Reconstructive and Aesthetic Surgeries on the Female Genitalia. Guideline of the DGGG, DGPRÄC, OEGGG and SGGG (S2k-Level, AWMF Registry No. 009/019, May 2022).

Aim This official guideline was coordinated and published by the German Society for Gynaecology and Obstetrics (DGGG), the German Society for Plastic, Reconstructive and Aesthetic Surgery (DGPRÄC), the Austrian Society for Gynaecology and Obstetrics (OEGGG), and the Swiss Society for Gynaecology and Obstetrics (SGGG). The guideline aims to provide a consensus-based overview of reconstructive and aesthetic surgeries on female genitalia based on an evaluation of the relevant literature. Methods This S2k-guideline was developed by representative members from different medical professions on behalf of the guidelines commission of the DGGG, DGPRÄC, OEGGG and SGGG using a structured consensus process. Recommendations Statements and recommendations on the epidemiology, aetiology, classification, symptoms, diagnosis, and treatment of acquired changes of the external genitalia are presented and special situations are discussed.

The association of childhood abuse and neglect with tattoos and piercings in the population: evidence from a representative community survey.

BACKGROUND: Tattoos and piercings are becoming increasingly popular in many countries around the world. Individuals seeking such body modifications have reported diverse psychological motives. Besides purely superficial considerations, tattoos and piercings can also have a deep, personal meaning. For example, they can mark and support the emotional processing of significant life events, including formative experiences from early childhood. However, there is a lack of studies that examine the links of tattoos and piercings with experiences of childhood abuse and neglect in large, population-based samples. METHODS: We investigated the association of reports of childhood abuse and neglect with the acquisition of body modifications (tattoos and piercings) within a representative German community sample. Survey participants (N = 1060; ages 14-44 years) were questioned whether they had tattoos and piercings and filled out the 28-item Childhood Trauma Questionnaire Short Form (CTQ-SF). RESULTS: Tattoos and piercings were more common among individuals who reported childhood abuse and neglect. The proportion of participants with tattoos and piercings increased as a function of the severity of all assessed types of abuse and neglect (emotional, physical, and sexual abuse; emotional and physical neglect). In logistic regression analyses which included the covariates age, gender, education, and income, the sum of significant kinds of childhood abuse and neglect was positively related to having tattoos and/or piercings (OR = 1.37 [95% CI 1.19-1.58]). CONCLUSIONS: The results corroborate previous research indicating that body modifications could have special significance for individuals who have survived adversity, in particular interpersonal trauma at the hands of caregivers. These findings could inform screening procedures and low-threshold access to psychotherapeutic care.

Psychosomatically Oriented Diagnostics and Therapy for Fertility Disorders. Guideline of the DGPFG (S2k-Level, AWMF Registry Number 016/003, December 2019).

Aim The purpose of this official guideline published and coordinated by the German Society for Psychosomatic Gynecology and Obstetrics [Deutsche Gesellschaft für Psychosomatische Frauenheilkunde und Geburtshilfe (DGPFG)] is to provide a consensus-based overview of psychosomatically oriented diagnostic procedures and treatments for fertility disorders by evaluating the relevant literature. Method This S2k guideline was developed using a structured consensus process which included representative members of various professions; the guideline was commissioned by the DGPFG and is based on the 2014 version of the guideline. Recommendations The guideline provides recommendations on psychosomatically oriented diagnostic procedures and treatments for fertility disorders.

The Narcissistic Personality Inventory 8: Validation of a Brief Measure of Narcissistic Personality.

The present study was conducted with the aim of constructing and validating a short form of the Narcissistic Personality Inventory (NPI). The NPI is the most widely-applied measure for the assessment of narcissistic personality traits and, therefore, it is of great relevance for many research questions in personality and social psychology. To develop the short scale, we first found the optimal eight-item solution among all valid combinations of the NPI-15 items in an exploratory subsample (n = 1, 165) of our complete representative sample of the German general population. We then validated this model in a confirmatory subsample (n = 1, 126). Additionally, we examined its invariance across age groups and sex, as well as its reliability, as well as construct and predictive validity -comparing it to the NPI-15. Our results indicate that the NPI-8 is a valid and reliable measure of narcissistic personality with minimal losses compared to the 15-item version. Particularly where brevity and an economical assessment are desired, the NPI-8 should be considered.

