Psychotherapie Psychosomatik Medizinische Psychologie最新文献

The study aimed to develop a questionnaire that captures the key effectiveness factors of the Communicative Movement Therapy (KomBT) method.A group of experts developed five content-related scales in an explorative and deductive manner to map specific factors of the method's effectiveness. The Inventory for Process Assessment of Treatment with Communicative Movement Therapy (IP-Kom) contains 62 items and was completed by 211 patients after a KomBT therapy session. The data was analyzed using cluster and factor analysis to check the assignment of the items to the scales. In addition, an artificial neural network was used to validate the predictive power of the item statistics for the subjective benefit of the therapy.The cluster analysis confirmed a 5-factor solution, and the subsequent factor analysis confirmed the five factors of the questionnaire: positive body experience, cohesion, inhibition, positive development and emotionality, and positive experience of closeness. The reliability of the individual factors was between α=0,73 and α=0,93, which indicates a high level of internal consistency. Factor analysis was used to reduce the number of items from 62 to 22 (IP-Com22) and to clarify the content of the statements in the scales. Whether the KomBT procedure is experienced as helpful could not be attributed to one factor alone. The assessment only correlated with the sum of all factors surveyed in the IP-Kom22.The IP-Kom22 is an economical questionnaire for the assessment of group and body psychotherapeutic factors that can be used both in routine clinical practice and in further scientific studies.

The Operationalized Psychodynamic Diagnosis (OPD) system extends the descriptive classification systems (e. g. DSM, ICD) of mental disorders and is well established in psychodynamic research and practice. With the 3rd version published in 2023, the OPD underwent a comprehensive revision, which also includes a stronger linking of the axes. Until OPD-3, the 'conflict' and 'structure' axes were considered separately, which resulted in a fragmentation of psychodynamic understanding. The OPD-3 changes this separation by now assessing conflicts at all levels of structural integration, which enables a more integrative view. In this study, the relationships between the conflicts and their coping modes were analyzed as a function of structural impairment (low vs. severely impaired). The study comprised two clinical subsamples with a total of N=3678 psychotherapy patients (N=1645 inpatients; N=2032 outpatients). Psychodynamic conflicts were assessed using the OPD conflict questionnaire (OPD-CQ), while the OPD structural questionnaire (OPD-SQS) was used to assess structural integration. The sample was divided using a median split on the OPD-SQS (Md=24). There were no group differences for the intraindividual variability measure in the OPD-KF or in the network models (network invariance test). Our results confirm the conceptual extensions of OPD-3: conflicts can be identified and differentiated also in patients with more severe structural impairments and the relationships between the conflicts remain stable regardless of the level of structural integration. These findings have relevant implications for psychodynamic diagnosis and treatment.

This study examines changes in therapeutic alliance and self-efficacy in the flexible, suicide-specific Attempted Suicide Brief Intervention Programme (ASSIP flex). It also examines the relationship between self-efficacy and suicidal ideation.The study was designed as a sub-analysis of a longitudinal observational study. The sample consists of 64 patients (51,6% women) aged 19-83 years (M=39,6, MD=35,5, SD=15,7) with suicidal behaviour who participated in ASSIP flex. The survey was conducted at two measurement points, before (t0) and after (t1) the ASSIP flex treatment, and after each of the three ASSIP flex sessions. Sociodemographic characteristics (e. g. age, gender), health-related data (e. g. therapeutic alliance, self-efficacy) and information on suicidal ideation and behaviour (e. g. intensity of suicidal thoughts, number of suicide attempts) were collected at both measurement points. The therapeutic alliance was recorded after each ASSIP flex session.Over the three therapy sessions, an increase in therapeutic alliance was observed (F(1, 63)=48,081, p<0,001). An increase in self-efficacy was observed from t0 to t1 (t(63)=-3,410, p<0,001). A positive relation between self-efficacy at t0 and the therapeutic alliance was found at both the first (β=0,433, p<0,001) and the third therapy session (β=0,293, p=0,041). Patients' suicidal ideation decreased from t0 to t1 (BSS: β=-0,220, p<0,001). Higher self-efficacy was associated with lower suicidal ideation (BSS: β=-0,315, p<0,001).The findings highlight the importance of the therapeutic alliance and self-efficacy in suicide prevention treatment. The narrative approach of ASSIP flex offers a structured way to specifically strengthen both the therapeutic alliance and self-efficacy. Follow-up studies are needed to better understand the relation between these constructs with suicidal ideation and to further develop targeted intervention strategies.

