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Teismann T, Forkmann T, Glaesmer H, Alpers GW, Brakemeier EL, Brockmeyer T, Christiansen H, Fehm L, Glombiewski J, Heider J, Hermann A, Hoyer J, Kaiser T, Klucken T, Lincoln TM, Lutz W, Margraf J, Pedersen A, Renneberg B, Rubel J, Rudolph A, Schöttke H, Schwartz B, Stark R, Velten J, Willutzki U, Wilz G, In-Albon T. Prevalence of suicidal ideation in German psychotherapy outpatients: A large multicenter assessment. J Affect Disord 2024; 351:971-976. [PMID: 38346649 DOI: 10.1016/j.jad.2024.02.019] [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: 11/01/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Suicidal ideation is a major concern in clinical practice. Yet, little is known about prevalence rates of suicidal ideation in patients undergoing outpatient psychotherapeutic treatment. Therefore, the aim of the current study is to assess the prevalence of suicidal ideation in a large sample of psychotherapy outpatients in Germany. The data analyzed in this study is taken from the KODAP-project on the coordination of data collection and analysis at German university-based research and training outpatient clinics for psychotherapy. METHODS A total of N = 10,357 adult outpatients (64.4 % female; age: M(SD) = 35.94 (13.54), range: 18-92 years of age) starting cognitive-behavioral therapy at one of 27 outpatient clinics in Germany were included in the current study. Prevalence of suicidal ideation was assessed with the Suicide Item (Item 9) of the Beck-Depression Inventory II. RESULTS Suicidal ideation was reported by 36.7 % (n = 3795) of the participants. Borderline Personality Disorder, Posttraumatic Stress Disorder, and recurrent Major Depression were the diagnoses most strongly associated with the presence and severity of suicidal ideation. LIMITATION Suicide ideation was assessed only with the respective item of the Beck Depression Inventory II. CONCLUSION Suicidal ideation is very common among adult patients who start psychotherapy in Germany. A well-founded knowledge of risk assessment in suicidal patients and suicide-specific treatment options is therefore highly relevant.
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Affiliation(s)
- T Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany.
| | - T Forkmann
- Clinical Psychology and Psychotherapy, Universität Duisburg-Essen, Germany.
| | - H Glaesmer
- Medical Psychology and Medical Sociology, Universität Leipzig, Germany.
| | - G W Alpers
- Otto Selz Institute & Department of Psychology, School of Social Sciences, University of Mannheim, Germany.
| | - E L Brakemeier
- Clinical Psychology and Psychotherapy, Universität Greifswald, Germany.
| | - T Brockmeyer
- Clinical Psychology and Psychotherapy, University of Goettingen, Germany.
| | - H Christiansen
- Clinical Child and Adolescent Psychology, Philipps-Universität Marburg, Germany.
| | - L Fehm
- Institute for Psychology, Humboldt-Universität zu Berlin, Germany.
| | - J Glombiewski
- Clinical Psychology and Psychotherapy of Adulthood, University of Kaiserslautern-Landau, Germany.
| | - J Heider
- Clinical Psychology and Psychotherapy of Adulthood, University of Kaiserslautern-Landau, Germany.
| | - A Hermann
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany.
| | - J Hoyer
- Faculty of Psychology, Technische Universität Dresden, Germany.
| | - T Kaiser
- Methods and Evaluation/Quality Assurance, Freie Universität Berlin, Germany.
| | - T Klucken
- Clinical Psychology and Psychotherapy, Universität Siegen, Germany.
| | - T M Lincoln
- Clinical Psychology and Psychotherapy, Universität Hamburg, Germany.
| | - W Lutz
- Clinical Psychology and Psychotherapy, Universität Trier, Germany.
| | - J Margraf
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - A Pedersen
- Clinical Psychology and Psychotherapy, Kiel University, Germany.
| | - B Renneberg
- Clinical Psychology and Psychotherapy, Freie Universität Berlin, Germany.
| | - J Rubel
- Clinical Psychology and Psychotherapy of Adulthood, Universität Osnabrück, Germany.
| | - A Rudolph
- Clinical Psychology and Psychotherapy, Universität Leipzig, Germany.
| | - H Schöttke
- Clinical Psychology and Psychotherapy, Universität Osnabrück, Germany.
| | - B Schwartz
- Clinical Psychology and Psychotherapy, Universität Trier, Germany.
| | - R Stark
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany.
| | - J Velten
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - U Willutzki
- Clinical Psychology and Psychotherapy, Faculty of Health, University Witten/Herdecke, Germany.
| | - G Wilz
- Counseling and Clinical Intervention, Department of Psychology, Friedrich-Schiller Universität Jena.
| | - T In-Albon
- Clinical Child and Adolescent Psychology and Psychotherapy, University of Kaiserslautern-, Landau, Germany.
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Begemann S, Willutzki U, Lutz G. Perception, experience and use of moments of change - a qualitative investigation. Z Psychosom Med Psychother 2023; 69:331-344. [PMID: 37830881 DOI: 10.13109/zptm.2023.69.oa5] [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: 10/14/2023]
Abstract
Objectives: In psychotherapeutic change processes, in addition to gradual changes, specific single special moments are described as a starting point for change. We investigated the perception of these moments of change (CMs) from the patient's perspective: What does each patient perceive and experience in a CM? Methods: A qualitative, explorative study of CMs was conducted by means of semi-structured questionnaires as well as qualitative interviews with patients (n = 12). Grounded theory was used for the analysis. Results: CMs were noticed by an "explicit mode of perception" based on physical, emotional and cognitive aspects. In addition, we found a "transcending mode of experience" that involved changes in consciousness and self-experience. CMs showed a "specific transformative pattern" and were preserved as "experience anchors". Conclusions: The intensification of consciousness, transformation of self-experience, and intense prototypical experience of a change process appeared particularly impressive. With the help of CMs, access could be gained to an embodied and implicit experience, which could subsequently be symbolised and used as an "experience anchor". This could be useful especially for the treatment of psychosomatic patients.
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Affiliation(s)
- Simone Begemann
- Abteilung für Psychosomatische Medizin und Psychotherapie Gemeinschaftskrankenhaus Herdecke Gerhard-Kienle-Weg 4 D-58313 Herdecke Deutschland
| | - Ulrike Willutzki
- Department of Clinical Psychology and Psychotherapy I, Faculty of Health, University of Witten/Herdecke Deutschland
| | - Gabriele Lutz
- Abteilung für Psychosomatische Medizin und Psychotherapie Gemeinschaftskrankenhaus Herdecke Gerhard-Kienle-Weg 4 D-58313 Herdecke Deutschland
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Health, University ofWitten/Herdecke, Germany Deutschland
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Schürmann-Vengels J, Troche S, Victor PP, Teismann T, Willutzki U. Multidimensional Assessment of Strengths and Their Association With Mental Health in Psychotherapy Patients at the Beginning of Treatment. Clin Psychol Eur 2023; 5:e8041. [PMID: 37732153 PMCID: PMC10508254 DOI: 10.32872/cpe.8041] [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] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/07/2023] [Indexed: 09/22/2023] Open
Abstract
Background Modern concepts assume that mental health is not just the absence of mental illness but is also characterized by positive well-being. Recent findings indicated a less pronounced distinction of positive and negative mental health dimensions in clinical samples. Self-perceived strengths were associated with markers of mental health in healthy individuals. However, analyses of strengths and their association with different mental health variables in clinical populations are scarce. Method A cross-sectional design was conducted at a German outpatient training and research center. 274 patients before treatment (female: 66.4%, mean age = 42.53, SD = 13.34, range = 18-79) filled out the Witten Strengths and Resource Form (WIRF), a multidimensional self-report of strengths, as well as other instruments assessing positive and negative mental health variables. Data was analyzed with structural equation modeling and latent regression analyses. Results Confirmatory factor analysis of the WIRF showed good model fit for the assumed three-subscale solution. Regarding mental health, a one-factor model with positive and negative variables as opposite poles showed acceptable fit. A correlated dual-factor model was not appropriate for the data. All WIRF subscales significantly predicted unique parts of variance of the latent mental illness factor (p = .035 - p < .001). Conclusion The context-specific assessment of patients' strengths was confirmed and led to an information gain in the prediction of mental health. Results suggest that positive and negative facets of mental health are highly entwined in people with pronounced symptoms. The scientific and practical implications of these findings are discussed.
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Affiliation(s)
- Jan Schürmann-Vengels
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Stefan Troche
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Philipp Pascal Victor
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
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Trimpop LF, Bielinski LL, Berger T, Willutzki U. Evaluation of Two Web-Based Interventions (Res-Up! and REMOTION) in Routine Outpatient Psychotherapy (Therapy Online Plus-TOP): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e41413. [PMID: 36920449 PMCID: PMC10131645 DOI: 10.2196/41413] [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] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Only 11%-40% of those with a mental disorder in Germany receive treatment. In many cases, face-to-face psychotherapy is not available because of limited resources, such as an insufficient number of therapists in the area. New approaches to improve the German health care system are needed to counter chronification. Web-based interventions have been shown to be effective as stand-alone and add-on treatments to routine practice. Interventions designed for a wide range of mental disorders such as transdiagnostic interventions are needed to make treatment for mental disorders more accessible and thus shorten waiting times and mitigate the chronification of mental health problems. In general, interventions can be differentiated as having either a capitalization (CAP) focus-thus drawing on already existing strengths-or a compensation (COMP) focus-trying to compensate for deficits. Up to now, the effectiveness of transdiagnostic web-based interventions with either a CAP or a COMP focus has not yet been evaluated. OBJECTIVE This study is the first to examine the effectiveness of two transdiagnostic web-based interventions: (1) the activation of resilience and drawing on existing strengths (CAP: Res-Up!) and (2) the improvement of emotion regulation (COMP: REMOTION), compared with care as usual (CAU) in routine outpatient psychotherapy. METHODS Adults with at least 1 mental health disorder will be recruited at 4 outpatient centers in Germany. Participants will then be randomized equally into 1 of the 2 intervention groups Res-Up! (CAP) and REMOTION (COMP) or into the control group (CAU). Assessments will be made at baseline (T0), at 6 weeks after treatment start (T1), and at 12 weeks after treatment start (T2). A primary outcome will be symptom severity (Brief Symptom Inventory-18). Secondary outcomes will focus on emotion regulation and resilience. RESULTS Participant recruitment and data collection started in April 2020 and were ongoing as of July 2022. We expect participants to benefit more from the interventions than from the CAU control on the dimensions of symptom severity, resilience, and emotion regulation. Furthermore, we expect to find possible differences between CAP and COMP. The results of the study are expected in 2023. CONCLUSIONS This randomized controlled trial will compare CAU with the transdiagnostic web-based interventions Res-Up! and REMOTION, and will thus inform future studies concerning the effectiveness of transdiagnostic web-based interventions in routine outpatient psychotherapy. TRIAL REGISTRATION ClinicalTrials.gov NCT04352010; https://clinicaltrials.gov/ct2/show/NCT04352010. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41413.
