[Functional-aesthetic rhinosurgery patients: psychometric parameters]. / Patienten mit dem Wunsch nach einer funktionell-ästhetischen Nasenoperation: Psychometrische Parameter.

BACKGROUND: The aim of this study was to acquire psychometric parameters in patients desiring functional-aesthetic nasal surgery. MATERIAL AND METHODS: Over a 1-year period, 101 patients were consecutively examined at the ENT department of the University of Ulm. Septoplasty or septorhinoplasty was indicated in all cases. The acquisition of psychometric data was performed by means of standardised and validated questionnaires. Data relating to anxiety, depression, private and public self-awareness as well as general satisfaction with oneself and in particular with one's nose was collected. RESULTS: Patients demonstrated greater levels of fear, self-awareness in public and dissatisfaction with their nose. The greatest expectation concerning the outcome of the operation was the improvement of nasal obstruction. Altering the outward appearance of the nose was a secondary consideration. CONCLUSION: The screening presented here enables ENT surgeons to identify possible "problem" patients before functional-aesthetic nasal surgery.

[Mastery of conflictual relationship patterns in the course of a psychodynamic focal therapy]. / Meisterung konflikthafter Beziehungsmuster im Verlaufe einer psychodynamischen Fokaltherapie.

Mastery is a psychological construct rooted in the psychodynamic psychotherapy research. The Mastery Scale provides a reliable content analytic method to measure the mastery of maladaptive interpersonal conflicts. With the help of model-sentences verbatim transcripts of relationship episodes are assessed regarding to six hierarchical so-called levels: lack of impulse-control, introjection and projection of negative emotions, difficulties in understanding and cognitive control, interpersonal consciousness, understanding of the self and self control. Further, mastery capabilities can be quantified by a mastery score. For the first time, the instrument is introduced in German by a study of a rather well known successful psychodynamic short-term psychotherapy which previously has been investigated with several empirical methods. The results verify the possibilities of the Mastery Scale in subtly describing changes in the course of a psychotherapy.

Long-term morbidity following axillary dissection in breast cancer patients--clinical assessment, significance for life quality and the impact of demographic, oncologic and therapeutic factors.

OBJECTIVE: This study describes in detail the surgery-related symptoms following axillary lymph node dissection in breast cancer patients and considers both their significance for long term quality of life and the impact of possible influencing factors. MATERIAL AND METHODS: Three hundred and ninety six patients were studied retrospectively using a self-report questionnaire and a clinical examination. The symptoms, numbness, pain, edema, arm strength and mobility were evaluated. The subjective assessment of the degree of symptom intensity was compared with objective measurements. The extent of surgery (number of resected nodes, level of dissection) as well as the influence of demographic, oncologic and adjuvant measures (age, time interval, number of involved nodes, chemotherapy) were evaluated. RESULTS: Shoulder-arm morbidity and fear of cancer recurrence were the most important long-term sources of distress following breast cancer surgery in our study population. Demographic, oncologic and therapeutic measures including the extent of surgery had no influence on long-term morbidity. The intensity of all evaluated symptoms was reported to be more severe in patients' subjective statements than in the results of clinical assessment. CONCLUSION: Shoulder-arm morbidity following axillary dissection is a frustrating polysymptomatic disease that seems to be relatively unaffected by therapeutic measures. The surgical trauma necessary for adequate tumor staging (removal of 10 lymph nodes) seems decisive for the postsurgery syndrome following axillary dissection. For node-positive patients complete axillary clearing may improve tumor control without worsening long-termmorbidity. New techniques, such as the sentinel-node-biopsy, that selects patients with negative axillary status while preserving the integrity of axillary structures, may improve the overall morbidity.

Stereotypical relationship patterns and psychopathology.

BACKGROUND: We explored the relationship between the consistency of relationship patterns and the severity of psychopathology. METHOD: Relationship patterns were assessed by means of Relationship Anecdote Paradigm interviews rated according to the Core Conflictual Relationship Theme (CCRT) method. The repetition of the same type of CCRT components across relationship narratives indicated stereotypical patterns. RESULTS: Subjects treated in an inpatient setting (n = 25) told narratives with more consistent patterns than subjects in an outpatient setting (n = 32). Relationship episodes of normal adults (n = 23) were more flexible compared with the two clinical groups. Especially repetitions of the wish component were closely associated with the severity of psychopathology assessed by SCL-90R. CONCLUSIONS: The consistency of relationship patterns seems to be connected with the severity of psychopathology.

[The core conflictual relationship theme of core relationship patterns. A further methodology-critical development of the "core conflictual relationship theme" method]. / Vom Zentralen Beziehungs-Konflikt-Thema (ZBKT) zu Zentralen Beziehungsmustern (ZBM). Eine methodenkritische Weiterentwicklung der Methode des "Zentralen Beziehungs-Konflikt-Themas".

The Core Conflictual Relationship Thema Method (CCRT) by Lester Luborsky is based on the analysis of narratives about relationship episodes within transcripts of therapy sessions. Wishes, responses of the other and responses of the self are identified and counted. The critical explanation with the CCRT-Method conducted to alternative methods of data analysis. In the result we have not only one Core Conflictual Relationship Theme (CCRT), but we analyse the structure of Central Relationship Pattern (CRP). We set an example with a completely judged brief psychodynamic psychotherapy with about 300 relationship episodes.

[DKPM basic documentation. A uniform basic documentation for inpatient psychosomatic treatment and psychotherapy]. / DKPM-Basisdokumentation. Eine einheitliche Basisdokumentation für die stationäre Psychosomatik und Psychotherapie.

The Arbeitsgemeinschaft Basisdokumentation presents the DKPM-Basisdokumentation, which is conceptualized as a uniform modul of a documentation system for the routine-like use in the in-patient psychosomatic and psychotherapy. We outline possibilities of use, aspects of the data security and the data access as well as some practical presuppositions.

[Application of the Relationship Episodes Interview]. / Die Praxis des Beziehungsepisoden-Interviews.

The Core Conflictual Relationship Theme (CCRT) is a content analytic assessment developed by Luborsky that uses narratives about relationship episodes with significant others as data base to identify repetitive relationship patterns that appear in individual behavior. Luborsky's Relationship Anecdotes Paradigm (RAP) Interview for which we introduced the German expression Relationship Episodes-Interview (RE-Interview) is a method for eliciting relationship episodes independently from therapy. In this paper we give an introduction into the practice and into the possible applications of this interview form according to the experiences the Ulm CCRT-group made with the instructions of Luborsky. The bases of our experience are 40 audio-visual recorded RE-Interviews. An example shows how to attain to the CCRT-formulation from the interview.

[Single case analytic evaluation of inpatient psychotherapy in a patient with ulcerative colitis]. / Einzelfallanalytische Evaluation stationärer Psychotherapie an einem Patienten mit Colitis ulcerosa.

This study outlines a practicable empirical method for the process-accompanying evaluation of the in-patient treatment-process. On the example of an integrative conceptualized psychoanalytic oriented therapy model for psychosomatic patients the treatment-process of a patient with ulcerative colitis is studied.