Couples Coping With Hematological Cancer: Support Within and Outside the Couple - Findings From a Qualitative Analysis of Dyadic Interviews.

Objective: Cancer affects the patients as well as their partners. Couples use different strategies to cope with cancer and the associated burden: individual coping, dyadic coping, and support from the social network and from professional health care. The aim of this qualitative dyadic interviews is to gain a deeper and more differentiated understanding of the support system inside and outside of the couple. Methods: Ten heterosexual couples (patients: seven men and three women) with different ages (patients: range = 22-75; spouses: range = 22-74), different hematological cancer (e.g., acute myeloid leukemia, non-Hodgkin's lymphoma) and cancer stages (initial diagnosis or relapse) participated in the study. Semi-structured dyadic interviews were conducted. Data of the verbatim transcripts were systematically coded and analyzed following structuring content analysis. Results: Three main categories (individual coping, dyadic coping, and outside support) and ten subcategories about coping and support strategies in hematological cancer patients and their spouses could be identified. All couples described cohesion in relationship as an essential common dyadic coping strategy. Most strategies were focused on the patient's wellbeing. Furthermore, couples reported different common plans for the future: while some wanted to return to normality, others were reaching out for new goals. Conclusion: Couples used various coping and support strategies, that differed in type and frequency between patients and spouses. Most of the strategies were perceived as beneficial, but some also triggered pressure. Overall, spouses seem to need more psychological support to improve their own wellbeing.

Dyadic coping and social support: Various types of support in hematooncological patients and their spouses-Associations with psychological distress.

OBJECTIVE: Patients and spouses use various support strategies to deal with cancer and its associated burden. Support can be perceived within the dyad [perceived dyadic coping (PDC)] or from others [perceived social support (PSS)]. The present study investigates the association of PDC and PSS with depression and anxiety symptoms experienced by hematooncological dyads. METHODS: A total of 330 hematooncological dyads participated in the study. Dyadic Coping Inventory (DCI) including perceived stress communication and four PDC strategies (supportive, negative, delegated, common), ENRICHED Social Support Instrument (ESSI) and Patient Health Questionnaire-4 (PHQ-4) are used for assessment. To take nonindependence of patient's and spouse's variables into account, data are analyzed with the Actor-partner-interdependence model (APIM). RESULTS: Hematological cancer patients and their spouses reported a similar level of depression and anxiety symptoms. Perceived negative dyadic coping (DC) was adversely related with both patient's and spouse's outcomes (all p < 0.01) and perceived positive DC was adversely related with depression symptoms in both and anxiety symptoms in spouses (all p < 0.05). More PSS was associated with less depression and anxiety symptoms in both (all p < 0.05), and spouse's PSS (b = -0.04, p < 0.05) was significantly associated with patient's depression symptoms. CONCLUSIONS: This study highlights the association between perceived negative DC, perceived positive DC and PSS with depression and anxiety symptoms. Focus should be on enhancement of PSS especially in spouses, as they experience a comparable amount of psychosocial distress and have considerable impact on the patient's wellbeing.

The relationship between acceptance, fatigue, and subjective cognitive impairment in hematologic cancer survivors.

Background/Objective: Cancer and its treatment can have a detrimental impact on psychological well-being. Acceptance as the basis of acceptance and commitment therapy (ACT) has shown beneficial effects on depression and anxiety. However, its relationship to fatigue and cognitive impairment has not been investigated. A protective effect of acceptance may open up a new target for psychological intervention. Method: A cross-sectional postal survey was undertaken. 922 hematological cancer survivors (≥ 2.5 years post diagnosis) were recruited through two regional cancer registries in Germany. Acceptance (AAQ-II), fatigue (BFI) and subjective cognitive impairment (AFI) were assessed. Results: Higher levels of acceptance were negatively associated with fatigue and subjective cognitive impairment (R2 = .34 and R2 = .26, respectively). The relationship between fatigue and fatigue-related impairment of daily life was weaker for survivors with high acceptance. Conclusions: Acceptance is strongly associated with fatigue and subjective cognitive impairment. ACT may be useful to reduce symptoms of fatigue and subjective cognitive impairment in cancer survivors.

