[Indication and Contraindication of Video-Based Psychotherapy: A Qualitative Delphi Survey to Capture Psychotherapists' Reflection and Deliberation Processes]. / Indikation und Kontraindikation videobasierter Psychotherapie: Eine qualitative Delphi-Befragung zur Erfassung der Reflexions- und Abwägungsprozesse von Psychotherapeut*innen.

OBJECTIVE: The Corona pandemic forced many psychotherapists to make a rapid transition to video setting. Even after the acute phase of the pandemic, video-based treatments can be determined to a certain extent in practice. Thus, indication and contraindication recommendations are essential to ensure treatment quality. However, empirical studies are almost completely lacking in this regard. In the context of this work, the decision-making and consideration processes of psychotherapists regarding video-based treatments are to be recorded and those factors that can have an effect on the indication are to be identified. METHODS: Two-stage, qualitative Delphi survey with psychodynamically oriented psychotherapists (n=9) and behavioural therapists (n=7) who can be assigned to the fields of research and practice. RESULTS: The quality of the therapeutic alliance guides the participants' choice of setting. An indication for video setting results from the feasibility of therapeutic interventions and the respective treatment goal. The therapists weighed the costs and benefits of video setting for various disorders. The changed feeling of control on both sides and the possibility of improving health care are decisive factors. DISCUSSION: Based on the results, a decision tree for psychotherapists was created, which includes the identified indication criteria.

Risk and protection factors of mental stress among medical staff in the third year of the COVID-19 pandemic.

Background: The COVID-19 pandemic placed an extraordinary burden on health care workers (HCW), who are reported to suffer from great mental stress. The current study investigates the mental health of HCW in the later phases of the pandemic. Methods: HCW completed the following questionnaires online (06/2021-02/2022, N=159): demographics (age, gender, profession, ward), Impact of Event Scale (IES-R, posttraumatic stress), State Trait Anxiety Inventory (STAI-S, state anxiety), stress-coping questionnaire (SVF-78), and bespoke corona-specific stress and protective-factor questions (5 items each). We used factor analysis to test scale properties and regression-type methods (t-tests, ANOVA, multiple regression) for hypothesis tests and effect-size estimation. Results/discussion: Mental stress in HCW is influenced by similar factors as described for earlier phases. However, differences to earlier phases were found in ward affiliation which is no longer a variable of concern for explaining differences in mental health of HCW. Further, even if nurses are the occupational group with the highest mental stress as in prior research, detailed analysis shows that medical specialists with close proximity to patients with a high-level of responsibility are the most burdened sub-group. Unlike nurses, they suffer from high levels of anxiety in addition to high levels of post-traumatic and COVID-specific stress. Analyses showed further that COVID-specific stress is the strongest predictor of mental stress, wherein COVID-specific stress factors remain the same as reported in literature on the early pandemic phases. HCW showed to use still more positive than negative coping strategies. Negative strategies increased as expected mental stress, whereas positive strategies alleviated only anxiety. Additionally, we found that doctors benefited from many protective factors while nurses had access to fewer protective factors like earlier waves. Conclusion: Data show that HCW still suffer from mental stress in the third year of the pandemic. HCW of all hospital wards may be affected by mental stress and need attention and protective measures. Medical specialists are the most burdened subgroup. Detailed analyses show that properties other than occupation, gender, or ward affiliation are more appropriate to evaluate mental stress of HCW. The findings have implications for developing specialized protection strategies for the post-pandemic phase and future pandemics.

Social media addiction: associations with attachment style, mental distress, and personality.

