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Glaser J, Jaeckle S, Beblo T, Mueller G, Eidenmueller AM, Schulz P, Schmehl I, Rogge W, Hollander K, Toepper M, Gonschorek AS. The effect of repeated concussions on clinical and neurocognitive symptom severity in different contact sports. Scand J Med Sci Sports 2024; 34:e14626. [PMID: 38610121 DOI: 10.1111/sms.14626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION The potential consequences of repeated concussions in sport are well documented. However, it remains unclear whether the cumulative impact of sports-related concussions differs between different contact sports. Therefore, the aim of the current study was to investigate the cumulative effects of sports-related concussions on clinical and neurocognitive health in different contact sports. MATERIALS AND METHODS In a prospective multicenter study, we examined 507 (74 females) active professional athletes between 18 and 40 years of age from five different contact sports (soccer, handball, American football, basketball, and ice hockey). Data collection involved concussion history, clinical symptom evaluation, neurocognitive assessment, and the collection of other sports-related information. Composite scores were built for clinical symptoms (such as neck pain and balance disturbances) and for neurocognitive symptoms (such as memory and attention impairments). RESULTS Athletes having suffered 3+ concussions in the past showed disproportionally higher clinical symptom severity than athletes with less than three concussions across all sports. The level of clinical symptom burden in athletes with 3+ concussions indicated mild impairment. The number of past concussions did not affect neurocognitive performance. DISCUSSION Repeated sports-related concussions appear to have a cumulative impact on clinical-but not cognitive-symptom severity. Although clinical symptom burden in athletes with 3+ concussions in the past was not alarmingly high yet in our sample, increased caution should be advised at this point. Despite few exceptions, results are similar for different contact sports, suggesting a similar multidisciplinary concussion management across all types of sport.
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Affiliation(s)
- Jennifer Glaser
- Concussion Center Hamburg, Neurozentrum, BG Klinikum Hamburg, Hamburg, Germany
| | - Sarah Jaeckle
- Concussion Center Würzburg, Praxis für Sport-Neuropsychologie Würzburg, Wuerzburg, Germany
| | - Thomas Beblo
- Evangelisches Klinikum Bethel gGmbH, University Hospital of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Gerhard Mueller
- Concussion Center Würzburg, Praxis für Sport-Neuropsychologie Würzburg, Wuerzburg, Germany
| | - Andreas M Eidenmueller
- Concussion Center Würzburg, Praxis für Sport-Neuropsychologie Würzburg, Wuerzburg, Germany
| | - Philipp Schulz
- Evangelisches Klinikum Bethel gGmbH, University Hospital of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Ingo Schmehl
- Concussion Center Berlin, Klinik für Neurologie, BG Klinikum Unfallkrankenhaus Berlin GmbH, Berlin, Germany
| | - Witold Rogge
- Concussion Center Berlin, Klinik für Neurologie, BG Klinikum Unfallkrankenhaus Berlin GmbH, Berlin, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Max Toepper
- Evangelisches Klinikum Bethel gGmbH, University Hospital of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
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Beblo T, Driessen M, Dehn L. Correspondence: No increased memory impairment in depressed patients under everyday life conditions. Psychiatry Res 2024; 331:115681. [PMID: 38134529 DOI: 10.1016/j.psychres.2023.115681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Thomas Beblo
- Department of Psychiatry and Psychotherapy, Ev. Hospital Bethel, University Hospital OWL, University of Bielefeld, Remterweg 69-71, Bielefeld 33617, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, Bielefeld 33615, Germany.
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Ev. Hospital Bethel, University Hospital OWL, University of Bielefeld, Remterweg 69-71, Bielefeld 33617, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, Bielefeld 33615, Germany
| | - Lorenz Dehn
- Department of Psychiatry and Psychotherapy, Ev. Hospital Bethel, University Hospital OWL, University of Bielefeld, Remterweg 69-71, Bielefeld 33617, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, Bielefeld 33615, Germany
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Berwinkel A, Driessen M, Beblo T, Weigelt M. Combined physical activity training versus aerobic activity training in unipolar depressive disorder: a quasi-randomised evaluation study. Neuropsychiatr 2023; 37:206-213. [PMID: 37084073 DOI: 10.1007/s40211-023-00464-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/03/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE The positive effect of sport and exercise interventions on the treatment of unipolar depressive disorder (UDD) is well documented with respect to aerobic exercise. However, few studies have determined the effectiveness of other types of interventions (e.g., weight training, body and mind oriented, qigong or progressive muscle relaxation). Additionally, the effectiveness of specific combined sport and exercise approaches has rarely been investigated. Therefore, recommendations for the use of sport and exercise therapy to treat UDD have been developed. METHODS This quasi-randomised study used a pretest/posttest design to compare the effectiveness of two different interventions (aerobic activity training vs. combined physical activity training) on psychiatric outcome parameters in a day clinic psychiatric setting. A total of 62 participants were quasi-randomised to one of the two conditions. Affective, cognitive, psychosocial and neuropsychological changes were assessed by a battery of questionnaires before (t1) and after (t2) treatment. Accelerometers were used to assess energy consumption. RESULTS The results show that both training interventions have similar effects on the treatment of UDD. CONCLUSION These findings highlight the effectiveness of different physical activities in the treatment of UDD and provide further information for good clinical practice.
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Affiliation(s)
- Andre Berwinkel
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany.
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany
| | - Thomas Beblo
- Universitätsklinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel, Remterweg 69-71, 33617, Bielefeld, Germany
| | - Matthias Weigelt
- Department Sport & Gesundheit, Universität Paderborn, Paderborn, Germany
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Beblo T, Bergdolt J, Kilian M, Toepper M, Moritz S, Driessen M, Dehn L. Do depressed patients really over-report cognitive impairment? J Affect Disord 2023; 338:466-471. [PMID: 37385388 DOI: 10.1016/j.jad.2023.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Depressed patients report more severe cognitive impairment than is detectable by neuropsychological tests because they may underestimate their cognitive performance. Alternatively, it is possible that cognitive impairment primarily occurs under everyday life conditions as referred to in most questionnaires. The aim of the present study is to investigate the validity of self-reports in patients with major depression in order to better understand the pronounced impairment in self-reports. METHODS We investigated 58 patients with major depression and 28 heathy control participants. We administered the "Screen for Cognitive Impairment in Psychiatry" (SCIP) to assess cognitive performance, the "Questionnaire for Cognitive Complaints" (FLei), and the newly developed scale for "Self-Perception of Cognitive Performance in everyday life and test settings" to ask for the self-assessed cognitive performance in everyday life and in a test situation more specifically. RESULTS Depressed patients showed an inferior test performance and reported much more general everyday life related cognitive problems compared to healthy participants. When asked more specifically for their cognitive performance in the test-situation compared to others and compared to everyday life, they did not report more test-related and everyday life related impairment than healthy participants did. LIMITATIONS Results might be influenced by comorbidity. CONCLUSIONS These results have implications for the assessment of subjective cognitive performance of depressed patients and shed light on the negative effects of general versus more specific recall of autobiographical information.
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Affiliation(s)
- Thomas Beblo
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany.
| | - Juliane Bergdolt
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany
| | - Mia Kilian
- Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Max Toepper
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Lorenz Dehn
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, University Hospital OWL, Remterweg 69-71, 33617 Bielefeld, Germany
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Dehn LB, Driessen M, Beblo T. Everyday memory in patients with depression: An explorative pilot study using an ecological assessment paradigm. Appl Neuropsychol Adult 2023:1-5. [PMID: 37708858 DOI: 10.1080/23279095.2023.2256917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND People with major depressive disorder (MDD) often experience significant memory problems in their daily lives, which, however, frequently do not correspond to standardized memory test (SMT) results. The present pilot study aimed to examine the everyday memory performance of people with MDD by means of an ecological assessment paradigm (EAP). METHODS Participants were unexpectedly called one week after their neuropsychological test assessment and asked about their memories of specific details of the former test situation. Associations of this EAP with SMT, subjective everyday memory problems, and symptom coping were exploratively analyzed. RESULTS The study involved 22 MDD inpatients (M = 42.5 years, 64% female) and 22 comparable healthy control persons. MDD patients showed a significantly reduced performance in the EAP as well as in the SMT and they reported more memory problems in their daily lives. However, the EAP was not related to SMT results assessed a week before. Moreover, only the EAP was significantly associated with subjective daily memory problems and (distraction) coping style in the MDD group. CONCLUSIONS The EAP appears to better reflect the everyday memory problems of persons with depression than standardized test procedures. However, the findings need to be validated by further research with larger samples.
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Affiliation(s)
- Lorenz B Dehn
- University Hospital for Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
- Department for Psychology, Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- University Hospital for Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- University Hospital for Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
- Department for Psychology, Bielefeld University, Bielefeld, Germany
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Steuwe C, Berg M, Driessen M, Beblo T. Therapeutic alliance and dropout in patients with borderline pathology receiving residential dialectical behavior therapy. BMC Psychiatry 2023; 23:605. [PMID: 37596568 PMCID: PMC10439653 DOI: 10.1186/s12888-023-05061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 07/28/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND This study focused on the impact of therapeutic alliance on therapy dropout in a naturalistic sample of patients with borderline pathology receiving dialectical behavior therapy (DBT) in a residential setting. We assumed that low therapeutic alliance shortly after admission would be associated with elevated dropout. METHODS 44 participants with borderline pathology (≥ 3 DSM-5 borderline personality disorder criteria) in a residential DBT program completed a quality assurance questionnaire set assessing demographic information, pretreatment psychopathology and therapeutic alliance during the first seven days of their residential stay. Predictors of dropout were investigated using binary logistic regression analyses. RESULTS The dropout rate was 34.1% (n = 15). In binary logistic regression analyses with variables covering demographic and clinical characteristics, comorbidities and childhood trauma history, only the therapeutic alliance significantly predicted dropout (z = -2.371, p = .018). CONCLUSIONS This study supports the importance of therapy process variables, here the therapeutic alliance at the beginning of treatment, as predictors of therapy dropout in borderline pathology. If this finding is replicated, it shows the potential importance of monitoring the therapeutic relationship throughout the therapeutic process. CLINICALTRIALS gov Identifier: NCT05289583, retrospectively registered on March 11, 2022.
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Affiliation(s)
- Carolin Steuwe
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany.
| | - Michaela Berg
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
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Schlueter DA, Austerschmidt KL, Schulz P, Beblo T, Driessen M, Kreisel S, Toepper M. Overestimation of on-road driving performance is associated with reduced driving safety in older drivers. Accid Anal Prev 2023; 187:107086. [PMID: 37146403 DOI: 10.1016/j.aap.2023.107086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/24/2023] [Accepted: 04/14/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES Older drivers often show less precise self-ratings with a tendency to overestimate themselves. It is unclear, however, how overestimators differ from underestimators or drivers with adequate self-ratings. METHODS 59 healthy older drivers participated in this on-road study. Besides standardized on-road driving assessment, the study protocol included the collection of neuropsychological and driving-related data as well as different self-ratings. Statistical analyses involved correlations between different subjective and objective ratings as well as statistical comparisons between drivers who overestimated and drivers who adequately rated their on-road driving performance (no drivers underestimated their performance). RESULTS Despite positive correlations between different self- and expert ratings, our results revealed that 25 % of the participants overestimated their on-road driving skills. Among other things, overestimators showed poorer on-road driving performances, more prospective near and minor at-fault accidents, poorer cognitive performances in specific driving-related domains and reduced annual mileage. DISCUSSION Our results suggest that older drivers who overestimate their driving skills show poorer performances within a broad range of skills that directly reflect or are closely related to driving safety. Against the background that an adequate self-assessment is required by German traffic regulations, our findings suggest that overestimators represent a risk group among the population of older drivers.
