Matching clients and therapist based on demographic variables might enhance therapeutic outcomes. Even so, research in this field is still inconclusive and not much is known about same-gender client therapist dyads in the context of cognitive behavioral (CBT) and psychodynamic methods. For this purpose, we studied the therapy outcomes of N = 1.212 participants that had received therapy (3 months-6 years) in Germany. The results showed a trend for same-gender client therapist dyads in terms of symptom reduction and quality of life specific to psychodynamic approaches. The latter applied specifically to female client-therapist dyads. On the other hand, this trend was not fully evident for CBT-based therapies. In conclusion, despite the robust sample and observed trends, it is not clear whether matching same gender dyads is advantageous with regards to symptom reduction and quality of life. Regardless, these results are preliminary and further studies are needed in order to find out whether same gender client-therapist dyads enhance therapy outcomes or not.
Cognitive Behavioral Therapy , Quality of Life , Cognitive Behavioral Therapy/methods , Cross-Sectional Studies , Female , Germany , Humans , Professional-Patient Relations
The present study was conducted with the aim of constructing and validating a short form of the Profile of Mood States (POMS). The POMS is a widely-applied measure for the assessment of an individual's mood. Thus, it is of great relevance for many research questions in clinical and social psychology. To develop the short scale, we first examined psychometric properties and found the optimal 16-item solution among all valid combinations of the full POMS in an exploratory subsample (n = 1,029) of our complete representative sample of the German general population. We then validated this model in a confirmatory subsample (n = 977). Additionally, we examined its invariance across age groups and sex, as well as its reliability. Our results indicate that the POMS-16 is a valid and reliable measure of mood states with minimal losses compared to the 35-item version. Particularly where brevity and an economical assessment is desired, the POMS-16 should be considered.
The Body Image Questionnaire-20 (FKB-20) is one of the most applied self-report measures in the context of body image assessment in German-speaking regions. A version of the FKB-20 capturing an ideal concept of body image is also available. A special property of the scale is its high sensitivity for individuals suffering from anorexia nervosa. The present research provided a short version of this scale (for both variants) and examined its validity in a representative sample (N = 2,347) of the German population. We utilized factor analysis methods to identify the optimal short scale of the measure, finding excellent model fit and reliability for a two-factor model (FKB-6) for both real and ideal body image. Both versions of the FKB-6 can be considered invariant across sex and age groups. Good reliability indices were shown for both versions of the FKB-6. The reliability indices were similar to those mentioned in previous studies. Our study also revealed, that large discrepancies between the real and an ideal body image are correlated with somatic and body dysmorphic symptoms. Finally, we provided norm values for comparisons of individual scores with the general population. The FKB-6 is a valid and a reliable measure that economizes assessments by clinicians and researchers.
INTRODUCTION: The aim of the present study was to show the development of the revised and shortened German version (6 items) of the "Systems of Belief Inventory" (SBI-6R-D) as well as to examine its psychometric properties. METHODS: In a representative German sample the questionnaire has been given to 2513 subjects. A confirmatory factor analysis has been made to prove the original American factor structure. Measurement invariance was tested using multigroup analysis. Correlations were used to determine convergent and discriminant validity towards other items. RESULTS: The SBI-6R-D showed good item and scale characteristics as well as good model fit. In difference to the work of Albani et al. (SBI-15R-D), the 2 factorial structure of the original American questionnaire could be replicated. Scalar invariance could be shown for gender and age, metric invariance for denomination and federal state. DISCUSSION: Due to the good psychometric properties of the questionnaire it should be further analyzed in future research with other validated religious instruments. CONCLUSIONS: The new German short version, the SBI-6R-D, is an economic, reliable and valid questionnaire to measure spiritual and religious attitudes.
