Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie最新文献

Indication Criteria in Psychoanalytically Based Psychotherapies Part 2: Grounded Theory Model and Clinical Application of Indication Criteria Objectives: This part of the study aims to construct a grounded theory model for determining indication criteria within psychoanalytic therapy modalities and to explore its clinical implications and practical application.

Methods: Building on the insights gleaned from Part 1, a grounded theory methodology was employed to formulate a model for indication criteria. This model underwent validation for its clinical relevance through the examination of case examples.

Results: The resultant model illuminates the intricate decision-making processes inherent in psychoanalytic practice and underscores the importance of patient characteristics, contextual factors, and relational dynamics in shaping indication criteria.

Conclusions: The clinical ramifications of the developed model are deliberated, and guidance is provided for therapists regarding its implementation in clinical settings. This study contributes to further integrating research and practice in psychoanalytically based therapies.

Indication Criteria in Psychoanalytically Based Psychotherapies Part 1: A Qualitative Analysis Objectives: This study aims to investigate how psychoanalytic practitioners make decisions about when to indicate different forms of therapy and which various factors influence these therapeutic decisions.

Methods: Qualitative interviews were conducted with 14 experienced psychoanalytic psychotherapists, and the data were analyzed using a constructivist grounded theory approach.

Results: Patient characteristics, treatment context, and relationship dynamics were identified as key components. The results emphasize the complexity of these decisions and indicate that therapists should adopt a holistic view of their patients' psychological processes.

Conclusions: A central focus is on the interactive nature of decision-making, highlighting the subjectivity of indication and the importance of the therapeutic alliance. The study provides practical insights for therapists and paves the way for future research in psychoanalytic practice.

Standardisation of the short version of the OPD Conflict Questionnaire (OPD-KF36) based on a clinical and representative sample Background: The short form of the Operationalized Psychodynamic Diagnosis - Conflict Questionnaire (OPD-KF36) allows the assessment of unconscious conflict themes and represents a valuable instrument for psychodynamic indication and treatment planning. Yet, representative norm values and clinically meaningful cut-off scores necessary for a more comprehensive clinical use have been lacking. The present study aims to address these limitations.

Methods: Based on a representative community sample (N = 2189) and a clinical sample (N = 4767), the study (1) examined differences in conflict patterns and their associations with various symptom dimensions, (2) established age- and gender-specific norms, and (3) determined cut-off scores for individual diagnostics and treatment planning. These cut-offs indicate thresholds above/below which the risk of clinically relevant symptom severity is substantially increased.

Results: Robust differences in conflict patterns were observed between the community and clinical samples. In line with theoretical assumptions, deviations from normative conflict profiles were associated with more pronounced psychological symptoms. Using nonparametric continuous norming, age- and gender-specific norms were developed for all conflict dimen-sions. With limitations for K3p, clinically meaningful cut-offs could be determined for all conflict scales, each associated with an increased risk (25 % or 50 %) of moderate symptom occurrence.

Discussion: This study is the first to systematically examine differences in conflict patterns between a representative community sample and a clinical sample. The resulting normative data and clinical cut-off scores offer a foundation for more comprehensive integration of conflict diagnostics into both clinical practice and psychodynamic research.

The WHO recently updated the guidelines for treating mental health conditions in low- and middle-income countries, emphasizing evidence-based manual-guided psychotherapeutic treatments. As a limitation, these recommendations predominantly endorse cognitive-behavior therapy for both adults and young people. In a comment, we emphasized that the WHO overlooked the significant evidence supporting other therapeutic approaches, including but not limited to psychodynamic therapy. The WHO responded to our comment in a reply by Carswell and colleagues. However, several statements made by the authors are debatable. In this short communication, we critically address these statements, showing that they are not tenable. As a conclusion we emphasize that it is necessary to embrace a broader array of empirical supported therapeutic methods to elevate the overall quality and efficacy of global mental health care. High-quality psychotherapy research in low- and middle-income countries is required, focusing not only on the narrow area of symptoms, but transdiagnostically on general psychopathology and psychosocial functioning, which are areas addressed in psychodynamic therapy.

"Emerging adults" in Germany: Differences in Identity, Work and Partnership and their Associations with Internalizing Symptoms Young adults are an increasingly common clientele in outpatient and inpatient psychotherapy facilities, many of them with internalizing disorders such as anxiety and depression.

Objective: The present study examines associations between identity, work- and relationshiprelated variables and internalizing symptoms in a sample of young adults with different professional and relationship status.

Methods: In a cross-sectional study with 3,267 young adults (M = 23.61 years, SD = 2.94, 59 % female), sociodemographic characteristics, health-related variables, and work- and relationship- related variables are analyzed. Gender- and professional group-specific differences are examined using MANOVAs. Associations with internalizing symptoms are analyzed through multiple regression models.

Results: The sample shows a high diversity in professional status, with occupation-specific differences in many of the variables examined. Compared to men, women report more somatic complaints, higher levels of internalizing symptoms, and greater work impairment. Overall, the professional domain is perceived as more burdensome than the relationship domain; however, self-efficacy regarding the problems of reconciling work and relationships is relatively high. Work-related stress, ruminative exploration in the domains of work and relationships, dependency in relationships, and work-family conflicts predict depressive symptoms (all p < 0.001).

Discussion: Difficulties in realizing one's own identity, as well as work and relationships-related challenges, are associated with internalizing symptoms in young adults. In a clinical context, it is therefore useful to consider for this age group developmentally relevant, age-specific variables in the sense of developmental psychopathology.

Objective: This study examines the feasibility and differential inter-rater reliability of Operationalized Psychodynamic Diagnosis 3 (OPD-3) for patients experiencing psychosis.

Method: We conducted OPD interviews with n₁ = 40 patients with SCID-diagnosed nonpsychotic disorders and n₂ = 40 patients with non-affective or affective psychoses. Each patient's video-recorded interview was independently rated by two trained OPD-3 raters, selected from a rater pool of five. We assessed feasibility based on extensive rater discussions and consultations with expert practitioners.

Results: OPD-based diagnostic assessment of individual psychodynamic patient characteristics with OPD-3 has proven feasible for patients with psychosis. Due to particularities of this patient group, some aspects of the rating necessitate specific attention during rater training. OPD-3 shows moderate to excellent inter-rater reliabilities for patients with psychosis with only minor differences to patients without psychosis.

Conclusion: OPD-3 is a clinically applicable and reliable instrument for psychodynamic diagnosis in patients with psychosis.

Body Experience and Eating Disorder Psychopathology: The Role of Personality Functioning in a Representative Population Sample Objective: The association between body experience and eating psychopathology is well established. However, research examining personality functioning (PF), defined as an impairment in self and interpersonal functioning, as an additional risk factor in this interplay is lacking.

Methods: In a representative sample (N = 2.510), body experience, eating disorder symptoms and PF were assessed using questionnaires. Multiple linear regression analyses were conducted controlling for age, gender, distress and BMI in order to investigate the moderating effects of PF on the relationship between body experience and eating psychopathology.

Results: Results show that eating psychopathology is significantly related to both body experience and impaired personality functioning. As a moderating effect, it was found that people with severe impairments in PF and lower scores on the attractiveness/self-confidence subscale of body experience were particularly likely to report eating disorder symptoms.

Conclusions: The results highlight the importance of body experience and personality functioning in the prevalence and severity of eating disorder psychopathology. These aspects should be considered in the prevention and diagnosis of eating disorders.