BACKGROUND: Social media bring not only benefits but also downsides, such as addictive behavior. While an ambivalent closed insecure attachment style has been prominently linked with internet and smartphone addiction, a similar analysis for social media addiction is still pending. This study aims to explore social media addiction, focusing on variations in attachment style, mental distress, and personality between students with and without problematic social media use. Additionally, it investigates whether a specific attachment style is connected to social media addiction. METHODS: Data were collected from 571 college students (mean age = 23.61, SD = 5.00, 65.5% female; response rate = 20.06%) via an online survey administered to all enrolled students of Sigmund Freud PrivatUniversity Vienna. The Bergen Social Media Addiction Scale (BSMAS) differentiated between students addicted and not addicted to social media. Attachment style was gauged using the Bielefeld Partnership Expectations Questionnaire (BFPE), mental distress by the Brief Symptom Inventory (BSI-18), and personality by the Big Five Inventory (BFI-10). RESULTS: Of the total sample, 22.7% of students were identified as addicted to social media. For personality, it was demonstrated that socially media addicted (SMA) students reported significantly higher values on the neuroticism dimension compared to not socially media addicted (NSMA) students. SMA also scored higher across all mental health dimensions-depressiveness, anxiety, and somatization. SMA more frequently exhibited an insecure attachment style than NSMA, specifically, an ambivalent closed attachment style. A two-step cluster analysis validated the initial findings, uncovering three clusters: (1) secure attachment, primarily linked with fewer occurrences of social media addiction and a lower incidence of mental health problems; (2) ambivalent closed attachment, generally associated with a higher rate of social media addiction and increased levels of mental health problems; and (3) ambivalent clingy attachment, manifesting a medium prevalence of social media addiction and a relatively equitable mental health profile. CONCLUSIONS: The outcomes are aligned with previous research on internet and smartphone addiction, pointing out the relevance of an ambivalent closed attachment style in all three contexts. Therapeutic interventions for social media addiction should be developed and implemented considering these findings.

[Psychoanalysts Online: Media regulation and digital boundary crossings]. / Psychoanalytiker im Cyberspace: Medieneinsatz in der Behandlung und digitale Grenzüberschreitungen.

Objectives: The present explorative study evaluates the question of media regulation in treatment and the question of psychoanalysts' experiences with digital crossings of boundaries. Methods: Using a self-constructed questionnaire, N = 50 completed questionnaires were distributed to psychoanalysts (age: M = 48,64, SD = 12,71; m = 44 %, f = 56 %) at the 51st IPA Congress held in July 2019 that were analyzed using aMann-Whitney U-test and Chi square test. Results: The majority of the psychoanalysts surveyed 68 %, (n = 34) do not regularly discuss the use ofmedia with their patients at the beginning of treatment, 28%(n = 14) of the analysts surveyed contacted their patients using digital media services without discussing this possibility of contact beforehand, 16 % (n = 8) contacted their patients at night, 46 %, n = 23 googled their patients and 24 %, (n = 12) secretly used a mobile phone during analysis. Conclusions: Due to the advancing technology of the health care system, further psychoanalytic research that accompanies the process of using media in treatment is necessary.

Comparison of attitudes to media representation of mental illness between journalists and mental health professionals in Russia with German-speaking countries of Switzerland, Germany, and Austria.

BACKGROUND: The media are an important source of information on mental health. They are often implicit in reinforcing negative stereotypes of people with mental health problems. There are no studies in German-speaking countries or Russia on media attitudes to mental health and mental health professionals' (MHP) attitudes to the media. AIMS: This study explored journalists and MHPs attitudes to mental health media reporting in the German speaking countries of Switzerland, Germany, and Austria and in Russia. METHODS: A cross-sectional online internet survey, of ten Likert scale statements to ascertain perceptions of stigma, role, and training needs following the STROBE guidance was conducted among journalists and MHPs via their professional organizations. A non-discriminatory exponential snowballing technique leading to non-probability sampling was used. Descriptive statistics, Kruskal-Wallis, and a post hoc Dunn's multiple comparisons test using Bonferroni adjustment were used to analyze data. RESULTS: A total of 106 German-speaking and 78 Russian journalists, 109 German-speaking, and 82 Russian MHPs fully answered the survey. Journalists felt the media were more balanced about mental health than MHPs, and MHPs were wary of engagement with the media. Small minorities of journalists had engaged with mental health training, similarly few MHPs had engaged with media training, but both groups were interested in doing so in the future. Significant differences between German and Russian speaking respondents were found on a range of issues (e.g. stigmatization, image about psychotherapy, the media/MHPs, and their own role in engaging with the media/MHPs). Russians were more likely to know specialized (media/mental health awareness) training compared to German-speaking MHPs and journalists. CONCLUSION: There are potential opportunities to engage journalists and MHPs in training about each other's worlds and reducing stigma toward mental illness through engaging MHPs with the media.