Culture , Personality Inventory/statistics & numerical data , Psychometrics/statistics & numerical data , Correlation of Data , Cross-Cultural Comparison , Factor Analysis, Statistical , Germany , Humans , Religion and Psychology , Reproducibility of Results , Spirituality , Surveys and Questionnaires
INTRODUCTION: The aim of the present study was to show the development of the revised and shortened German version (6 items) of the scale "Transpersonales Vertrauen" (TPV-6R; 2017) as well as to examine its psychometric properties. METHODS: In a representative German sample the questionnaire has been given to 2513 subjects. Collected data from 2464 subjects could be analysed. Exploratory and confirmatory factor analysis has been made to prove the original one-factor model (Belschner, 2000) as well as the 2-factorial structure found by Albani et al. (2003). Measurement invariance was tested using multigroup analysis. Correlations were used to determine convergent and discriminant validity towards other items. RESULTS: After excluding 2 items due to their unsatisfactory scale fit, the 4 item model showed good item and scale characteristics as well as excellent model fit. The one factorial structure of the original work of Belschner and colleagues (2000) could be replicated. Metric invariance could be shown for gender and age, partial scalar invariance could be only generated for gender. No metric or scalar invariance could be shown for federal state and denomination. DISCUSSION: Due to the good psychometric properties of the TPV-4R questionnaire it should be further analyzed in future research with other validated instruments that are measuring spiritual or religious attitudes. CONCLUSIONS: The new German short version, the TPV-4R, is an economic, reliable and valid questionnaire to measure spiritual attitudes.
Psychometrics , Spirituality , Surveys and Questionnaires , Trust , Adolescent , Adult , Aged , Aged, 80 and over , Attitude , Factor Analysis, Statistical , Female , Germany , Humans , Male , Middle Aged , Reproducibility of Results , Translations , Young Adult
The Trier Inventory for Chronic Stress (TICS), consisting of 57 items, is an instrument for measuring chronic stress in nine areas. There is also a short form (SSCS) of the TICS consisting of 12 items. However, this 12-item short form does not include all nine areas of the theoretical model and the long version. Therefore, a short version including all nine scales/areas was investigated. The TICS was taken by a sample of N = 2,473 respondents from the general population, aged 14 to 99, selected by random-route sampling. Confirmatory factor analyses applying robust maximum likelihood estimations (MLM) tested the model fit. The one-factor-model proposed by the original authors was tested, and the SSCS showed an unacceptable model fit. For the development of an economical short version of the TICS, including items of the nine areas of chronic stress, nine items based on the alphamax algorithm were selected. The one-factor-model of this new short version of the TICS of nine items provided a good fit for the latent construct and showed good reliability (α = .88). A new and reliable short version of the TICS consisting of only 9 items representing the 9 scales/areas for the assessment of chronic stress was identified to possess a good model fit and good reliability.
Psychometrics/methods , Stress, Psychological/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Factor Analysis, Statistical , Female , Germany , Humans , Male , Mass Screening/methods , Mass Screening/statistics & numerical data , Middle Aged , Models, Psychological , Psychometrics/statistics & numerical data , Reference Values , Young Adult
INTRODUCTION: Waiting times for the admission into a so called psychosomatic hospital in Germany prevent the necessary immediate treatment. They lead to further incapacity for work and chronic manifestation of the disease. It is reported that most psychosomatic hospitals have waiting times, but there are no studies on data on that. Therefore, it was the aim of this study to access prospectively in a defined region, how long it takes for the patients to get an outpatient preliminary talk and thereafter, how long they have to wait for their admission. METHODS: 7 hospitals out of the region of South-Württemberg took part on this study, 2 of them had bigger day hospitals. Data were assessed prospectively in 2015 over 9 months, in total 916 admissions were assessed. RESULTS: The waiting time until a preliminary talk, in which the indication for inpatient treatment was secured, was in the mean 25 days (SD=31). The waiting time after this talk until admission was 56 days (SD=47). Patients who waited for a day treatment had to wait even longer. An urgency remark, given by the therapist of the preliminary talk, as well as a private illness insurance led to shorter waiting times. The diagnosis had no influence on the waiting time. CONCLUSIONS: The waiting times are substantial and imply a burden for the patient and also for the health care system. It is recommended to assess and publish these waiting times on a regularly basis. Politics, but also the actors in the health care system should discuss if and how this deficit can be changed.