Eating disorders occur in approximately 4.3% of pregnant women, with previously affected women representing a particularly high-risk group. Pregnancy and the postpartum period are characterized by profound physical, hormonal, and psychosocial changes that can increase the risk of developing, worsening, or recurring eating disorders. Body image, coping with weight gain, and the pressure to regain one's previous body shape are particularly important risk factors in all phases, from the time of conception to the postpartum period. Eating disorders can lead to menstrual irregularities and infertility in women, with hormonal imbalances and disordered eating behavior often being causes that also increase the risk of pregnancy complications. Women with eating disorders have a higher risk of pregnancy complications such as premature births, miscarriages, anemia, and hyperemesis gravidarum, although these risks vary depending on the type of eating disorder. The stigma and shame associated with eating disorders represent significant barriers to open communication and the use of therapeutic help. Therefore, therapists should choose a sensitive and appreciative approach, avoid stigmatization, and courageously but empathetically address possible eating disorders directly to enable early support.

Obesity is a chronic disease that can be associated with a variety of physical and psychological comorbidities, such as metabolic syndrome or depression. Bariatric surgery is recommended in the S3 guideline as a treatment option from a BMI≥40 kg/m² without comorbidities or from a BMI≥35 kg/m² with at least one obesity-associated comorbidity. Bariatric surgery is an important therapeutic approach, the long-term success of which can be influenced by psychosocial factors. This longitudinal study investigates the influence of attachment style on the long-term success of surgery. The sample comprises N=30 participants with obesity (M/SD age=56.2/8.6 years, 83.3% female) who underwent bariatric sleeve gastrectomy between 2010 and 2015. Data was collected preoperatively (approx. 3 months before the operation) and postoperatively at the end of 2019/beginning of 2020. In addition to socio-demographic data, weight-related data and psychosocial stress factors were collected. The success of the operation was defined on the basis of the weight reduction achieved, the improvement in quality of life and the reduction in depression, anxiety and overall psychological stress. Postoperatively, the attachment style (categorised as secure-attached and insecure-attached) was assessed. Questionnaires were used except for the weight-related data. The attachment style is relevant for postoperative success in relation to the variables of depression and overall psychological stress. Securely attached participants showed significant improvements in these variables, while insecurely attached participants showed stagnating or slightly worsening values postoperatively. Regarding BMI, significant postoperative improvements were observed in all participants, regardless of attachment style. The results indicate that the attachment groups do not benefit equally from the operation in terms of psychosocial variables in the long term. It is therefore necessary to identify vulnerable patients preoperatively in order to ensure customised support. Individualised, attachment-oriented care appears to be particularly effective.

The present study examines the validity and clinical utility of the German version of the Inventory of Interpersonal Problems (IIP-32) for assessing interpersonal difficulties and their associations with personality functioning, attachment dimensions, and self-perception in a large clinical sample. Interpersonal problems are closely linked to mental health disorders and are often a central focus of psychotherapeutic interventions. Recent findings underscore the importance of interpersonal aspects for understanding and treating mental health disorders, particularly personality disorders, especially through a dimensional perspective as emphasized in DSM-5 and ICD-11.Using data from 7,507 patients in a psychosomatic rehabilitation clinic, we evaluated the internal consistency and construct validity of the IIP-32, as well as its correlations with key variables such as attachment avoidance, attachment anxiety, and structural deficits in personality functioning, measured with the OPD-SFK and ECR-RD12. Additionally, the circumplex structure of the IIP-32 was assessed through correlation-based analyses with the SASB.Overall interpersonal distress correlated strongly with structural deficits in personality functioning (r=0.71), attachment anxiety (r=0.45), and attachment avoidance (r=0.38). Attachment avoidance showed strong associations with hostile-withdrawing and socially avoidant behavior (r=0.50), while no relevant associations with friendly-dominant interpersonal problems were found. The IIP-32 primarily captured submissive-avoidant interpersonal patterns, which were linked to deficits in personality structure. SASB analyses confirmed the circumplex structure of the IIP-32 (R²>0.80) and its alignment with the dominance and affiliation axes. High correlations with structural deficits support the convergent validity, while differentiated associations with attachment measures and interpersonal profiles in the SASB model indicate discriminant validity.The findings demonstrate that the IIP-32 is a reliable instrument for the differentiated assessment of interpersonal problems. The combination of analyses with the OPD-SFK, ECR-RD12, and SASB provides evidence for the structural validity and clinical utility of the IIP-32, both for diagnosing interpersonal distress and identifying specific behavioral patterns that can be addressed in psychotherapy.

This article goes beyond a collection of the most important feedback rules by discussing the role and empirical foundations of feedback for learning in general, in psychotherapy training as well as the ongoing practice. In particular problems related to the gaining and interpreting of feedback are illustrated by examples.