[Who is using outpatient psychotherapy in Germany?]. / Wer nimmt in Deutschland ambulante Psychotherapie in Anspruch?

Facing the current political controversies concerning health care, the present study examines the question who is using outpatient psychotherapy in Germany. Using data drawn from a nationally representative survey of 5120 Germans 7% stated they had used oupatient psychotherapy in the former 6 years or being actually in outpatient psychotherapy. Comparisions of socio-economic variables between persons with and without use of outpatient psychotherapy showed, contrary to expectations, that psychotherapy is not utilised by so called "YARVIS" (young, attractive, rich, verbal, intelligent, successful) patients.

[Central Relationship Patterns in Comparison with Different Objects]

In the present study the Relationship Episode Paradigm Interviews of 70 female patients with different psychoneurotic diseases were analysed with respect to object-specific patterns with the CCRT method. The most frequent categories are the same in all relationship episodes and in subsamples of relationship episodes with mother and father. These categories are also predominant in episodes with women and men. Relationship episodes with mother do not differ from episodes with father, and relationship episodes with women do not differ from episodes with men. But there are substantial differences in relationship episodes with the mother and women and between episodes with the father and men. Patients recount much more positive relationship patterns with women and men than with their parents. This could be understood as a hint of interpersonal resources.

Ambivalence over Emotional Expressiveness: psychometric evaluation of the AEQ-G18 in a representative German survey.

OBJECTIVE: The present study evaluates a questionnaire on ambivalence over emotional expressiveness, the AEQ-G18 [1], [2], with regard to its statistical parameters, the influence of socio-demographic variables, and its interrelationship with depression and quality of life. METHODS: A representative German sample (1009 participants from East Germany and 1034 participants from West Germany) completed the AEQ-G18 [1], [2], the depression screener DEP-2 [3], the Profile of Mood States POMS [4], the revised Beck Depression Inventory BDI [5], the short form of the Patient Health Questionnaire PHQ-9 [6] and the SF-36 health survey questionnaire [7]. RESULTS: Our study was only partially able to confirm the two factors effect ambivalence and competence ambivalence postulated by Traue et al. [1], [2]. Women scored somewhat higher on the scale effect ambivalence. Participants with a higher educational background exhibited less emotional ambivalence. Emotional ambivalence correlated positively with depression and reduced psychological state of health (depression, fatigue, and anger), whereas it correlated negatively with health-related quality of life and positive attitude (vigor). In addition to the scales of the AEQ-G18, we developed a short form, the AEQ-G10, and provide normative data for the AEQ-G18 and the AEQ-G10. CONCLUSION: This study presents normative data for two variations of a clinically relevant, valid, and time-efficient diagnostic instrument used for the evaluation of ambivalence over emotional expressiveness, the AEQ-G18 and its short form, the AEQ-G10.

[Development of a short version of the Insecurity Questionnaire (U-Bogen-24) by Ullrich & Ullrich de Muynck]. / Die Entwicklung einer Kurzversion (U-Bogen-24) des Unsicherheitsfragebogens von Ullrich und Ulirich de Muynck.

The psychometric properties of a newly developed short version of the "Unsicherheitsfragebogen" (Insecurity Questionnaire) by Ullrich & Ullrich de Muynck are examined using data drawn from a nationally representative survey of 652 former East and 1283 former West Germans. In addition, the questionnaire was tested on a clinical sample of 318 psychotherapy inpatients. The study demonstrates good test-theoretical features regarding parameters of items and subscales. In the population sample woman score higher on subscales fear of criticism and incapacity in saying NO and lower on scale being able to demand. Female psychotherapy patients score higher on scale fear of criticism and lower on scale being able to demand than male psychotherapy patients. When comparing psychotherapy patients to the population sample with respect to gender, male and female psychotherapy patients score higher on scales fear of criticism, fear of contact and incapacity in saying NO and lower on scale being able to demand. Scale means as reference values for the population sample as well as for the psychotherapy patients are reported.

[Validation and standardization of the "Questionnaire for Assessing Subjective Physical Well-Being" by Kolip and Schmidt in a representative German sample]. / Validierung und Normierung des "Fragebogen zur Erfassung des körperlichen Wohlbefindens" (FEW-16) von Kolip und Schmidt an einer repräsentativen deutschen Bevölkerungsstichprobe.