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Affiliation(s)
- Daniel A Schlueter
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany; Bielefeld University, Department of Biopsychology and Cognitive Neuroscience, Universitätsstraße 25, D-33615 Bielefeld, Germany.
| | - Kim L Austerschmidt
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Philipp Schulz
- University Hospital OWL, Bielefeld University, Mara Hospital, Maraweg 21, D-33617 Bielefeld, Germany
| | - Thomas Beblo
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Martin Driessen
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Stefan Kreisel
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Max Toepper
- University Hospital OWL, Bielefeld University, Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy, Remterweg 69-71, D-33617 Bielefeld, Germany
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Moritz S, Xie J, Penney D, Bihl L, Hlubek N, Elmers J, Beblo T, Hottenrott B. The magnitude of neurocognitive impairment is overestimated in depression: the role of motivation, debilitating momentary influences, and the overreliance on mean differences. Psychol Med 2023; 53:2820-2830. [PMID: 35022092 PMCID: PMC10235659 DOI: 10.1017/s0033291721004785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/11/2021] [Accepted: 11/01/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Meta-analyses agree that depression is characterized by neurocognitive dysfunctions relative to nonclinical controls. These deficits allegedly stem from impairments in functionally corresponding brain areas. Increasingly, studies suggest that some performance deficits are in part caused by negative task-taking attitudes such as poor motivation or the presence of distracting symptoms. A pilot study confirmed that these factors mediate neurocognitive deficits in depression. The validity of these results is however questionable given they were based solely on self-report measures. The present study addresses this caveat by having examiners assess influences during a neurocognitive examination, which were concurrently tested for their predictive value on performance. METHODS Thirty-three patients with depression and 36 healthy controls were assessed on a battery of neurocognitive tests. The examiner completed the Impact on Performance Scale, a questionnaire evaluating mediating influences that may impact performance. RESULTS On average, patients performed worse than controls at a large effect size. When the total score of the Impact on Performance Scale was accounted for by mediation analysis and analyses of covariance, group differences were reduced to a medium effect size. A total of 30% of patients showed impairments of at least one standard deviation below the mean. CONCLUSIONS This study confirms that neurocognitive impairment in depression is likely overestimated; future studies should consider fair test-taking conditions. We advise researchers to report percentages of patients showing performance deficits rather than relying solely on overall group differences. This prevents fostering the impression that the majority of patients exert deficits, when in fact deficits are only true for a subgroup.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jingyuan Xie
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Danielle Penney
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Ouest-de-l’Île-de-Montréal, Douglas Mental Health University Institute, Montreal, Canada
| | - Lisa Bihl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Niklas Hlubek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Elmers
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld, Germany
| | - Birgit Hottenrott
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Boedeker S, Driessen M, Schulz P, Beblo T, Kreisel S, Toepper M. Give me a sign: Concrete symbols facilitate orientation in Alzheimer's disease dementia. J Gerontol B Psychol Sci Soc Sci 2023:7069150. [PMID: 36869738 DOI: 10.1093/geronb/gbad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES Persons with Alzheimer's disease dementia (ADD) often show impaired orientation particularly in unknown environments. Signs may offer an opportunity to compensate for these deficits and thus improve participation. METHOD We assessed 30 persons with ADD and 36 healthy controls by using a Sign Comprehension Paradigm (SCP) in a real-life like environment. Nonparametric mixed model analyses of variance were used to analyze the effect of different symbols and additional scripture (coding condition) on SCP performance speed and accuracy. RESULTS Analyses revealed a significant main effect of symbol design on SCP speed as well as an interaction effect of group*symbol, indicating a benefit of concrete, optimized signs for persons with ADD. Furthermore, analyses of SCP error rates revealed main effects of group and coding condition as well as an interaction effect of group*coding. Persons with ADD made more errors than healthy controls, but SCP error rates decreased significantly in ADD in the double-coding condition. DISCUSSION Our findings revealed an advantage of concrete double-coded symbols over conventional symbols and therefore strongly suggest the implementation of concrete double-coded signs to support older people living with ADD.
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Affiliation(s)
- Sebastian Boedeker
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld University, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Martin Driessen
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld University, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Philipp Schulz
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld University, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Thomas Beblo
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld University, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Stefan Kreisel
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld University, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Max Toepper
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld University, Remterweg 69-71, D-33617 Bielefeld, Germany
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Santel M, Neuner F, Berg M, Steuwe C, Jobes DA, Driessen M, Beblo T. The Collaborative Assessment and Management of Suicidality compared to enhanced treatment as usual for inpatients who are suicidal: A randomized controlled trial. Front Psychiatry 2023; 14:1038302. [PMID: 36937739 PMCID: PMC10017970 DOI: 10.3389/fpsyt.2023.1038302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Background Although use of inpatient crisis hospital intervention for suicide risk is common, the evidence for inpatient treatments that reduce suicidal thoughts and behaviors is remarkably limited. To address this need, this novel feasibility pilot randomized controlled trial compared the use of the Collaborative Assessment and Management of Suicidality (CAMS) to enhanced treatment as usual (E-TAU) within a standard acute inpatient mental health care setting. Objectives We hypothesized that CAMS would be more effective than E-TAU in reducing suicidal thoughts and behaviors. As secondary outcomes we also investigated depressive symptoms, general symptom burden, reasons for living, and quality of the therapeutic relationship. Methods All patients were admitted due to acute suicidal thoughts or behaviors. They were randomly assigned to CAMS (n = 43) or E-TAU (n = 45) and assessed at four time points (admission, discharge, 1 month and 5 months after discharge). We used mixed-effects models, effect sizes, and reliable change analyses to compare improvements across and between treatment groups over time. Results Intent-to-treat analyses of 88 participants [mean age 32.1, SD = 13.5; n = 47 (53%) females] showed that both groups improved over time across all outcome measures with no significant between-group differences in terms of change in suicidal ideation, depression, reasons for living, and distress. However, CAMS showed larger effect sizes across all measures; for treatment completers CAMS patients showed significant improvement in suicidal ideation (p = 0.01) in comparison to control patients. CAMS patients rated the therapeutic relationship significantly better (p = 0.02) than E-TAU patients and were less likely to attempt suicide within 4 weeks after discharge (p = 0.05). Conclusions CAMS and E-TAU were both effective in reducing suicidal thoughts and symptom distress. Within this feasibility RCT the pattern of results was generally supportive of CAMS suggesting that inpatient use of CAMS is both feasible and promising. However, our preliminary results need further replication within well-powered multi-site randomized controlled trials. Trial registration DRKS-ID/ICTRP-ID: DRKS00013727. The trial was retrospectively registered in the German Clinical Trials Register, registration code/ DRKS-ID: DRKS00013727 on 12.01.2018 and also in the International Clinical Trials Registry Platform of the World Health Organization (identical registration code).
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Affiliation(s)
- Miriam Santel
- Clinic of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
- *Correspondence: Miriam Santel
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Michaela Berg
- Clinic of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
| | - Carolin Steuwe
- Clinic of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
| | - David A. Jobes
- Department of Psychology, The Catholic University of America, Washington, DC, United States
| | - Martin Driessen
- Clinic of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Clinic of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
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Angleitner A, Dehn L, Driessen M, Beblo T. Kognitive Beeinträchtigungen alkoholabhängiger Patient_innen im Abstinenzverlauf und die Relevanz depressiver Komorbidität. Zeitschrift für Neuropsychologie 2022. [DOI: 10.1024/1016-264x/a000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Zusammenfassung: Hintergrund: Mit dieser Studie wird der Frage nachgegangen, inwieweit sich kognitive Beeinträchtigungen alkoholabhängiger Patient_innen in Abhängigkeit von Abstinenz und Depressivität im Behandlungsverlauf verbessern. Methode: Alkoholabhängige Patient_innen mit ( n = 22) und ohne Depression ( n = 58) wurden neuropsychologisch und hinsichtlich der Depressivität zu drei Zeitpunkten untersucht (nach Entzug und 6 Wochen bzw. 6 Monate später). 33 gesunde Kontrollproband_innen wurden zusätzlich zum ersten Zeitpunkt untersucht. Ergebnisse: Alkoholabhängige Patient_innen zeigten verglichen mit gesunden Kontrollpersonen eine verminderte Leistung im schlussfolgernden Denken. Im Behandlungsverlauf zeigte sich eine trendweise günstigere Entwicklung für abstinente verglichen mit rückfälligen Patient_innen und eine größere Depressivität war mit schwächeren Leistungen assoziiert. Diskussion: Alkoholabhängige Patient_innen leiden an kognitiven Defiziten, die sich z. T. im weiteren Behandlungsverlauf zu verbessern scheinen, v. a. bei Abstinenz.
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Affiliation(s)
- Alexander Angleitner
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
| | - Lorenz Dehn
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Deutschland
| | - Martin Driessen
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Deutschland
| | - Thomas Beblo
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bielefeld, Deutschland
- Fakultät für Psychologie und Sportwissenschaft, Universität Bielefeld, Deutschland
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Schniedermann I, Dehn LB, Micheel S, Beblo T, Driessen M. Evaluation of a supported education and employment program for adolescents and young adults with mental health problems: A study protocol of the StAB project. PLoS One 2022; 17:e0271803. [PMID: 35905081 PMCID: PMC9337640 DOI: 10.1371/journal.pone.0271803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 11/19/2022] Open
Abstract
The majority of mental illnesses begins in childhood, adolescence and young adulthood before the age of 25. The transition from adolescence to adulthood is a particularly vulnerable time for adolescents with mental illness, affecting psychosocial functioning and participation in work life. Therefore, they need—in contrast to classic standard vocational interventions—a long-term, holistic and individually oriented vocational rehabilitation program. With the innovative model project "Start in education and employment (StAB)”, adolescents and young adults with mental illnesses are to be supported with regard to their vocational perspectives and participation by a new type of individualized, holistic, long-term job coaching. It follows the Individual Placement and Support (IPS) concept, as a manualized form of the Supported Employment Approach and is based on the "first place–then train" principle. In order to evaluate the effectiveness and feasibility of the StAB program, a double-centre prospective single arm evaluation study in a mixed-methods design will be conducted. The focus is on quantitative research analysing pre-post-effects of the StAB intervention in a two-year observational study. Young people between 15 and 25 years with a psychiatric diagnosis who are currently in receipt of means-tested benefits or are entitled to them will be recruited. The study will take place in two major cities in the north-western part of Germany, Bielefeld and Dortmund. We expect to contribute to gain more empirical data about the implementation of Supported Employment and Education to severely mentally ill adolescents and young adults in German settings. Moreover, these results may also provide the scientific foundation for future measures focusing the improvement of vocational rehabilitation for young people with mental illness. The study was registered in the German Clinical Trials Register (DRKS00027576) on March 10, 2022.
