Question: Comorbidity, i.e., additional psychological distress in patients already suffering from... more Question: Comorbidity, i.e., additional psychological distress in patients already suffering from chronic somatic diseases (e.g., orthopedic conditions) is of growing importance. The quality of analyzing and interpreting the often used Brief Symptom Inventory (BSI) used with orthopedic patients should improve by employing a new “case definition” of four groups (instead of two) of differentially psychologically distressed patients instead of two groups as before.Methods: Four groups with the different psychological distress definitions of “no,” “mild,” “remarkable,” and “severe” were to be analyzed from a group of 639 orthopedic patients in inpatient rehabilitation clinics. The BSI is transformed into T values (M=50, SD=10). There is “no” distress if no T [two scales] is ≥60 and “mild” distress if T [two scales] and/or T [GSI] is ≥60 and <63. If T [two scales] and/or T [GSI] is ≥63 and <70, it is “remarkable,” and if T [two scales] and/or T [GSI] ≥70, it speaks for “severe” psy...
Praxis der Kinderpsychologie und Kinderpsychiatrie, 2017
Healthy Siblings of Children with Autism Spectrum Disorders. A Mixed-methods Pilot Study Healthy ... more Healthy Siblings of Children with Autism Spectrum Disorders. A Mixed-methods Pilot Study Healthy siblings of chronically ill and/or disabled children may have an increased risk of developing behavioral problems; this is particularly given for siblings of children with Autism Spectrum Disorders (ASD). Quality of life and distress of five siblings (12-15 years) of children with ASD were examined using self- and parent-proxy-reports. Guideline-based interviews were conducted with the siblings and their parents and analyzed according to Mayring. Quality of life described by the children resembled the KINDLR´s standardized range of scores, but parents described a decreased quality of life. Both siblings and parents reported low to medium distress. Interviews revealed healthy children are asked by their parents to take responsibility for their siblings with ASD. Parents assumed their healthy children are less affected by the ASD of the sibling. The healthy siblings described being "a...
Objectives: Psychometric instruments are commonly applied in psychotherapeutic research and care ... more Objectives: Psychometric instruments are commonly applied in psychotherapeutic research and care for the baseline assessment of symptoms, the planning of therapeutic interventions, the assessment of the longitudinal course of symptoms and outcomes of therapeutic interventions as well as quality management of care. Psychometric properties as well as economic aspects should be considered in the selection of specific instruments. It is assumed that users of psychometric instruments face a great variety of instruments and related information. For that reason, it seems challenging to absorb the current knowledge and to integrate it into clinical practice and research. Thus, it is likely that well-known, established and easily accessible instruments are commonly used, while new developed instruments might not be disseminated in research and healthcare. Methods: Based on available international review models, the working group &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Psychometrics and Psychodiagnostics&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of the German College of Psychosomatic Medicine (DKPM) has developed and tested a review model specifically tailored for psychotherapeutic research and care. Results: The different steps of development, as well as the final review model based on the consensus of the working group are presented. The review model contains 6 generic terms (reliability, validity, objectivity, reference groups and aspects of application) with 21 different criteria to be assessed with 0-3 asterisks (*). The criteria are clearly operationalized and the practical use of the review model is explained and discussed. Conclusions: With the review model for the assessment of psychometric instruments a well-defined evaluation system is made available for research and clinical practice which has been developed by an expert group. The review model facilitates systematic, transparent and comparative evaluation of psychometric instruments along clearly defined criteria. It also supports the selection of psychometric instruments in research and care. Next, the working group aims at disseminating and implementing the review model as well as the application and publication of reviews for different psychometric instruments based on the review model.
Objective: The SCL-90 and the SCL-90-R are the most applied measures regarding psychological dist... more Objective: The SCL-90 and the SCL-90-R are the most applied measures regarding psychological distress. To reduce and prevent an overload to of the individuals, the Brief Symptom Inventory with 18 items (BSI-18) was developed based on the SCL-90. Since psychological disorders more frequently occur at an older age, there is a growing need for efficient instruments to measure distress in the elderly. However, the BSI-18's psychometric properties, norm values, and factorial structure have not yet been investigated in this age group. Methods: The aim of this study was to evaluate the BSI-18 in a sample of elderly people and to establish norm values for this specific population. Subsequently, demographic information and BSI-18 results were collected from a sample totaling 884 (55% female, mean age of 70.75 years, SD = 7.08, age range = 60-95 years). The questionnaire contains three six-item scales: somatization (SOMA), anxiety (ANX), and depression (DEPR), which form a general symptom index (GSI). Results: We found an acceptable to good model fit for a three-factor-model with a general GSI factor. The BSI-18's psychometric properties were satisfactory. Strict measurement invariance was shown for age and gender. Additionally, we found differences in psychological distress based on sociodemographic variables. Conclusions: These findings underline the growing need for preventive mechanisms for elderly people such as, e.g., (re)activating their social networks and strengthening their physical and psychological well-being.