The "Questionnaire for Assessing Subjective Physical Well-Being" by Kolip and Schmidt is examined using data drawn from a nationally representative survey of 573 former East and 1900 former West Germans. In this non-clinical sample the construct "subjective physical well-being" assessed by the "Questionnaire for Assessing Subjective Physical Well-Being" seems to have just one dimension. As women and probands with growing age score lower for "subjective physical well-being" a differentiated standardization was done for gender and age. Connections between "subjective physical well-being" and body-image assessed by the "Body Image Questionnaire" (FKB-20), quality of life ("EURO-HIS-QOL"), and questions for concerns about financial situation, family and health give hints for validity of the questionnaire.

[Standardization of the German short version of "profile of mood states" (POMS) in a representative sample--short communication]. / Normierung der deutschen Kurzform des Fragebogens "Profile of Mood States" (POMS) anhand einer repräsentativen Bevölkerungsstichprobe--Kurzbericht.

The questionnaire "Profile of Mood States (POMS)" is recommended as a measure of mood states in patients and non-clinical samples. On the basis of a representative sample (2043 subjects) reference values for the four scales (DEPRESSION/ANXIETY, FATIGUE, VIGOR, ANGER) of the German short version of the "Profile of Mood States" (POMS--35 items, 7 point scale, instruction "How you have been feeling during the past 24 hours?") are presented. The scale ANGER was independent from variables gender, age, education and current residence. In contrast to the other three scales these differentiations were necessary and detailed reference values are reported.

Worrying about one's job, family, financial situation and health - results of a population-representative study.

OBJECTIVE: Worrying about one's job, family, financial situation and health is distressing. How intense are these worries in the general population? METHODS: An inquiry representative of the German population (N=2473, age>14 years) was performed. The total score of the "Questionnaire for Assessing Subjective Physical Well-Being" (FEW) and the screening scale of the "Trier Inventory for the Assessment of Chronic Stress" (TICS) were correlated with the four above mentioned items addressing worries (range 1-4). RESULTS: Worries about one's financial situation were scored highest (mean=2.04, SD=0.92), followed by worries about one's health (mean=1.94; SD=0.87), one's family (mean=1.85; SD=0.86) and worries about one's job (mean=1.69; SD=0.92). Health worries increased with age. Those without a job and single parents showed the highest grades of solicitude. Increasing income decreased worrying. The correlations with chronic stress were moderate (.24

Two-question depression-screeners - the solution to all problems?

UNLABELLED: Depression constitutes a considerable issue in medicine and it is anticipated that the amount of people suffering from affective disorders will increase significantly. It would be useful to have a simple, fast screening procedure which would help detect depression. In four recently published articles a two-question depression-screener is recommended. METHOD: Sensitivity, specificity, likelihood ratios, negative and positive predictive values were compared. RESULTS: For four different clinical samples and one sample that was representative of the German population the prevalence for depression ranged from 6.9 % to 18.1 %. Sensitivity and specificity reached values from 72.6 % to 96.6 % and from 56.9 % to 90.0 % respectively. All negative predictive values were high (< 97 %) opposed to positive predictive values (17.8 % to 38.5 %). CONCLUSION: Overall, it seems that the two-question screenings are well suited for the exclusion of a major depression. It is possible that regular screening could further lower the percentage of undiagnosed cases.

[The German short version of "Profile of Mood States" (POMS): psychometric evaluation in a representative sample]. / Uberprüfung der Gütekriterien der deutschen Kurzform des Fragebogens "Profile of Mood States" (POMS) in einer repräsentativen Bevölkerungsstichprobe.

The German short version of "Profile of Mood States" (POMS) was psychometrically tested in a representative sample (1009 subjects in Eastern Germany and 1034 subjects in Western Germany). The 35 items (7 point scale, instruction "How you have been feeling during the past 24 hours?") form the following scales: Depression/Anxiety, Fatigue, Vigor, Hostility. The POMS appears to be an internally consistent instrument (Cronbach's Alpha from 0.89 to 0.95). Replication of the postulated 4 factors was limited. There are hints for convergent validity of POMS-Scales using two questions: "1. Over the past two weeks, have you felt down, depressed, or helpless?" and "2. Over the past two weeks, have you felt little interest or pleasure in doing things?"

[Screening for depression -- two questions practically oriented]. / Depressivitäts-Screening -- zwei Fragen für die Praxis.

