that and the inclusion of sociodemographic variables, environmental job demands and personality could be observed in their association with mental health. Results were compared between citizens of the former Eastern and Western states of Germany. An ordinary least squares regression was performed to predict emotional exhaustion. Additionally, region in East or West Germany was added as a variable in the next step to observe regional differences of the predictors. In the second article, 3,848 respondents at two time points (2006 and 2011) of the German Socio-Economic Panel were observed. Life satisfaction as a component of subjective well-being (Diener et al., 1999; Fergusson et al., 2015) served as dependent variable. Siegrist’s (1996) effort-reward imbalance at work model indicated participants’ working conditions. Overcommitment and personal net income served as additional crucial predictors. Besides sociodemographic variables, job-related environmental and individual resources as well as personality could be assessed in their associations with well-being. A within-between model was estimated to include both fixed and random effects separately. Additional interaction terms between region in East or West Germany and ERI, overcommitment, as well as personal income gave insights into further regional differences.
Two studies confirmed the hypothesized mechanisms of the theoretical model, portraying how East and West Germans diverged in job-related demands while exhibiting different levels of resources. Region as macro level impacts the process of job-related stress genesis. While the first article highlighted that the prevalence of observed job demands indicated by technostress was inconsistently distributed between East and West, West Germans exhibited higher levels of emotional exhaustion. This might be a consequence of the finding that West Germans’ exhaustion levels showed a stronger association with technostress indicators compared to East Germans. It also signals that East and West Germans appraise stressors differently since the components leading to this appraisal diverge, as well. The second article presented the findings that East Germans received fewer rewards within their work domain, resulting in higher imbalances between such rewards and their accomplished efforts compared to West Germans. Further, East Germans turned out to be more overcommitted to their work, indicating an unhealthy number of sacrifices to their jobs. East Germans thus receive fewer environmental resources and exhibit more detrimental individual resources through overcommitment. This could partially explain the lower life satisfaction in East Germany compared to West Germany. Moreover, compared to West Germans, East Germans’ life satisfaction could be more strongly improved by increasing personal incomes. Again, this indicates a differing appraisal of stressors between regions. With an increased environmental resource via personal income, East Germans were less afflicted by job demands. This underlines that job-related rewards (especially in the form of personal income) should be increased to improve East Germans’ working conditions, thereby enhancing social and health-related equity between the former states of East and West Germany. In general, the observed job demands as well as low individual or environmental resources and their disparate exchange were associated with adverse health symptoms and lower well-being. Therefore, the importance of both environmental and individual resources for employee health was confirmed. Regional disparities and peculiarities regarding work structures and job characteristics should be further highlighted in future research on occupational health.Psychologische Anforderungen im Job sind in den letzten Jahrzehnten gestiegen (Rigó et al., 2021). Darum ist es von großer Bedeutung zu erfassen, welche Anforderungen Disstress unter Erwerbstätigen fördern und welche Ressourcen diese Assoziationen abschwächen. Da sich Arbeitsstrukturen sowie (häufig ökonomische) Ressourcen zwischen den ehemaligen ost- und westdeutschen Bundesländern unterscheiden, können ebenso regionale Unterschiede hinsichtlich des Prozesses der Stressgenese vermutet werden.
Zu diesem Zweck wurde in dieser Dissertation ein theoretisches Modell gebildet, das die Mechanismen der Auswirkungen von jobspezifischen Anforderungen, umweltbezogenen sowie individuellen Ressourcen und Personenmerkmalen auf den evaluativen Bewertungsprozess von Stressoren als überwältigend (Disstress) oder positiv fordernd (Eustress) erklärt. Disstress stellt einen gesundheitlichen Risikofaktor dar. All diese Komponenten sind auf einer höheren (Makro-)Ebene davon betroffen, die sich durch den Wohnort in ehemaligen ost- oder westdeutschen Bundesländern ergibt. Auf diesem Modell aufbauend kann die Frage beantwortet werden, wie sich die Assoziationen und Effekte hinsichtlich jobspezifischer Anforderungen und anderer jobspezifischer Attribute sowie Arbeitsgesundheit zwischen den neuen und alten Bundesländern Deutschlands unterscheiden. Regionenspezifische Arbeitsbedingungen und Gesundheit wurden hierbei betont.