Antecedentes/Objetivo: El cáncer y su tratamiento pueden tener un impacto perjudicial sobre el bienestar psicológico. La aceptación, base de la terapia de aceptación y compromiso (ACT), ha mostrado efectos beneficiosos sobre la depresión y la ansiedad. Sin embargo, su relación con la fatiga y el deterioro cognitivo no ha sido investigada. Un efecto protector de la aceptación puede abrir un nuevo objetivo para la intervención psicológica.Método: Se llevó a cabo un estudio transversal de encuesta por correo. Un total de 922 supervivientes al cáncer hematológico (≥ 2,5 años después del diagnóstico) fueron reclutados a través de dos registros regionales en Alemania. Se evaluaron la aceptación (AAQ-II), la fatiga (BFI) y el deterioro cognitivo subjetivo (AFI).Resultados: Los niveles elevados de aceptación se asociaron negativamente con la fatiga y el deterioro cognitivo subjetivo (R2 = 0,34 y R2 = 0,26, respectivamente). La relación entre fatiga y deterioro ede la vida diaria relacionado con la fatiga fue más débil en supervivientes con una mayor aceptación.Conclusiones: La aceptación se asocia fuertemente con la fatiga y el deterioro cognitivo subjetivo. La ACT puede ser útil para reducir los síntomas de fatiga y el deterioro cognitivo subjetivo en supervivientes al cáncer.

The relationship between acceptance, fatigue, and subjective cognitive impairment in hematologic cancer survivors

Background/Objective: Cancer and its treatment can have a detrimental impact on psychological well-being. Acceptance as the basis of acceptance and commitment therapy (ACT) has shown beneficial effects on depression and anxiety. However, its elationship to fatigue and cognitive impairment has not been investigated. A protective effect of acceptance may open up a new target for psychological intervention. Method: A cross-sectional postal survey was undertaken. 922 hematological cancer survivors (≥ 2.5 years post diagnosis) were recruited through two regional cancer registries in Germany. Acceptance (AAQ-II), fatigue (BFI) and subjective cognitive impairment (AFI) were assessed. Results: Higher levels of acceptance were negatively associated with fatigue and subjective cognitive impairment (R2= .34 and R2= .26, respectively). The relationship between fatigue and fatigue-related impairment of daily life was weaker for survivors with high acceptance. Conclusions: Acceptance is strongly associated with fatigue and subjective cognitive impairment. ACT may be useful to reduce symptoms of fatigue and subjective cognitive impairment in cancer survivors

Antecedentes/Objetivo: El cáncer y su tratamiento pueden tener un impacto perjudicial sobre el bienestar psicológico. La aceptación, base de la terapia de aceptación y compromiso (ACT), ha mostrado efectos beneficiosos sobre la depresión y la ansiedad. Sin embargo, su relación con la fatiga y el deterioro cognitivo no ha sido investigada. Un efecto protector de la aceptación puede abrir un nuevo objetivo para la intervención psicológica. Método: Se llevó a cabo un estudio transversal de encuesta por correo. Un total de 922 supervivientes al cáncer hematológico (≥ 2,5 años después del diagnóstico) fueron reclutados a través de dos registros regionales en Alemania. Se evaluaron la aceptación (AAQ-II), la fatiga (BFI) y el deterioro cognitivo subjetivo (AFI). Resultados: Los niveles elevados de aceptación se asociaron negativamente con la fatiga y el deterioro cognitivo subjetivo (R2= 0,34 y R2= 0,26, respectivamente). La relación entre fatiga y deterioro ede la vida diaria relacionado con la fatiga fue más débil en supervivientes con una mayor aceptación. Conclusiones: La aceptación se asocia fuertemente con la fatiga y el deterioro cognitivo subjetivo. La ACT puede ser útil para reducir los síntomas de fatiga y el deterioro cognitivo subjetivo en supervivientes al cáncer

[Dyadic Coping of Patients with Haemato-Oncological Diseases and their Partners: Discrepancy Indexes and Association with Social Support and Psychological Distress]. / Dyadisches Coping von hämatoonkologischen Patienten und ihren Partnern: Übereinstimmungsmaße und Zusammenhänge mit sozialer Unterstützung und psychischer Belastung.