El presente estudio se realizó con el objetivo de construir y validar una forma corta del Inventario de Personalidad Narcisista (NPI). El NPI es la medida más ampliamente aplicada para la evaluación de los rasgos narcisistas de la personalidad y, por lo tanto, es de gran relevancia para muchas preguntas de investigación en personalidad y psicología social. Para desarrollar la escala corta, primero encontramos la solución óptima de ocho ítems entre todas las combinaciones válidas de los ítems NPI-15 en una submuestra exploratoria (n = 1, 165) de nuestra muestra representativa completa de la población general alemana. Luego validamos este modelo en una submuestra confirmatoria (n = 1, 126). Además, examinamos su invariancia entre grupos de edad y sexo, así como su confiabilidad y validez constructiva y predictiva, comparándola con el NPI-15. Nuestros resultados indican que el NPI-8 es una medida válida y confiable de la personalidad narcisista con pérdidas mínimas en comparación con la versión de 15 ítems. Particularmente donde se desea brevedad y una evaluación económica, se debe considerar el NPI-8.

Body hair removal: Prevalence, demographics, and body experience among men and women in Germany.

BACKGROUND: Body hair removal is an increasing trend that has an impact on the individual's body image. AIMS: To characterize current body hair removal practices in Germany and the extent to which body hair removal was related to demographic characteristics, body image, and body mass index. PATIENTS/METHODS: A national survey was conducted from September to October 2016 in men and women in Germany. Body experience was measured by a standardized questionnaire. In addition to sociodemographic data, age, gender, education, marital status, monthly income, and body mass index were collected. RESULTS: A total of n = 2510 participants aged 14 to 94 years (Mage = 48.4 years (SD = 18.2), 53.4% females) were randomly selected from the general population. 69% of the questioned women removed their body hair while only 41% of men do. The gender effect is statistically significant (χ2  = 203.43; df = 1; P < .001). Income, a higher level of education, and living in an urban region were significantly associated with body hair removal in both, men and women. Furthermore, significant differences with regard to body image were found between hair removers and nonremovers which are associated with a different attitude toward the own body. CONCLUSIONS: Germans were likely to remove body hair if they were of younger age, better educated, and with high income. Hair removal is above all a women's issue. Especially, female hair removers experience their body as an esthetic entity with the need of active reshaping. There is a "shift" from ideal of a naturally hairy body to an increased hairlessness in Germany.

[Tattoos in Germany: prevalence, demographics, and health orientation]. / Tattoos in der deutschen Bevölkerung ­ Prävalenzen, Soziodemografie und Gesundheitsorientierung.

BACKGROUND: Tattooing has become very popular in recent years. In this context, socio-demographic information and health orientation is important. OBJECTIVES: The objective of this study was to evaluate the development of the prevalence of tattoos over the last thirteen years and the social and economic background of people with tattoos. Three national representative surveys were compared for this purpose; men and women residing in Germany were included. Additionally, the purpose of the study was to assess socio-demographic information and the health orientation of respondents with tattoos. MATERIALS AND METHODS: Three national, representative surveys were conducted on German participants (2016: n = 2510, 2009: n = 2512, 2003: n = 2043). The number of tattoos and socio-demographic information were investigated. The Health Regulatory Focus Scale (HRFS) assessing the individual's health orientation was used in 2016. RESULTS: Currently, one out of five Germans (≥14 years) has at least one tattoo. In Germany, tattoos are most prevalent among younger adults of both sexes aged 25 to 34 years. People with all levels of education have tattoos, although there were weak correlations with a lower education level and unemployment. Only men with several tattoos showed a significantly lower health orientation than non-tattooed ones. CONCLUSION: The fact that nearly one fifth of the German population has tattoos suggests that this permanent body art is becoming more and more accepted in German society. As a result, a need for better health risk information on the topic for both tattooists and the people getting tattoos appears evident because of the high prevalence of tattoos in younger generations as well as the lower health orientation in men with several tattoos.

Body modification in Germany: prevalence, gender differences and attitude towards cosmetic surgery.

BACKGROUND: The most popular body modifications are tattoos and piercings and their prevalence has increased in recent years. The current study gathered statistics regarding tattoing, piercing and body-hair removal, differentiated by gender and attitude towards cosmetic surgery. METHODS: The study was based on 2512 individuals and was performed as a population-based survey with the assistance of a demographic consulting company. In addition to sociodemographic questions, specific issues concerning body modification were asked. RESULTS: Men get tattoos more frequently while women more often choose piercings and body hair removal. Women are catching up in the tattoo department and one can no longer observe age differentiations among the younger age groups. Instead there is a decrease in piercings among men. Body hair removal is widespread above all women. People with body modifications tend to be more open-minded about cosmetic surgery. CONCLUSIONS: Tattoos and piercings continue to be the most popular body modification among young adults. The number engaged in tattooing is rising while piercings are still popular among women. Individuals being engaged in body modification are prone to consider cosmetic surgery procedures.