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Affiliation(s)
- Leonie Franziska Trimpop
- Department of Clinical Psychology and Psychotherapy, University of Witten/Herdecke, Witten, Germany
| | - Laura Luisa Bielinski
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ulrike Willutzki
- Department of Clinical Psychology and Psychotherapy, University of Witten/Herdecke, Witten, Germany
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5
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Schürmann-Vengels J, Appelbaum S, Apel MK, Trimpop L, Muermans MM, Ostermann T, Teismann T, Willutzki U. Association of patients’ pre-therapy strengths and alliance in outpatient psychotherapy: A multilevel growth curve analysis. Psychother Res 2022; 33:551-565. [DOI: 10.1080/10503307.2022.2146543] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jan Schürmann-Vengels
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Sebastian Appelbaum
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
- Trimberg Research Academy, University of Bamberg, Bamberg, Germany
| | - Marie-Kristin Apel
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Leonie Trimpop
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | | | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
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Keller F, Kühner C, Alexandrowicz RW, Voderholzer U, Meule A, Fegert JM, Legenbauer T, Holtmann M, Bräscher AK, Cordes M, Fehm L, Fladung AK, Fydrich T, Hamm A, Heider J, Hoyer J, In-Albon T, Lincoln TM, Lutz W, Margraf J, Renneberg B, Schlarb A, Schöttke H, Teismann T, Velten J, Willutzki U, Witthöft M, Ziem M, Hautzinger M. Zur Messqualität des Beck-Depressionsinventars (BDI-II) in unterschiedlichen klinischen Stichproben. Zeitschrift für Klinische Psychologie und Psychotherapie 2022. [DOI: 10.1026/1616-3443/a000676] [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: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das BDI-II ist ein Selbstbeurteilungsinstrument zur Erfassung des Schweregrads einer Depression. Es liegen kaum Analysen mit Modellen aus der Item-Response-Theorie (IRT) vor. Fragestellung: Wie hoch ist die Messgenauigkeit des BDI-II über die unterschiedlichen Ausprägungen des latenten Traits (Depressivität) hinweg und sind die Kategorien der Items jeweils aufsteigend geordnet? Methode: Anhand von sechs großen Datensätzen aus verschiedenen klinischen Bereichen wurden psychometrische Analysen mit dem Graded Response Model durchgeführt. Ergebnisse: In allen Stichproben fand sich eine hohe interne Konsistenz. Die Schwellenwerte waren mit Ausnahme von Item 6 („Bestrafungsgefühle“) geordnet. Gemäß Testinformationsfunktion misst das BDI-II im mittleren bis hohen Depressionsbereich sehr gut (Reliabilität > .90) und im unteren Bereich gut. Schlussfolgerung: Für das BDI-II ergibt sich eine hohe und relativ gleichbleibende Messpräzision über einen weiten Bereich des latenten Traits, weshalb es insbesondere im klinischen, aber auch im nicht klinisch relevanten Wertebereich zur Erhebung des Schweregrades einer Depression gut geeignet ist.
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Affiliation(s)
- Ferdinand Keller
- Klinik für Kinder- und Jugendpsychiatrie / Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Christine Kühner
- AG Verlaufs- und Interventionsforschung, Zentralinstitut für Seelische Gesundheit, Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Deutschland
| | | | - Ulrich Voderholzer
- Klinik für Psychiatrie und Psychotherapie, Klinikum der LMU München, Deutschland
- Schön Klinik Roseneck, Prien am Chiemsee, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Deutschland
| | - Adrian Meule
- Klinik für Psychiatrie und Psychotherapie, Klinikum der LMU München, Deutschland
- Schön Klinik Roseneck, Prien am Chiemsee, Deutschland
| | - Jörg M. Fegert
- Klinik für Kinder- und Jugendpsychiatrie / Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Tanja Legenbauer
- LWL-Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ruhr-Universität Bochum, Hamm, Deutschland
| | - Martin Holtmann
- LWL-Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ruhr-Universität Bochum, Hamm, Deutschland
| | | | - Martin Cordes
- Institut für Psychologie, Poliklinische Psychotherapieambulanzen, Universität Osnabrück, Deutschland
| | - Lydia Fehm
- Institut für Psychologie, Humboldt-Universität zu Berlin, Deutschland
| | - Anne-Katharina Fladung
- Institut für Psychologie, Arbeitsbereich Klinische Psychologie und Psychotherapie, Universität Hamburg, Deutschland
| | - Thomas Fydrich
- Institut für Psychologie, Humboldt-Universität zu Berlin, Deutschland
| | - Alfons Hamm
- Zentrum für Psychologische Psychotherapie, Universität Greifswald, Deutschland
| | - Jens Heider
- Psychotherapeutische Universitätsambulanz, Campus Landau, Universität Koblenz-Landau, Deutschland
| | - Jürgen Hoyer
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Deutschland
| | - Tina In-Albon
- Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Koblenz-Landau, Deutschland
| | - Tania M. Lincoln
- Institut für Psychologie, Arbeitsbereich Klinische Psychologie und Psychotherapie, Universität Hamburg, Deutschland
| | - Wolfgang Lutz
- Poliklinische Psychotherapieambulanz, Klinische Psychologie und Psychotherapie, Universität Trier, Deutschland
| | - Jürgen Margraf
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum, Deutschland
| | - Babette Renneberg
- Hochschulambulanz für Psychotherapie, Diagnostik und Gesundheitsförderung, Freie Universität Berlin, Deutschland
| | - Angelika Schlarb
- Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Abteilung für Psychologie, Universität Bielefeld, Deutschland
| | - Henning Schöttke
- Institut für Psychologie, Klinische Psychologie und Psychotherapie, Universität Osnabrück, Deutschland
| | - Tobias Teismann
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum, Deutschland
| | - Julia Velten
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum, Deutschland
| | - Ulrike Willutzki
- Department für Psychologie und Psychotherapie, Fakultät für Gesundheit, Universität Witten / Herdecke, Deutschland
| | - Michael Witthöft
- Psychologisches Institut, Johannes-Gutenberg-Universität Mainz, Deutschland
| | - Max Ziem
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Deutschland
| | - Martin Hautzinger
- Klinische Psychologie und Psychotherapie, Fachbereich Psychologie, Eberhard-Karls-Universität Tübingen, Deutschland
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Schürmann-Vengels J, Teismann T, Margraf J, Willutzki U. Patients' self-perceived strengths increase during treatment and predict outcome in outpatient cognitive behavioral therapy. J Clin Psychol 2022; 78:2427-2445. [PMID: 35334118 DOI: 10.1002/jclp.23352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/28/2021] [Revised: 01/18/2022] [Accepted: 03/10/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Modern conceptualizations suggest the independence of positive and negative mental health constructs. Research of positive constructs in psychotherapy is scarce. This study analyzed the development of patients' strengths during psychotherapy and whether pre-therapy strengths incrementally predict treatment outcome. METHODS Two hundred and two patients (56.44% female, mean age = 42.49) treated by 54 therapists underwent cognitive behavioral therapy. Patients' strengths in different contexts as well as psychopathology, interpersonal problems, and self-esteem were assessed at the beginning and end of therapy. RESULTS Strengths increased in the contexts of everyday life (EvdayS; d = 0.44, p < 0.001) and current problems (ProbS; d = 0.70, p < 0.001). Strengths in the context of previous crises that were managed successfully (CrisesS) did not change. However, baseline scores of CrisesS were a significant incremental predictor of all outcomes. CONCLUSION A differentiated assessment of positive constructs is useful for outcome prediction and the implementation of strength-based interventions.
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Affiliation(s)
- Jan Schürmann-Vengels
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
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Heinonen E, Orlinsky DE, Willutzki U, Rønnestad MH, Schröder T, Messina I, Löffler-Stastka H, Hartmann A. Psychotherapist Trainees' Quality of Life: Patterns and Correlates. Front Psychol 2022; 13:864691. [PMID: 35401345 PMCID: PMC8988184 DOI: 10.3389/fpsyg.2022.864691] [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] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 02/05/2023] Open
Abstract
While psychotherapists are trained to improve their clients' quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A comprehensive questionnaire was used at the outset of trainings to assess trainees' professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees' lives could be characterized as fortunate or happy (i.e., experiencing great life satisfaction and not much stress), whereas 14.3% could be characterized as clearly distressed or troubled (i.e., experiencing great life stress and not much satisfaction). The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees' life quality when it may be deficient, such as those on a societal level (e.g., availability of low-cost student loans), training program level (e.g., promoting supportive supervision, positive between-trainee relationships and group collaboration), and individual level (e.g., personal therapy and learning self-care), in order to promote effective learning and therapy practice.
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Affiliation(s)
- Erkki Heinonen
- Department of Psychology, University of Oslo, Oslo, Norway
- Finnish Institute for Health and Welfare, Helsinki, Finland
- *Correspondence: Erkki Heinonen,
| | - David E. Orlinsky
- Department of Comparative Human Development, University of Chicago, Chicago, IL, United States
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, University of Witten/Herdecke, Witten, Germany
| | | | - Thomas Schröder
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, United Kingdom
| | | | | | - Armin Hartmann
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Center – University of Freiburg, Freiburg im Breisgau, Germany
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Bielinski LL, Krieger T, Moggi F, Trimpop L, Willutzki U, Nissen C, Berger T. REMOTION Blended Transdiagnostic Intervention for Symptom Reduction and Improvement of Emotion Regulation in an Outpatient Psychotherapeutic Setting: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e20936. [PMID: 33180026 PMCID: PMC7691093 DOI: 10.2196/20936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/10/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Emotion regulation has been identified as an important transdiagnostic factor relevant to the treatment of mental health disorders. Many empirically validated psychotherapeutic treatments incorporate elements targeting emotion regulation. Most of these treatment approaches are conceptualized as standard face-to-face treatments not as blended treatments, which include an internet-based intervention. OBJECTIVE The aim of this study is to examine, for the first time, a new internet-based intervention-REMOTION-that will be provided transdiagnostically, as an add-on to psychotherapy, to provide a blended treatment format. METHODS A total of 70 participants will be assigned (1:1 allocation ratio) to either the intervention group (REMOTION + psychotherapy) or the treatment-as-usual group that receives psychotherapy alone. To maximize external validity, a typical outpatient treatment sample of patients diagnosed with a range of disorders such as depression, anxiety disorders, and adjustment disorder will be recruited from a university outpatient clinic. Patients with bipolar disorder, psychotic disorders, or acute suicidality will be excluded from the study. The feasibility and potential effectiveness of the intervention will be examined by assessing data at baseline, 6 weeks (post), and 12 weeks (follow-up). The primary outcome is general symptom severity, assessed with the Brief Symptom Inventory. Secondary outcomes are emotion regulation, depressive symptoms, anxiety symptoms, health related quality of life, well-being, and a variety of feasibility parameters. Quantitative data will be analyzed on an intention-to-treat basis. RESULTS Participant recruitment and data collection started in February 2020, and as of November 2020, are ongoing. Results for the study are expected in 2022. CONCLUSIONS This pilot randomized controlled trial will inform future studies using transdiagnostic blended treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04262726; http://clinicaltrials.gov/ct2/show/NCT04262726. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/20936.