BACKGROUND: Cancer is often associated with negative psychosocial consequences not only for patients but also for their partners. These consequences are also influenced by the applied coping strategies. OBJECTIVE: The study examines the influence of Dyadic Coping (DC) on social support and psychological distress (symptoms of depression and anxiety) in haemato-oncological patients and their partners. Of particular interest is the significance of dyadic accordance (conformity) of the assessment of DC ("discrepancy indexes"). METHODS: The study investigates 330 couples (haemato-oncological patients and their partners, average age patient 57.0 years, 63.3 percent male, 25.8 percent acute leukemia). In addition to Dyadic Coping Inventory (DCI), standardized instruments are used. Research data is being analyzed with t-tests, partial correlation and regression. RESULTS: Patients and partners use similar dyadic coping strategies, whereby partners assess coping behaviors of patients more accurately than vice versa. Regarding social support, the DC total score plays a more decisive role than discrepancy indexes, in particular with patients (R2=20.4%). Conversely, discrepancy indexes explain a large part of the patients' variance (R2=10.2%); regarding psychological stress, the DC total score shows no effects in this model. DISCUSSION: The results demonstrate the relevance of the DC discrepancy indexes as a measure for interpersonal accordance for psychosocial outcomes, especially for psychological distress. Further application-related research is necessary to generate reliable statements about these associations.

[Acceptance and Commitment Therapy in the Treatment of Chronic Disease]. / Akzeptanz- und Commitmenttherapie bei chronischen körperlichen Erkrankungen.

Acceptance and Commitment Therapy (ACT) is an intervention representing a transdiagnostic and contextual approach that assumes that psychological suffering is caused by experiential avoidance. The primary intention of ACT is not to eliminate symptoms and to treat mental disorders. Instead, ACT aims to increase psychological flexibility, i. e. to broaden the repertoire of cognitions and behaviors when facing inner and outer aversive events or experiences. Psychological flexibility can be enhanced by working with the 6 core components of the ACT model. Experience-focused methods like metaphors and exercises for acceptance play a crucial role in the therapeutic work. In short, with ACT patients can learn: ▪ that rigid and inflexible attempts to fight aversive experience are problematic ▪ a mindful experience of inner and outer experience ▪ to differentiate between unchangeable and changeable events (acceptance) ▪ to identify values or respectively life goals and to behave in a way that is consistent with them (commitment)The therapeutic focus of ACT is to create a balance between acceptance and behavioral change consistent with chosen values. Chronic diseases are often associated with aversive inner and outer experiences. A growing number of studies support the efficacy of ACT. There is evidence that ACT can increase psychological flexibility and potentially also lead to better self-management within the context of chronic somatic diseases.

Therapeutic alliance and treatment outcome in psychodynamic psychotherapy of depressed breast cancer patients: the same old story or different from other populations?

BACKGROUND: A good therapeutic alliance is associated with better treatment outcomes in diverse types of psychotherapy and patient populations, but little is known about therapeutic alliance in psychotherapies with cancer patients. This study examines the association of therapeutic alliance and treatment outcome in short term psychodynamic psychotherapy (STPP) for breast cancer patients. METHODS: Within a randomized controlled trial, 47 completers of STPP could be included in the analyses. The therapeutic alliance was assessed by patients and therapists at treatment termination with the Helping Alliance Questionnaire. Outcome was defined as no diagnosis of depression assessed with Structured Clinical Interview for DSM-IV (SCID-I) and a reduction of the HADS-depression score by at least two points at treatment termination. RESULTS: Patients' alliance ratings were significantly associated with outcome (r = 0.46, p = 0.015), while, in contrast to findings in non-cancer populations, therapists' ratings were unrelated. There was no association between patients' and therapists' ratings of therapeutic alliance. Especially success and working related aspects of patients' alliance scores were associated with outcome. Patients' and therapists' alliance scores were unrelated to any of their baseline characteristics, therapist characteristic or treatment variables. CONCLUSION: We conclude that therapists should regularly assess the quality of patients' perceived therapeutic alliance in the course of psychotherapy with breast cancer patients to improve psychotherapy outcome. The breast cancer patients' perspective should be actively inquired and considered throughout treatment by therapists. Possible discrepancies between both judgements can be addressed in treatment.

Dyadic coping of patients with hematologic malignancies and their partners and its relation to quality of life - a longitudinal study.

Coping with cancer can potentially modify couples' quality of life (QoL). The predictive impact of dyadic coping (DC) on QoL was investigated within patients with hematological cancer and their partners. Data were collected in a multi-centre longitudinal study (N = 208 couples). We use the SF-12 questionnaire (QoL) and the Dyadic Coping Inventory. Data were mainly analyzed with actor-partner interdependence models (APIM). Within the APIM, baseline QoL was the most significant predictor for QoL (t2). Regarding DC, there were partner effects on physical QoL (t2) and actor and partner effects on mental QoL at t2. Different subtypes of DC have intra- and/or interpersonal impact on patient's or partner's QoL. In a clinical setting, patients as well as partners should be seen as both a source of support for each other and as individuals in need of support themselves. Such awareness and targeted intervention may help couples adapt to and cope with cancer.