Patient Admission/statistics & numerical data , Psychophysiologic Disorders/psychology , Psychophysiologic Disorders/therapy , Psychotherapy/statistics & numerical data , Waiting Lists , Adolescent , Adult , Aged , Cross-Sectional Studies , Day Care, Medical/statistics & numerical data , Female , Germany , Health Facility Size/statistics & numerical data , Hospital Bed Capacity/statistics & numerical data , Humans , Male , Middle Aged , Prospective Studies , Psychophysiologic Disorders/epidemiology , Time Factors , Young Adult
BACKGROUND: Published validation studies have reported different factor structures for the Self-Compassion Scale (SCS). The objective of this study was to assess the factor structure of the SCS in a large general population sample representative of the German population. METHODS: A German population sample completed the SCS and other self-report measures. Confirmatory factor analysis (CFA) in MPlus was used to test six models previously found in factor analytic studies (unifactorial model, two-factor model, three-factor model, six-factor model, a hierarchical (second order) model with six first-order factors and two second-order factors, and a model with arbitrarily assigned items to six factors). In addition, three bifactor models were also tested: bifactor model #1 with two group factors (SCS positive items, called SCS positive) and SCS negative items, called SCS negative) and one general factor (overall SCS); bifactor model #2, which is a two-tier model with six group factors, three (SCS positive subscales) corresponding to one general dimension (SCS positive) and three (SCS negative subscales) corresponding to the second general dimension (SCS negative); bifactor model #3 with six group factors (six SCS subscales) and one general factor (overall SCS). RESULTS: The two-factor model, the six-factor model, and the hierarchical model showed less than ideal, but acceptable fit. The model fit indices for these models were comparable, with no apparent advantage of the six-factor model over the two-factor model. The one-factor model, the three-factor model, and bifactor model #3 showed poor fit. The other two bifactor models showed strong support for two factors: SCS positive and SCS negative. CONCLUSION: The main results of this study are that, among the German general population, six SCS factors and two SCS factors fit the data reasonably well. While six factors can be modelled, the three negative factors and the three positive factors, respectively, did not reflect reliable or meaningful variance beyond the two summative positive and negative item factors. As such, we recommend the use of two subscale scores to capture a positive factor and a negative factor when administering the German SCS to general population samples and we strongly advise against the use of a total score across all SCS items.
Empathy , Adolescent , Adult , Aged , Female , Germany , Humans , Male , Middle Aged , Young Adult
Self-compassion, typically operationalized as the total score of the Self-Compassion Scale (SCS; Neff, 2003b), has been shown to be related to increased psychological well-being and lower depression in students of the social sciences, users of psychology websites and psychotherapy patients. The current study builds on the existing literature by examining the link between self-compassion and depressive symptomatology in a sample representative of the German general population (n = 2,404). The SCS subscales of self-judgment, isolation, and over-identification, and the "self-coldness", composite score, which encompass these three negative subscales, consistently differed between subsamples of individuals without any depressive symptoms, with any depressive syndromes, and with major depressive disorder. The contribution of the positive SCS subscales of self-kindness, common humanity, and mindfulness to the variance in depressive symptomatology was almost negligible. However, when combined to a "self-compassion composite", the positive SCS subscales significantly moderated the relationship between "self-coldness" and depressive symptoms in the general population. This speaks for self-compassion having the potential to buffer self-coldness related to depression--providing an argument for interventions that foster self-caring, kind, and forgiving attitudes towards oneself.
Depression/psychology , Empathy , Self Care , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult
BACKGROUND: The population-based study examined postulated effects, derived from a resources-demands-model about gender-related aspects of self-efficacy, optimism, chronic stress, and exhaustion. METHODS: Data acquisition was carried out by a market research institute with a multi-topic questionnaire in the general population (N = 2,552). Instruments administered were the Questionnaire for Self-Efficacy and Optimism, the Trier Inventory for Chronic Stress, and the Chalder-Fatigue-Scale. Households and target persons were selected randomly. The analyses focused on structural equation modeling. RESULTS: There were significant differences in structural relations among the resource paths. In particular, significant gender differences were found with respect to self-efficacy, and among the exhaustion paths, namely in the mental dimension of exhaustion. The observed measures of chronic stress were found to be operating equivalently for both genders. Results suggest that resources play an important role in the understanding of how chronic stress is preceded and may lead to exhaustion in both genders. CONCLUSION: Personal resources seem to be more expressed by men than by woman, for whom the relation of resources to health is of greater importance than for men.
