Psychotherapie Psychosomatik Medizinische Psychologie最新文献

The negative attitude of psychotherapists towards the treatment of older patients in the past has weakened in the recent past. Nevertheless, the question remains as to how therapists perceive older patients in comparison to younger patients, what clinical judgements they arrive at and how they perceive the relationship with them. In the present study, which was conducted as part of the ÄPP study (Older Patients in Psychotherapy), therapists were asked to assess a self-selected younger (<40 years) or an older patient (>65) with regard to various variables. A total of 527 completed questionnaires were available. Two-factor analyses of variance were used to show, among other things, that younger therapists (compared to their older colleagues) rate older patients more negatively in terms of suitability for psychotherapy, the patient's ability to establish a therapeutic working relationship and other parameters. In comparison with their older colleagues, younger therapists perceive themselves as less competent in their relationships with older patients. There are only slight differences with younger patients.

Objective: From the very beginning of the COVID-19 pandemic, gender was shown to play a significant role in how people were affected by it, while aspects related to sexual and gender minorities (SGM) have been rather understudied. The aim of this review was to synthesize systematic reviews and meta-analyses that explicitly addressed the impact of gender within the context of the pandemic, with a focus on SGM.

Methods: We based the narrative synthesis of results on a literature search of PubMed. We included systematic reviews and meta-analyses as of 2019 with an identifiable gender comparison or SGM reference and a specified clinical outcome.

Results: The search yielded 2 658 hits; 29 systematic reviews were included for content synthesis. Of these, we identified 23 systematic reviews with gender comparisons and 8 related to SGM. Men showed higher prevalence, severity, and mortality of COVID-19 compared with women, but the psychological consequences of the COVID-19 pandemic affected women more compared with men. Evidence suggests that women are at higher risk for Long-COVID-19. SGM experienced increased mental health problems during the COVID-19 pandemic compared to the general population.

Discussion: It appears that biological and social risks led to differential susceptibility to infection and manifestation of COVID-19 disease and also accounted for differences in mortality between men and women. Insights on prevalence, disease burden, and mortality among SGM during the COVID-19 pandemic are lacking. This suggests an underrepresentation of SGM in COVID-19-related research. Despite the abundance of COVID-19 publications, gender effects have not often been explicitly and adequately studied.

Conclusion: Future studies should examine gender differences and needs and concerns of SGM in mental disorders and further understudied entities like Long-COVID-19, to gain insights and help to provide preventive measures and adequate treatments for all, for potential future pandemics as well.

Objective: The current study follows the question if psychotherapists with lived experiences of crisis and treatment address these experiences during their processes of self-experience. Further, the conceptual differentiation between self-experience and psychotherapy of this group of staff is explored.

Methods: 108 professionals with psychotherapeutic qualification were surveyed on their training self-experience. Relationships between processing of crisis experiences, crises frequency, and experienced benefit were analyzed using correlation analyses. Conceptual differences between self-experience and psychotherapy were gauged via nine content categories whose importance for self-experience and psychotherapy were rated by the participants. The means of these ratings were compared via t-test.

Results: Most participants reported that they had used their self-experience to process lived crisis experiences, and that they benefited from their self-experience, with processing and benefit being correlated significantly and positively. Conceptual differentiation of the two formats appeared to be complex. Participants ascribed biographical and personal categories rather to psychotherapy, and professional categories to self-experience.

Discussion: Given the prevalence of stigmatization towards individuals with mental health problems, it was surprising that most of the participants were able to address and process their lived experiences during their self-experience. It was surprising too that personal factors were ascribed to psychotherapy rather than self-experience, as the major importance of the therapeutic relationship and, by extension, personality development is well-known.

Conclusion: Training self-experience should be a stigma-free setting, where future therapists are able to address their biographical burdens freely and thereby develop their personalities.

Background: Patients with borderline personality disorder (BPD) present difficulties in self-regulation and interaction, which is a challenge for psychotherapists that is also addressed in BPD-specific interventions. Against this background, outpatient psychotherapists were surveyed about the factors playing a decisive role in their treatment offer for patients with BPD.

Methods: Psychotherapists for adults were contacted via their email address published on the website of the Kassenärztliche Vereinigung (Association of Statutory Health Insurance Physicians), 231 of whom answered an online questionnaire. The results were analysed descriptively and examined inferentially with regard to the psychotherapists' admission behaviour.

Results: Almost 90% reported that they would generally accept patients with BPD in therapy. However, of those, 85% did not have a therapy slot available. The psychotherapists' learned approach of treatment was not a decisive factor in determining whether they were willing to provide treatment. Most of the psychotherapists (85%) recommended a BPD disorder-specific therapy such as Dialectical Behavior Therapy (DBT), Mentalization-Based Treatment (MBT), Transference-Focused Psychotherapy (TFP) or Schema Therapy (ST). However, only just under 7% were certified in such a disorder-specific approach. Significant individual stress factors described by the psychotherapists were suicidal risk (70%) and potential other-directed aggression (59%). In addition, it was shown that it played a role whether the psychotherapists were trained in an additional therapy approach (with at least 16 teaching units) or not.