Associations between dyadic coping and supportive care needs: findings from a study with hematologic cancer patients and their partners.

PURPOSE: The way couples mutually cope with hematologic cancer is likely to influence their levels of supportive care needs (SCN). Therefore, this study evaluated the levels of dyadic coping (DC) and SCN and the concurrent associations between both variables. METHODS: Three hundred thirty patients with a hematologic malignancy (63% male) and their partners completed the dyadic coping inventory (DCI) and the supportive care needs survey (SCNS-SF-34-G). The levels of dyadic coping (DC) and supportive care needs (SCN) were compared with representative validation samples. Correlational analyses and actor-partner interdependence models (APIM) were calculated to estimate the association between DC and SCN. RESULTS: Partners' stress communication of cancer patients (as part of DC) was decreased in contrast to that of a non-cancer sample. The perception of partners' delegated DC was higher (both with a moderate effect size of g ≥ |0.50|). SCN of patients and partners were lower in the dimensions health system/information and physical problems/daily living in contrast to those of a cancer patients' validation sample (both with a small effect of g ≥ |0.20|). Higher perceptions of partners' negative DC were associated with higher SCN for both patients and partners. The same was true for patients' own stress communication and SCN, but only for the patients. Sociodemographic and illness-related factors were only partially related with the SCN of patients and partners. CONCLUSIONS: In order to diminish SCN of patients and partners, a possible way is to strengthen the quality of the dyadic relation. Due to its associations with elevated SCN, stress communication and negative dyadic coping behaviours may be useful targets for psychosocial interventions.

[Stigmatizing Attitudes towards Cancer Patients--Results of a Representative Population Survey]. / Stigmatisierende Einstellungen gegenüber Krebspatienten--Ergebnisse einer repräsentativen Bevölkerungsbefragung.

OBJECTIVE: To investigate stigmatizing attitudes towards cancer patients in the general population and to examine their association with socio-structural characteristics and perceived causes of disease. METHODS: We recruited a representative sample from the German general population (n=2420; mean age: 52 years; 54% women). Stigmatizing attitudes were assessed with a 9-item scale. Predictors of stigmatizing attitudes were identified using a regression analysis. RESULTS: Agreement with stigmatization items ranged from 3.6% (item: work together with a cancer patient) to 18.9% (item: use the same dishes as a cancer patient). Perceived causes of disease with a high levels of personal responsibility showed only weak correlations with stigmatizing attitudes (all r<0.31) and were partially statistical significant (e. g. food intake) or not significant (e. g. alcohol). The strongest predictors of stigmatizing attitudes were lack of cancer-related experiences (Beta=-0,26), age <60 years (Beta=0,1) and the assumption that one cannot protect oneself from cancer (Beta=0,11) (all p<0.001). Further predictors were male gender and living in rural area (p<0.01). CONCLUSION: The results demonstrate a need for further research and the development of valid methodological instruments to assess stigmatization towards cancer patients.

Does psychodynamic short-term psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial.

The purpose of this study was to determine (a) the course of fatigue in depressed breast cancer patients, (b) the effect of a depression-focused individual psychodynamic psychotherapy on fatigue, and (c) the associations of fatigue with depression, quality of life and treatment-related variables. In a German multicentre randomized controlled trial in Leipzig and Mainz, depressed early breast cancer patients (UICC stage 0-III, age 18-70 years) were randomly assigned to a short-term psychodynamic psychotherapy (STPP, an adaptation of the Supportive-Expressive psychotherapy by Luborsky for cancer patients) or treatment as usual (TAU) and completed data assessment pre- and post-treatment. Fatigue was assessed with the Multidimensional Fatigue Inventory (MFI-20). All analyses were conducted as complete case analyses including 52 STPP and 54 TAU completers (n = 106). The trial is registered at http://www.controlled-trials.com , number ISRCTN96793588. Fatigue declined significantly from a high level pre-treatment to post-treatment, but remained significantly higher than among population-based controls and a mixed sample of cancer patients. Significant time by group interactions favoured STPP for the subscales reduced activity and physical fatigue and the total scale. The strength of the associations between total fatigue and depression increased from 0.49 pre-treatment to 0.63 (Quality of life -0.52 to -0.63) at follow-up. STPP is beneficial for reducing dimensions of fatigue (particularly reduced activity and physical fatigue) in depressed breast cancer patients. Chronic fatigue needs more clinical attention in this vulnerable group.