Adaptation, Psychological , Mental Fatigue/etiology , Self Efficacy , Stress, Psychological/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Fatigue , Female , Health Resources , Hope , Humans , Male , Mental Fatigue/psychology , Middle Aged , Models, Psychological , Sex Factors , Surveys and Questionnaires , Young Adult
The study examined the relationships of resources, chronic activated distress, and fatigue. Data acquisition was carried out by a market research institute in a multitopic questionnaire in the general population (N=2 552). Administered were the TICS, the CFS-Scale, and the SWOP. The analyses focused on structural equation modelling. Hypotheses derived from a demands-resources model proved to be most worthwhile. Especially dispositional optimism, seemed to be most relevant. The prevalence rate for elevated chronic stress was 19.1%. Group differences were significant for age but not for gender. Part-time worker exhibited the highest rates of chronic stress. A lower social economic status also favoured an increased chronic stress experience. Theoretical implications, practical consequences for health promotion and prevention as well as limitations of the study are discussed.
Fatigue/epidemiology , Fatigue/psychology , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Employment , Female , Germany/epidemiology , Health Resources , Health Status , Humans , Male , Middle Aged , Prevalence , Socioeconomic Factors , Surveys and Questionnaires , Young Adult
BACKGROUND: Chronic stress results from an imbalance of personal traits, resources and the demands placed upon an individual by social and occupational situations. This chronic stress can be measured using the Trier Inventory for Chronic Stress (TICS). Aims of the present study are to test the factorial structure of the TICS, report its psychometric properties, and evaluate the influence of gender and age on chronic stress. METHODS: The TICS was answered by N = 2,339 healthy participants aged 14 to 99. The sample was selected by random-route sampling. Exploratory factor analyses with Oblimin-rotated Principal Axis extraction were calculated. Confirmatory factor analyses applying Robust Maximum Likelihood estimations (MLM) tested model fit and configural invariance as well as the measurement invariance for gender and age. Reliability estimations and effect sizes are reported. RESULTS: In the exploratory factor analyses, both a two-factor and a nine-factor model emerged. Confirmatory factor analyses resulted in acceptable model fit (RMSEA), with model comparison fit statistics corroborating the superiority of the nine-factor model. Most factors were moderately to highly intercorrelated. Reliabilities were good to very good. Measurement invariance tests gave evidence for differential effects of gender and age on the factor structure. Furthermore, women and younger individuals, especially those aged 35 to 44, tended to report more chronic stress than men and older individuals. CONCLUSIONS: The proposed nine-factor structure could be factorially validated, results in good scale reliability, and heuristically can be grouped by two higher-order factors: "High Demands" and "Lack of Satisfaction". Age and gender represent differentiable and meaningful contributors to the perception of chronic stress.
Chronic Disease/psychology , Personality Inventory , Psychometrics , Stress, Psychological/diagnosis , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Chronic Disease/epidemiology , Factor Analysis, Statistical , Female , Germany/epidemiology , Humans , Male , Middle Aged , Models, Psychological , Reproducibility of Results , Sex Factors , Social Environment , Stress, Psychological/etiology , Work Schedule Tolerance
BACKGROUND: Disgust sensitivity is defined as a predisposition to experiencing disgust, which can be measured on the basis of the Disgust Scale and its German version, the Questionnaire for the Assessment of Disgust Sensitivity (QADS). In various studies, different factor structures were reported for either instrument. The differences may most likely be due to the selected factor analysis estimation methods and the small non-representative samples. Consequently, the aims of this study were to explore and confirm a theory-driven and statistically coherent QADS factor structure in a large representative sample and to present its standard values. METHODS: The QADS was answered by N = 2473 healthy subjects. The respective households and participants were selected using the random-route sampling method. Afterwards, the collected sample was compared to the information from the Federal Statistical Office to ensure that it was representative for the German residential population. With these data, an exploratory Promax-rotated Principal Axis Factor Analysis as well as comparative confirmatory factor analyses with robust Maximum Likelihood estimations were computed. Any possible socio-demographic influences were quantified as effect sizes. RESULTS: The data-driven and theoretically sound solution with the three highly interrelated factors Animal Reminder Disgust, Core Disgust, and Contamination Disgust led to a moderate model fit. All QADS scales had very good reliabilities (Cronbach's alpha) from .90 to .95. There were no age-differences found among the participants, however, the female participants showed remarkably higher disgust ratings. CONCLUSIONS: Based on the representative sample, the QADS factor structure was revised. Gender-specific standard percentages permit a population-based assessment of individual disgust sensitivity. The differences of the original QADS, the new solution, and the Disgust Scale - Revised will be discussed.