Therapeutic alliance in psychotherapy across online and face-to-face settings: A quantitative analysis.

Lockdown enacted by government in response to the Covid-19 pandemic in Austria forced psychotherapy practice into an online-only setting for several months in 2020. Although there is evidence supporting the effectiveness of psychotherapy in remote settings, research investigating therapeutic alliance in online psychotherapy is still limited, with a specific need for research in assessing possible effects of changes in therapeutic setting from face-to-face to online and vice versa. We measured therapeutic alliance in client-therapist dyads using the Helping Alliance Questionnaire (HAQ) at the Adult Outpatient Clinic of Sigmund Freud University, Vienna. Eighty-seven dyads completed HAQ twice, assessing three time-points: after switching from face-to-face to online therapy, providing a retrospective assessment of their alliance before the setting change as well as a concurrent account of their experience during online therapy, then another assessment after switching back to face-to-face setting after lockdown restrictions were lifted. Data were analysed by fitting a multilevel linear model, where the variables person (client/therapist) and time (before online therapy; online therapy; back to face-to-face) were nested within the client-therapist dyad. We found a statistically significant small improvement in the quality of therapeutic alliance over time, but no differences due to change in therapeutic setting. Separate analysis of HAQ sub-scales revealed that clients rated their relationship statistically significantly higher than their therapists with medium effect size, while there were no differences in success ratings over time and settings, nor between clients and therapists. The findings support the feasibility of online therapy in terms of therapeutic alliance in general, and alternating between face-to-face and online therapy settings in particular.

Preoperative anxiety after face-to-face patient assessment versus preanaesthesia telemedicine (PANTEM) in adults: a randomised clinical trial.

Preanaesthesia consultation is performed to assess and optimise patient-specific risk factors before surgery, to inform patients about anaesthesia techniques and to obtain consent. Aside from face-to-face visits, telephone consultation is increasingly being used clinically. Concentration on the content and avoidance of confounding factors could lead to improved patient preparation. We hypothesised that patients receiving a telemedical intervention have less anxiety. Patients scheduled for elective surgery were randomised into two groups according to the consultation performed face-to-face (FTF) or via telephone (TEL). Before consultation (< 48 h) and 1-2 h prior to surgery, both groups had to fill in the State-Trait Anxiety Inventory (STAI). A total of 271 patients were randomised and 130 were analysed. There were no significant intergroup differences in mean state anxiety (STAI-S) before and after the intervention. Patients' positive feedback on telemedical consultation urges future studies on its effect on satisfaction and quality of life.

[Exploration and consideration of media problems in the psychotherapy of adults: An online survey of psychotherapists]. / Exploration und Berücksichtigung von Medienproblemen in der Psychotherapie von Erwachsenen: Eine Online- Befragung von Psychotherapeut*innen.

Exploration and consideration of media problems in the psychotherapy of adults: An online survey of psychotherapists Background: The inclusion of media-related behavioral addictions in DSM-5 and ICD-11 indicates the necessity of media anamnesis as secondary prevention (early detection) in psychotherapy. Objectives: The aim of the study was to document the extent of media problems in therapeutic practice and to identify factors related to exploration (media anamnesis). Method: Using an online survey (11/2019-03/2020), N = 160 psychotherapists from Germany and Austria were interviewed. Design: a self-constructed questionnaire plus standardised scales, i. e. subscales E1 and E2 of Therapeutic Identity Questionnaire (ThId), scales for affinity to techniques (TA-EG) and personality (BFI-10). Results: Of the participating psychotherapists 60 % reported patients with media-issues, of which (54 %) consider themselves competent in respective treatment, 72 % did not participate in further training; however, the ones attended did not feel competent of handling media-issues in psychotherapy after training. Two thirds (63 %) did not/rather did not explore media consumption in anamnesis and treatment. The exploration of media consumption was significantly related to specific training, the personality dimensions neuroticism and openness, and an affinity for technology. Conclusions: Current further training courses do not meet the needs of psychotherapists and should be adapted. The personality dimensions of the psychotherapists play a role in handling media problems in psychotherapy.