[Family Focused Grief Therapy - A Suitable Model for the Palliative Care of Cancer Patients and their Families?]. / Die familienzentrierte Trauertherapie - ein geeignetes Modell für die Palliativversorgung von Krebspatienten und ihren Familien?

Loss is a universal human experience. Within the context of cancer and especially in the palliative care of oncological patients, anticipated and real losses and their management play a crucial role. A high proportion of patients and family members develop a treatment requiring psychiatric comorbidity (for both groups between 20 and 30%, mainly adjustment and anxiety disorders and depression). Approximately 15% of the bereaved persons suffer from complicated grief after the death of their relative. Within the early palliative care, the implementation of the Family Focused Grief Therapy (FFGT) has the potential to reduce psychological distress incl. mental comorbidities in patients and their relatives. Simultaneously, the incidence of the prolonged grief disorder in bereaved persons could be diminished (after the death of their relative). Thus, the FFGT can make a substantial contribution in order to improve the palliative care of cancer patients and their bereaved persons.

Psychosocial interventions for adolescents and young adult cancer patients: A systematic review and meta-analysis.

Adolescent and young adult (AYA) cancer patients experience unique psychosocial needs and developmental challenges. A cancer diagnosis can stress this development and disrupt AYAs in their normal life. The aim of this systematic review and meta-analysis was to assess the impact of psychosocial interventions on mental health in AYAs. A literature research was conducted, which resulted in twelve eligible studies. The standardized mean difference between intervention and control conditions was 0.13 (95% CI: -0.16 to 0.42) for quality of life, 0.27 (95% CI: -0.22 to 0.76) for cancer-related knowledge and -0.16 (95% CI: -0.73 to 0.42) on psychological distress indicating, small and non-significant effects for interventions improving mental health. This work strengthens the need for age-appropriated interventions in psycho-oncology. Future research should develop interventions more graduated by age. Randomized intervention studies with larger samples and focusing psychosocial outcomes are needed to establish evidence-based psycho-oncological interventions for AYAs.

Construct validity of the EORTC quality of life questionnaire information module.

PURPOSE: Providing sufficient information about diagnosis and treatment is an important feature of high-quality patient care in oncology. To measure patient satisfaction with information received, the European Organisation for Research and Treatment of Cancer Quality of Life Group has recently developed a new tool, the information module (INFO25). The aim of this study was to evaluate the scale structure of the INFO25. METHODS: A total of n = 423 patients completed the INFO25 after finishing cancer therapy. The internal consistency of multi-item subscales was calculated using Cronbach's Alpha. The scale structure was evaluated using multi-trait methods and confirmatory factor analysis. RESULTS: Cronbach's Alpha of the multi-item scales ranged from 0.79 to 0.88. Only two items correlated somewhat higher with another scale than with their own, indicating a good scale structure. Construct validity with latent variable models, including a general information factor and four multi-item scales, resulted in the following fit indices CFI = 0.96, RMSEA = 0.08, TLI = 0.99 and WRMR = 1.03. CONCLUSION: The suggested construct of the INFO25 with a total score (general factor) in addition to the subscales is valid.

Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: study protocol for a randomized controlled trial.

BACKGROUND: There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. Our study determines the efficacy of a manualized short-term psychodynamic psychotherapy and predictors of outcome by personality and quality of the therapeutic relationship. METHODS/DESIGN: Eligible breast cancer patients with comorbid depression are assigned to short-term psychodynamic psychotherapy (up to 20 + 5 sessions) or to treatment as usual (augmented by recommendation for counseling center and physician information). We plan to recruit a total of 180 patients (90 per arm) in two centers. Assessments are conducted pretreatment, after 6 (treatment termination) and 12 months (follow-up). The primary outcome measures are reduction of the depression score in the Hospital Anxiety and Depression Scale and remission of depression as assessed by means of the Structured Clinical Interview for DSM IV Disorders by independent, blinded assessors at treatment termination. Secondary outcomes refer to quality of life. DISCUSSION: We investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment. TRIAL REGISTRATION: ISRCTN96793588.

