Psychotherapie Psychosomatik Medizinische Psychologie最新文献

Recognizing and adequately dealing with problems in the therapeutic relationship are considered key competencies of psychotherapists. Therefore, a concept for the inclusion of an external observation procedure for the assessment and classification of alliance ruptures in the new German licensing program was tested.In a 7-hour seminar, students were able to learn how to use the Rupture Resolution Rating System (3RS) and central repair strategies for alliance ruptures. A questionnaire regarding possible positive effects of the 3RS and a seminar evaluation form were applied. In addition, video ratings were carried out with the 3RS on the basis of a role-playing exercise in order to record changes in the students' abilities to deal with alliance ruptures.N=35 students took part in the 3RS seminar. The use of the 3RS was considered helpful by students to better recognize problems in the therapeutic alliance (74% agreement) and to be able to deal with them adequately in the future (91% agreement). n=8 students took part in the role-play exercise, of which 3 (37.5%) achieved an improvement in the effectiveness of their repair strategies. The other participants showed no change (n=2, 25%) or a decrease in the effectiveness of repair (n=3, 37.5%).Beyond the research context, applying the 3RS can be useful for teaching central aspects of therapeutic alliance in therapist training. In addition, it offers the potential to demonstrate individual change, although a more standardized basis of assessment is required.

Following a SARS-CoV-2 infection, around 10% of patients develop post-COVID symptoms, with fatigue being one of the most common symptoms. This leads to a considerable reduction in quality of life and a high level of absenteeism from work. In the chronification of pain, dysfunctional patterns in the sense of the avoidance/endurance concept are relevant and clinical experience with PCS patients shows that these could also play a role here.The explorative observational study tests the assumption that maladaptive fear-avoidance reactions or endurance reactions have a significant influence on the maintenance of post-COVID fatigue symptoms.In N=97 patients with post-COVID fatigue symptoms from a rehabilitation facility, fatigue (FSMC), avoidance-endurance behaviour (AEQ) and psychological and work-related variables were recorded using self-report questionnaires, and a 6-minute walking test was also carried out.The following distribution pattern emerged: 2/3 distress perseveration, 1/3 avoidance and no adequate copers. The anxiety-avoidance response pattern was able to explain significant variance in the expression of fatigue (F (3, 88)=17,072, p<0,001; R²=0,368). The avoidance of physical activity is associated with an increased number of sick days.The results support the assumption that maladaptive response patterns contribute to the chronification of post-COVID symptoms. In view of this chronified sample, this speaks in favour of the importance of these constructs. Screening could be used to filter these out in advance and implement more targeted, individually tailored therapies.

Lipedema is a chronical progressive disease mostly found in women, characterized by an unproportional increase of fat in the limbs and pain. So far mental perspectives are not acceptably resolved. This study examines patients' aspects in health-related quality of life.733 women with lipedema were asked to answer the questionnaires SF-36, Mini-SCL, EFK, DKB-35 and RSES which were compared with normative data. Additional questions for continuative analysis were appended.Depending on the comparison sample, statistical calculation showed significant differences of means in all collected aspects of health-related quality of life. Affected people reported consistently more impairment. Investigations in coping showed that 'depressive processing' is used most frequently. Furthermore, there were significant saliences in SF-36 scales regarding to the stadium and the use of conservative therapies. Analyses of answers to additional questions showed that most patients feel insufficient understood by fellow men. Also, nearly the half feels inadequately informed about the disease.The outcome exposes clear restrictions in quality of life in patients with lipedema. Previous publications can be confirmed and supplemented. However, the study design of an open online survey makes distortions (e. g. selection of highly informed patients) within the sample possible.The resulting need of psychological interventions is obvious. In addition, enlightenment and sensitization in science and public are important to reduce stigmatization, to relieve patients' everyday life and increase the quality of life.

Teachers are confronted with a multitude of complex demands, which are further intensified by the challenges currently facing educational policy, such as the shortage of teaching staff. Teachers represent a high-risk group for stress and the development of stress-related disorders, which are often caused by a tendency to over-indulge in the short term, combined with a high sense of responsibility and duty. Chronic stress levels not only affect the well-being of teachers, but also their relationship with their pupils and the general learning climate. The job demand-control model, for instance, can help to gain a better understanding of the development of stress and stress-related illnesses in the teaching profession. Furthermore, analysing specific stressors, such as high work intensity, lack of control and difficult interactions with parents and colleagues, is crucial in order to develop effective preventative measures. It is therefore necessary to implement resilience-promoting strategies and support systems in order to sustainably improve the well-being of teachers and thus maintain and increase the attractiveness of the teaching profession. This article provides an overview of the psychosocial health of teachers and discusses prevention and intervention approaches.

Background: Patients facing the diagnosis of cancer are confronted with high stress levels, which increase the risk of developing a mental disorder. Being in a relationship moderates patients' mental health and can have a risk-reducing effect. We aim to describe the influence of partnership status on the 4-week-prevalence of mental disorders in cancer patients and how it varies by gender.