Emotions , Factor Analysis, Statistical , Surveys and Questionnaires , Adult , Aged , Cross-Sectional Studies , Female , Germany , Humans , Male , Middle Aged , Models, Statistical , Psychometrics , Reproducibility of Results , Sampling Studies , Socioeconomic Factors
OBJECTIVE: To examine the Patient Global Impression Scale of Improvement (PGI) as a quality indicator in routine psychiatric in-patient treatment and to determine its concordance with doctors' assessments. METHODS: Patients treated in 2007 in 5 hospitals and 4 day-clinics were included. A set of patient and treatment characteristics (German BADO) and CGI scales were recorded in all patients. Patients were required to give a PGI rating at discharge. RESULTS: PGI ratings could be obtained in 70.3 of the patients (N = 3957). PGI and doctors' CGI-I ratings were in agreement with no more than one degree of difference on the 7-point scale of the PGI in 89.8â%. Characteristics of those patients who significantly deviated from the doctors' assessments were determined. CONCLUSIONS: The PGI scale is appropriate as a quality indicator for routine clinical treatment which can rather easily be obtained.
Day Care, Medical , Hospitals, Psychiatric , Mental Disorders/therapy , Outcome and Process Assessment, Health Care , Patient Admission , Quality Indicators, Health Care , Adolescent , Adult , Aged , Attitude of Health Personnel , Female , Germany , Health Care Rationing , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Middle Aged , National Health Programs , Patient Discharge , Psychiatric Status Rating Scales , Young Adult
The present paper examined the connection between a negative body image and body complaints in N = 788 persons above 60 years of age from the general population. From a psychosomatic view, it is to be expected that psychological adjustment problems to the aging body are accompanied by physical complaints. A cluster analysis resulted in a group of older people with a strongly negative body image and a high degree of body complaints. This group is mainly formed by women, persons in high age, elderly alone living and persons with little social support. A second cluster includes persons with a positive body image and few body complaints. These are mainly younger persons, men, persons with a high degree of social support and older people living in a partnership. A further cluster includes persons with a very negative body image, however, with few body complaints. These persons are younger and more often live in a partnership, compared to the elderly with negative body image and a high degree of body complaints. A fourth cluster represents persons with a low degree of a negative body image and few body complaints. Their vitality and physical well-being, however, are also low. The study confirms that body complaints are partly determined by the body image. Sex, life in partnership and social support are risk or protective factors, respectively.
Body Image , Health Status , Self Concept , Somatosensory Disorders/epidemiology , Somatosensory Disorders/psychology , Aged , Female , Germany/epidemiology , Humans , Incidence , Male , Middle Aged
Facing the current political controversies concerning health care, the present study examines the question who is using outpatient psychotherapy in Germany. Using data drawn from a nationally representative survey of 5120 Germans 7% stated they had used oupatient psychotherapy in the former 6 years or being actually in outpatient psychotherapy. Comparisions of socio-economic variables between persons with and without use of outpatient psychotherapy showed, contrary to expectations, that psychotherapy is not utilised by so called "YARVIS" (young, attractive, rich, verbal, intelligent, successful) patients.
Ambulatory Care/statistics & numerical data , Psychotherapy/statistics & numerical data , Adolescent , Adult , Aged , Female , Germany/epidemiology , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/therapy , Middle Aged , Socioeconomic Factors , Young Adult
This study investigates the association between body image and body dysmorphic symptoms in the population by taking different kinds of self-consciousness into account. Body dysmorphic symptoms are characterized by a distressing and impairing preoccupation with an imagined or slight defect in appearance. A representative sample of 1621 persons in Germany was examined with screening instruments for body image, body dysmorphic symptoms and self-consciousness. Women reported more body dysmorphic symptoms and higher self-consciousness than men. People with body dysmorphic symptoms reported a more negative body image and higher self-consciousness. Different aspects of self-consciousness moderated the association between body dysmorphic symptoms and negative body image. Results were discussed towards hypotheses of affect modulation and depression tendency of patients with body dysmorphic symptoms.
