Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie最新文献

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.

Objectives: The introduction of a new dimensional approach for the diagnosis of personality disorders in ICD-11 entails the need for valid instruments to operationalize the new model. The present study aims to provide a comprehensive overview of the existing research on the available instruments for the new model.

Methods: A systematic literature search was carried out with PubMed. Only empirical data on the ICD-11 personality model in adults were considered.

Results: Of 93 publications, 79 studies applied at least one relevant diagnostic instrument. The majority showed satisfactory reliability, construct validity and criterion-related validity. The most investigated measures are the Standardized Assessment of Severity of Personality Disorder (SASPD), Personality Disorder Severity ICD-11 scale (PDS-ICD-11), Personality Inventory for ICD-11 (PiCD) and Personality Inventory for DSM-5 Brief-Version-Modified+ (PID-5-BF+M).

Conclusion: The available diagnostic instruments for the new ICD-11 PD model show promising results. The development of a sound structured clinical interview is desirable.

Psychodynamic Conflicts in the Intergenerational Context: A Pilot Study on Adolescents with Mental Health Problems and Their Parents Objectives: Psychodynamic conflicts are intrapsychic phenomena shaped by familial relationship experiences, playing a key role in mental disorders. Studies on intergenerational associations of these conflicts are scarce. This study explores the extent and intergenerational links of psychodynamic conflicts in adolescents with mental health problems and their parents.

Methods: 290 adolescents (Mage = 18.0 ± 1.9), 95 mothers (Mage = 49.7 ± 5.3), and 52 fathers (Mage = 52.4 ± 4.2) completed the Operationalized Psychodynamic Diagnostics Conflict Questionnaires. After examining the extent of conflicts, intergenerational associations were analyzed using regression models.

Results: Adolescents experienced self-worth and identity conflicts, whereas parents struggled with the need for care versus self-sufficiency conflict. Parental and adolescent conflicts were significantly associated. Gender-specific analyses revealed that paternal conflicts particularly explained the passive identity conflict in female adolescents, whereas the maternal active oedipal conflict was linked to the corresponding conflict in male adolescents.

Conclusions: Findings underscore intergenerational and gender-specific conflict dynamics. Longitudinal studies should clarify underlying mechanisms.