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Affiliation(s)
- Ina Schniedermann
- Department of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
| | - Lorenz B. Dehn
- Department of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
- * E-mail:
| | - Sabrina Micheel
- Department of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, University Hospital OWL of Bielefeld University, Bielefeld, Germany
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Schulz P, Schaebitz WR, Driessen M, Beblo T, Toepper M. Recovery of driving fitness after stroke: A matter of time? J Am Geriatr Soc 2022; 70:1578-1580. [PMID: 35150128 DOI: 10.1111/jgs.17681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Philipp Schulz
- Epilepsie-Zentrum Bethel, Krankenhaus MARA, Bielefeld, Germany
| | | | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Max Toepper
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
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Bergdolt J, Sellin P, Driessen M, Beblo T, Dehn LB. Neuropsychological predictors of vocational rehabilitation outcomes in individuals with major depression: A scoping review. Front Psychiatry 2022; 13:942161. [PMID: 36440409 PMCID: PMC9682155 DOI: 10.3389/fpsyt.2022.942161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Major depression is one of the leading causes of disability and limited capacity to work. Neuropsychological impairment is a common symptom in acute and remitted major depression and is associated with poor psychosocial functioning. This scoping review aimed to identify research on the role of neuropsychological functioning in outcomes of vocational rehabilitation programs in individuals with depression. METHODS We report on the conduct of this pre-registered (https://osf.io/5yrnf) scoping review in accordance with PRISMA-ScR guidelines. PubMed and PsychInfo were systematically searched for English or German research articles published between 1990 and September 2021 that studied objective neuropsychological tests as predictors of vocational rehabilitation interventions and included participants with depression. RESULTS The systematic literature search yielded no studies that specifically targeted subjects with major depression. However, eight articles published since 2016 were included in the review, analyzing data from five trials that evaluated the effectiveness of supported employment in North America and Europe in severe mental illnesses. An estimated 31% of the total number of participants included (n = 3,533) had major depression. Using a variety of cognitive tests and covariates, seven articles found that neuropsychological functioning - especially global cognition scores, verbal and visual learning and memory - significantly predicted vocational outcomes of rehabilitation programs. CONCLUSION Despite a lack of studies specifically targeting major depressive disorder, the identified literature suggests that higher baseline neuropsychological functioning predicts better vocational outcomes of supported employment programs in individuals with depression. In clinical practice, additional neuropsychological modules during return-to-work interventions might be helpful for vocational outcomes of such programs.
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Affiliation(s)
- Juliane Bergdolt
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Pauline Sellin
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Lorenz B Dehn
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
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Dehn LB, Driessen M, Steinhart I, Beblo T. Participating in Longitudinal Observational Research on Psychiatric Rehabilitation: Quantitative Results From a Patient Perspective Study. Front Psychiatry 2022; 13:834389. [PMID: 35185660 PMCID: PMC8854761 DOI: 10.3389/fpsyt.2022.834389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Longitudinal observational studies play on an important role for evidence-based research on health services and psychiatric rehabilitation. However, information is missing about the reasons, why patients participate in such studies, and how they evaluate their participation experience. METHODS Subsequently to their final assessment in a 2-year follow-up study on supported housing for persons with severe mental illness, n = 182 patients answered a short questionnaire on their study participation experience (prior experiences, participation reasons, burden due to study assessments, intention to participate in studies again). Basic respondent characteristics as well as symptom severity (SCL-K9) were also included in the descriptive and analytical statistics. RESULTS To help other people and curiosity were cited as the main initial reasons for study participation (>85%). Further motives were significantly associated with demographic and/or clinical variables. For instance, "relieve from boredom" was more frequently reported by men and patients with substance use disorders (compared to mood disorders), and participants 'motive" to talk about illness" was associated with higher symptom severity at study entry. Furthermore, only a small proportion of respondents indicated significant burdens by study participation and about 87% would also participate in future studies. CONCLUSIONS The respondents gave an overall positive evaluation regarding their participation experience in an observational study on psychiatric rehabilitation. The results additionally suggest that health and social care professionals should be responsive to the expectations and needs of patients with mental illness regarding participation in research.
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Affiliation(s)
- Lorenz B Dehn
- Department of Psychiatry and Psychotherapy, Evangelische Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelische Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, University of Bielefeld, Bielefeld, Germany
| | - Ingmar Steinhart
- von Bodelschwinghsche Stiftungen Bethel, Bielefeld, Germany.,Institut für Sozialpsychiatrie Mecklenburg-Vorpommern e. V., University of Greifswald, Greifswald, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelische Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, University of Bielefeld, Bielefeld, Germany
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Boedeker S, Halstenberg E, Schulz P, Beblo T, Kreisel S, Driessen M, Toepper M. Impaired Color Discrimination in Alzheimer Disease Dementia. Alzheimer Dis Assoc Disord 2022; 36:22-28. [PMID: 34861672 DOI: 10.1097/wad.0000000000000478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/11/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Patients with Alzheimer disease dementia (ADD) often show impaired orientation and navigation. Signage offers an opportunity to compensate for these deficits, communicate information efficiently and facilitate wayfinding. Certain properties of signs such as colors and contrasts may beneficially affect the uptake and processing of information particularly in ADD patients. METHODS Thirty-six healthy older adults and 30 ADD patients performed a computerized color perception task that required discriminating different color combinations. The effects of different contrast features on performance accuracy and speed in the 2 experimental groups were examined by nonparametric mixed analysis of variances. RESULTS Analyses revealed a significant effect of contrast polarity on reaction times, significant effects of group on reaction times and errors as well as a marginally significant interaction of group×color on errors. All participants benefitted from positive contrast polarity (ie, dark target on lighter background) as indicated by increased performance speed. Furthermore, ADD patients reacted slower and less accurate than healthy controls, but showed higher accuracy at black-white and red-yellow than at blue-green color combinations. CONCLUSIONS Our findings suggest the implementation of signs with positive contrast polarity to ensure faster reactions. In addition, certain color combinations may enhance accuracy, particularly in patients with ADD.
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Affiliation(s)
- Sebastian Boedeker
- Research Division, Department of Psychiatry and Psychotherapy
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy
- Department of Psychiatry and Psychotherapy, Memory Clinic, Evangelisches Klinikum Bethel (EvKB), Universitätsklinikum OWL der Universität Bielefeld
| | - Eileen Halstenberg
- Department of Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Philipp Schulz
- Research Division, Department of Psychiatry and Psychotherapy
| | - Thomas Beblo
- Research Division, Department of Psychiatry and Psychotherapy
| | - Stefan Kreisel
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy
| | - Martin Driessen
- Research Division, Department of Psychiatry and Psychotherapy
| | - Max Toepper
- Research Division, Department of Psychiatry and Psychotherapy
- Department of Psychiatry and Psychotherapy, Memory Clinic, Evangelisches Klinikum Bethel (EvKB), Universitätsklinikum OWL der Universität Bielefeld
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Fernando SC, Beblo T, Lamers A, Schlosser N, Woermann FG, Driessen M, Toepper M. Neural correlates of emotion acceptance and suppression in borderline personality disorder. Front Psychiatry 2022; 13:1066218. [PMID: 36704727 PMCID: PMC9871986 DOI: 10.3389/fpsyt.2022.1066218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Emotion dysregulation is a central feature of borderline personality disorder (BPD). Since impaired emotion regulation contributes to disturbed emotion functioning in BPD, it is crucial to study underlying neural activity. The current study aimed at investigating the neural correlates of two emotion regulation strategies, namely emotion acceptance and suppression, which are both important treatment targets in BPD. METHODS Twenty-one women with BPD and 23 female healthy control participants performed an emotion regulation task during functional magnetic resonance imaging (fMRI). While watching fearful movie clips, participants were instructed to either accept or to suppress upcoming emotions compared to passive viewing. RESULTS Results revealed acceptance-related insular underactivation and suppression-related caudate overactivation in subjects with BPD during the emotion regulation task. CONCLUSION This is a first study on the neural correlates of emotion acceptance and suppression in BPD. Altered insula functioning during emotion acceptance may reflect impairments in emotional awareness in BPD. Increased caudate activity is linked to habitual motor and cognitive processes and therefore may accord to the well-established routine in BPD patients to suppress emotional experiences.
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Affiliation(s)
- Silvia Carvalho Fernando
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University of Bielefeld, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University of Bielefeld, Bielefeld, Germany
| | - Agnes Lamers
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University of Bielefeld, Bielefeld, Germany
| | - Nicole Schlosser
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University of Bielefeld, Bielefeld, Germany
| | - Friedrich G Woermann
- Epilepsy Center Bethel, Mara Hospital, University of Bielefeld, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University of Bielefeld, Bielefeld, Germany
| | - Max Toepper
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University of Bielefeld, Bielefeld, Germany
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Dehn LB, Böske N, Beblo T, Steinhart I, Stengler K, Driessen M. [Vocational Perspectives for People with Mental Illness Under Corona Conditions: An Exploratory Brief Survey]. Psychiatr Prax 2021; 49:152-155. [PMID: 34674200 DOI: 10.1055/a-1623-4622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Exploratory study of corona-related impacts on vocational perspectives of people with mental illness. METHODS Short survey with quantitative and qualitative questions among employees from vocational rehabilitation. RESULTS More than 90 % of the n = 76 participants stated that the situation regarding vocational reintegration or job search had worsened due to corona. Moreover, 75 % considered that there would still be a negative impact on vocational rehabilitation in the longer term. In addition to the main problem of a lack of job offers, open responses on obstacles also referred to increased psychological stress among clients as well as problems in reaching cooperation partners or in dealing with online processes. CONCLUSIONS Under Corona conditions, the work-related perspectives and participation opportunities of people with mental illness have been additionally worsened.