Der erste Artikel dieser Dissertation nutzte querschnittliche Daten einer repräsentativen Bevölkerungsumfrage aus 2014 (N = 1.065). Für die Spezifikation der abhängigen Variable emotionaler Erschöpfung wurde das Copenhagen Burnout Inventory (Kristensen et al., 2005) genutzt. Disstress durch digitale Medien gilt als Technostress. Dieser wurde durch mehrere einzelne Variablen indiziert: Belastung durch die Internetnutzung am Arbeitsplatz, die Anzahl an eingehenden E-Mails während Arbeits- und Freizeit sowie den wahrgenommenen sozialen Druck ständig erreichbar sein zu müssen. Mit diesen sowie weiteren soziodemographischen Variablen wurden umweltbezogene, jobspezifische Anforderungen sowie Personenmerkmale in ihren Assoziationen mit mentaler Gesundheit beobachtet. Die Ergebnisse wurden zwischen Personen wohnhaft in neuen oder alten Bundesländern verglichen. Die Kleinstquadratemethode (OLS-Regression) wurde genutzt, um emotionale Erschöpfung vorherzusagen. Zusätzlich wurden in einem weiteren Schritt Interaktionsterme zwischen den unabhängigen Variablen und dem Wohnort in Ost oder West hinzugefügt, um regionale Unterschiede zu erfassen. Im zweiten Artikel dieser Dissertation wurden 3.848 Befragte zu zwei Zeitpunkten (2006 und 2011) des Sozioökonomischen Panels beobachtet. Als abhängige Variable diente die allgemeine Lebenszufriedenheit, welche eine Komponente des subjektiven Wohlbefindens bildet (Diener et al., 1999; Fergusson et al., 2015). Siegrists (1996) Maß der beruflichen Gratifikation stellte einen Indikator für Arbeitsbedingungen dar. Zu hohe persönliche Anstrengungen (‘Overcommitment’) sowie das persönliche Nettoeinkommen waren weitere zentrale Prädiktoren. Durch diese und die weitere Integration soziodemographischer Variablen konnten jobspezifische umweltbezogene sowie individuelle Ressourcen und Personenmerkmale berücksichtigt werden, um Wohlbefinden vorherzusagen. Ein Within-Between-Modell wurde eingesetzt, um sowohl Fixed als auch Random Effects zu messen. Somit konnten Unterschiede zwischen den Befragten sowie Veränderungen zwischen den Befragungswellen berücksichtigt werden. Zusätzliche Interaktionsterme zwischen dem Wohnort in den neuen oder alten Bundesländern und der beruflichen Gratifikation, Overcommitment und dem Einkommen gaben einen Einblick in regionale Differenzen.
Die zwei Studien bestätigten die vermuteten Mechanismen des theoretischen Modells, indem sie zeigten, dass die neuen und alten Bundesländer sich hinsichtlich der jobspezifischen Anforderungen und Ressourcen unterschieden. Die Makroebene des Wohnorts bedingt den Prozess der arbeitsbezogenen Stressgenese. Während der erste Artikel betonte, dass die Prävalenz von jobspezifischen Anforderungen, welche durch Technostress indiziert wurden, in variierenden Richtungen zwischen den beiden Regionen differierte, wiesen Westdeutsche höhere Ausmaße emotionaler Erschöpfung auf. Dies könnte aus der stärkeren Assoziation zwischen Technostress-Indikatoren und Erschöpfung in Westdeutschland resultieren. Es signalisiert zudem, dass Ost- und Westdeutsche Stressoren auf unterschiedliche Weise bewerten, da sich die Komponenten, die diese Bewertung bedingen, ebenso unterscheiden. Der zweite Artikel konnte zeigen, dass Ostdeutsche im Vergleich zu Westdeutschen weniger Belohnungen für ihre geleistete Arbeit erhielten, was zu stärkeren Ungleichgewichten zwischen Arbeit und Belohnung im Osten führte. Außerdem verfügten Ostdeutsche über ein größeres Ausmaß an Overcommitment, was darauf hindeutet, dass sie eher auf ungesunde Weise Einsatz für ihren Job erbringen. Somit erhielten Ostdeutsche weniger umweltspezifische Ressourcen und verfügten über mehr schädliche individuelle Ressourcen in Form von Overcommitment. Diese Befunde konnten teilweise erklären, wieso Ostdeutsche weniger zufrieden mit ihrem Leben waren als Westdeutsche. Weiterhin profitierte die Lebenszufriedenheit von Ostdeutschen mehr von einem steigenden Einkommen als die von Westdeutschen. Dies betonte wiederum die unterschiedlichen Bewertungsprozesse von Stressoren zwischen Ost- und Westdeutschen. Durch eine höhere umweltspezifische Ressource durch persönliches Einkommen wurden Ostdeutsche weniger durch Arbeitsbedingungen beeinflusst. Hierdurch konnte die Bedeutung jobspezifischer Belohnungen (insbesondere