Psychocardiological assessment in the acute phase of the takotsubo syndrome : Somatic and depressive disorders, resilience and illness perception.

OBJECTIVE: To analyze the psychocardiological profile and the clinical characteristics in the acute phase of takotsubo syndrome (TTS). METHODS: Prospective multicenter cohort study of TTS patients evaluating the clinical characteristics as well as the prevalence of somatic, depressive, panic, stress and anxiety disorders. Assessment of illness perception and resilience in the acute phase of the syndrome. RESULTS: All 27 evaluated TTS patients were female with a mean age of 68 years (±11.4 years). The apical type of TTS was found in 60% of patients, followed by the combined type of TTS in 30% of patients. Main clinical symptom leading to hospital admission was chest pain in nearly 80% of patients. An ST-segment elevation mimicking acute myocardial infarction was found in 44% of patients and T wave inversion in 26% of patients. An endogenous (emotional) stress event was found in 17 patients (63.0%), an exogenous (physical) stress event in 5 patients (18.5%) and a combined stress event in 2 patients (7.4%). In 11.1% of patients (n = 3) no stress event could be found. Moderate to high levels of illness threatening were found in 48% of patients and low to moderate resilience scores were found in 40% of patients. Somatic disorders were found in half of the patients (56%) followed by depressive disorders in 26% of patients. CONCLUSION: Moderate to low resilience scores and moderate to high levels of illness threatening can be seen in the acute phase of TTS, reflecting the severity of the experience as an adverse life event. Patients suffering from TTS present in the acute phase with a high prevalence of somatic disorders and relatively high prevalence of depressive disorders.

[Indifferent, Responsible or Overwhelmed? An Online Survey About the Emotional State of Young Adults During the Early Phases of the Covid-19 Lockdown in Germany and Austria]. / Gleichgültig, verantwortungsbewusst oder überfordert? Eine Online-Befragung zum emotionalen Befinden junger Erwachsener in der Frühphase des Corona-bedingten Lockdowns in Deutschland und Österreich.

BACKGROUND: In the COVID 19 pandemia compliance by the population with legally established preventive measures is of utmost importance to contain the spread of the virus. It can be assumed that these prevention measures are associated with specific burdens which are managed differently by the various population groups. OBJECTIVES: The survey assesses not only the general public's acceptance, concerns and burdens with regard to the prevention measures, but also the corresponding applied coping strategies depending on various socio-demographic and personality-specific factors. METHOD: An online survey of N=3006 persons living in Germany and Austria during the early lockdown, by means of a self-constructured questionnaire, assesses concerns about the virus and the prevention measures taken by the governments. In addition, standardized scales were used: Stress Processing Questionnaire (SVF 78), Positive and Negative Affect Schedule (PANAS), Insecurity-Intolerance scale (UI-18) and the State Trait Anxiety Inventory (STAI). RESULTS: Overall, a high level of acceptance of the required prevention measures was found. However, the shown emotional reactions were differing among the various population groups: Individuals between 18 and 29 years showed significantly higher negative emotional reactions compared to all other groups. A cluster analysis of this young population group revealed five groups that differed significantly in all surveyed personality factors and showed group-specific coping profiles. DISCUSSION: Younger people are often described as a particularly vulnerable group in connection with the pandemic. The present study shows, however, that the group of the young adults should not be considered as homogeneous.

Emotional distress in the early stages of the COVID-19 related lockdowns depending on the severity of the pandemic and emergency measures: a comparative online-survey in Germany, Austria and Italy.