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Affiliation(s)
- Lorenz B Dehn
- Universitätsklinikum OWL der Universität Bielefeld, Klinik für Psychiatrie und Psychotherapie am Evang. Klinikum Bethel (EvKB)
| | - Nils Böske
- Universitätsklinikum OWL der Universität Bielefeld, Klinik für Psychiatrie und Psychotherapie am Evang. Klinikum Bethel (EvKB)
| | - Thomas Beblo
- Universitätsklinikum OWL der Universität Bielefeld, Klinik für Psychiatrie und Psychotherapie am Evang. Klinikum Bethel (EvKB)
| | - Ingmar Steinhart
- Universität Greifswald, Institut für Sozialpsychiatrie Mecklenburg-Vorpommern; v. Bodelschwinghsche Stiftungen Bethel, Vorstand
| | - Katarina Stengler
- HELIOS Park-Klinikum Leipzig, Klinik für Psychiatrie, Psychosomatik und Psychotherapie
| | - Martin Driessen
- Universitätsklinikum OWL der Universität Bielefeld, Klinik für Psychiatrie und Psychotherapie am Evang. Klinikum Bethel (EvKB)
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Toepper M, Schulz P, Beblo T, Driessen M. Predicting On-Road Driving Skills, Fitness to Drive, and Prospective Accident Risk in Older Drivers and Drivers with Mild Cognitive Impairment: The Importance of Non-Cognitive Risk Factors. J Alzheimers Dis 2021; 79:401-414. [PMID: 33325384 PMCID: PMC7902978 DOI: 10.3233/jad-200943] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND On-road driving behavior can be impaired in older drivers and particularly in drivers with mild cognitive impairment (MCI). OBJECTIVE To determine whether cognitive and non-cognitive risk factors for driving safety may allow an accurate and economic prediction of on-road driving skills, fitness to drive, and prospective accident risk in healthy older drivers and drivers with MCI, we examined a representative combined sample of older drivers with and without MCI (N = 74) in an observational on-road study. In particular, we examined whether non-cognitive risk factors improve predictive accuracy provided by cognitive factors alone. METHODS Multiple and logistic hierarchical regression analyses were utilized to predict different driving outcomes. In all regression models, we included cognitive predictors alone in a first step and added non-cognitive predictors in a second step. RESULTS Results revealed that the combination of cognitive and non-cognitive risk factors significantly predicted driving skills (R2adjusted = 0.30) and fitness to drive (81.2% accuracy) as well as the number (R2adjusted = 0.21) and occurrence (88.3% accuracy) of prospective minor at-fault accidents within the next 12 months. In all analyses, the inclusion of non-cognitive risk factors led to a significant increase of explained variance in the different outcome variables. CONCLUSION Our findings suggest that a combination of the most robust cognitive and non-cognitive risk factors may allow an economic and accurate prediction of on-road driving performance and prospective accident risk in healthy older drivers and drivers with MCI. Therefore, non-cognitive risk factors appear to play an important role.
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Affiliation(s)
- Max Toepper
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld, Germany
| | - Philipp Schulz
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld, Germany
| | - Thomas Beblo
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld, Germany
| | - Martin Driessen
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Bielefeld, Germany
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Forster SD, Beblo T, Pohl S, Steuwe C, Gauggel S, Mainz V. Self-referential processing and perspective taking in patients with a borderline personality disorder. J Psychiatr Res 2021; 140:87-94. [PMID: 34098390 DOI: 10.1016/j.jpsychires.2021.05.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/17/2023]
Abstract
Divergent self- and other-referential processes play a particular role in the development and maintenance of borderline personality disorder (BPD). This study investigated self-referential processes in patients with BPD and age-matched controls. Participants performed a trait-judgment task, taking their own and the perspective of a close other person. Memory was assessed during recall of the previous choices. Results revealed over all more negative self-appraisals in patients than controls, which seemed due to making less positive self-referential choices rather than an increased choice of negative traits. Interestingly, taking another perspective, patients had a healthier, predominantly positive self-assessment, albeit still attenuated compared to controls. The characteristics of the appraisals were mirrored in memory performances. Moreover, self-esteem seems to be a potential protective factor, as self-appraisals were more positive with higher self-esteem. Altogether, this study shows significantly deviant self-referential processes in patients with BPD, suggesting that patients do not integrate what they believe others think about them into their self-concept.
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Affiliation(s)
- Saskia Doreen Forster
- Institute of Medical Psychology and Medical Sociology, University Hospital of the RWTH Aachen University, Aachen, Germany.
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Research Division, Evangelisches Klinikum Bethel, Bielefeld, Germany; Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Sina Pohl
- Department of Psychiatry and Psychotherapy, Research Division, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Carolin Steuwe
- Department of Psychiatry and Psychotherapy, Research Division, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Siegfried Gauggel
- Institute of Medical Psychology and Medical Sociology, University Hospital of the RWTH Aachen University, Aachen, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, University Hospital of the RWTH Aachen University, Aachen, Germany
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Santel M, Beblo T, Leygraf J, Driessen M. [Collaborative Assessment and Management of Suicidality: An Effective Brief Intervention for the Treatment of Suicidal Patients]. Psychother Psychosom Med Psychol 2021; 72:9-17. [PMID: 34282600 DOI: 10.1055/a-1524-3060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Das "Collaborative Assessment and Management of Suicidality" (CAMS) ist einer von mehreren Interventionsansätzen zur Behandlung von suizidalen Patienten und Patientinnen und wurde weltweit seit 3 Jahrzehnten untersucht und weiterentwickelt. Das CAMS ist auf die Etablierung einer tragenden therapeutischen Beziehung auf Augenhöhe zu einer suizidalen Person ausgerichtet. Der Patient wird aktiv an der Einschätzung seines Suizidrisikos beteiligt und zum "Mitverfasser" seines eigenen suizidspezifischen Behandlungsplans. Das konkrete therapeutische Vorgehen wird durch ein vielseitig anwendbares Instrument, die sogenannte Suizidstatusform (SSF), strukturiert und geleitet. Das CAMS kann von verschiedenen therapeutischen Berufsgruppen sowie bei Patienten und Patientinnen mit unterschiedlichen Diagnosen angewandt werden. Die Wirksamkeit im Hinblick auf eine Verringerung von Suizidgedanken, der allgemeinen psychischen Belastung und Depressivität sowie auf eine Zunahme von Hoffnung und Zuversicht ist mittlerweile empirisch gut belegt.The "Collaborative Assessment and Management of Suicidality" (CAMS) is an intervention approach for the treatment of suicidal patients that has been studied and developed for three decades around the world. CAMS is focused on establishing a continuing therapeutic relationship at eye level with a suicidal person. The patient is actively involved in assessing his or her suicide risk and becomes the "co-author" of his or her own suicide-specific treatment plan. The specific therapeutic procedure is structured and guided by a versatile instrument called the Suicide Status Form (SSF). CAMS can be applied by different therapeutic professional groups to patients with different diagnoses. Its effectiveness in reducing suicidal ideation, general psychological distress and depressiveness, and increasing hope and confidence is now empirically well established.
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Affiliation(s)
- Miriam Santel
- Klinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Bielefeld, Deutschland
| | - Thomas Beblo
- Klinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Bielefeld, Deutschland
| | - Jan Leygraf
- Klinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Bielefeld, Deutschland
| | - Martin Driessen
- Klinik für Psychiatrie und Psychotherapie, Evangelisches Klinikum Bethel gGmbH, Bielefeld, Deutschland
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Schulz P, Beblo T, Spannhorst S, Boedeker S, Kreisel SH, Driessen M, Labudda K, Toepper M. Assessing fitness to drive in older adults: Validation and extension of an economical screening tool. Accid Anal Prev 2021; 149:105874. [PMID: 33221660 DOI: 10.1016/j.aap.2020.105874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Due to demographic change, the number of older drivers with impaired driving skills will increase in the next decades. The current study aimed at the validation and extension of the screening tool Safety Advice For Elderly drivers (SAFE) that allows a cost-efficient assessment of driving-related risk factors in older drivers. METHOD Seventy-four older drivers aged ≥65 years (M = 77 years) recruited from the general population were included in this prospective observational study. Receiver operating characteristic curve (ROC) and hierarchical logistic regression analyses were utilized to examine whether the SAFE and further evidence-based driving-related factors may allow the differentiation between fit and unfit older drivers assessed in standardized on-road driving assessments. RESULTS ROC analyses revealed significant diagnostic accuracy of the number of SAFE risk factors in differentiating between fit and unfit older drivers (AUC = 0.71). A stepwise logistic regression model revealed that adding further evidence-based risk factors into the SAFE clearly improved diagnostic accuracy (AUC = 0.85). DISCUSSION The current study shows that the risk assessed by the SAFE predicts on-road driving fitness in older adults. However, the results also suggest a need for a modification of the SAFE by the inclusion of additional evidence-based risk factors. With sensitivity and specificity scores of about 90 % and 75 %, this modified version may be more suitable for clinical use.
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Affiliation(s)
- Philipp Schulz
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, 33617, Bielefeld, Germany.
| | - Thomas Beblo
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, 33617, Bielefeld, Germany
| | - Stefan Spannhorst
- Zentrum für Seelische Gesundheit, Klinikum Stuttgart, Clinic for Psychiatry and Psychotherapy for Older People, Prießnitzweg 24, D-70374, Stuttgart, Germany
| | - Sebastian Boedeker
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, 33617, Bielefeld, Germany; Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Division of Geriatric Psychiatry, Bethesdaweg 12, 33617, Bielefeld, Germany; Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Memory Clinic, Gadderbaumer Straße 33, D-33602, Bielefeld, Germany
| | - Stefan H Kreisel
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, 33617, Bielefeld, Germany; Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Division of Geriatric Psychiatry, Bethesdaweg 12, 33617, Bielefeld, Germany
| | - Martin Driessen
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, 33617, Bielefeld, Germany; Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Division of Geriatric Psychiatry, Bethesdaweg 12, 33617, Bielefeld, Germany; Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Memory Clinic, Gadderbaumer Straße 33, D-33602, Bielefeld, Germany
| | - Kirsten Labudda
- Department of Psychology, Bielefeld University, Universitätsstraße 25, D-33615, Bielefeld, Germany
| | - Max Toepper
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, 33617, Bielefeld, Germany; Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Division of Geriatric Psychiatry, Bethesdaweg 12, 33617, Bielefeld, Germany; Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Memory Clinic, Gadderbaumer Straße 33, D-33602, Bielefeld, Germany
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Steuwe C, Berg M, Beblo T, Driessen M. Narrative Exposure Therapy in Patients With Posttraumatic Stress Disorder and Borderline Personality Disorder in a Naturalistic Residential Setting: A Randomized Controlled Trial. Front Psychiatry 2021; 12:765348. [PMID: 34899426 PMCID: PMC8663140 DOI: 10.3389/fpsyt.2021.765348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Comorbid Posttraumatic Stress Disorder (PTSD) increases the already high symptom burden of patients with Borderline Personality Disorder (BPD). As the gold standard for BPD treatment, Dialectical Behavior Therapy (DBT), does not focus on PTSD, other treatment approaches are needed. Narrative Exposure Therapy (NET) was designed to address multiple traumatic events and may be especially useful in this patient group. The aim of the present study was to determine the efficacy of NET compared to DBT based treatment (DBT-bt) in a randomized controlled trial. Methods: Female patients (n = 60) with BPD and comorbid PTSD were randomized to either a 10-week residential NET or DBT-bt. The primary outcome was change in PTSD severity as assessed by the Clinician Administered PTSD Scale (CAPS). Mixed linear models as well as reliable change, remission, and response rates were used to compare improvement across treatment groups. Results: Mixed linear model showed that patients in both treatments improved significantly over time across all outcome measures. This improvement was not more pronounced in NET (no significant time × type of treatment effect). However, NET resulted in a higher remission rate as compared to DBT-bt. PTSD remission was accompanied by BPD remission in all cases. Conclusions: This study shows the value of trauma-focused therapy in patients with BPD and PTSD for recovery in both disorders. To shorten the duration of both illnesses as much as possible, future studies should focus on the factors predicting treatment success and enabling patients to benefit from trauma-focused treatment as soon as possible. Trial registration: ClinicalTrials.gov, identifier: NCT02517723.