What do you know about reproductive medicine?--results of a German representative survey.

OBJECTIVE: The use of reproductive medical treatments has become increasingly routine in recent years. This paper reports on a study of how different aspects of modern reproductive medicine are perceived by the German population. DESIGN: Findings from a nationally representative sample of 2110 men and women aged 18 to 50 are presented. Participants responded to a questionnaire seeking self-report information about attitudes and knowledge regarding different aspects of reproductive medicine. RESULTS: The majority of respondents had already heard or read something about reproductive medicine; knowledge gaps were prevalent in men and individuals with lower levels of education. The decrease in female fertility usually was underestimated, whereas both the number of involuntarily childless couples and the success rate of reproductive medical treatment were overestimated. One-third of participants would make use of reproductive medicine to have their own child. CONCLUSION: This study revealed inadequacies in the knowledge of the German general population regarding reproductive medicine. Despite the low interest and poor knowledge of the topic, a broad acceptance of reproductive medical methods was reported. The results illustrate the need for adequate information transfer regarding female fertility as well as success rate and risks of reproductive medical interventions.

Changes in body image and health-related quality of life following breast reduction surgery in German macromastia patients: a new tool for measuring body image changes.

Health insurance funds in Germany are increasingly reluctant to fund the cost for reduction mammaplasty. However, several studies have already demonstrated the beneficial effects of breast reduction on symptom relief and health-related quality of life. More specifically, the psychologic and social consequences of breast reduction surgery were also recently evaluated. Relating to the contemporary debate on financial restraint, the present article describes a follow-up study conducted in a sample of 40 patients undergoing reduction mammaplasty. The purpose of the investigation was to assess indicators of health-related quality of life following reduction mammaplasty. Furthermore, the study aimed to assess body image changes and to test a new assessment instrument, Digital-Body-Photo-Test (DBPT), in comparison with a well-validated body image measure (Color-a-Person Body Dissatisfaction Test, CAPT) (concurrent validity). As hypothesized, the findings indicate significant improvements in health-related quality-of-life measures and body-image characteristics. The substantial improvement of body-image satisfaction of all body areas suggests a generalized positive effect of reduction mammaplasty on overall body image. The strong association between the DBPT and the CAPT scores in this study indicates that DBPT is an efficient and valid new tool for measuring body-image changes relating to patients' evaluations of their average satisfaction of specific body parts or areas and their overall appearance acceptance.

The prevalence of body dysmorphic disorder: a population-based survey.

BACKGROUND: Body dysmorphic disorder (BDD) is a highly distressing and impairing disorder characterized by a preoccupation with imagined or slight physical defects in appearance. Well designed studies on its prevalence and on base rates for diagnostic criteria are rare. Therefore this study aimed to reveal prevalence rates of BDD in the general population and to examine clinical features associated with BDD. METHOD: Of 4152 selected participants 2552, aged 14-99 years, participated in this German nationwide survey. Participants were carefully selected to ensure that the sample was representative; they were visited by a study assistant who provided instructions and help if needed. Participation rate was 62.3%. DSM-IV criteria for BDD, as well as subthreshold features (e.g. individuals who consider some part(s) of their body as ugly or disfigured, but do not fulfill all BDD criteria) were examined. We also assessed suicidal ideation associated with the belief of having an ugly body part, as well as the desire for cosmetic surgery. Furthermore, somatization symptoms were assessed. RESULTS: The prevalence of current BDD was 1.7% (CI 1.2-2.1%). Individuals with BDD reported higher rates of suicidal ideation (19% v. 3%) and suicide attempts due to appearance concerns (7% v. 1%) than individuals who did not meet criteria for BDD. Somatization scores were also increased in individuals with BDD, relative to those without. BDD was associated with lower financial income, lower rates of living with a partner, and higher rates of unemployment. CONCLUSIONS: Our study shows that self-reported BDD is relatively common and associated with significant morbidity.

Ambivalent attitudes towards pre-implantation genetic diagnosis in Germany.