durch finanzielle Gratifikation) für die Verbesserung ostdeutscher Arbeitsbedingungen unterstrichen werden, um die soziale und gesundheitsbezogene Chancengleichheit zwischen den neuen und den alten Bundesländern weiter anzugleichen. Im Allgemeinen konnte gezeigt werden, dass die beobachteten jobspezifischen Anstrengungen, die niedrigen individuellen sowie umweltspezifischen Ressourcen und deren Ungleichgewicht die Gesundheit sowie das Wohlbefinden von Erwerbstätigen beeinträchtigen. Dadurch wurde die Bedeutung von umweltbezogenen und individuellen Ressourcen für die Arbeitsgesundheit bestätigt. Regionale Differenzen und Eigenheiten hinsichtlich Arbeitsstrukturen und jobspezifischer Charakteristika wurden zudem herausgestellt und sollten in künftiger Forschung weiter untersucht werden.IV, 91 Seiten ; Diagramm
The Diagnosis of and Treatment Recommendations for Anxiety Disorders
No full textBackground: Anxiety disorders (panic disorder/agoraphobia, generalized anxiety disorder, social phobia, and specific phobias) are the most common mental illnesses. For example, the 12-month prevalence of panic disorder/agoraphobia is 6%. Methods: This guideline is based on controlled trials of psychotherapy and pharmacotherapy, retrieved by a systematic search for original articles that were published up to 1 July 2013. Experts from 20 specialty societies and other organizations evaluated the evidence for each treatment option from all available randomized clinical trials and from a synthesis of the recommendations of already existing international and German guidelines. Results: 403 randomized controlled trials were evaluated. It was concluded that anxiety disorders should be treated with psychotherapy, psychopharmacological drugs, or both. Response rates to initial treatment vary from 45% to 65%. Cognitive behavioral therapy is supported by higher-level evidence than any other psychotherapeutic technique. Psychodynamic therapy is recommended as a second-line treatment. Among anxiolytic drugs, the agents of first choice are selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. The patient's preference should be considered in the choice of treatment. Drug treatment should be continued for 6 to 12 months after remission. If psychotherapy or drug treatment is not adequately effective, then the treatment should be switched to the other form, or to a combination of both. Conclusion: The large amount of data now available from randomized controlled trials permits the formulation of robust evidence-based recommendations for the treatment of anxiety disorders. Future work should more closely address the necessary duration of psychotherapy and the efficacy of combined psychotherapy and drug treatment.Lilly; Lundbeck; Otsuka; Pfizer; Servier; Boehringer-Ingelhei
Typical symptom change patterns and their predictors in patients with social anxiety disorder: A latent class analysis
No full textMental comorbidities of alcohol-related disorders
No full textAlcohol-related disorders have a high comorbidity with mental disorders and vice versa, alcohol consumption plays an important role in affective disorders and schizophrenic psychoses. In developing the current S3 guidelines evidence-based knowledge on the rate and significance of comorbid disorders in alcohol use disorders has been compiled to generate recommendations for treatment. In preparation for the guidelines, previous international guidelines and a systematic literature search were taken into consideration. Recommendations for various and specific clinical situations were derived from these sources based on evidence grading. Evidence and recommendations were subdivided into psychotherapy, pharmacotherapy and combination therapy, each having differential efficacies in the treatment of psychiatric symptoms and alcohol consumption behavior. Furthermore, a separate treatment pathway was developed for a stepwise approach to affective disorders for both comorbidities. Appearing for the first time in guidelines are specific treatment recommendations for comorbid mental diseases in alcohol use disorders. These recommendations extend to different treatment approaches including diagnostics and settings, affording clinicians more pragmatic relevance
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