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Affiliation(s)
- Laura Luisa Bielinski
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Tobias Krieger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Franz Moggi
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Leonie Trimpop
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
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10
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Altmann U, Nodop S, Dinger U, Ehrenthal JC, Schauenburg H, Dymel W, Willutzki U, Strauss BM. Differential effects of adult attachment in cognitive-behavioural and psychodynamic therapy in social anxiety disorder: A comparison between a self-rating and an observer rating. Clin Psychol Psychother 2020; 28:373-383. [PMID: 32888374 DOI: 10.1002/cpp.2513] [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: 11/14/2019] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 01/04/2023]
Abstract
Different measures of attachment are usually weakly correlated. In a subsample of an RCT comparing short-term cognitive-behavioural therapy (CBT) and psychodynamic therapy (PDT), we examined the association between attachment and outcome using two attachment measures. The sample comprises 148 patients with social anxiety disorder who were treated in the SOPHO-NET trial. Pretreatment attachment was assessed using the Adult Attachment Prototype Rating (AAPR) and the Bielefeld Questionnaire of Client Expectations (BQCE). Regression models were used to predict the therapeutic alliance (HAQ) at session 8, the Liebowitz Social Anxiety Scale (LSAS) at the end of therapy and a 6-month follow-up. Attachment groups (secure, avoidant, and ambivalent) classified with the AAPR and the BQCE were not significantly correlated (Cohen's κ = 0.08). Only the BQCE was associated with the HAQ indicating avoidantly attached patients showing lower HAQ scores than securely attached (Cohen's d = 0.722). Regarding the AAPR, we found an interaction effect of treatment and attachment related to the post-treatment LSAS scores. Post hoc tests revealed that securely attached patients in CBT had lower scores than securely attached in PDT (d = 0.922) and, on a trend level, avoidantly attached in CBT (d = 0.782). We conclude that attachment-outcome associations are affected by the applied measure. The identified differential effects suggest that psychotherapists should adapt the interventions on the attachment of their patients.
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Affiliation(s)
- Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psycho-Oncology, Jena University Hospital, Jena, Germany
| | - Steffi Nodop
- Institute of Psychosocial Medicine, Psychotherapy and Psycho-Oncology, Jena University Hospital, Jena, Germany
| | - Ulrike Dinger
- Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg, Germany
| | | | - Henning Schauenburg
- Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg, Germany
| | | | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, University of Witten-Herdecke, Witten-Herdecke, Germany
| | - Bernhard M Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psycho-Oncology, Jena University Hospital, Jena, Germany
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Graser J, Menge E, Lyons N, Willutzki U, Michalak J. Verhaltenstherapie bei Erwachsenen mit intellektueller Beeinträchtigung: Eine systematische Review. Verhaltenstherapie 2020. [DOI: 10.1159/000508955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
<b><i>Hintergrund:</i></b> Menschen mit intellektueller Beeinträchtigung (IB) sind häufig von psychischen Störungen betroffen. Gleichzeitig ist die psychotherapeutische Versorgung in diesem Bereich bisher unzureichend, und die Evidenz bezüglich der Wirksamkeit verhaltenstherapeutischer Interventionen bei Erwachsenen mit IB ist unklar. <b><i>Ziele:</i></b> Eine systematische Literaturrecherche in den Datenbanken PubMed, PsycINFO und Google Scholar wurde durchgeführt, um die aktuelle Studienlage zu verhaltenstherapeutischen Interventionen bei Menschen mit IB zu evaluieren. Ausgewählt wurden Studien zu verhaltenstherapeutischen Verfahren bei psychischen Störungen und Problemverhalten im Erwachsenenalter. <b><i>Ergebnisse:</i></b> Zweiunddreißig Studien entsprachen den Einschlusskriterien; es wurden sowohl einzeltherapeutische als auch gruppentherapeutische Interventionen eingeschlossen. Für Menschen mit leichter IB (IQ 50–69) und teilweise auch bei mittlerer IB (IQ 35–49) konnten in einigen Studien Hinweise auf effektive und gut umsetzbare Verfahren gefunden werden. Deutliche positive Effekte aus verschiedenen Studien zeigten sich bei depressiven Symptomen und bei aggressivem Verhalten sowohl im ambulanten wie auch im forensischen Setting. Für Angstsymptome und bei Raucherentwöhnung liegen ebenfalls positive Befunde vor. Bei psychotischen Störungen und bei pathologischem Horten muss die Wirksamkeit von verhaltenstherapeutischen Interventionen noch als unklar eingeschätzt werden. <b><i>Schlussfolgerungen:</i></b> Es bedarf weiterer Forschung (insbesondere randomisierter kontrollierter Studien mit aktiven Kontrollbedingungen), in der differenzierter überprüft wird, welche Aspekte der Therapien/welche Settingbedingungen die Effektivität bei den verschiedenen Graden der IB beeinflussen.
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12
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Altmann U, Gawlytta R, Hoyer J, Leichsenring F, Leibing E, Beutel M, Willutzki U, Herpertz S, Strauss B. Typical symptom change patterns and their predictors in patients with social anxiety disorder: A latent class analysis. J Anxiety Disord 2020; 71:102200. [PMID: 32126336 DOI: 10.1016/j.janxdis.2020.102200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/24/2019] [Revised: 02/08/2020] [Accepted: 02/15/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The use of trajectories and analysis of change patterns is a promising way toward better differentiation of subgroups in psychotherapy studies. Research on change patterns in social anxiety disorder (SAD) are still rare, although SAD is one of the most common mental disorders. In a secondary analysis of data from the SOPHO-NET-trial (ISRCTN53517394) this study aimed to investigate change patterns and their predictors in a sample of SAD patients. METHODS Patients with SAD (N = 357) were randomly assigned to cognitive-behavioral or psychodynamic therapy. The Liebowitz Social Anxiety Scale (LSAS) was assessed at 1st session (pre), 8th session, 15th session and at the end of treatment (post). We used latent state variables and latent class analysis for the classification of change patterns and logistic regression for the identification of different predictors. RESULTS Analyses revealed three typical patterns: (i.) responders with a high initial impairment (N = 57), (ii.) responders with a moderate initial impairment (N = 225), and (iii.) patients with a high initial impairment and no remission (N = 75). Among other significant predicators, patient´s attachment anxiety and therapeutic alliance at session eight contributed to the prediction of change patterns. DISCUSSION Psychotherapy of SAD should consider patient's attachment and focus on the establishment of a solid therapeutic alliance in an early therapy stage.
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Affiliation(s)
- Uwe Altmann
- Universitätsklinikum Jena, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, 07740 Jena Germany.
| | - Romina Gawlytta
- Universitätsklinikum Jena, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, 07740 Jena Germany.
| | - Jürgen Hoyer
- Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Hohe Straße 53, 01187 Dresden Germany.
| | - Falk Leichsenring
- Universitätsklinikum Giessen, Clinic of Psychosomatic and Psychotherapy, Friedrichstr. 33, 35392 Gießen Germany.
| | - Eric Leibing
- Universitätsmedizin Göttingen Clinic of Psychosomatic Medicine and Psychotherapy Von-Siebold-Str. 5, 37075 Göttingen Germany.
| | - Manfred Beutel
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, Untere Zahlbacher Strasse 8, 55131 Mainz Germany.
| | - Ulrike Willutzki
- Universität Witten/Herdecke, Department of Psychology and Psychotherapy, Alfred-Herrhausen-Straße 44, 58455 Witten Germany.
| | - Stephan Herpertz
- LWL-Universitätsklinikum der Ruhr-Universität Bochum Clinic of Psychosomatic Medicine and Psychotherapy Alexandrinenstr. 1-3, 44791 Bochum Germany.
| | - Bernhard Strauss
- Universitätsklinikum Jena, Institute of Psychosocial Medicine and Psychotherapy, Stoystr. 3, 07740 Jena Germany.
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von Brachel R, Hirschfeld G, Berner A, Willutzki U, Teismann T, Cwik JC, Velten J, Schulte D, Margraf J. Long-Term Effectiveness of Cognitive Behavioral Therapy in Routine Outpatient Care: A 5- to 20-Year Follow-Up Study. Psychother Psychosom 2020; 88:225-235. [PMID: 31121580 DOI: 10.1159/000500188] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/08/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Long-term follow-ups several years after receiving cognitive behavioral therapy (CBT) are scarce and most of the existing literature describes follow-up data of randomized-controlled trials. Thus, very little is known about the long-term effects of CBT in routine care. METHODS We investigated psychological functioning in a sample of 263 former outpatients who had received CBT for a variety of mental disorders such as depression, anxiety-, eating- or somatoform disorders 8.06 (SD 5.08) years after treatment termination. All participants completed a diagnostic interview as well as the Brief-Symptom Inventory (BSI) and the Beck Depression Inventory (BDI). Effect sizes and response rates according to Jacobson and Truax [J Consult Clin Psychol 1991;59:12-9] were calculated from pre- to posttreatment and from pretreatment to follow-up assessment. RESULTS Pre- to posttreatment effect sizes ranged between 0.75 (BDI) and 0.63 (BSI) and pretreatment to follow-up effect sizes were 0.92 (BDI) and 0.75 (BSI). Of all patients, 29% (BDI) and 17% (BSI) experienced clinically significant change at posttreatment and 42% (BDI) and 24% (BSI) at follow-up. CONCLUSION The results point to the long-term effectiveness of CBT under routine conditions for a wide array of problems, especially when compared to the long-term effects of medical treatment. It is noteworthy that the results at follow-up were even better than at posttreatment, indicating further improvement. However, about a quarter of the patients did not respond sufficiently to therapy, neither concerning short-term nor long-term effects.
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Affiliation(s)
- Ruth von Brachel
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany,
| | - Gerrit Hirschfeld
- Faculty of Business and Health, University of Applied Sciences Bielefeld, Bielefeld, Germany
| | - Arleta Berner
- Faculty of Psychology and Psychotherapy, University Witten-Herdecke, Witten, Germany
| | - Ulrike Willutzki
- Faculty of Psychology and Psychotherapy, University Witten-Herdecke, Witten, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Jan Christopher Cwik
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Julia Velten
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Dietmar Schulte
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
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Löffler-Stastka H, Gelo O, Pleschberger I, Hartmann A, Orlinsky DE, Rønnestad MH, Willutzki U. [Psychotherapy training in Austria: Baseline and socio-demographic background data from a SPRISTAD ( Society of Psychotherapy Research Interest Section on Therapist Training and Development)-Pilotstudy]. Z Psychosom Med Psychother 2019; 65:341-352. [PMID: 31801441 DOI: 10.13109/zptm.2019.65.4.341] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objectives: Description of the qualifications of psychotherapy-training candidates in Austria at the beginning of their training. Methods: Psychotherapists in training in Austria were interviewed at the beginning of their training concerning their socio-demographic background and prior education. These background data were collected using the Trainee Background Information Form (TBIF), which was designed by the Society for Psychotherapy Research Interest Section on Therapist Training and Development (SPRISTAD). Results: The group of 197 psychotherapy trainees from Austria consists largely of women, of persons with high school education and with a satisfactory, financially secure life situation. One-third of them show a "second career" pattern, which is in line with the predominantly part-time training programs in Austria. A high percentage of the candidates have previous professional experience in the psychosocial field. Conclusions: As this is a pilot study, results can be seen as a starting point for further research in psychotherapy training and competence development. In discussing the findings, both national conditions and opportunities for future interdisciplinary research are considered.