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Affiliation(s)
- Carolin Steuwe
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Michaela Berg
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
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Schulz P, Beblo T, Spannhorst S, Labudda K, Wagner T, Bertke V, Boedeker S, Driessen M, Kreisel SH, Toepper M. Avoidance Behavior Is an Independent Indicator of Poorer On-road Driving Skills in Older Adults. J Gerontol B Psychol Sci Soc Sci 2020; 75:2152-2161. [PMID: 31091321 DOI: 10.1093/geronb/gbz063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of the current work was to investigate the relationship between avoidance of specific driving situations and on-road driving skills in older drivers considering factors found to be related to both avoidance behavior and driving skills. METHOD Seventy-two older drivers (M = 76 years) from the general population were included in this study. Self-reported avoidance behavior, driving practice, perceived driving difficulties, driving-related cognitive functions, as well as medical conditions were assessed within two sessions. Standardized on-road assessments served for assessing on-road driving skills in a third session. RESULTS Self-reported avoidance behavior was associated with reduced driving skills (r = -.41), and this relationship remained significant beyond the influence of cognitive skills, self-reported health, driving practice, and perceived driving difficulties. Specifically, avoidance of driving in bad weather, poor visibility and complicated parking was found to be associated with reduced driving skills. DISCUSSION This study suggest that avoidance behavior is an independent indicator of impaired driving skills in older drivers. Our results argue against the assumption that avoidance behavior may be a reasonable strategy for safe traffic participation. Longitudinal studies are urgently needed to get more evidence on safety aspects of avoidance behavior.
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Affiliation(s)
- Philipp Schulz
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany
| | - Thomas Beblo
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany
| | - Stefan Spannhorst
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany
| | | | - Thomas Wagner
- Head of Business Unit Assessment Centers for Driving Fitness, DEKRA Automobil GmbH, Dresden, Germany
| | - Volkmar Bertke
- Assessment Center for Driving Fitness, DEKRA Automobil GmbH, Detmold, Germany
| | - Sebastian Boedeker
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany.,Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany
| | - Martin Driessen
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany
| | - Stefan H Kreisel
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany.,Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany
| | - Max Toepper
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany.,Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel (EvKB), Bielefeld, Germany
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Pohl S, Steuwe C, Mainz V, Driessen M, Beblo T. Borderline personality disorder and childhood trauma: Exploring the buffering role of self-compassion and self-esteem. J Clin Psychol 2020; 77:837-845. [PMID: 33037647 DOI: 10.1002/jclp.23070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/28/2020] [Accepted: 09/19/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate whether patients with borderline personality disorder (BPD) show lower self-compassion and self-esteem than healthy controls and whether patients' self-compassion and self-esteem moderate the association between childhood trauma and the severity of their BPD symptoms. METHOD Self-reported self-compassion, self-esteem, and the current severity of BPD symptoms were assessed in 35 female patients with BPD and 35 age-matched control participants. Further, traumatic childhood experiences were recorded in the patient group. RESULTS Patients with BPD reported significantly lower self-compassion and self-esteem compared to healthy controls. In addition, self-compassion but not self-esteem moderated the positive correlation between childhood trauma and the severity of BPD symptoms. DISCUSSION Self-compassion appears to buffer the negative consequences of childhood traumatization. Therefore, cultivating self-compassion may be an important therapeutic aim for patients with BPD.
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Affiliation(s)
- Sina Pohl
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
| | - Carolin Steuwe
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, University Hospital of the RWTH Aachen University, Aachen, Germany
| | - Martin Driessen
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
| | - Thomas Beblo
- Department of Research, Evaluation and Documentation, Clinic of Psychiatry and Psychotherapy, Evangelical Hospital Bethel, Bielefeld, Germany
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Santel M, Beblo T, Neuner F, Berg M, Hennig-Fast K, Jobes DA, Driessen M. Collaborative Assessment and Management of Suicidality (CAMS) compared to enhanced treatment as usual (E-TAU) for suicidal patients in an inpatient setting: study protocol for a randomized controlled trial. BMC Psychiatry 2020; 20:183. [PMID: 32321477 PMCID: PMC7178967 DOI: 10.1186/s12888-020-02589-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/07/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The Collaborative Assessment and Management of Suicidality (CAMS) is a therapeutic framework that has been shown to reduce suicidal ideation and overall symptom distress. CAMS has not been previously evaluated in a standard acute inpatient mental health care setting with only short treatment times for suicidal patients. In this randomized controlled trial (RCT) we are investigating whether CAMS is more effective than Enhanced-Treatment as Usual (E-TAU) in reducing suicidal thoughts as primary outcome variable. We are also investigating depressive symptoms, general symptom relief, and the quality of the therapeutic alliance as secondary outcomes. METHODS/DESIGN This RCT is designed as a single-center, two-armed, parallel group observer-blinded clinical effectiveness investigation. We are recruiting and randomizing 60 participants with different diagnoses, who are admitted as inpatients because of acute suicidal thoughts or behaviors into the Clinic for Psychiatry and Psychotherapy, Ev. Hospital Bethel in Bielefeld, Germany. The duration of treatment will vary depending on patients' needs and clinical assessments ranging between 10 and 40 days. Patients are assessed four times, at admission, discharge, 1 month, and 5 months post-discharge. The primary outcome measure is the Beck Scale for Suicide Ideation. Other outcome measures are administered as assessment timepoints including severity of psychiatric symptoms, depression, reasons for living, and therapeutic relationship. DISCUSSION This effectiveness study is being conducted on an acute ward in a psychiatric clinic where patients have multiple problems and diagnoses. Treatment is somewhat limited, and therapists have a large caseloads. The results of this study can thus be generalizable to a typical inpatient psychiatric hospital settings. TRIAL REGISTRATION This clinical trial has been retrospectively registered with the German Clinical Trials Register; registration code/ DRKS-ID: DRKS00013727 (on January 12, 2018). In addition, the study was also registered with the International Clinical Trials Registry Platform of the World Health Organization (identical registration code). Registry Name: "Evaluation von CAMS versus TAU bei suizidalen Patienten - Ein stationärer RCT".
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Affiliation(s)
- Miriam Santel
- Clinic of Psychiatry and Psychotherapy, Ev. Hospital Bethel, Bielefeld, Germany.
| | - Thomas Beblo
- Clinic of Psychiatry and Psychotherapy, Ev. Hospital Bethel, Bielefeld, Germany
| | - Frank Neuner
- grid.7491.b0000 0001 0944 9128Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Michaela Berg
- Clinic of Psychiatry and Psychotherapy, Ev. Hospital Bethel, Bielefeld, Germany
| | | | - David A. Jobes
- grid.39936.360000 0001 2174 6686Department of Psychology, The Catholic University of America, Washington, DC USA
| | - Martin Driessen
- Clinic of Psychiatry and Psychotherapy, Ev. Hospital Bethel, Bielefeld, Germany
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Abstract
Background: Cognitive impairment is a common symptom of patients with Major Depression (MDD) with negative clinical and social effects. With this study we investigated the question of whether MDD patients' effort to memorize items is reduced and whether this reduction is related to patients' memory impairment.Research design and methods: Twenty-two patients with MDD and 28 healthy control participants took part in the study. Both groups did not differ with respect to age, gender, and basic education. MDD was confirmed by the Mini Diagnostic Interview for Mental Disorders (Mini-DIPS). Willingness to make an effort was assessed by the Amsterdam Short-Term Memory Test (ASTM). Logical Memory (LM) from the Wechsler Memory Scale (WMS IV) was used to assess verbal memory.Results: With respect to the willingness to make an effort, all MDD-patients performed above the cutoff and did not perform worse than healthy control participants. Depression appears to have a negative impact on recall and recognition of verbal information, but the effect on recall was larger.Conclusions: These findings support studies indicating no motivational deficits in patients with depression during standardized neuropsychological testing. Reduced motivation is not a plausible explanation for depressive patients' cognitive deficits assessed with neuropsychological tests.
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Affiliation(s)
- Thomas Beblo
- Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, Bielefeld, Germany.,Department of Psychology, University of Bielefeld, Bielefeld, Germany
| | - Martin Driessen
- Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, Bielefeld, Germany.,Department of Psychology, University of Bielefeld, Bielefeld, Germany
| | - Lorenz Dehn
- Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bethel, Bielefeld, Germany.,Department of Psychology, University of Bielefeld, Bielefeld, Germany
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Dehn LB, Driessen M, Beblo T. Patients with major depression show greater memory improvement if motivation is increased: An exploratory study under real-life-like conditions. J Clin Exp Neuropsychol 2020; 42:307-318. [DOI: 10.1080/13803395.2020.1711874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Lorenz B. Dehn
- Clinic for Psychiatry and Psychotherapy, Evang. Klinikum Bethel, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Clinic for Psychiatry and Psychotherapy, Evang. Klinikum Bethel, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Clinic for Psychiatry and Psychotherapy, Evang. Klinikum Bethel, Bielefeld, Germany
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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Lamers A, Toepper M, Fernando SC, Schlosser N, Bauer E, Woermann F, Driessen M, Beblo T. Nonacceptance of negative emotions in women with borderline personality disorder: association with neuroactivity of the dorsal striatum. J Psychiatry Neurosci 2019; 44:303-312. [PMID: 30964611 PMCID: PMC6710090 DOI: 10.1503/jpn.180077] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Emotion dysfunction is a key symptom in patients with borderline personality disorder (BPD) and is considered a consequence of dysfunctional emotion regulation (e.g., reduced emotion acceptance). In the present functional MRI (fMRI) study, we investigated the neural correlates of habitual emotion acceptance in individuals with BPD. METHODS Female patients with BPD and female healthy controls passively viewed negative and neutral movie clips of faces during fMRI. We assessed emotion acceptance using the Emotion Acceptance Questionnaire (EAQ). To examine brain activation associated with habitual emotional acceptance of negative stimuli, the EAQ score was included as a regressor of interest in brain data analyses of activation intensity during negative compared with neutral movies. RESULTS We included 20 women with BPD and 20 heatlhy controls in our analysis. Compared with healthy controls, patients with BPD showed significantly more activation in frontostriatal brain regions (i.e., left superior frontal gyrus, right caudate) as well as in the left precuneus, left precentral gyrus, left posterior cingulate cortex and left hippocampus when confronted with negative (v. neutral) stimuli. Patients with BPD reported decreased emotion acceptance compared with healthy controls, and habitual emotion acceptance was inversely associated with activation of striatal areas (i.e., left putamen, left caudate) in patients with BPD. LIMITATIONS Causal conclusions are not possible. Comorbid diagnoses were not excluded, and only female participants were investigated. Stimuli were not rated immediately and may not be generalizable to all negative emotions. We cannot make any statements about other emotion-regulation strategies that may have been applied here. CONCLUSION Data indicate that striatal hyperactivation during the processing of negative stimuli in women with BPD is related to their decreased disposition to accept unpleasant emotional states. Thus, individuals with BPD may benefit from therapy approaches that focus on emotion acceptance in order to normalize emotional reactions.