Despite the high epidemiological relevance of depressive disorders in daily clinical practice, they are insufficiently diagnosed. For screening, the U.S. Preventive Services Task Force proposed two questions aiming at finding depressive core symptoms: "Over the past two weeks, have you felt down, depressed, or helpless?" and "Over the past two weeks, have you felt little interest or pleasure in doing things?". We tested comparable questions in a representative sample from the German population. The correlations between the screening and validated questionnaires for depression point towards the validity of the screener. Relevant indices are satisfying: For major depression the sensitivity is 72.6% and specificity is 87.4%.

[Empirical analysis of transference and relationship patterns--A single case study]. / Zur empirischen Erfassung von Ubertragung und Beziehungsmustern - Eine Einzelfallanalyse1.

In the present study a psychoanalytic therapy was assessed by the CCRT method for the first time. We used reformulated categories for CCRT scoring. The data analyses were based not only on the most frequent categories but on newly developed alternative strategies. We could determine specific relationship patterns with special objects reflecting aspects of the clinical concept of transference.

[Religious and spiritual beliefs - validation of the German version of the "Systems of Belief Inventory" (SBI-15R-D) by Holland et al. in a population-based sample]. / Erfassung religiöser und spiritueller Einstellungen - Psychometrische Uberprüfung der deutschen Version des "Systems of Belief Inventory" (SBI-15R-D) von Holland et al. in einer repräsentativen Bevölkerungsstichprobe.

The present study describes the German version of the "Systems of Belief Inventory (SBI-15R)" developed by Holland et al. The questionnaire was used in a representative sample of 954 eastern and 1031 western Germans. The SBI met tests of internal consistency and demonstrated discriminant validity. But the two factors of the original version could not clearly be replicated. For the relevance of religious beliefs we found that women score higher than men, older score higher than younger, persons with lower education score higher than persons with higher education, western Germans score higher than eastern Germans. Connections between the SBI-15R-D and self-evaluation as being religious and importance of faith during childhood give hints to the instrument's validity. The SBI-15R-D can serve as a valid and economic tool to explore the role of religious and spiritual beliefs.

[Connections between attachment prototypes and relationship patterns]. / Zum Zusammenhang von Bindungsprototypen und zentralen Beziehungsmustern.

Connections between attachment styles and relationship patterns are studied on 32 female psychotherapy patients. Our study gives first hints to a connection between attachment variables, assessed by the German version of the Adult Attachment Prototype Rating (AAPR) and predominant relationship patterns, assessed by the Core Conflictual Relationship Theme Method (CCRT) developed by Luborsky, if both methods are used independently. Subsamples according to the attachment styles show differences in CCRT variables.

[The German short version of the interpersonal guilt questionnaire--Validation in a population-based sample and clinical application]. / Der "Fragebogen zu interpersonellen Schuldgefühlen" (FIS) - Anwendung in einer repräsentativen Bevölkerungsstichprobe und bei PsychotherapiepatientInnen.

The present study describes the development of the German short version "Fragebogen zu interpersonellen Schuldgefühlen" (FIS) of the "Interpersonal Guilt Questionnaire" (IGQ) developed by O'Connor et al. The questionnaire was used in a representative sample of 652 eastern and 1283 western Germans. Woman show higher scores on the subscales "Seperation Guilt" and "Omnipotent Responsibility Guilt" than man. Eastern Germans mark higher scores on the subscale "Omnipotent Responsibility Guilt" than western Germans. Correlations between interpersonal guilt and social anxiety and differences between a non-clinical and a clinical sample show that maladaptive aspects of guilt feelings can be assessed by the "Interpersonal Guilt Questionnaire".

[The connection between affective evaluation of recollected relationship experiences and the severity of the psychic impairment]. / Zum Zusammenhang zwischen der Valenz von Beziehungserfahrungen und der Schwere der psychischen Beeinträchtigung.

This study, carried out at three different university centers contributes to validating the valence dimension of the CCRT-method. Working on the state of the CCRT-research on affective evaluation of relationship narratives, the connection between the valence dimension of the responses from others (RO), responses of the self (RS) and the severity of the psychic disorder has been analysed with the help of two different samples (n = 266 resp. n = 32) taken from female patients. Both, therapists as well as patients themselves, evaluated the severity of the impairment similarly. The more the patients were impaired, the more negatively they describes both their own reactions and those of their interaction partners as shown in the relationship episodes.