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Affiliation(s)
- Henriette Löffler-Stastka
- Klinik für Psychoanalyse und Psychotherapie Medizinische Universität Wien Währinger Gürtel 18-20 A-1090 Wien Österreich Medizinische Universität Wien
| | - Omar Gelo
- University of Lecce Italien University of Lecce
| | - Ingrid Pleschberger
- Klinik für Psychoanalyse und Psychotherapie Medizinische Universität Wien Währinger Gürtel 18-20 A-1090 Wien Österreich Medizinische Universität Wien
| | - Armin Hartmann
- Klinik für Psychosomatische Medizin und Psychotherapie Zentrum für Psychische Erkrankungen Universitätsklinikum Freiburg Deutschland Uniklinik Freiburg - Klinik für Psychosomatische Medizin und Psychotherapie
| | | | | | - Ulrike Willutzki
- Universität Witten/Herdecke Deutschland Universität Witten/Herdecke
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15
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Schünemann O, Jansen A, Willutzki U, Heinrichs N. Allegiance Bias and Treatment Quality as Moderators of the Effectiveness of Humanistic Psychotherapy: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2019; 8:e15140. [PMID: 31763989 PMCID: PMC6902128 DOI: 10.2196/15140] [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] [Received: 06/26/2019] [Revised: 08/15/2019] [Accepted: 08/17/2019] [Indexed: 11/18/2022] Open
Abstract
Background In many countries, humanistic psychotherapy (HPT) is viewed as a broad psychotherapeutic approach and is accepted in health care systems. To qualify for reimbursement by health insurance in Germany, psychotherapy approaches have to be evaluated positively by the German Scientific Board of Psychotherapy (GSBP). The GSBP examined HPT and its subapproaches based on an application by a number of professional organizations affiliated with HPT (Work Group Humanistic Psychotherapy, WGHPT). The GSBP came to the decision that none of the HPT subapproaches provided sufficient evidence to be evaluated as evidence based. Potential reasons for the discrepancy between international recognition of HPT and GSBP’s decision will be explored: researchers’ allegiance may have led to a risk of bias disadvantaging HPT. Furthermore, the evaluation criteria of the GSBP did not systematically consider whether HPT was conceptualized bona fide and implemented with sufficient treatment integrity in the studies. Objective This systematic review will re-examine the studies included in the review of the GSBP. Within 2 comparisons (HPT vs control and HPT vs other psychotherapeutic interventions), we will examine moderating effects of treatment quality (bona fide and treatment integrity) and allegiance on the effectiveness of HPT. Methods This review is based on the prior systematic review by the GSBP. The GSBP examined randomized controlled trials (RCTs) and studies with non-RCTs of HPT interventions for individuals with mental disorders. All studies suggested by the WGHPT were included; moreover, the GSBP conducted searches in standard electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and PSYNDEX) and handsearches in relevant systematic reviews and contacted experts. A total of 2 independent GSBP reviewers performed study screening using a structured form. On the basis of the prior work of the GSBP, all studies that were positively screened by the GSBP will be included in this review. Data will be extracted independently by 4 authors. Standardized mean difference will be calculated, and possible publication bias will be tested using funnel plots and Egger test. A priori defined subgroup or meta-regression analyses will be performed for treatment quality, allegiance, type of nonactive control, study quality, type of subapproach, and target population (children and adolescents or adults). Results The GSBP identified 115 eligible studies that will be reanalyzed in this systematic review. Conclusions Results about moderator effects of treatment quality and allegiance will provide important information about their impact on the evaluation of HPT and other psychotherapy approaches and can be used for further evaluation methods. Trial Registration PROSPERO CRD42019128983; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=128983 International Registered Report Identifier (IRRID) PRR1-10.2196/15140
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Affiliation(s)
| | - Alessa Jansen
- Bundespsychotherapeutenkammer Germany, Berlin, Germany
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16
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Orlinsky DE, Rønnestad MH, Hartmann A, Heinonen E, Willutzki U. The personal self of psychotherapists: Dimensions, correlates, and relations with clients. J Clin Psychol 2019; 76:461-475. [PMID: 31714591 DOI: 10.1002/jclp.22876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The personal self of psychotherapists, that is, experiences of self in close personal relationships and its association with therapists' individual and professional attributes is explored. The study aimed to: (a) describe therapists' self-ratings on specific self-attributes; (b) determine their dimensionality; (c) explore demographic, psychological, and professional correlates; and (d) assess the convergence with professional self. METHOD Data from the Development of Psychotherapists Common Core Questionnaire were available for > 10,000 psychotherapists of various professions, theoretical orientations, career levels, and nations. RESULTS Most psychotherapists described themselves in close relationships in affirming terms (e.g., warm/friendly), although a substantial minority also described themselves in negative terms. Factor analyses yielded four dimensions: Genial/Caring, Forceful/Exacting, Reclusive/Remote, and Ardent/Expressive. Being Genial/Caring was associated with life satisfaction. Among professional attributes, personal self-experiences, and parallel dimensions of relationship with clients correlated strongly. CONCLUSIONS Analyses of > 10,000 psychotherapists revealed meaningful variations in personal self relevant to personal and professional life.
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Affiliation(s)
- David E Orlinsky
- Department of Comparative Human Development, University of Chicago, Chicago, Illinois
| | | | - Armin Hartmann
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany
| | - Erkki Heinonen
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, University of Witten/Herdecke, Witten, Germany
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Abstract
Abstract. Background: Suicide ideation is a prerequisite for suicide attempts. However, the majority of ideators will never act on their thoughts. It is therefore crucial to understand factors that differentiate those who consider suicide from those who make suicide attempts. Aim: Our aim was to investigate the role of protective factors in differentiating non-ideators, suicide ideators, and suicide attempters. Method: Inpatients without suicide ideation ( n = 32) were compared with inpatients with current suicide ideation ( n = 37) and with inpatients with current suicide ideation and a lifetime history of suicide attempts ( n = 26) regarding positive mental health, self-esteem, trust in higher guidance, social support, and reasons for living. Results: Non-ideators reported more positive mental health, social support, reasons for living, and self-esteem than suicide ideators and suicide attempters did. No group differences were found regarding trust in higher guidance. Suicide ideators and suicide attempters did not differ regarding any of the study variables. Limitations: Results stem from a cross-sectional study of suicide attempts; thus, neither directionality nor generalizability to fatal suicide attempts can be determined. Conclusion: Various protective factors are best characterized to distinguish ideators from nonsuicidal inpatients. However, the same variables seem to offer no information about the difference between ideators and attempters.
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Affiliation(s)
- Tobias Teismann
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany
| | - Laura Paashaus
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany
| | - Paula Siegmann
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany
| | | | | | - Ulrike Willutzki
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
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18
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Odyniec P, Probst T, Göllner R, Margraf J, Willutzki U. An exploratory study of patients' sudden losses during outpatient CBT and therapists' experience of difficulties. J Clin Psychol 2019; 75:1790-1809. [PMID: 31254365 DOI: 10.1002/jclp.22828] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Patients' sudden deterioration in symptomatology, also called sudden losses, is a rarely explored phenomenon. METHOD Psychological distress of 1,763 patients treated by 140 therapists was monitored after every therapy session. Patient-reported outcome measures and patients' therapy satisfaction was assessed. Therapists rated their experience of difficulties for every patient repeatedly over the course of therapy. RESULTS More than one-quarter of patients (26.5%) experienced at least one sudden loss during therapy. Patients with sudden losses did not differ significantly in psychotherapy outcome and therapy satisfaction from patients without sudden shifts. Therapists did not experience professional self-doubt more often when working with sudden loss patients. CONCLUSION Sudden losses were not necessarily harmful for the outcome of psychotherapy and patients' global therapy satisfaction. The results suggest that sudden losses can be compensated over the course of treatment.
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Affiliation(s)
- Patrizia Odyniec
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Richard Göllner
- Hector Research Institute of Education Sciences and Psychology, University of Tübingen, Tübingen, Germany
| | - Jürgen Margraf
- Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
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Fliegel S, Willutzki U, Strauß B. 10 Jahre Forschungsgutachten zur Ausbildung in psychologischer Psychotherapie und Kinder- und Jugendlichenpsychotherapie. Psychotherapeut 2019. [DOI: 10.1007/s00278-019-0359-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Siegmann P, Willutzki U, Fritsch N, Nyhuis P, Wolter M, Teismann T. Positive mental health as a moderator of the association between risk factors and suicide ideation/behavior in psychiatric inpatients. Psychiatry Res 2019; 273:678-684. [PMID: 31207852 DOI: 10.1016/j.psychres.2019.01.091] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 09/01/2018] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 11/27/2022]
Abstract
In recent studies positive mental health has been shown as a resilience factor related to suicide ideation/behavior. It is not known if positive mental health buffers the effect of various risk factors (depression, perceived burdensomeness, hopelessness, childhood maltreatment) on suicide ideation/behavior in psychiatric inpatients-a high risk population. A total of 100 psychiatric inpatients were included in the survey. Four hierarchical regression analyses were conducted to examine, whether positive mental health moderates the association between the four risks factors and suicide ideation/behavior. Positive mental health was shown to moderate the association between perceived burdensomeness and suicide ideation/behavior. The association between the other three risk factors and suicide ideation/behavior was not moderated by positive mental health. Given the cross-sectional nature of the data, conclusions on causality cannot be drawn. The buffering effect of positive mental health suggests that positive mental health may improve the identification of individuals at risk of suicide ideation/behavior and may be an important area to target in the prevention and treatment of individuals at risk of suicide. Further research is needed.
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Affiliation(s)
- Paula Siegmann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany.
| | - Ulrike Willutzki
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Nathalie Fritsch
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | | | | | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
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Rønnestad MH, Orlinsky DE, Schröder TA, Skovholt TM, Willutzki U. The professional development of counsellors and psychotherapists: Implications of empirical studies for supervision, training and practice. Couns Psychother Res 2018. [DOI: 10.1002/capr.12198] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Victor P, Dikloo AS, Schwert P, Willutzki U. Resilienz- vs. problemorientierte Beratung von Studierenden. Zeitschrift für Klinische Psychologie und Psychotherapie 2018. [DOI: 10.1026/1616-3443/a000496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Studierende suchen zunehmend psychologische Beratung wegen Stressbelastung oder psychischer Störungen auf. Während viele Interventionen auf die Reduktion psychopathologischer Symptome fokussieren, nutzt das persönliche Resilienzmodell (PRM) vorhandene Stärken zur Bewältigung von Hindernissen. Fragestellung: Das PRM sollte mit einer problemorientierten Intervention (ABC-Modell) als aktive Kontrollbedingung und einer Wartekontrollgruppe (WKG) über sechs Wochen hinweg verglichen werden. Methode: In einer randomisierten kontrollierten Studie mit n = 57 Studierenden (Completer) wurde das PRM mit ABC-Modell und WKG verglichen. Ergebnisse: Bei beiden Interventionen zeigten sich überwiegend signifikante Verbesserungen oder Trends in Psychopathologie, Inkongruenz, Depressivität, Selbstwert und Resilienz im Vergleich zur WKG. Die mittleren Prä-Post-Effektstärken lagen bei d = 0.62 (PRM), d = 0.42 (ABC) und d = 0.07 (WKG). Schlussfolgerungen: Das PRM bietet eine ökonomische und ressourcenorientierte Alternative zu problemorientierter Studienberatung.