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Affiliation(s)
- Agnes Lamers
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
| | - Max Toepper
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
| | - Silvia Carvalho Fernando
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
| | - Nicole Schlosser
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
| | - Eva Bauer
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
| | - Friedrich Woermann
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
| | - Martin Driessen
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
| | - Thomas Beblo
- From the Evangelisches Klinikum Bethel, Department of Psychiatry and Psychotherapy Bethel, Research Division, Germany (Lamers, Toepper, Fernando, Schlosser, Driessen, Beblo); the Bielefeld University, Department of Psychology, Beielefeld, Germany (Lamers, Driessen, Beblo); the University of Giessen, Cognitive Neuroscience at the Centre for Psychiatry, Germany (Bauer); and the Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany (Woermann)
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Dehn LB, Beblo T. Are they just exaggerating? Differences between subjective and objective cognitive performance in patients with depression: Mounting evidence and open questions. J Affect Disord 2019; 248:198-199. [PMID: 30777171 DOI: 10.1016/j.jad.2018.05.082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/27/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Lorenz B Dehn
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, Bielefeld D-33617, Germany; Bielefeld University, Department of Psychology, Universitätsstraße 25, Bielefeld D-33615, Germany.
| | - Thomas Beblo
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, Bielefeld D-33617, Germany; Bielefeld University, Department of Psychology, Universitätsstraße 25, Bielefeld D-33615, Germany
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Dehn LB, Beblo T. [Depressed, biased, forgetful: The interaction of emotional and cognitive dysfunctions in depression]. Neuropsychiatr 2019; 33:123-130. [PMID: 30875025 DOI: 10.1007/s40211-019-0307-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/02/2019] [Indexed: 02/04/2023]
Abstract
Major depressive disorder is characterized by changes in the emotional state, e. g. the diminished experience of positive emotions, as well as cognitive impairments such as concentration and memory difficulties. These emotional and cognitive dysfunctions are closely interrelated and play a key role for the development and maintenance of depressive symptoms. For instance, patients with depression show negatively biased information processing that affects attention and memory as well as their reaction to feedback. In addition, there is an increased motivation to avoid negatively evaluated conditions and at the same time a reduced motivation to approach positive goals. Furthermore, depressed patients often show a specific style of thinking, called rumination, which involves repeated, intensive thinking about the causes, consequences and symptoms of one's own negative feelings. In this review, the different relationships between emotional, motivational and cognitive symptoms of depressive patients will be presented and the influence of their interaction on cognitive performance will be discussed. The highlighted clinical relevance of emotional-cognitive dysfunctions should be considered more often in therapeutic interventions for depressed patients.
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Affiliation(s)
- Lorenz B Dehn
- Klinik für Psychiatrie und Psychotherapie - Forschungsabteilung, Evangelisches Klinikum Bethel (EvKB), Remterweg 69-71, 33617, Bielefeld, Deutschland.
| | - Thomas Beblo
- Klinik für Psychiatrie und Psychotherapie - Forschungsabteilung, Evangelisches Klinikum Bethel (EvKB), Remterweg 69-71, 33617, Bielefeld, Deutschland
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Beblo T, Pelster S, Schilling C, Kleinke K, Iffland B, Driessen M, Fernando S. Breath Versus Emotions: The Impact of Different Foci of Attention During Mindfulness Meditation on the Experience of Negative and Positive Emotions. Behav Ther 2018; 49:702-714. [PMID: 30146138 DOI: 10.1016/j.beth.2017.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 11/30/2017] [Accepted: 12/13/2017] [Indexed: 12/30/2022]
Abstract
Mindfulness meditation yields beneficial effects on the processing of emotions. However, it is still unclear whether the focus of attention during meditation influences these effects. In the present study we aimed at comparing the effects of breathing meditation and emotion-focused meditation on the immediate and delayed processing of negative and positive emotions. The study included 65 adult novice meditators who were exposed to positively and negatively valenced film clips. Participants were randomly assigned to three conditions. While watching the films at t1, they were asked to mindfully focus on their breath (condition 1), on emotions (condition 2), or on nothing in particular (condition 3). Ten minutes later at t2, comparable film clips were shown but all participants watched them without taking up a mindful attitude. Dependent measures were emotional states at t1 and t2. Participants of both meditation conditions particularly showed a more preferable delayed emotional reaction to negative stimuli than participants of the control condition. Breathing meditation and emotion-focused meditation may constitute effective emotion regulation strategies to deal with negatively valenced emotional states.
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Affiliation(s)
- Thomas Beblo
- Clinic of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany; University of Bielefeld.
| | | | | | | | | | - Martin Driessen
- Clinic of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany; University of Bielefeld
| | - Silvia Fernando
- Clinic of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany
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Dehn LB, Boedeker S, Nienhaus M, Labudda K, Beblo T, Driessen M, Toepper M. Whether to ask or not: How Valid Are Memory Complaints in Alzheimer's Disease? J Am Geriatr Soc 2018; 66:1237-1238. [PMID: 29701906 DOI: 10.1111/jgs.15373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Lorenz B Dehn
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Sebastian Boedeker
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Monika Nienhaus
- Department of Psychology, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Kirsten Labudda
- Department of Psychology, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Thomas Beblo
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Martin Driessen
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Max Toepper
- Research Division, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Bielefeld, Germany
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Dehn LB, Toepper M, Driessen M, Beblo T. Methodological Influences on the Association Between Self-Rated and Objective Memory Functioning. GeroPsych 2017. [DOI: 10.1024/1662-9647/a000177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Lorenz B. Dehn
- Ev. Hospital Bethel, Clinic for Psychiatry and Psychotherapy Bethel, Research Division, Bielefeld, Germany
| | - Max Toepper
- Ev. Hospital Bethel, Clinic for Psychiatry and Psychotherapy Bethel, Research Division, Bielefeld, Germany
| | - Martin Driessen
- Ev. Hospital Bethel, Clinic for Psychiatry and Psychotherapy Bethel, Research Division, Bielefeld, Germany
| | - Thomas Beblo
- Ev. Hospital Bethel, Clinic for Psychiatry and Psychotherapy Bethel, Research Division, Bielefeld, Germany
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Schulz P, Beblo T, Ribbert H, Kater L, Spannhorst S, Driessen M, Hennig-Fast K. How is childhood emotional abuse related to major depression in adulthood? The role of personality and emotion acceptance. Child Abuse Negl 2017; 72:98-109. [PMID: 28787645 DOI: 10.1016/j.chiabu.2017.07.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 06/07/2023]
Abstract
Accumulated evidence provides support that childhood emotional abuse (CEA) is related to adult major depressive disorder (MDD) outcomes. However, the psychological mechanisms of this relation are still not well understood. Changes in personality and emotion regulation are indicated to play a mediating role what should be examined in this paper. A sample of 123 MDD inpatients was examined in a prospective observational study with two times of measurement. Patients provided data on childhood trauma history, personality disorder (PD) traits and emotion acceptance. Self- and expert-ratings of depressive symptoms were assessed at baseline and at the end of treatment. Treatment duration as an objective indicator of treatment outcome was additionally considered. Partial correlation analyses revealed associations between CEA and self-ratings of MDD symptom severity and symptom improvement independent of sexual and physical abuse. Expert-ratings of depression and treatment duration were not related to CEA. Mediation analyses revealed that particularly the factors borderline psychopathology as well as acceptance of pleasant emotions mediated the association of CEA and self-rated MDD symptoms. Passive-aggressive PD traits mediated the link between CEA and a lower self-rated symptom improvement. CEA affect specific personality traits and acceptance of emotions. This association may play a critical role for self-reported depressive symptoms with implications for prevention, psychoeducation, and treatment of MDD.
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Affiliation(s)
- Philipp Schulz
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, D-33617 Bielefeld, Germany.
| | - Thomas Beblo
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Hedda Ribbert
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Division of General Psychiatry, Bethesdaweg 12, D-33617 Bielefeld, Germany
| | - Leona Kater
- Evangelisches Klinikum Bethel (EvKB), Department of Internal and Geriatric Medicine Johannesstift, Schildescher Straße 99, D-33611 Bielefeld, Germany
| | - Stephanie Spannhorst
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Division of General Psychiatry, Bethesdaweg 12, D-33617 Bielefeld, Germany
| | - Martin Driessen
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Research Division, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Kristina Hennig-Fast
- Evangelisches Klinikum Bethel (EvKB), Department of Psychiatry and Psychotherapy, Division of General Psychiatry, Bethesdaweg 12, D-33617 Bielefeld, Germany; Faculty of Psychology, Department of Applied Psychology, Health, Development, Enhancement, and Intervention, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria.
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Moritz S, Stöckert K, Hauschildt M, Lill H, Jelinek L, Beblo T, Diedrich S, Arlt S. Are we exaggerating neuropsychological impairment in depression? Reopening a closed chapter. Expert Rev Neurother 2017. [DOI: 10.1080/14737175.2017.1347040] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Stöckert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marit Hauschildt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah Lill
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld, Germany
| | - Sabrina Diedrich
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sönke Arlt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Beblo T, Kater L, Baetge S, Driessen M, Piefke M. Memory performance of patients with major depression in an everyday life situation. Psychiatry Res 2017; 248:28-34. [PMID: 27992768 DOI: 10.1016/j.psychres.2016.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 10/11/2016] [Accepted: 12/10/2016] [Indexed: 11/19/2022]
Abstract
Although patients with major depressive disorder (MDD) report severe memory impairment in their everyday life, memory tests indicate only moderate deficits. In order to clarify these conflicting observations, the present study aimed at the investigation of MDD patients' memory performance in a real everyday life situation. The study included 20 MDD patients and 20 healthy control subjects. Nonverbal memory was assessed by means of the Rey Complex Figure Test whereas verbal memory was assessed by the recall of a 20-item wordlist with supermarket products. For the assessment of everyday life memory, subjects had to purchase as many products as possible of the 20-item wordlist in a real supermarket. Furthermore, subjects were asked for memory complaints. MDD patients' performance in the supermarket resembled memory test results and was not significantly impaired. MDD patients' self-reports, however, indicated severe memory problems that clearly fell below their performance in the supermarket. This study helped to identify everyday life-related factors that do not impair MDD patients' cognitive performance beyond their performance in standard laboratory testing situations. These factors may not be relevant for remediation programs that are specifically developed for depressed patients.