Methods: As part of the secondary data analysis of a multicenter cross-sectional study, 1857 patients with cancer (51,6% women, age 18-75 years, Ø age 57 years, 79,7% in a partnership) were assessed using a written questionnaire and, for the diagnosis of psychological disorders (4-week prevalence), the CIDI-O interview. Frequency calculations and binary logistic analyses were carried out.

Results: In the univariate analyses, the frequency of the presence of at least one mental disorder is significantly lower in patients who are in a relationship (25,4% vs. 35,3%, p<0,001). They are also less likely to simultaneously suffer from multiple mental disorders. These differences are also evident for individual classes of disorders. The multivariate gender-differentiated analysis confirms this trend. In addition to age and income as significant predictors, only men experience a significant protective effect of their relationship against the occurrence of a mental disorder (OR=2,5, p<0,001).

Discussion: There has been very limited research on the links between partnership status, gender, and mental disorders in cancer patients. The results found in our analyses should be further explored, particularly regarding the protective role of partnership against developing mental disorders.

Conclusion: In the context of psycho-oncological care the status of living alone should be considered as a possible risk factor for developing mental disorders, especially in men.

Long COVID describes long-term health sequelae after a SARS-CoV-2 infection. Despite various theoretical approaches, the pathogenesis of long COVID is not yet fully understood and the diagnostic criteria are vague. This makes the development of targeted, cause-specific therapies challenging. In addition to the symptoms, many patients suffer from various psychosocial burdens and a significantly reduced quality of life. In order to address this, psychosomatic or psychotherapeutic interventions should be used in addition to symptom-oriented treatment. Within the PsyLoCo project, a psychotherapeutic treatment manual was developed that is tailored to the specific needs of long COVID patients. In four modules, it addresses (1) coping and distress management, (2) physical complaints and pain, (3) chronic fatigue and affective symptoms and (4) social and working life. The manual was tested for feasibility and effectiveness in a multicentre, randomized controlled pilot study. The contents of this treatment manual are presented below.

The evidence on the association between lifetime traumatic events (LTE) and the occurrence of cognitive changes and dementia is heterogeneous and often based on studies in high-risk populations. Using data from a German population-based study, this study examines whether there is a connection between LTE and experiences of abuse (CA) and neglect (CN) in childhood with mild Neurocognitive Disorder (miNCD) in old age.889 participants were included in the analysis. The trauma list of the PTSD module of the Structured Clinical Interview for DSM-IV (SKID-I) and the Childhood Trauma Screener (CTS) were used to record LTE. miNCD was diagnosed using a neurocognitive test battery according to DSM-5 criteria. Binary logistic regression analyses were used to examine the extent to which the presence LTE is related to the presence of miNCD.In the sample 31.0% reported at least one LTE, 30.3% reported CN and 13.2% reported CA. 19.1% met the criteria for miNCD. Four models were tested, including age, gender and educational level as possible confounding variables. Model 1 examined whether LTE (yes/no) was associated with miNCD in old age. Model 2 tested whether the number of LTE was related to miNCD. Model 3 tested whether CN was related to miNCD, and model 4 tested whether CA was related to miNCD. None of the models showed a significant effect of the investigated variables on the occurrence of miNCD.International studies show indications of a correlation between TLE, CN, CA and miNCD, but there is a lack of corresponding studies in Germany. Despite methodological strengths (standardized recording of all variables, population-based study), our analysis found no correlations. Maybe study requirements led to a positive selection of healthy older people. Nevertheless, LTE, CA and CN were not underrepresented. The results contradict those in high-risk populations, but are consistent with more recent population-based studies that find no associations.In the wider population, the investigated link does not appear to be as clearly demonstrable as in populations with high traumatic burden, such as veterans, which seems reassuring news given that LTE are risk factors for numerous comorbidities that could then play a role in the development of the cognitive changes.

The psychotherapy guidelines of the Federal Joint Committee (GBA) are oriented towards the model of distinct psychotherapeutic approaches. The consequences of these guidelines for therapeutic practice and training have been controversially discussed for some time. The present study investigated the attitude of licensed psychotherapists in Germany towards distinct psychotherapeutic approaches.Data were collected using an online survey of n=507 licensed psychotherapists. The participants were asked about their therapeutic orientation, the use of techniques compliant or non-compliant with their own approach, and their opinion on therapeutic approaches in practice and clinical training.The majority of therapists described their orientation as integrative, with assimilative integration being the most common. Techniques that are non-compliant with the therapist's own approach were considered relevant for everyday practice. The majority of respondents were able to identify well with their own approach and described that having distinct therapeutic approaches was helpful for everyday practice. The majority of behavioral therapists were in favor of transtheoretical clinical training, whereas the majority of psychoanalytic therapists rejected it.According to GBA, a combination of different psychotherapeutic approaches is prohibited, but this contradicts the current practice. Although the model of distinct therapeutic approaches offers an important frame of reference for practitioners, it can also be perceived as restrictive if it is interpreted too rigidly.The perspective of practitioners should be given greater weight in the scientific discourse on psychotherapeutic approaches.