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Affiliation(s)
- Philipp Victor
- Department für Psychologie und Psychotherapie, Universität Witten / Herdecke
| | | | - Pia Schwert
- Department für Psychologie und Psychotherapie, Universität Witten / Herdecke
| | - Ulrike Willutzki
- Department für Psychologie und Psychotherapie, Universität Witten / Herdecke
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Strauß B, Grass N, Ritter V, Stangier U, Nolting B, Herpertz S, Dymel W, Willutzki U, Nodop S. [Negative Indicators in the Psychotherapeutic Process: Frequency and Relationship with Attachment Characteristics and Treatment Outcome among Patients with Social Anxiety Disorder]. Psychother Psychosom Med Psychol 2018; 68:408-416. [PMID: 30286507 DOI: 10.1055/a-0639-5568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Within the SOPHO-Net-Project, mainly focusing on a randomized-controlled trial comparing short term cognitive and psychodynamic psychotherapy for social anxiety disorder, a subsample consisting of 88 patients from 3 of the 5 study sites was investigated to examine the relationship between outcome, initial attachment characteristics and negative indicators during the process. These negative indicators were assessed with the Vanderbilt Negative Indicators Scale which was applied to an early (3rd), a middle (9th) as well as a late therapy (22nd) session. The study shows that negative indicators as a whole were relatively rare with a higher frequency within the psychodynamic therapies for which a relationship between negative indicators and outcome could be found. Contrary to expectation, initial attachment characteristics were not related to negative indicators.
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Affiliation(s)
- Bernhard Strauß
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena
| | - Nadja Grass
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena
| | - Viktoria Ritter
- Institut für Psychologie, Goethe-Universität Frankfurt am Main
| | - Ulrich Stangier
- Institut für Psychologie, Goethe-Universität Frankfurt am Main
| | | | - Stephan Herpertz
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum der Ruhr-Universität Bochum
| | | | - Ulrike Willutzki
- Psychologie und Psychotherapie, Universität Witten/Herdecke, Witten
| | - Steffi Nodop
- Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena
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24
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Strauß B, Altmann U, Manes S, Tholl A, Koranyi S, Nolte T, Beutel ME, Wiltink J, Herpertz S, Hiller W, Hoyer J, Joraschky P, Nolting B, Ritter V, Stangier U, Willutzki U, Salzer S, Leibing E, Leichsenring F, Kirchmann H. Changes of attachment characteristics during psychotherapy of patients with social anxiety disorder: Results from the SOPHO-Net trial. PLoS One 2018. [PMID: 29518077 PMCID: PMC5843211 DOI: 10.1371/journal.pone.0192802] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objectives Within a randomized controlled trial contrasting the outcome of manualized cognitive-behavioral (CBT) and short term psychodynamic therapy (PDT) compared to a waiting list condition (the SOPHO-Net trial), we set out to test whether self-reported attachment characteristics change during the treatments and if these changes differ between treatments. Research design and methods 495 patients from the SOPHO-Net trial (54.5% female, mean age 35.2 years) who were randomized to either CBT, PDT or waiting list (WL) completed the partner-related revised Experiences in Close Relationships Questionnaire (ECR-R) before and after treatment and at 6 and 12 months follow-up. The Liebowitz Social Anxiety Scale (LSAS) was administered at pre-treatment, post-treatment, and at 6-month and 1-year follow-up. ECR-R scores were first compared to a representative healthy sample (n = 2508) in order to demonstrate that the clinical sample differed significantly from the non-clinical sample with respect to attachment anxiety and avoidance. Results LSAS scores correlated significantly with both ECR-R subscales. Post-therapy, patients treated with CBT revealed significant changes in attachment anxiety and avoidance whereas patients treated with PDT showed no significant changes. Changes between post-treatment and the two follow-ups were significant in both conditions, with minimal (insignificant) differences between treatments at the 12- month follow-up. Conclusions The current study supports recent reviews of mostly naturalistic studies indicating changes in attachment as a result of psychotherapy. Although there were differences between conditions at the end of treatment, these largely disappeared during the follow-up period which is line with the other results of the SOPHO-NET trial. Trial registration Controlled-trials.com ISRCTN53517394
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Affiliation(s)
- Bernhard Strauß
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany
| | - Uwe Altmann
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany
| | - Susanne Manes
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany
| | - Anne Tholl
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany
| | - Susan Koranyi
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany
| | - Tobias Nolte
- Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Stephan Herpertz
- Psychosomatic Medicine and Psychotherapy, LWL University Clinic, Bochum, Germany
| | - Wolfgang Hiller
- Clinical Psychology and Psychotherapy, Johannes Gutenberg University, Mainz, Germany
| | - Jürgen Hoyer
- Clinical Psychology and Psychotherapy, Technical University, Dresden, Germany
| | - Peter Joraschky
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital, Technical University, Dresden, Germany
| | | | - Viktoria Ritter
- Clinical Psychology and Psychotherapy, Johann Wolfgang von Goethe University, Frankfurt, Germany
| | - Ulrich Stangier
- Clinical Psychology and Psychotherapy, Johann Wolfgang von Goethe University, Frankfurt, Germany
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, University of Witten-Herdecke, Witten-Herdecke, Germany
| | - Simone Salzer
- International Psychoanalytic University, Berlin, Germany
| | - Eric Leibing
- Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University, Göttingen, Germany
| | - Falk Leichsenring
- Psychosomatic and Psychotherapy, University Hospital Justus-Liebig-University, Giessen, Germany
| | - Helmut Kirchmann
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital, Jena, Germany
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25
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von Glischinski M, Willutzki U, Stangier U, Hiller W, Hoyer J, Leibing E, Leichsenring F, Hirschfeld G. Liebowitz Social Anxiety Scale (LSAS): Optimal cut points for remission and response in a German sample. Clin Psychol Psychother 2018; 25:465-473. [DOI: 10.1002/cpp.2179] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 01/07/2018] [Accepted: 01/08/2018] [Indexed: 11/08/2022]
Affiliation(s)
| | - U. Willutzki
- Department of Psychology; Witten/Herdecke University; Witten Germany
| | - U. Stangier
- Clinical Psychology and Psychotherapy; Goethe University Frankfurt; Frankfurt Germany
| | - W. Hiller
- Institute of Psychology; University of Mainz; Mainz Germany
| | - J. Hoyer
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Dresden Germany
| | - E. Leibing
- Center of Psychosocial Medicine; University of Goettingen; Goettingen Germany
| | - F. Leichsenring
- Clinic of Psychosomatics and Psychotherapy; Justus-Liebig-University Giessen; Giessen Germany
| | - G. Hirschfeld
- Department of Quantitative Methods; Osnabrück University of Applied Sciences; Osnabrück Germany
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26
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Teismann T, Brailovskaia J, Siegmann P, Nyhuis P, Wolter M, Willutzki U. Dual factor model of mental health: Co-occurrence of positive mental health and suicide ideation in inpatients and outpatients. Psychiatry Res 2018; 260:343-345. [PMID: 29232575 DOI: 10.1016/j.psychres.2017.11.085] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 05/31/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
Positive and negative mental health are independent but correlated concepts. Yet, it is unknown whether positive mental health does co-occur with suicide ideation. The present study aimed to determine the proportion of patients who have positive mental health as well as suicide ideation. Inpatients (N=100) and outpatients (N=182) completed self-report measures of positive mental health, suicide ideation and lifetime suicide attempts. Eleven outpatients (6%) and ten inpatients (10%) with suicide ideation reported moderate to high levels of positive mental health. Lifetime suicide attempts were less likely in inpatients who suffered from suicide ideation in the presence of positive mental health. Positive mental health does co-occur with suicide ideation and should be considered as a protective factor in suicide risk assessments.
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Affiliation(s)
- Tobias Teismann
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Massenbergstraße 11, 44787 Bochum, Germany.
| | - Julia Brailovskaia
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Massenbergstraße 11, 44787 Bochum, Germany
| | - Paula Siegmann
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Massenbergstraße 11, 44787 Bochum, Germany
| | | | | | - Ulrike Willutzki
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
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27
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Strauss B, Koranyi S, Altmann U, Nolte T, Beutel ME, Wiltink J, Herpertz S, Hiller W, Hoyer J, Joraschky P, Nolting B, Stangier U, Willutzki U, Salzer S, Leibing E, Leichsenring F, Kirchmann H. Partner-related attachment as a moderator of outcome in patients with social anxiety disorder-a comparison between short-term cognitive-behavioral and psychodynamic therapy. ACTA ACUST UNITED AC 2017; 54:339-350. [PMID: 29251953 DOI: 10.1037/pst0000129] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/08/2022]
Abstract
This study investigated whether partner-related attachment characteristics differentially predict premature treatment termination as well as posttreatment and 1-year follow-up outcome in patients with social anxiety disorder treated with a manualized cognitive-behavioral therapy (CBT) or short-term psychodynamic therapy (PDT) in the SOPHO-NET (Social Phobia Psychotherapy Network) trial. Participants were 412 patients with social anxiety disorder (57% female) with a mean age of 35.4 years (SD = 12.1) who were randomized to either CBT or PDT. Partner-related attachment characteristics were measured using the revised Experiences in Close Relationships Questionnaire (ECR-R) at pretreatment. The Liebowitz Social Anxiety Scale was administered at pretreatment, posttreatment, and a 1-year follow-up. To address our research questions, linear regression models were applied. Furthermore, we compared CBT versus PDT patients within ECR-R quartiles. Treatment dropout did not differ between CBT and PDT and was not predicted by pretreatment attachment. In both treatment conditions, there was a trend for higher attachment anxiety to be associated with a more limited reduction in symptoms if controlling for pretreatment Liebowitz Social Anxiety Scale scores. Exploratory analyses showed that patients assigned to the highest quartile of the ECR-R-Avoidance distribution showed more benefit within the CBT condition posttreatment and at follow-up than the PDT condition. Our findings suggest that it may be useful to assess attachment characteristics in patients with social anxiety disorder before psychotherapeutic treatment. Patients characterized by very high pretreatment attachment avoidance (ECR-R-Avoidance >3.87) may specifically benefit more from CBT than from PDT. However, replication studies are needed that also should investigate nonlinear effects of pretreatment attachment. (PsycINFO Database Record
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Affiliation(s)
- Bernhard Strauss
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena
| | - Susan Koranyi
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena
| | - Uwe Altmann
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena
| | | | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University of Mainz
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University of Mainz
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr-University Bochum
| | - Wolfgang Hiller
- Department of Clinical Psychology and Psychotherapy, Johannes Gutenberg University of Mainz
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden
| | - Peter Joraschky
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universitaet Dresden
| | | | - Ulrich Stangier
- Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt
| | - Ulrike Willutzki
- Department of Psychology and Psychotherapy, University Witten/Herdecke
| | - Simone Salzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen
| | - Erik Leibing
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen
| | - Falk Leichsenring
- University Hospital of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen
| | - Helmut Kirchmann
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena
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28
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Cwik JC, Siegmann P, Willutzki U, Nyhuis P, Wolter M, Forkmann T, Glaesmer H, Teismann T. Brief reasons for living inventory: a psychometric investigation. BMC Psychiatry 2017; 17:358. [PMID: 29110653 PMCID: PMC5674870 DOI: 10.1186/s12888-017-1521-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 05/23/2017] [Accepted: 10/26/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The present study aimed at validating the German version of the Brief Reasons for Living inventory (BRFL). METHODS Validity and reliability were established in a community (n = 339) and a clinical sample (n = 272). Convergent and discriminant validity were investigated, and confirmatory factor analyses were conducted for the complete BRFL as well as for a 10-item version excluding conditional items on child-related concerns. Furthermore, it was assessed how BRFL scores moderate the association between depression and suicide ideation. RESULTS Results indicated an adequate fit of the data to the original factor structure. The total scale and the subscales of the German version of the BRFL had sufficient internal consistency, as well as good convergent and divergent validity. The BRFL demonstrated clinical utility by differentiating between participants with vs. without suicide ideation. Reasons for living proved to moderate the association between depression and suicide ideation. CONCLUSIONS Results provide preliminary evidence that the BRFL may be a reliable and valid measure of adaptive reasons for living that can be used in clinic and research settings.