Conclusion: The care situation for people with BPD seeking an outpatient psychotherapy place is clearly in need of improvement. This is mainly due to a general lack of available therapy places as well as various fears and anxieties, such as increased suicidality, which in turn can have a negative impact on the provision of outpatient therapy. Psychotherapists who have undergone disorder-specific further training feel less burdened by suicidal behaviour. However, since only a small number of them are able to offer BPD-specific therapies, it is essential to expand and (financially) support specific training programmes. In order to meet the demand for care, professional changes are urgently needed.

Objective: To date the relationships between rape myths and other psychological constructs within males who have committed rape have not been explored sufficiently. Considered as a risk factor for the perpetration of rape it seems significant to examine their association to individual behavioral and personality characteristics more in detail.

Methods: Therefore, we analyzed the relations between self-reported rape myth acceptance and the self-evaluation of aggressiveness, assertiveness, hypersexuality, social anxiety, sexual anxiety, SCID personality characteristics and the external assessment of psychopathy within a sample of N=569 males convicted of rape.

Results: The results showed significant correlations with all constructs except sexual anxiety, antisocial personality and psychopathy. Furthermore, findings indicated the assignment of the relevant variables to two principal components: rape myths, aggressiveness, hypersexuality, paranoid and narcissistic personality (K1) on the one hand and psychopathy and antisocial personality (K2) on the other hand.

Discussion: Following the results, rape myths are contextualized within the investigated psychological constructs and their potential differentiation from psychopathy and antisocial personality is discussed.

Background:   With the help of statements from contemporary witnesses, it shall be deduced, if and to what extent Psychiatry was experienced as a shelter for employees and patients in the state controlled society of the GDR and which effort of adaptation to the authoritarian regime was needed to organize protected and protective spaces, here called "niches".

Method:   74 guide-based interviews from subjects including former patients and different staff groups of the East german Psychiatry were analyzed qualitatively.

Results:   Many quotations show, that Psychiatry in the GDR was experienced as a "niche" for dissenting people and could offer a certain amount of protection for patients. On the other hand, the autonomy of the psychiatric care was often violated by political intrusions regarding individual treatments. Moreover, treatment autonomy was restricted by harsh shortages in supplies.

Conclusion:   Psychiatrists in the GDR could protect their patients through their actings and so Psychiatry could establish a "niche" for patients and employees. However, establishing such protected spaces required efforts in adaptation. In reverse, Psychiatry has also been politically instrumentalised - either directly through unjustified admissions and exit restrictions or indirectly by a stigmatization of dissenters and removing them from society.

Background: Burnout and procrastination are widespread phenomena among students. The role of personality structure has been little researched so far.

Objective of the study: The relationship between personality structure and study-related work disorders in psychology and medical students is examined, taking into account resources and demands.

Methods: As part of a cross-sectional study, data was collected online from 61 German colleges and universities. Personality structure variables (levels of personality functioning, OPD-SFK; attachment, ECR-RD 12; emotion regulation, ERQ), study-related work disorders (burnout, MBI-SS-d; procrastination; APSI-d) as well as resources (social support, F-SozU K-6; scope for decision-making in studies, self-developed scale) and demands (Corona pandemic, self-developed scale) were assessed. The research question was answered by means of a hierarchical regression analysis.

Results: From February 2020 to December 2021, 775 students (49.2% psychology students, 50.8% medical students; age M=24.1 years, SD=5.1 years; 82.3% female, 17.4% male, 0.3% diverse) participated in the survey. In the overall model, 30.4% of the variance in burnout exhaustion, 16.2% of the variance in burnout cynicism, 20.9% of the variance in burnout inefficiency and 30.1% of the variance in procrastination was explained (p<0.001). Levels of personality functioning showed significant negative correlations with all burnout variables as well as with procrastination (p<0.001). The emotion regulation strategy reappraisal was associated with lower burnout inefficiency and procrastination (p<0.001), and the emotion suppression strategy with lower burnout cynicism (p≤0.01). Scope for decision-making in studies was negatively associated with all burnout variables and procrastination (p<0.001), and social support was negatively associated with burnout inefficiency (p≤0.01). The general stress level during the Corona pandemic showed a positive association with burnout exhaustion (p≤0.001).

Conclusions: Personality structure (levels of personality functioning, emotion regulation) is significantly related to study-related burnout and procrastination. Training opportunities to promote emotion regulation skills could be very helpful for vulnerable student groups in dealing with burnout and procrastination.