BACKGROUND: The first wave of the COVID-19-pandemic hit different countries with varying degrees of severity, so that differences in the type and level of emergency measures were also necessary. It can be assumed that the psychological burden was higher in countries subjected to a more severe course of the pandemic (Italy) than in countries subjected to a less severe one (Germany, Austria). OBJECTIVE: To investigate and contrast the wellbeing of the population in Italy, Austria, and Germany in the early phase of the first lockdown. METHOD: Online survey on N = 4289 individuals. The questionnaire comprised a self-administered section, exploring the dimensions: perceived severity of COVID-19, perceived risk of disease, concerns related to COVID-19, emergency measure acceptance and emotional distress due to emergency measures; and standardized scales to record emotional state and coping: Stress-Coping-Style Questionnaire, Positive and Negative Affect Schedule, State-Trait-Anxiety-Inventory. RESULTS: The three countries displayed significant differences in all investigated dimensions (p < .001). Italian participants assessed the COVID-19 virus as much more dangerous (p < .001), but despite the prevalence of the virus, the subjective risk of disease was perceived to be lower in Italy (p < .001). This could be a positive effect of the restrictive curfews set by the government in Italy. The emergency measures were generally perceived to be very effective in all three countries, but due to the duration and the severity of the measures, the fear and stress-reaction were the strongest among Italian participants (p < .001). CONCLUSION: The stricter measures in Italy prevented an application of many positive stress processing strategies, which, in turn, fostered the perpetuation of stresses and fear.

[Video-based treatment in psychodynamic psychotherapy in times of the COVID-19 pandemic]. / Videobasierte Behandlungen in der psychodynamischen Psychotherapie in Zeiten der COVID-19-Pandemie: Interviewstudie mit Psychotherapeut*innen und Patient*innen.

BACKGROUND: In the course of the pandemic triggered by the coronavirus disease 2019 (COVID-19), video-based treatment (VBT) has undergone a trend reversal. It must be assumed that the abrupt switch from traditional psychotherapy to the video setting (VS) has an impact on the therapeutic relationship and thus on the therapeutic process. This study examined how the switch from traditional treatment to VBT (and back again) during the COVID-19 pandemic was experienced by patients and therapists with respect to the therapeutic relationship and the therapeutic process. METHODS: Group-specific, semi-structured interviews with therapists (n = 8), therapists in training (n = 6), and patients (n = 9). RESULTS: The results show that the majority of participants, both therapists as well as patients, experienced the therapeutic situation in VS as more permeable and less predictable. Although the VS contributes to maintenance of the therapeutic situation, the interaction was described as shallow and less oriented. Furthermore, every setting change was associated with a process of habituation. Therefore, the therapeutic work can only be carried out with the highest possible intensity after several sessions within each setting. CONCLUSION: The possibility of maintaining the therapeutic relationship using VBT can lead to a strengthening of the therapeutic alliance. Although the VS is associated with uncertainties, shame-ridden topics can be addressed more freely. Anxiety patients, in particular, could engage in a more intense therapeutic process after a universally observed phase of habituation.

The Relationship Between the Implementation of Statutory Preventative Measures, Perceived Susceptibility of COVID-19, and Personality Traits in the Initial Stage of Corona-Related Lockdown: A German and Austrian Population Online Survey.

Background: Particularly during the early and middle stages of the COVID-19 pandemic, a population's compliance with precautionary measures (e.g., hygiene rules, smart working, travel restrictions, and quarantine) is paramount in preventing the virus from spreading. Objective: The investigation and documentation of different socio-demographic and personality-specific factors in regards to preventative measures and consequent specific health behaviors during the COVID-19 pandemic, based on the Health Belief Model. Method: An online survey was conducted on N = 3,006 individuals living in Germany and Austria during the early stages of lockdown. The questionnaire consisted of a self-administered section, exploring the dimensions posited in the Health Belief Model: perceived severity, perceived susceptibility, perceived barriers, perceived benefits of health-promoting measures, and engagement in health-promoting behaviors. Additionally, the following standardized scales were used to record personality determinants: the Stress Coping Style Questionnaire SVF 78 to evaluate coping and processing strategies in stressful circumstances, the Positive and Negative Affect Schedule (PANAS) to assess the emotional state induced by the coronavirus crisis, the UI-18 scale to diagnose the intolerance of uncertainty, and the State-Trait Anxiety Inventory (STAI) to assess anxiety. Results: In line with the Health Belief model, four groups were created based on perceived susceptibility and engagement in health-promoting behaviors, and consequently studied in relation to personality determinants. Those four groups differed significantly in regards to almost all personality dimensions (p ≤ 0.005). Group 1 (n = 450) shows a reduced engagement with protective measures and displays underestimation of the COVID-19-pandemic. Group 2 (n = 984) displays many positive personality variables and high compliance with protective measures. Group 3 (n = 468) perceives the subjective risk of disease as high, but high emotional discomfort and stress caused by the protective measures leads to the activation of a complex fear defense. Group 4 (n = 1,004) is highly anxious and therefore compliant. Conclusion: This typification has implications for establishing the appropriate support systems. This is particularly important to encourage compliance with preventive regulations within the groups, which showed poor abidance for several reasons. For Group 1, further education on the realistic threat and efficient protective measures is as central as the fostering of empathy for others; with its resource-conscious exemplary behavior Group 2 could be used as a positive social role model. Group 3 would benefit from promoting self-care, while Group 4 requires information on psychosocial assistance availability in order to mitigate the high stress to which the group members are subjected.