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Affiliation(s)
- Jan Christopher Cwik
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 11, 44787, Bochum, Germany.
| | - Paula Siegmann
- 0000 0004 0490 981Xgrid.5570.7Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 11, 44787 Bochum, Germany
| | - Ulrike Willutzki
- 0000 0000 9024 6397grid.412581.bDepartment for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Peter Nyhuis
- grid.440217.4St. Marien-Hospital Eickel, Herne, Germany
| | - Marcus Wolter
- grid.440217.4St. Marien-Hospital Eickel, Herne, Germany
| | - Thomas Forkmann
- 0000 0000 8653 1507grid.412301.5Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Heide Glaesmer
- 0000 0001 2230 9752grid.9647.cDepartment of Medical Psychology and Medical Sociology, University Leipzig, Leipzig, Germany
| | - Tobias Teismann
- 0000 0004 0490 981Xgrid.5570.7Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Massenbergstrasse 11, 44787 Bochum, Germany
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29
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Teismann T, Willutzki U, Michalak J, Siegmann P, Nyhuis P, Wolter M, Forkmann T. Religious beliefs buffer the impact of depression on suicide ideation. Psychiatry Res 2017; 257:276-278. [PMID: 28783575 DOI: 10.1016/j.psychres.2017.07.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/24/2017] [Revised: 06/08/2017] [Accepted: 07/29/2017] [Indexed: 10/19/2022]
Abstract
Depression and suicide ideation co-occur regularly. The present study investigated whether religious beliefs, i.e. trust in higher guidance, buffers the association between depression and suicide ideation. A total of 427 participants (n = 93 inpatients, n = 334 online sample) completed measures of suicide ideation, trust in higher guidance, and depression. Trust in higher guidance moderated the impact of depression on suicide ideation. Trust in higher guidance seems to confer resilience and should be taken into account when assessing individuals for suicide risk.
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Affiliation(s)
- Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany.
| | - Ulrike Willutzki
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Johannes Michalak
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Paula Siegmann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | | | | | - Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
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30
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Victor P, Dresenkamp A, Haag E, Merod R, Ruggaber G, Sauer K, Schneider W, Ruppert J, Veith A, Willutzki U. Ausbildungsforschung in Ausbildungsinstituten der Deutschen Gesellschaft für Verhaltenstherapie. Psychotherapeut 2017. [DOI: 10.1007/s00278-017-0225-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Velten J, Margraf J, Benecke C, Berking M, In-Albon T, Tania Lincoln, Lutz W, Schlarb A, Schöttke H, Willutzki U, Jürgen Hoyer. Methodenpapier zur Koordination der Datenerhebung und -auswertung an Hochschul- und Ausbildungsambulanzen für Psychotherapie (KODAP). Zeitschrift für Klinische Psychologie und Psychotherapie 2017. [DOI: 10.1026/1616-3443/a000431] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Zusammenfassung. Die Forschung an psychotherapeutischen Hochschulambulanzen (HSA) leistet einen entscheidenden Beitrag zur Behandlung von Menschen mit psychischen Störungen und zur Weiterentwicklung und wissenschaftlichen Fundierung von Psychotherapie im Kindes-, Jugend- und Erwachsenenalter. Durch das im Jahr 2013 gestartete Projekt zur Koordination der Datenerhebung und -auswertung an Forschungs- und Ausbildungsambulanzen für Psychotherapie (KODAP) sollen unter der Trägerschaft des Verbundes universitärer Ausbildungsgänge für Psychotherapie unith.ev ab 2018 jährlich relevante Daten aus den teilnehmenden HSA aggregiert und gemeinsam ausgewertet werden. Im vorliegenden Beitrag beschreiben wir die mit dem Projekt im Zusammenhang stehenden rechtlichen, methodischen und durchführungstechnischen Herausforderungen sowie den derzeitigen Stand des Kooperationsprojektes, einschließlich einer für das Jahr 2017 geplanten Pilotstudie.
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Affiliation(s)
- Julia Velten
- Ruhr-Universität Bochum, Klinische Psychologie und Psychotherapie
| | - Jürgen Margraf
- Ruhr-Universität Bochum, Klinische Psychologie und Psychotherapie
| | - Cord Benecke
- Universität Kassel, Klinische Psychologie und Psychotherapie
| | - Matthias Berking
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinische Psychologie und Psychotherapie
| | - Tina In-Albon
- Universität Koblenz-Landau, Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters
| | - Tania Lincoln
- Universität Hamburg, Klinische Psychologie und Psychotherapie
| | - Wolfgang Lutz
- Universität Trier, Klinische Psychologie und Psychotherapie
| | - Angelika Schlarb
- Universität Bielefeld, Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters
| | | | - Ulrike Willutzki
- Universität Witten / Herdecke, Klinische Psychologie und Psychotherapie
| | - Jürgen Hoyer
- Technische Universität Dresden, Klinische Psychologie und Psychotherapie
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32
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Odyniec P, Probst T, Margraf J, Willutzki U. Psychotherapist trainees’ professional self-doubt and negative personal reaction: Changes during cognitive behavioral therapy and association with patient progress. Psychother Res 2017; 29:123-138. [DOI: 10.1080/10503307.2017.1315464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Patrizia Odyniec
- School of Psychology, University Witten/Herdecke, Witten, Germany
| | - Thomas Probst
- Georg-Elias-Müller Institute for Psychology, Georg-August-University Göttingen, Göttingen, Germany
| | - Jürgen Margraf
- Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Ulrike Willutzki
- School of Psychology, University Witten/Herdecke, Witten, Germany
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33
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Victor P, Teismann T, Willutzki U. [Fostering Resilience while Waiting for Psychotherapy: Evaluation of a Group Intervention in an Outpatient Care Setting]. Psychother Psychosom Med Psychol 2016; 66:486-488. [PMID: 27923256 DOI: 10.1055/s-0042-117716] [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
Background: High untreated prevalence of mental disorders and long waiting lists for psychotherapy at the same time call for innovative intervention concepts. The positive brief intervention "Personal Model of Resilience" 1 is offered as group training and evaluated for the first time in a naturalistic clinical setting. Method: In a pre-post-design data from 84 wait-list patients are analysed via intention-to-treat (n=84) and completer analysis at 6-week-follow-up (n=54). Results: Repeated measures ANOVAs demonstrate significant improvements in psychopathology, incongruence and self-esteem. Effect sizes range from d=0.30-0.49 at follow-up. Intention-to-treat analyses support these results with significant improvements for all evaluation instruments. Discussion: The "Personal Model of Resilience" is a promising intervention module that may be offered to patients while waiting for psychotherapy.
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Affiliation(s)
- Philipp Victor
- Department für Psychologie und Psychotherapie, Universität Witten/Herdecke, Witten
| | - Tobias Teismann
- Fakultät für Psychologie, Klinische Psychologie und Psychotherapie, Ruhr-Universität, Bochum
| | - Ulrike Willutzki
- Department für Psychologie und Psychotherapie, Universität Witten/Herdecke, Witten
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34
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Egger N, Konnopka A, Beutel ME, Herpertz S, Hiller W, Hoyer J, Salzer S, Stangier U, Strauss B, Willutzki U, Wiltink J, Leibing E, Leichsenring F, König HH. Long-term cost-effectiveness of cognitive behavioral therapy versus psychodynamic therapy in social anxiety disorder. Depress Anxiety 2016; 33:1114-1122. [PMID: 27428816 DOI: 10.1002/da.22540] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 09/10/2015] [Revised: 06/12/2016] [Accepted: 06/14/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND To determine the cost-effectiveness of cognitive behavioral therapy (CBT) versus psychodynamic therapy (PDT) in the treatment of social anxiety disorder after a follow-up of 30 months from a societal perspective. METHODS This analysis was conducted alongside the multicenter SOPHO-NET trial; adults with a primary diagnosis of social anxiety disorder received CBT (n = 209) or PDT (n = 207). Data on health care utilization and productivity loss were collected at baseline, after 6 months (posttreatment), and three further follow-ups to calculate direct and indirect costs. Anxiety-free days (AFDs) calculated based on remission and response were used as measure of effect. The incremental cost-effectiveness ratio (ICER) was determined. Net benefit regressions, adjusted for comorbidities and baseline differences, were applied to derive cost-effectiveness acceptability curves. RESULTS In the descriptive analysis, the unadjusted ICER favored CBT over PDT and the adjusted analysis showed that CBT's cost-effectiveness relative to PDT depends on the willingness to pay (WTP) per AFD. As baseline costs differed substantially the unadjusted estimates might be deceptive. If additional WTPs for CBT of €0, €10, and €30 were assumed, the probability of CBT being cost-effective relative to PDT was 65, 83, and 96%. Direct costs increased compared to baseline across groups, whereas indirect costs did not change significantly. Results were sensitive to considered costs. CONCLUSIONS If the society is willing to pay ≥€30 per additional AFD, CBT can be considered cost-effective, relative to PDT, with certainty. To further increase the cost-effectiveness more knowledge regarding predictors of treatment outcome seems essential.