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Affiliation(s)
- Thomas Beblo
- Clinic of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany.
| | - Leona Kater
- Clinic of Internal and Geriatric Medicine, Schildescher Str. 99, 33611 Bielefeld, Germany
| | - Sharon Baetge
- Clinic of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, 33617 Bielefeld, Germany
| | - Martin Driessen
- Clinic of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, 33617 Bielefeld, Germany; Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Martina Piefke
- Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany
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Steuwe C, Berg M, Driessen M, Beblo T. Impact of therapist change after initial contact and traumatic burden on dropout in a naturalistic sample of inpatients with borderline pathology receiving dialectical behavior therapy. Borderline Personal Disord Emot Dysregul 2017. [PMID: 28649383 PMCID: PMC5480417 DOI: 10.1186/s40479-017-0067-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study focused on the predictors of therapy dropout in a naturalistic sample of patients with borderline pathology receiving dialectical behavior therapy (DBT) in an inpatient setting. We assumed that the change of the therapist between DBT-briefing and start of DBT-treatment as well as comorbid posttraumatic stress disorder (PTSD) and childhood trauma history were associated with elevated dropout. METHODS Eighty-nine participants with borderline pathology (≥ 3 borderline personality disorder criteria) receiving an inpatient DBT program completed a quality assurance questionnaire set assessing demographic information and pretreatment psychopathology during the days of their inpatient stay. Beyond that, changes of therapists were documented. The predictor analyses were investigated with generalized estimating equations. RESULTS The dropout rate was 24.7%. A change of therapist between DBT-briefing and treatment as well as high childhood emotional abuse was associated with premature termination of treatment. Higher values of physical neglect during childhood were associated with a protective effect on treatment dropout. Surprisingly, this was also true for comorbid PTSD. CONCLUSIONS This study supports the importance of therapy process variables as predictors of therapy dropout in borderline pathology. A change of therapist between DBT-briefing and treatment was associated with an increased vulnerability for dropping out of treatment and should therefore be avoided if possible. Against our hypotheses, a comorbid PTSD was even protective with regard to DBT dropout. Therefore, this severely suffering patient group should not be rejected from treatment assuming them to be too unstable for psychotherapy. However, results need to be replicated. ClinicalTrials.gov Identifier: NCT03018639, retrospectively registered on January 9, 2017.
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Affiliation(s)
- Carolin Steuwe
- Research Department, Clinic of Psychiatry and Psychotherapy, Ev. Kliníkum Bethel, Bielefeld, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Michaela Berg
- Research Department, Clinic of Psychiatry and Psychotherapy, Ev. Kliníkum Bethel, Bielefeld, Germany
| | - Martin Driessen
- Research Department, Clinic of Psychiatry and Psychotherapy, Ev. Kliníkum Bethel, Bielefeld, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Research Department, Clinic of Psychiatry and Psychotherapy, Ev. Kliníkum Bethel, Bielefeld, Germany.,Department of Psychology, Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
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Wingenfeld K, Bullig R, Mensebach C, Hartje W, Driessen M, Beblo T. Attention Bias towards Personally Relevant Stimuli: The Individual Emotional Stroop Task. Psychol Rep 2016; 99:781-93. [PMID: 17305196 DOI: 10.2466/pr0.99.3.781-793] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The emotional Stroop task is a widely used method for investigating attentional bias towards stimuli due to mood or affect. In general, standardized stimuli are used, which might not be appropriate when investigating individual contextual frameworks. It was investigated whether words chosen to be related to individuals' personal life events would produce more pronounced Stroop interference (as an indicator of attentional bias) than stimuli without any personal relevance. Twenty-six non-clinical subjects, 20 female and 6 male, participated in the study. Mean age was 36.1 yr. ( SD=18.1). All were recruited by means of local advertising. Stimulus material consisted of four word types: personal words related to negative life events with and without current personal relevance, and negative and neutral words without any personal relevance. Words were presented in three blocks. Analysis of variance showed main effects for word type and blocks, with slower reactions in the personally relevant conditions than in the negative, or neutral conditions, and in response to the first blocks as opposed to the last. These findings indicate that regardless of the word valence, personally relevant stimuli evoke more pronounced Stroop interference than do stimuli without personal relevance.
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Affiliation(s)
- Katja Wingenfeld
- Department of Psychiatry and Psychotherapy Bethel, Evangelisches Hospital Bielefeld, Remterweg 69-71, D-33617 Bielefeld, Germany.
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Steuwe C, Driessen M, Beblo T. Traumaorientierte Psychotherapie. Psychotherapeut 2016. [DOI: 10.1007/s00278-016-0129-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Steuwe C, Rullkötter N, Ertl V, Berg M, Neuner F, Beblo T, Driessen M. Effectiveness and feasibility of Narrative Exposure Therapy (NET) in patients with borderline personality disorder and posttraumatic stress disorder - a pilot study. BMC Psychiatry 2016; 16:254. [PMID: 27439618 PMCID: PMC4955150 DOI: 10.1186/s12888-016-0969-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 07/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This pilot study focused on the feasibility and potential effectiveness of a protocol based on Narrative Exposure Therapy (NET) that was integrated into a standard inpatient program to treat patients with comorbid Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD). METHODS Eleven patients (1 male, 10 female) without previous stabilization periods or the absence of intentional self-injury received NET during a ten-week inpatient program. Patients were assessed again at post-treatment and a 12-month follow-up. RESULTS Drop-out rates during treatment were low, with 90.9 % completing NET. Furthermore, acceptance of NET was high, with only one patient rejecting treatment. The program was safe because it did not lead to aggravations in symptom severity at either the post-treatment or 12-month follow-up. Additionally, the rate of self-harming behaviors throughout the treatment phase was low (18.2 %). In fact, treatment was associated with positive effects on PTSD and BPD symptom severity as well as secondary outcome measures, including depression, dissociation and quality of life. CONCLUSIONS The present study found that NET is feasible and safe in an inpatient setting for treating highly burdened patients with BPD and PTSD. There is also evidence for the potential effectiveness of NET in this highly burdened population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02517723 . Registered 6 January 2014.
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Affiliation(s)
- Carolin Steuwe
- />Clinic of Psychiatry and Psychotherapy, Bethel, Bielefeld University, Bielefeld, Germany
| | | | | | - Michaela Berg
- />Clinic of Psychiatry and Psychotherapy, Bethel, Bielefeld, Germany
| | | | - Thomas Beblo
- />Clinic of Psychiatry and Psychotherapy, Bethel, Bielefeld, Germany
| | - Martin Driessen
- />Clinic of Psychiatry and Psychotherapy, Bethel, Bielefeld, Germany
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Abstract
Zusammenfassung. Beeinträchtigungen der Exekutivfunktionen, der Aufmerksamkeit und des Gedächtnisses sind einige der häufigsten und hartnäckigsten Symptome depressiver Störungen. Bisher konnte allerdings kein eindeutiges Profil dieser Defizite identifiziert werden, wahrscheinlich auch deshalb, weil die Defizite von verschiedenen klinischen und demografischen Faktoren, wie dem Depressionssubtypus, Grübeln, Komorbiditäten und Alter beeinflusst werden. Die kognitiven Beeinträchtigungen verbessern sich mit der Remission der Störung, häufig findet jedoch keine vollständige Rückbildung statt. Sie sind klinisch sehr relevant und gehen einher mit Suizidalität, reduzierten Therapieeffekten und negativen Auswirkungen auf Alltagsaktivitäten. Aus diesen Gründen ergibt sich für betroffene Patienten die Notwendigkeit einer neuropsychologischen Behandlung. Erste Ergebnisse lassen hoffen, dass die kognitiven Beeinträchtigungen mithilfe neuropsychologischer Therapie, Achtsamkeitstraining, psychopharmakologischer Therapie und weiteren neurobiologischen Behandlungen, wie z. B. der repetitiven transkraniellen Magnetstimulation, erfolgreich behandelt werden können.
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Affiliation(s)
- Thomas Beblo
- Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld, Bielefeld
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Guhra M, Thomas C, Boedeker S, Kreisel S, Driessen M, Beblo T, Ohrmann P, Toepper M. Linking CSF and cognition in Alzheimer's disease: Reanalysis of clinical data. Exp Gerontol 2015; 73:107-13. [PMID: 26585048 DOI: 10.1016/j.exger.2015.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Memory and executive deficits are important cognitive markers of Alzheimer's disease (AD). Moreover, in the past decade, cerebrospinal fluid (CSF) biomarkers have been increasingly utilized in clinical practice. Both cognitive and CSF markers can be used to differentiate between AD patients and healthy seniors with high diagnostic accuracy. However, the extent to which performance on specific mnemonic or executive tasks enables reliable estimations of the concentrations of different CSF markers and their ratios remains unclear. METHODS To address the above issues, we examined the association between neuropsychological data and CSF biomarkers in 51 AD patients using hierarchical multiple regression analyses. In the first step of these analyses, age, education and sex were entered as predictors to control for possible confounding effects. In the second step, data from a neuropsychological test battery assessing episodic memory, semantic memory and executive functioning were included to determine whether these variables significantly increased (compared to step 1) the explained variance in Aβ42 concentration, p-tau concentration, t-tau concentration, Aβ42/t-tau ratio, and Aβ42/Aβ40 ratio. RESULTS The different models explained 52% of the variance in Aβ42/t-tau ratio, 27% of the variance in Aβ42 concentration, and 28% of the variance in t-tau concentration. In particular, Aβ42/t-tau ratio was associated with verbal recognition and code shifting, with Aβ42 being related to verbal recognition and t-tau being related to code shifting. By contrast, the inclusion of neuropsychological data did not allow reliable estimations of Aβ42/Aβ40 ratio or p-tau concentration. CONCLUSION Our results showed that strong associations exist between the cognitive key symptoms of AD and the concentrations and ratios of specific CSF markers. In addition, we revealed a specific combination of neuropsychological tests that may facilitate reliable estimations of CSF concentrations, thereby providing important diagnostic information for non-invasive early AD detection.
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Affiliation(s)
- Michael Guhra
- Evangelisches Krankenhaus Bielefeld, Department of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany.
| | - Christine Thomas
- Clinical Centre Stuttgart, Clinic for Psychiatry and Psychotherapy for the Elderly, Prießnitzweg 24, D-70374 Stuttgart, Germany
| | - Sebastian Boedeker
- Evangelisches Krankenhaus Bielefeld, Department of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Stefan Kreisel
- Evangelisches Krankenhaus Bielefeld, Department of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Martin Driessen
- Evangelisches Krankenhaus Bielefeld, Department of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Thomas Beblo
- Evangelisches Krankenhaus Bielefeld, Department of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany
| | - Patricia Ohrmann
- University of Muenster, Department of Psychiatry, Albert-Schweitzer-Campus 1, A9, D-48149 Muenster, Germany
| | - Max Toepper
- Evangelisches Krankenhaus Bielefeld, Department of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany
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Steuwe C, Driessen M, Beblo T. [Trauma-focused psychotherapy: Technique, area of application, and treatment outcome]. Nervenarzt 2015; 86:1427-35; quiz 1436-7. [PMID: 26542157 DOI: 10.1007/s00115-015-4360-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Traumatic events may lead to trauma-related disorders such as the posttraumatic stress disorder (PTSD) and constraints in quality of life. Meanwhile, there are different trauma-focused psychotherapies that aim to prevent PTSD shortly after experiencing a traumatic event and interventions that aim to treat PTSD. In Germany, cognitive-behavioral and psychodynamic trauma-focused approaches are commonly applied. While cognitive-behavioral programs aim at early exposure with the traumatic event, psychodynamic approaches emphasize the need of a period of stabilization before undergoing exposure. With regard to empirical evidence, cognitive-behavioral programs were able to prove their efficacy most often and are recommended in national and international guidelines. The German S3 guideline PTSD is currently under revision.