[Depression in children of cancer patients over time and dependence of the parental distress]. / Depressivität bei 11- bis 17-jährigen Kindern krebskranker Eltern im Verlauf und Abhängigkeit zur elterlichen Belastung.

This study was part of the German multicentre project "Psychosocial Services for Children of Parents with Cancer" (2009-2012, research grant: German Cancer Aid). 60 parent-child-dyads (children's age: >10 years, at least one parent with cancer) could be included in data analysis. Depressive symptoms of children were assessed with the CES-DC at two times (t1 and t2). Depression scores were compared with a representative comparison group from the general population. Further, the relationship between the distress of cancer patients and the depression of the children was examined. Children with at least one parent with cancer were significantly more depressed than the comparison group (t1 and t2). 25.8% of the boys and 35.7% of the girls reported clinically relevant scores of depression at t1. There were no significant changes in the depression scores on the individual level for boys and girls at t2. There was a positive correlation between children's depression (t1) and the parental anxiety at t1 with r = 0.26 (p <0.05). Depressive symptoms in children of parents with cancer persist over time, and therefore should be identified early.

Quality of life of colorectal cancer patients in certified centers versus non-certified hospitals.

BACKGROUND: Since 2006, in Germany colorectal cancer patients can be treated in certified colorectal cancer centers. The aim of this explorative study was to investigate whether there are differences in the quality of life (QoL) of colorectal cancer patients who were treated in certified versus noncertified centers. PATIENTS AND METHODS: A total of 284 colorectal cancer patients participated in the study: 184 patients from certified colorectal cancer centers and 100 patients from noncertified centers. Data on QoL (using the Quality of Life Questionnaire of the European Organization for Research and Treatment of Cancer (EORTC-QLQ C30)), patient satisfaction, mental distress and sociodemographic data were assessed with a questionnaire in a written survey after the hospital stay. The moderating influence of patientrelated characteristics (e.g. age, sex, patient satisfaction, and psychological distress) and cancerrelated factors (Union internationale contre le cancer (UICC) stage) were tested. RESULTS: On a descriptive level, patients from noncertified centers had a higher QoL in 5 subdimensions (higher physical and role functioning and less insomnia, appetite loss and financial difficulties). After adjustment, only 2 differences remained significant: physical functioning (p < 0.01) and role functioning (p = 0.02). CONCLUSION: Structural improvements in the oncological care are not necessarily reflected in a better QoL of the patients treated in certified colorectal cancer centers. The findings are discussed in the context of the applied study design.

[Male partners of cancer patients with underage children - psychological distress in comparison to the general population and the diseased partner]. / Partner von Krebspatientinnen mit minderjährigen Kindern - Psychische Belastung im Vergleich zur Allgemeinbevölkerung und zur krebskranken Partnerin.

The psychological distress of men with underage children, whose female partners have cancer, was examined using the Hospital Anxiety and Depression Scale (HADS). The sample (N=141) was compared with the partners who have cancer and a comparison group of men from the general population (N=154). The male partners of cancer patients were psychological strongly distressed. About half of the partners showed increased scores in anxiety and one third of the partners had a high level of depression. There was a high correlation within the couple. The male partners of cancer patients were significantly more distressed than the comparison group of men with underage children from the general population. It is very important to assess psychosocial support needs of partners of cancer patients and to provide adequate options of possible psychosocial treatment.

[Anxiety, depression, somatoform symptoms and posttraumatic stress in the offspring of political detainees in Eastern Germany (1945-1989)]. / Ängstlichkeit, Depressivität, Somatisierung und Posttraumatische Belastungssymptome bei den Nachkommen ehemals politisch inhaftierter Personen in Ostdeutschland (1945-1989).

Between 1945 and 1989, approximately 300 000 persons were imprisoned because of political reasons in Eastern Germany. There is that evidence the detainees' offspring are affected by the trauma of their parents. In a study with cross-sectional design, depressive (PHQ-9), somatoform (PHQ-15) and anxiety symptomatology (GAD-7), and Posttraumatic Stress (IES-R) were assessed with self-rating measures in 43 children of former political prisoners. In comparison to 2 representative gender education and age matched samples from the general population, offspring of former political detainees show higher levels of psychopathological symptoms. The life-time prevalence for PTSD was 9.1%. Regarding the psychopathology, children who were born after their parents' imprisonment did not differ from those who were already born when the imprisonment happened. First evidence for the transgenerational transmission of traumatisation and the methods will be discussed critically.