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Affiliation(s)
- Nina Egger
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Clinic Bochum, Ruhr-University Bochum, Bochum, Germany
| | - Wolfgang Hiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Juergen Hoyer
- Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany
| | - Simone Salzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University, Goettingen, Germany
| | - Ulrich Stangier
- Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Ulrike Willutzki
- Clinical Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Joerg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eric Leibing
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University, Goettingen, Germany
| | - Falk Leichsenring
- Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wachtel S, Siegmann P, Ocklenburg C, Hebermehl L, Willutzki U, Teismann T. Acquired Capability for Suicide, Pain Tolerance, and Fearlessness of Pain-Validation of the Pain Tolerance Scale of the German Capability for Suicide Questionnaire. Suicide Life Threat Behav 2015; 45:541-555. [PMID: 25534248 DOI: 10.1111/sltb.12149] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 10/17/2014] [Indexed: 11/28/2022]
Abstract
The interpersonal theory of suicide (Joiner, 2005) postulates that for a serious suicide attempt, one has to possess the acquired capability to commit suicide. Acquired capability includes higher pain tolerance, which is further assumed to comprise both an elevated physical pain tolerance and fearlessness of pain. Recently, the German Capability for Suicide Questionnaire (GCSQ) was validated. The aim of this study is further validation of the GCSQ's Pain Tolerance scale by investigating the scale's association with objective pain tolerance and fearlessness of pain in two undergraduate samples (N = 81; N = 76). Both associations were found indicating a strong criterion validity of the Pain Tolerance scale.
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Affiliation(s)
- Sarah Wachtel
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Paula Siegmann
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Cäcilia Ocklenburg
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Lisa Hebermehl
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Ulrike Willutzki
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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Willutzki U, Fydrich T, Strauß B. Aktuelle Entwicklungen in der Psychotherapieausbildung und der Ausbildungsforschung. Psychotherapeut 2015. [DOI: 10.1007/s00278-015-0048-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Egger N, Konnopka A, Beutel ME, Herpertz S, Hiller W, Hoyer J, Salzer S, Stangier U, Strauss B, Willutzki U, Wiltink J, Leichsenring F, Leibing E, König HH. Short-term cost-effectiveness of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: Results from the SOPHO-NET trial. J Affect Disord 2015; 180:21-8. [PMID: 25879721 DOI: 10.1016/j.jad.2015.03.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 10/23/2014] [Revised: 02/05/2015] [Accepted: 03/23/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND To investigate the short-term cost-effectiveness of cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) compared to waiting list (WL). METHODS The analysis was conducted alongside the SOPHO-NET multi-center efficacy trial. Patients were randomly assigned to CBT (n=209), PDT (n=207), or WL (n=79). Resource use was assessed prior and during treatment to determine direct and absenteeism costs. Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated based on remission and response rates. To visualize statistical uncertainty, cost-effectiveness acceptability curves (CEACs) were constructed based on adjusted net-benefit regression. Different values for the society׳s willingness to pay (WTP) were assumed. RESULTS Both interventions were more efficacious than WL but were associated with increased direct costs besides intervention costs. Unadjusted ICERs per responder were €3615 for CBT and €4958 for PDT. Unadjusted ICERs per remitted patient were €5788 and €10,733. CEACs revealed a high degree of uncertainty: applying the 97.5% probability threshold, CBT proved cost-effective at a WTP ≥€16,100 per responder and ≥€26,605 per remitted patient. Regarding PDT cost-effectiveness only was certain for response at a WTP ≥€27,290. LIMITATIONS The WL condition is assumed to represent untreated patients, although the expectation to start treatment in the near future probably affects symptom severity and health care utilization. CONCLUSIONS At the end of treatment cost-effectiveness of CBT and PDT compared to WL is uncertain and depends on the societal WTP. The interventions may induce a more adequate utilization of other health care services - involving increased costs. Development of costs and effects in the long-run should be considered.
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Affiliation(s)
- Nina Egger
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Germany.
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr-University Bochum, Germany
| | - Wolfgang Hiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Juergen Hoyer
- Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technische Universitaet Dresden, Germany
| | - Simone Salzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Germany
| | - Ulrich Stangier
- Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Germany
| | - Ulrike Willutzki
- Clinical Psychology and Psychotherapy, University Witten/Herdecke, Germany
| | - Joerg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - Falk Leichsenring
- Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Germany
| | - Eric Leibing
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf, Germany
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Hoyer J, Velten J, Benecke C, Berking M, Heinrichs N, In-Albon T, Lincoln T, Lutz W, Schlarb A, Schöttke H, Willutzki U, Margraf J. Koordination der Forschung an Hochschulambulanzen für Psychotherapie. Zeitschrift für Klinische Psychologie und Psychotherapie 2015. [DOI: 10.1026/1616-3443/a000308] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Forschungsaktivitäten an psychotherapeutischen Hochschulambulanzen (HSA) können einen entscheidenden Beitrag zur Weiterentwicklung und wissenschaftlichen Fundierung von Psychotherapie leisten. Um die vielfältigen Daten, die in HSA in Deutschland gesammelt werden, besser nutzbar zu machen, erscheint eine Koordination der Datenerhebungen und Forschung perspektivisch sinnvoll. In diesem Artikel stellen wir die Ergebnisse einer Umfrage zu den Kernmerkmalen deutscher Hochschulambulanzen (z. B. Fallzahlen, diagnostische Instrumente, verwendete Software) vor und entwickeln auf Basis der Ergebnisse Vorschläge zur besseren Integration der Forschungsbemühungen. Es wurden 53 Hochschulambulanzen in Deutschland identifiziert. Diese erhielten einen Fragebogen zu den jährlichen Fallzahlen, der eingesetzten klinisch-psychologischen Diagnostik, zu den störungsübergreifenden und -spezifischen Fragebögen sowie den erhobenen Patienten- und Therapeutenvariablen und der verwendeten Software. Die Rücklaufquote lag bei 100 %. Insgesamt werden demnach in den deutschen HSA im Erwachsenen- und Kinder-Jugendlichenbereich über 10 000 neue Patienten pro Jahr behandelt. Für die strukturierte und störungsübergreifende Diagnostik werden fast ausnahmslos dieselben Verfahren genutzt. Dem steht eine große Vielfalt von störungsspezifischen Verfahren gegenüber. Die verwendete Datenbanksoftware ist heterogen und nicht vollständig miteinander kompatibel. In der Diskussion verdeutlichen wir, welche außergewöhnliche Plattform für weitere Forschung bereits gegeben ist, aber auch welche Schwierigkeiten, zum Beispiel beim Datenschutz, im Vorfeld einer besseren Forschungsintegration zu lösen sind.
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Affiliation(s)
- Jürgen Hoyer
- Technische Universität Dresden, Klinische Psychologie und Psychotherapie
| | - Julia Velten
- Ruhr-Universität Bochum, Klinische Psychologie und Psychotherapie
| | - Cord Benecke
- Universität Kassel, Klinische Psychologie und Psychotherapie
| | - Matthias Berking
- Philipps-Universität Marburg, Klinische Psychologie und Psychotherapie
| | - Nina Heinrichs
- Technische Universität Braunschweig, Klinische Psychologie, Psychotherapie und Diagnostik
| | - Tina In-Albon
- Universität Koblenz-Landau, Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters
| | - Tania Lincoln
- Universität Hamburg, Klinische Psychologie und Psychotherapie
| | - Wolfgang Lutz
- Universität Trier, Klinische Psychologie und Psychotherapie
| | - Angelika Schlarb
- Universität Bielefeld, Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters
| | | | - Ulrike Willutzki
- Universität Witten/Herdecke, Klinische Psychologie und Psychotherapie
| | - Jürgen Margraf
- Ruhr-Universität Bochum, Klinische Psychologie und Psychotherapie
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Teismann T, Ertle A, Furka N, Willutzki U, Hoyer J. The German Version of the Behavioral Activation for Depression Scale (BADS): A Psychometric and Clinical Investigation. Clin Psychol Psychother 2015; 23:217-25. [PMID: 25772711 DOI: 10.1002/cpp.1948] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 08/31/2014] [Revised: 02/16/2015] [Accepted: 02/16/2015] [Indexed: 11/08/2022]
Abstract
UNLABELLED The Behavioral Activation for Depression Scale (BADS) was developed to measure core concepts of behavioural activation for depression. A number of studies, mostly based on analogue samples, have provided initial support for the BADS. In the present study, we examined the psychometric properties of the German version of the scale more broadly, including change sensitivity and clinical treatment data. A mixed sample of students (N = 312) and depressed outpatients in partial remission undergoing cognitive-behavioural group treatment for depressive rumination (N = 59) was examined. To analyze construct validity, a set of theoretically relevant constructs such as perseverative thinking, distraction and mindfulness was also assessed. Results indicated good psychometric properties, additional evidence for construct validity of the total scale and subscales, and adequate fit of the data to the original factor structure. Furthermore, the BADS proved to be sensitive to changes in participants undergoing treatment for depression. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE Behavioural activation (BA) is an effective treatment for patients suffering from unipolar depression. The Behavioral Activation for Depression Scale (BADS) can be used to measure core elements of the BA treatment rationale. It is useful to track changes in activation within treatment. The BADS is available in different languages and has shown to possess good psychometric properties.
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Affiliation(s)
- Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Andrea Ertle
- Institute of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nadine Furka
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Ulrike Willutzki
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Juergen Hoyer
- Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden, Germany
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Schröder T, Orlinsky D, Rønnestad MH, Willutzki U. Psychotherapeutic Process from the Psychotherapist’s Perspective. Psychother Res 2015. [DOI: 10.1007/978-3-7091-1382-0_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Hoyer J, Wiltink J, Hiller W, Miller R, Salzer S, Sarnowsky S, Stangier U, Strauss B, Willutzki U, Leibing E. Baseline Patient Characteristics Predicting Outcome and Attrition in Cognitive Therapy for Social Phobia: Results from a Large Multicentre Trial. Clin Psychol Psychother 2014; 23:35-46. [PMID: 25504802 DOI: 10.1002/cpp.1936] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [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: 06/07/2014] [Revised: 10/30/2014] [Accepted: 11/03/2014] [Indexed: 11/09/2022]
Abstract
UNLABELLED We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed. METHOD Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied. RESULTS Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-treatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with end-state functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher end-state functioning and more shame with better response. Attrition could not be significantly predicted. CONCLUSIONS The results indicate that the initial probability for treatment success mainly depends on severity of disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical-based foundation for differential indication and argues to search for more potent moderators of therapeutic change rather on the process level. KEY PRACTITIONER MESSAGE Personality, self-esteem, shame, attachment style and interpersonal problems do not or only marginally moderate the effects of interventions in CT of social phobia. Symptom severity and comorbid diagnoses might affect treatment outcome negatively. Beyond these two factors, most patients share a similar likelihood of treatment success when treated according to the manual by Clark and Wells. Copyright © 2014 John Wiley & Sons, Ltd.