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Affiliation(s)
- C Steuwe
- Klinik für Psychiatrie und Psychotherapie, Evangelisches Krankenhaus Bielefeld, Remterweg 69-71, 33649, Bielefeld, Deutschland.
| | - M Driessen
- Klinik für Psychiatrie und Psychotherapie, Evangelisches Krankenhaus Bielefeld, Remterweg 69-71, 33649, Bielefeld, Deutschland
| | - T Beblo
- Klinik für Psychiatrie und Psychotherapie, Evangelisches Krankenhaus Bielefeld, Remterweg 69-71, 33649, Bielefeld, Deutschland
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Abstract
Fragestellung: Positive Effekte tiergestützter Therapie (TGT) auf Patienten sind belegt. Die vorliegende Studie geht der Frage nach, ob auch Substanzabhängige im stationären Drogenentzug von TGT profitieren und sich unmittelbare Effekte auf die emotionale Befindlichkeit und das subjektive Craving zeigen lassen. Methode: 26 Patienten (ICD-10: F11.2; F12.2, Alter:18 – 65 Jahre) wurden in der randomisiert-kontrollierten Studie im Cross-Over-Design untersucht und in Gruppe A und B aufgeteilt. Gruppe A erhielt zuerst das Interventionsangebot (Spaziergänge mit Hund) und dann das Kontrollangebot (Spaziergänge ohne Hund), bei Gruppe B wurde umgekehrt verfahren. Vor und nach jeder Intervention wurden die emotionale Befindlichkeit und das Craving der Probanden erfasst. Außerdem wurde über den Studienzeitraum hinweg die globale psychopathologische Symptombelastung der Patienten ermittelt. Ergebnisse: Es konnten signifikant stärkere prä-/post-Veränderungen unter der Interventionsbedingung mit Hund im Vergleich zu ohne Hund auf die emotionale Befindlichkeit und eine tendenziell signifikant ausgeprägtere Verringerung des Cravings nach der Intervention mit Hund aufgezeigt werden. Im Studienverlauf reduzierte sich die globale psychopathologische Symptombelastung deutlich, hier fanden sich keine hundespezifischen Effekte. Schlussfolgerung: Es ergeben sich erste Hinweise darauf, dass substanzabhängige Patienten im akutpsychiatrischen Drogenentzug kurzfristig von TGT mit einem Hund profitieren.
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Affiliation(s)
- Sabine Urban
- Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld
| | - Lorenz B. Dehn
- Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld
| | - Björn Zillmer
- Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld
| | - Martin Driessen
- Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld
| | - Thomas Beblo
- Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld
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Toepper M, Boedeker S, Bauer E, Westphal S, Driessen M, Beblo T. Does Mount Vesuvius indicate an outbreak of Alzheimer's disease? J Am Geriatr Soc 2014; 62:1989-91. [PMID: 25333539 DOI: 10.1111/jgs.13042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Max Toepper
- Research Department, Department of Geriatric Psychiatry, Clinic of Psychiatry and Psychotherapy Bethel, Evangelic Hospital Bielefeld, Bielefeld, Germany
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Beblo T, Mensebach C, Wingenfeld K, Rullkoetter N, Schlosser N, Driessen M. Subjective memory complaints and memory performance in patients with borderline personality disorder. BMC Psychiatry 2014; 14:255. [PMID: 25214199 PMCID: PMC4172827 DOI: 10.1186/s12888-014-0255-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 08/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is still a matter of debate as to whether patients with Borderline Personality Disorder (BPD) suffer from memory deficits. Existing studies indicate no or small impairments in memory test performance. However, it was shown in patients with related disorders, such as depression, that self-reported impairment exceeds test malfunction. In the present study we assessed memory performance of BPD patients through the use of memory tests and a questionnaire for subjective memory complaints (SMC) in everyday life. METHODS Thirty-two patients with BPD and 32 healthy control subjects were included in the study. The groups of subjects were comparable with respect to age, education, and gender. Subjects completed verbal and nonverbal memory tests, as well as the everyday memory questionnaire (EMQ). RESULTS BPD patients reported severe SMC but did not show memory test impairment. The results remained stable even when all BPD patients with acute or lifetime depression comorbidity were excluded from analyses. In both groups, SMC and test performances were not related but in BPD patients SMC were related to BPD symptoms. CONCLUSIONS Our data indicate memory impairment of BPD patients in everyday life. However, it cannot be ruled out that increased memory complaints result from patients' negative self-perception. Future research needs to clarify the reasons for memory complaints of BPD patients.
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Affiliation(s)
- Thomas Beblo
- Department of Research, Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany ,Department of Psychology, University of Bielefeld, Bielefeld, Germany
| | - Christoph Mensebach
- Department of Psychosomatic Medicine and Psychotherapy, University Duisburg-Essen, Essen, Germany
| | - Katja Wingenfeld
- Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Nina Rullkoetter
- Department of Research, Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany
| | - Nicole Schlosser
- Department of Research, Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany
| | - Martin Driessen
- Department of Research, Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Remterweg 69-71, 33617 Bielefeld, Germany
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Fernando SC, Griepenstroh J, Urban S, Driessen M, Beblo T. [Attentional bias and emotional suppression in borderline personality disorder]. Neuropsychiatr 2014; 28:121-129. [PMID: 25037993 DOI: 10.1007/s40211-014-0112-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 05/17/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Emotion regulation dysfunctions marked by negative affectivity are a core feature of borderline personality disorder (BPD). In addition, patients with BPD show disturbed attentional processes which become particularly apparent in the domain of selective attention when emotional stimuli are presented (negative attentional bias). Assuming that emotion regulation is linked to attentional deployment processes, this study aimed (1) to determine whether a negative attentional bias is established by using film clips of fearful faces and (2) to investigate the association between dysfunctional emotion regulation strategies (emotional suppression) and negative attention bias in BPD. METHODS We investigated 18 inpatients with BPD and 18 healthy control participants using the modified version of the fearful face-paradigm to assess the inhibition of emotional stimuli. We also administered self-report emotion regulation questionnaires. RESULTS Compared to the healthy controls, patients with BPD showed significant longer reaction times during the emotional versus the neutral film stimuli in the modified fearful face-paradigm. With regard to the second hypothesis, we failed to find an association between the negative attentional bias and the habitual use of emotional suppression in BPD. CONCLUSIONS In this study, we could confirm an attentional bias for negative stimuli, using complex, dynamic material. Future studies need to address the impact of confounding variables (e. g. comorbid disorders) on the relationship between maladaptive emotion regulation and selective attentional bias.
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Affiliation(s)
- Silvia Carvalho Fernando
- Klinik für Psychiatrie und Psychotherapie Bethel, Evangelisches Krankenhaus Bielefeld, Remterweg 69-71, 33617, Bielefeld, Deutschland,
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Ilic M, Reinecke J, Bohner G, Röttgers HO, Beblo T, Driessen M, Frommberger U, Corrigan PW. Managing a stigmatized identity-evidence from a longitudinal analysis about people with mental illness. J Appl Soc Psychol 2014. [DOI: 10.1111/jasp.12239] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Marie Ilic
- Institute for Interdisciplinary Research on Conflict and Violence; University of Bielefeld
| | - Jost Reinecke
- Institute for Interdisciplinary Research on Conflict and Violence; University of Bielefeld
| | - Gerd Bohner
- Institute for Interdisciplinary Research on Conflict and Violence; University of Bielefeld
| | | | - Thomas Beblo
- Clinic of Psychiatry and Psychotherapy Bethel; Bielefeld
| | | | - Ulrich Frommberger
- Hospital of Psychiatry, Psychotherapy and Psychosomatic Medicine; Offenberg
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Toepper M, Gebhardt H, Bauer E, Haberkamp A, Beblo T, Gallhofer B, Driessen M, Sammer G. The impact of age on load-related dorsolateral prefrontal cortex activation. Front Aging Neurosci 2014; 6:9. [PMID: 24550826 PMCID: PMC3913830 DOI: 10.3389/fnagi.2014.00009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 01/15/2014] [Indexed: 01/18/2023] Open
Abstract
Healthy aging is accompanied by working memory-related functional cerebral changes. Depending on performance accuracy and the level of working memory demands, older adults show task-related patterns of either increased or decreased activation compared to younger adults. Controversies remain concerning the interpretation of these changes and whether they already manifest in earlier decades of life. To address these issues, functional magnetic resonance imaging (fMRI) was used to examine brain activation during spatial working memory retrieval in 45 healthy individuals between 20 and 68 years of age. Participants performed a modified version of the Corsi Block-Tapping test (CBT). The CBT requires the storage and subsequent reproduction of spatial target sequences and allows modulating working memory load by a variation of sequence length. Results revealed that activation intensity at the lowest CBT load level increased with increasing age and positively correlated with the number of errors. At higher CBT load levels, activation intensity decreased with increasing age together with a disproportional accuracy decline on the behavioral level. Moreover, results suggests that younger individuals showed higher activation intensity at high CBT load than at low CBT load switching to the opposite pattern at an age of about 40 years. Consistent with the assumptions of the Compensation-Related Utilization of Neural Circuits Hypothesis (CRUNCH), the present results reveal specific age-related alterations in left dorsolateral prefrontal cortex activation in response to increasing task load. Specifically, the results point toward increasing neural inefficiency with age at low task load and a progressive limitation of resources with age at higher task load. The present findings argue for an increasing functional cerebral dysfunction over a time span of 50 years that may partly be compensated on the behavioral level until a resource ceiling is approached.
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Affiliation(s)
- Max Toepper
- Research Department, Evangelic Hospital Bielefeld (EvKB) Bielefeld, Germany ; Cognitive Neuroscience at Centre for Psychiatry, Justus-Liebig-University Giessen Giessen, Germany
| | - Helge Gebhardt
- Cognitive Neuroscience at Centre for Psychiatry, Justus-Liebig-University Giessen Giessen, Germany ; Bender Institute of Neuroimaging, Justus-Liebig-University Giessen Giessen, Germany
| | - Eva Bauer
- Cognitive Neuroscience at Centre for Psychiatry, Justus-Liebig-University Giessen Giessen, Germany
| | - Anke Haberkamp
- Clinical Psychology and Psychotherapy, Philipps-University Marburg Marburg, Germany
| | - Thomas Beblo
- Research Department, Evangelic Hospital Bielefeld (EvKB) Bielefeld, Germany
| | - Bernd Gallhofer
- Cognitive Neuroscience at Centre for Psychiatry, Justus-Liebig-University Giessen Giessen, Germany
| | - Martin Driessen
- Research Department, Evangelic Hospital Bielefeld (EvKB) Bielefeld, Germany
| | - Gebhard Sammer
- Cognitive Neuroscience at Centre for Psychiatry, Justus-Liebig-University Giessen Giessen, Germany ; Bender Institute of Neuroimaging, Justus-Liebig-University Giessen Giessen, Germany
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