[Online psychotherapy in times of the corona pandemic]. / Onlinepsychotherapie in Zeiten der Coronapandemie.

BACKGROUND: The prevalence of mental illnesses in the population has enormously increased during the corona pandemic due to the accompanying burdens and distress. Therefore, it is important to continue with the provision of psychotherapeutic treatment even in times of social distancing. As a result, psychotherapists were soon confronted with the need to expand their traditional treatment setting and offer remote treatment. OBJECTIVE: Which digital treatment options are available to psychotherapists since the pandemic, also with respect to the legal regulations? To what extent and how did they use video-based or telephone-based psychotherapy? What is the current stage of research regarding the effectiveness of video(telephony)? How can therapeutic alliance be built into video(telephony) settings? How can psychotherapists successfully apply their personal therapeutic method to different patient groups (children, adolescents, adults) in the new digital setting? METHODS: These questions are answered based on a literature search and clinical considerations. RESULTS: The majority of psychotherapists have immediately adapted to remote treatment. This has been supported by the government by expanding existing regulations in order to continue treatment with current and new patients without physical contact during the pandemic crisis. Survey studies have shown that psychotherapists consider the effectiveness of digital treatment settings to be lower than the traditional setting. CONCLUSION: Further training is necessary to educate psychotherapists in the theory, practice and self-awareness for quality assurance in the video(telephony) setting.

Problematic Smartphone Use-Comparison of Students With and Without Problematic Smartphone Use in Light of Personality.

Background: As a device with multiple functions, a smartphone become more and more relevant in everyday life. However, this goes along with an increase in reports about smartphone addiction and its unwanted consequences. One of the most important variables in the etiopathogenesis of addictive smartphone use is personality. Objective: This study aimed to investigate predictors of problematic smartphone use. Clinically relevant differences in personality, psychopathology, and social support between students with and without problematic smartphone use were investigated. Method: All currently enrolled students at the Sigmund Freud University in Vienna (N = 1,836) were surveyed. Response rate was 27.07% (N = 497, age: M = 19.6, SD = 8.04). The Smartphone Addiction Scale (SPAS), the 10-Item Big Five Inventory (BFI-10), the Brief Symptom Inventory (BSI-18), and a questionnaire on social support (F-SozU-K-14) were used. Results: A total of 75 students (15.1% of the total sample) showed problematic smartphone use. In terms of personality, respondents with problematic smartphone use showed significantly higher values for extraversion and neuroticism compared than non-addicted users. Students with problematic smartphone use showed significantly higher levels in terms of depression and anxiety. Contrary to expectations, individuals with problematic smartphone use showed significantly higher values for perceived social support than with individuals without problematic smartphone use. Discussion: Therapy for problematic smartphone use should be carried out taking into account discussed, important etiological factors, such as personality.

Comparison of Students With and Without Problematic Smartphone Use in Light of Attachment Style.