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Affiliation(s)
- Juergen Hoyer
- Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany
| | - Joerg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wolfgang Hiller
- Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Robert Miller
- Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany
| | - Simone Salzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August University Goettingen, Goettingen, Germany
| | - Stephan Sarnowsky
- Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany
| | - Ulrich Stangier
- Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Ulrike Willutzki
- Clinical Psychology and Psychotherapy, Ruhr University Bochum, Bochum, Germany
| | - Eric Leibing
- Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August University Goettingen, Goettingen, Germany
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Willutzki U, Victor P. [Social Anxiety Disorders.]. Psychother Psychosom Med Psychol 2014; 64:481-491. [PMID: 25494190 DOI: 10.1055/s-0034-1387322] [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] [Indexed: 10/24/2022]
Affiliation(s)
| | - Philipp Victor
- Psychologie und Psychotherapie, Universität Witten/Herdecke
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Leichsenring F, Salzer S, Beutel ME, Herpertz S, Hiller W, Hoyer J, Huesing J, Joraschky P, Nolting B, Poehlmann K, Ritter V, Stangier U, Strauss B, Tefikow S, Teismann T, Willutzki U, Wiltink J, Leibing E. Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder. Am J Psychiatry 2014; 171:1074-82. [PMID: 25016974 DOI: 10.1176/appi.ajp.2014.13111514] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Relatively few studies have examined the long-term outcome of psychotherapy in social anxiety disorder. The authors previously reported findings of a clinical trial comparing cognitive-behavioral therapy (CBT), psychodynamic therapy, and a wait-list control. The purpose of the present study was to follow the participants' status over the ensuing 24 months. METHOD Outpatients with social anxiety disorder who were treated with CBT (N=209) or psychodynamic therapy (N=207) in the previous trial were assessed 6, 12, and 24 months after the end of therapy. Primary outcome measures were rates of remission and response. RESULTS For both CBT and psychodynamic therapy, response rates were approximately 70% by the 2-year follow-up. Remission rates were nearly 40% for both treatment conditions. Rates of response and remission were stable or tended to increase for both treatments over the 24-month follow-up period, and no significant differences were found between the treatment conditions after 6 months. CONCLUSIONS CBT and psychodynamic therapy were efficacious in treating social anxiety disorder, in both the short- and long-term, when patients showed continuous improvement. Although in the short-term, intention-to-treat analyses yielded some statistically significant but small differences in favor of CBT in several outcome measures, no differences in outcome were found in the long-term.
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Wachtel S, Vocks S, Edel MA, Nyhuis P, Willutzki U, Teismann T. Validation and psychometric properties of the German Capability for Suicide Questionnaire. Compr Psychiatry 2014; 55:1292-302. [PMID: 24721192 DOI: 10.1016/j.comppsych.2014.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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] [Received: 01/18/2014] [Revised: 03/16/2014] [Accepted: 03/18/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Our study aimed at the validation of the newly developed German Capability for Suicide Questionnaire, the GCSQ. It is supposed to assess both fearlessness of death and pain tolerance, both facets of the acquired capability to commit suicide as postulated by the interpersonal theory of suicide. METHODS This cross-sectional study was conducted on two clinical (n=424) and an online sample (n=532). Factor structure, convergent and discriminant validity, predictive validity as well as test-retest reliability were investigated. RESULTS Two factors-"Fearlessness of Death" and "Pain Tolerance"-were derived. One item, the "perceived capability" item, assesses the subject's self-perception of acquired capability. Both subscales and the "perceived capability"-item demonstrate good construct validity and a high test-retest reliability. Fearlessness of death proves to be predictive for the occurrence of suicidal behaviors, whereas the importance of pain tolerance for suicidal behaviors was not confirmed. The subject's perception of his own capability is of high predictive value for both attempt status and suicidal behaviors. CONCLUSION The GCSQ seems to be a useful measure of pain tolerance, fearlessness of death and the self-perception of acquired capability of suicide.
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Affiliation(s)
- Sarah Wachtel
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany.
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology, Universität Osnabrück, Germany
| | - Marc-Andreas Edel
- Department of Psychiatry, LWL University Hospital, Ruhr-Universität, Bochum, Germany
| | | | - Ulrike Willutzki
- Department for Psychology and Psychotherapy, Universität Witten/Herdecke, Witten, Germany
| | - Tobias Teismann
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Germany
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Sonntag M, Konnopka A, Leichsenring F, Salzer S, Beutel ME, Herpertz S, Hiller W, Hoyer J, Joraschky P, Nolting B, Pöhlmann K, Stangier U, Strauss B, Willutzki U, Wiltink J, Leibing E, König HH. Reliability, validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with social phobia. Health Qual Life Outcomes 2013; 11:215. [PMID: 24365384 PMCID: PMC3878044 DOI: 10.1186/1477-7525-11-215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 12/18/2013] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of the study was to analyse the psychometric properties of the EQ-5D in patients with social phobia. Methods We used a sample of 445 patients with social phobia with five measurement points over a 30 month period. The discriminative ability of the EQ-5D was analysed by comparing the patients’ responses with the general population and between different disease severity levels. For test-retest reliability we assessed the level of agreement in patients’ responses over time, when there was no change in the Liebowitz Social Anxiety Scale (LSAS). Construct validity was analysed by identifying correlations of the EQ-5D with more specific instruments. For responsiveness we compared the means of EQ VAS/EQ-5D index anchored on improved (deteriorated) health status and computed effect sizes as well as a receiver operating characteristic (ROC) curve. Results Compared to the general population, patients with social phobia reported more problems in the dimensions “usual activities”, “pain/discomfort”, and “anxiety/depression” and less problems in “mobility” and “self-care”. The EQ-5D was able to distinguish between different disease severity levels. The test-retest reliability was moderate (intraclass correlation coefficient > 0.6). Correlations between the EQ-5D and other instruments were mostly small except for correlations with Beck Depression Inventory. The EQ-5D index seemed to be more responsive than the EQ VAS, but with only medium effect sizes (0.5 < effect size < 0.8) in the British EQ-5D index and only significant in patients with improved health status. The ROC analysis revealed no significant results. Conclusions The EQ-5D was moderately reliable and responsive in patients with improved health status. Construct validity was limited. Trial registration Current controlled trials ISRCTN53517394
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Affiliation(s)
- Michael Sonntag
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246 Hamburg, Germany.
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Sonntag M, Konnopka A, Leichsenring F, Salzer S, Beutel ME, Herpertz S, Hiller W, Hoyer J, Joraschky P, Nolting B, Pöhlmann K, Stangier U, Strauss B, Willutzki U, Wiltink J, Leibing E, König HH. Reliability, validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with social phobia. Health Qual Life Outcomes 2013. [PMID: 24365384 DOI: 10.1186/1477-7525-11-215.:215-11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE The aim of the study was to analyse the psychometric properties of the EQ-5D in patients with social phobia. METHODS We used a sample of 445 patients with social phobia with five measurement points over a 30 month period. The discriminative ability of the EQ-5D was analysed by comparing the patients' responses with the general population and between different disease severity levels. For test-retest reliability we assessed the level of agreement in patients' responses over time, when there was no change in the Liebowitz Social Anxiety Scale (LSAS). Construct validity was analysed by identifying correlations of the EQ-5D with more specific instruments. For responsiveness we compared the means of EQ VAS/EQ-5D index anchored on improved (deteriorated) health status and computed effect sizes as well as a receiver operating characteristic (ROC) curve. RESULTS Compared to the general population, patients with social phobia reported more problems in the dimensions "usual activities", "pain/discomfort", and "anxiety/depression" and less problems in "mobility" and "self-care". The EQ-5D was able to distinguish between different disease severity levels. The test-retest reliability was moderate (intraclass correlation coefficient > 0.6). Correlations between the EQ-5D and other instruments were mostly small except for correlations with Beck Depression Inventory. The EQ-5D index seemed to be more responsive than the EQ VAS, but with only medium effect sizes (0.5 < effect size < 0.8) in the British EQ-5D index and only significant in patients with improved health status. The ROC analysis revealed no significant results. CONCLUSIONS The EQ-5D was moderately reliable and responsive in patients with improved health status. Construct validity was limited. TRIAL REGISTRATION Current controlled trials ISRCTN53517394.
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Affiliation(s)
- Michael Sonntag
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246 Hamburg, Germany.
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Abstract
Theoretischer Hintergrund: Verfahren zur direkten Veränderungsmessung bestimmen den Psychotherapieerfolg in ökonomischer Ein-Punkt-Messung. Hierzu wurde der Bochumer Veränderungsbogen-2000 (BVB-2000) als überarbeitete und gekürzte Variante des Veränderungsfragebogens des Erlebens und Verhaltens (VEV; Zielke & Kopf-Mehnert, 1978 ) entwickelt. Fragestellung: Der BVB-2000 soll einer testtheoretischen Reanalyse mit Fokus auf die konvergente Validität unterzogen werden. Kritische Veränderungswerte auf Basis der Werte einer klinischen Wartekontrollgruppe sollen die Möglichkeit bieten den Therapieerfolg auch in Einzelfällen zu bestimmen. Methode: Die Psychotherapie von N = 205 Patienten wird mit verschiedenen Instrumenten zur Therapieerfolgsmessung inklusive des BVB-2000 begleitet. Auf Basis einer Wartekontrollgruppe (N = 88) werden kritische Veränderungswerte für den BVB-2000 berechnet. Ergebnisse: Der BVB-2000 weist eine hohe interne Konsistenz auf (α = .96; 26 Items) und zeigt durchgängig statistisch bedeutsame Zusammenhänge mit anderen Therapieerfolgsmaßen vor allem der Zielerreichung. Kritische Veränderungswerte ermöglichen die Einschätzung des Therapieerfolgs im Einzelfall. Schlussfolgerungen: Der BVB-2000 ist ein verständliches, ökonomisches, reliables und valides Instrument zur Psychotherapieerfolgsmessung.
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Teismann T, von Brachel R, Hanning S, Grillenberger M, Hebermehl L, Hornstein I, Willutzki U. A randomized controlled trial on the effectiveness of a rumination-focused group treatment for residual depression. Psychother Res 2013; 24:80-90. [PMID: 23962173 DOI: 10.1080/10503307.2013.821636] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The maintenance of residual symptoms following acute treatment is common and is associated with poor long-term prognosis. This study investigates whether a cognitive-behavioral group treatment is effective in reducing residual depression by targeting depressive rumination. Participants (N=60) were randomly assigned to either the group treatment or a wait-list control condition. Treatment significantly improved depressed mood, rumination, perceived control over rumination and dysfunctional metacognitive beliefs compared with the wait condition. Treatment gains were maintained over the follow-up period of 1 year. Attrition was low and treatment satisfaction was high. Eight individuals suffered from a depressive relapse/recurrence in the year following treatment. The results indicate that cognitive-behavioral group therapy for depressive rumination is effective and well accepted by patients suffering from residual depression.
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Affiliation(s)
- Tobias Teismann
- a Clinical Psychology and Psychotherapy , Ruhr-Universität Bochum , Bochum , Germany
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