BACKGROUND: Pre-implantation genetic diagnosis (PGD) is a modern technique in reproductive medicine which can be used to diagnose genetic disorders of an embryo. PGD is currently not legal in Germany, still there are debates being held regarding the issue of legalization. Both the internationally "accepted" indications and new or alternative approaches can lead to complex ethical dilemmas. The attitudes towards PGD have rarely been assessed in the general population. METHODS: In our study, 2110 persons aged 18-50 years were interviewed about their attitudes towards PGD and related topics. We assumed that religion, world views and the evaluation of PGD would influence the attitude a person has towards this procedure. RESULTS AND CONCLUSIONS: In our survey, the majority of respondents would agree to a restricted legalization of PGD in Germany. Our results also confirmed some of our assumptions but religion did not have the expected influence. The evaluation of costs and benefits of PGD and the feelings associated with this technique explained more of the final attitude whether PGD should remain prohibited in Germany or not. The agreement to a restricted legalization may be connected to an overall rejection of prohibitions made by the state concerning the individual reproductive autonomy.

[Consensus paper on the terminological differentiation of various aspect of body experience]. / Konsensuspapier zur terminologischen Abgrenzung von Teilaspekten des Körpererlebens in Forschung und Praxis.

In the past, phenomenological research on subjective body experience was characterised by vaguely defined terminology and methodological shortcomings. The term "body image" has been applied heterogeneously in literature in order to describe a variety of bodily phenomena. In this paper, the German terminology applied to the phenomenology of body experiences is described systematically. In developing a systematic terminology the authors refer to scientific evidence as well as recent reviews, and closely adhere to definitions commonly used in English literature. Different perspectives are utilised, particularly anthropological concepts and theories from developmental and self-psychology. Distinct aspects of body experience are described within the context of a network of external determinants and along a continuum between somatic and mental anchor points. Applying the term "body experience" as umbrella term, different aspects are defined: perceptive (body schema/-perceive), affective (body-cathexis), cognitive-evaluative (body-image, body-ego) and body-consciousness. It is emphasized, that the distinct description of functional levels has to be taken as an approximation of the reality of integrated body experience.

Differences in body image between anorexics and in-vitro-fertilization patients - a study with Body Grid.

OBJECTIVES: The purpose of the investigation was to explore the body image disturbance of anorexics and in-vitro-fertilization patients (IvF-patients) with Body Grid and Body Identity Plot. METHODS: The paper reports on an empirical study conducted with 32 anorexic patients and 30 IvF-patients. The structure of the body image was derived from the Body Grid, an idiographic approach following the Role Repertory Grid developed by George A. Kelly [17]. The representation of the body image and the degree of body-acceptance is represented graphically. RESULTS: By the Body Grid and Body Identity Plot measures we were able to identify important differences in body image between anorexics and IvF-patients. CONCLUSION: The tendencies of dissociation in the body image of anorexics which we found must be seen in the sense of a specific body image disturbance which differs significantly from the body-experience profile of IvF-patients. With the grid approach it was possible to elicit the inner structure of body image and determine the acceptance of the body and integration of single body parts.

On raising the international dissemination of German research: Does changing publication language to English attract foreign authors to publish in a German basic psychology research journal?

It has been proposed that German basic psychology journals should change publication language to English in order to facilitate access to research from German-speaking countries. However, to truly increase the dissemination of German research, it seems crucial to progress towards an internationalization of authors and readers. We applied bibliometric analysis to investigate the impact of the transition to English on the rate of foreign authors publishing in Zeitschrift für Experimentelle Psychologie/Experimental Psychology, as well as possible associated changes in citation patterns. There was an increase in the rate of articles published by foreign authors from 14.6 and 8.7 per cent, respectively, for the last biannual periods as German-language journal, to 52.7 per cent in the first biannual period as English-language journal. Regarding citations patterns, the clearest changes emerged for domestic authors. The results illustrate possible consequences of a transition to English as publication language, and reveal that Experimental Psychology has successfully established certain prerequisites for an increase of the international dissemination of German psychology research.

[The demand for integrative approaches in psychotherapy research demonstrated in an bibliometrical and speech statistic analysis of the PPMP]. / Integration und Pluralität in der psychosozialen Forschung - eine sprachstatistische und bibliometrische Analyse der PPmP.

Based upon the recent discussion on integrative approaches in psychotherapy research, the last two volumes of the PPmP were bibliometrically analyzed. The articles of authors which belong to different disciplines like psychosomatic or medical psychology were compared with respect to the word and speech statistic, leading representatives and the reception of the international state of research. The interdisciplinary standard of the PPmP has proven successful in view of the impact of the journal within the Scientific Community and among the flagship journals of the field. The study shows that the plurality of methodological approaches and interdisciplinarity provides an important criterion for the quality of psychotherapy research and for the corresponding publication institutions. Related to scientific quality standard the PPmP has found good impact in the scientific community but there are points to be changed.