Background: Nowadays, media addictions are especially of high relevance to psychotherapeutic practice. More recently, this particularly includes excessive smartphone usage. Even though a growing number of scientific literature and also mainstream media highlight problematic smartphone use as a serious health problem, there is only little research on this issue. Objective: The aim of this study was to examine this phenomenon with a focus on attachment-specific differences between students with and without problematic smartphone use. Method: A survey was carried out on all enrolled students of the Sigmund Freud University Vienna. The Smartphone Addiction Scale (SPAS) was used to differentiate between students with and without problematic smartphone use. The attachment style was assessed using the Bielefeld Partnership Expectations Questionnaire (BFPE). Results: Of the total sample, 75 of the students (15.1%) showed a problematic smartphone use. A positive correlation between excessive smartphone usage and an insecure attachment style was found. Discussion: Therapy for problematic smartphone use should be carried out in light of patient's attachment style. Further research into other factors of mental stress and personality is needed to better understand problematic smartphone use.

The Attitudes of Therapists and Physicians on the Use of Sex Robots in Sexual Therapy: Online Survey and Interview Study.

BACKGROUND: Various types of robots have already been successfully used in medical care, and the use of new technologies is also playing an increasing role in the area of sexuality. Sex robots are marketed as advanced sex toys and sex dolls with artificial intelligence. Only a few considerations about the therapeutic use of sex robots in sexual therapy are debated in expert discussions. OBJECTIVE: The aim of this study was to conduct a first exploratory survey on the attitudes of sex therapists and physicians toward the therapeutic benefits of sex robots. METHODS: This study comprised a quantitative online survey and a qualitative interview study. A self-constructed questionnaire was used to survey the general attitudes of sex therapists and physicians regarding the benefits of sex robots in therapy. The qualitative study was designed to gain in-depth insight into the participants' beliefs and attitudes. Therefore, semistructured interviews were conducted. The quantitative data were evaluated by statistical analysis, and the interviews were transcribed and analyzed by using a grounded theory approach. RESULTS: A total of 72 sex therapists and physicians completed our self-constructed questionnaire (response rate 15%, 72/480). Only a few respondents (11%, 8/72) said that the use of sex robots was not conceivable for them, and almost half of all therapists and physicians could imagine recommending sex robots in therapy (45%, 33/72). The attitude toward sex robots as a therapeutic tool was very heterogeneous, with gender (P=.006), age (P=.03), and occupational differences (P=.05); female therapists, older therapists, and psychologists (in contrast to physicians) were more critical toward the therapeutic use of sex robots. The analysis of the 5 interviews identified 3 high-level core themes that were representative of the participants' responses: (1) the importance of the personal definition of sex robots for the assessment of their therapeutic benefits, (2) therapeutic benefits and dangers of sex robots, and (3) considerations on the quality of human-robot sexuality. Initial insights into the possible therapeutic use of sex robots in different disorders (eg, sexual dysfunction or pedophilia) and situations were gained from the perspective of sex therapists. CONCLUSIONS: The results of this study provide a first overview of the potential therapeutic use of sex robots. Moral, ethical, and treatment-related issues in this context are still unresolved and need to be further researched. We suggest integrating the topic into the training of sex therapists to form opinions beyond media images and to show therapy possibilities. Scientists engaged in sexual research should be involved in the development of sex robots to design robots with positive effects on sexual education, sexual therapy, sexual counseling, and sexual well-being for interested groups.

Use of Web-Based Health Services in Individuals With and Without Symptoms of Hypochondria: Survey Study.

BACKGROUND: An increasing number of people consult physicians because of distressing information found online. Cyberchondria refers to the phenomenon of health anxiety because of online health information. OBJECTIVE: This study aimed to examine online health research of individuals with and without symptoms of hypochondria and their impact on health anxiety as well as behavior. METHODS: An online survey was conducted. Demographic data, health-related internet use, and general health behavior were assessed. The illness attitude scale was used to record symptoms of hypochondria. RESULTS: The final sample consisted of N=471 participants. More than 40% (188/471) of participants showed at least some symptoms of hypochondria. Participants with symptoms of hypochondria used the internet more frequently for health-related purposes and also frequented more online services than individuals without symptoms. Most online health services were rated as more reliable by individuals with symptoms of hypochondria. Changes to behavior such as doctor hopping or ordering nonprescribed medicine online were considered more likely by individuals with symptoms of hypochondria. CONCLUSIONS: Results show that individuals with symptoms of hypochondria do not turn to online research as a result of lacking alternatives but rather consult health services on- as well as offline.