Body Image , Neurotic Disorders/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Depression/epidemiology , Depression/psychology , Female , Germany/epidemiology , Humans , Male , Middle Aged , Neurotic Disorders/epidemiology , Psychiatric Status Rating Scales
Over these past years, German researchers have shown much interest for Costa and McCrae's five factor model as well as for their instrument: the NEO-Five-Factor Inventory . Nevertheless, results from a recent survey study using the German version of the NEO-FFI on a representative population sample (n = 1908) have reported problems to replicate the factor structure of the instrument. Insufficient psychometric indices of single items led to partly unsatisfactory scale values. A logical consequence of this was the development of a short version of the instrument with better psychometric properties. This article reports item and scale values of the NEO-FFI-30 for the German population sample. The five scales reach good internal consistency and are highly correlated with the original NEO-FFI scales. Furthermore, the influence of sociodemographic variables and correlations with the Giessentest appear to be very similar for both the original instrument and the short version. Moreover, the factor structure was replicated in an independent sample of 2508 adults. Results confirm the reliability, and factor and construct validity of this economic instrument without any significant loss in information.
Personality Disorders/diagnosis , Personality Inventory/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Cultural Comparison , Factor Analysis, Statistical , Female , Germany , Humans , Male , Middle Aged , Personality Disorders/psychology , Psychometrics/statistics & numerical data , Reproducibility of Results
OBJECTIVE: The article gives an overview over the relevance of religiousness for mental health. METHODS: After a short terminological introduction some characteristics of the demographic situation of religion in the Federal Republic of Germany are presented, and the differences to the situation in the US are discussed. Furthermore, chosen results of empirical studies about the connection between religiousness and health are summarised, and the possible modes of working of this connection are explained. RESULTS: There is some evidence, that religion might be a possible resource for mental health in many cases, while some forms of religious beliefs also might have an impairing, destructive potential. The more religious someone is, the more relevant are his beliefs for his health. CONCLUSIONS: An attitude of openness and consideration, knowledge about the relations between religion and mental health, and ideological competence allow a sensible exploration of patients' religious beliefs, a cautious integration of religious issues and, if possible, the use of the beliefs as a resource for treatment. Thereby, medical caregivers should be aware of the limitations of their treatment.
Mental Disorders/psychology , Mental Health , Religion and Psychology , Adaptation, Psychological , Cross-Cultural Comparison , Health Behavior , Humans , Mental Disorders/diagnosis , Mental Disorders/therapy , Patient Satisfaction , Psychotherapy , Spirituality , Statistics as Topic
OBJECTIVE: The present study evaluates a questionnaire on ambivalence over emotional expressiveness, the AEQ-G18 [1], [2], with regard to its statistical parameters, the influence of socio-demographic variables, and its interrelationship with depression and quality of life. METHODS: A representative German sample (1009 participants from East Germany and 1034 participants from West Germany) completed the AEQ-G18 [1], [2], the depression screener DEP-2 [3], the Profile of Mood States POMS [4], the revised Beck Depression Inventory BDI [5], the short form of the Patient Health Questionnaire PHQ-9 [6] and the SF-36 health survey questionnaire [7]. RESULTS: Our study was only partially able to confirm the two factors effect ambivalence and competence ambivalence postulated by Traue et al. [1], [2]. Women scored somewhat higher on the scale effect ambivalence. Participants with a higher educational background exhibited less emotional ambivalence. Emotional ambivalence correlated positively with depression and reduced psychological state of health (depression, fatigue, and anger), whereas it correlated negatively with health-related quality of life and positive attitude (vigor). In addition to the scales of the AEQ-G18, we developed a short form, the AEQ-G10, and provide normative data for the AEQ-G18 and the AEQ-G10. CONCLUSION: This study presents normative data for two variations of a clinically relevant, valid, and time-efficient diagnostic instrument used for the evaluation of ambivalence over emotional expressiveness, the AEQ-G18 and its short form, the AEQ-G10.