Quality of life (QOL) of patients in opioid substitution treatment (OST) is increasingly being ad... more Quality of life (QOL) of patients in opioid substitution treatment (OST) is increasingly being addressed in research. However, no disease- or treatment-specific instrument is available to assess the QOL of this target population. The purpose of this project was to develop the first QOL instrument for OST patients. Focus groups with 60 OST patients were analyzed using thematic analysis to elicit key QOL themes as perceived by patients. Identified themes were developed into items and refined through pilot testing and cognitive debriefing. The resulting 82 items were tested in a large sample of OST patients (n = 577). Principal component analysis with varimax rotation was performed to explore a possible factor structure and reduce the number of items. Psychometric properties were assessed. Factor analysis revealed 6 subscales accounting for 46.1% of the variance: Personal Development, Mental Distress, Social Contacts, Material Well-being, Opioid Substitution Treatment, and Discriminati...
The Health Regulatory Focus Scale (HRFS) is a short scale which measures an individual's prev... more The Health Regulatory Focus Scale (HRFS) is a short scale which measures an individual's prevention and promotion focus in a health-specific context. The main objective of this study was to examine the psychometric properties of the newly translated German version of the HRFS. Reliability and item characteristics were found to be satisfactory. Validity of both subscales toward other psychological constructs including behavioral approach and avoidance, core self-evaluations, optimism, pessimism, neuroticism, as well as several measures of physical and mental health was shown. In addition, invariance of the measure across age and gender groups was shown. Exploratory as well as confirmatory factor analyses clearly indicated a two-factorial structure with a moderate correlation between the two latent constructs. Differences in health promotion and prevention focus between socio-demographic groups are discussed. The HRFS is found to be a valid and reliable instrument for the assessme...
Background: International studies have revealed that gay and bisexual men present more mental hea... more Background: International studies have revealed that gay and bisexual men present more mental health problems than the general male population. Furthermore, there is evidence that minority stress predicts mental health problems in gay and bisexual men. The aim of the present study is to provide initial data on mental health differences in Germany and to analyze the effect of minority stress. Methods: Mental health data on n = 1903 German gay and bisexual men and n = 958 men from a populationbased sample were assessed using a shortened version of the SCL-90-S. The mental health of the two samples was compared. Furthermore, a linear regression was conducted for the gay and bisexual sample: mental health was used as the criterion and minority stressors as predictors. Results: As compared to our population sample, gay and bisexual men demonstrated more mental health problems with a moderate effect size. In the regression, minority stress predicted mental health problems in the gay and bisexual sample. Conclusions: We observed pronounced mental health differences between gay and bisexual men versus the population sample. These differences could be at least partly due to the minority stress gay and bisexual men face. Research should focus on how to reduce and cope with minority stress.
The BSI-18 contains the three six-item scales somatization, depression, and anxiety as well as th... more The BSI-18 contains the three six-item scales somatization, depression, and anxiety as well as the Global Severity Index (GSI), including all 18 items. The BSI-18 is the latest and shortest of the multidimensional versions of the Symptom-Checklist 90-R, but its psychometric properties have not been sufficiently clarified yet. Based on a representative sample of N = 2516 participants (aged 14-94 years), detailed psychometric analyses were carried out. The internal consistency was good: Somatization α = .82, Depression α = .87, Anxiety α = .84 and GSI α = .93. Confirmatory factor analysis supported the three scales as second-order and GSI as first-order factors. The model fit based on RMSEA is good but that model fit based on CFI and TLI are too low. Therefore, it is a very short, reliable instrument for the assessment of psychological distress. The BSI-18 can be used to reliably assess psychological distress in the general population. However, further studies need to evaluate the use...
Menschen mit einer geistigen Behinderung erkranken bis zu dreimal häufiger an einer psychischen S... more Menschen mit einer geistigen Behinderung erkranken bis zu dreimal häufiger an einer psychischen Störung als die Allgemeinbevölkerung. Depressive Erkrankungen treten dabei mit einer Prävalenz von 15-20% mehr als doppelt so häufig in Erscheinung. Bislang fehlt ein Screeningverfahren zur Erfassung von Depressivität, das an die Besonderheiten von Menschen mit Intelligenzminderung angepasst ist. Die vorliegende Praktikabilitätsstudie beschreibt Defizite und notwendige Bearbeitungsgebiete sowie Verbesserungsvorschläge eines Ansatzes zur Erfassung depressiver Symptome mittels eines modifizierten Selbstbeurteilungsverfahrens, der Skala Depressivität der SCL-90®-S. Methodik: Es wurden Daten von N=11 Patienten auf der Station für Verhaltenstherapie für Menschen mit geistiger Behinderung des AWO Fachkrankenhauses Jerichow erhoben. Den Teilnehmern wurden die Items der Skala Depressivität der SCL-90®-S im Original sowie die Items einer in Bezug auf besseres Verständnis und erweiterte Unterstützungsmöglichkeiten adaptierten Version vorgelegt. Weiterhin erfolgte die strukturierte Erfassung von Verständnisschwierigkeiten der Teilnehmer und des Grades der notwendigen Unterstützung durch den Testleiter. Ergebnisse: Die Patienten waren durchschnittlich 34 Jahre alt (SD=12; 64% männlich) und zeigten einen durchschnittlichen Gesamt-IQ von 59. Die Prüfung der Praktikabilität belegte insgesamt eine gute Akzeptanz und legte Schwächen in der Umsetzung der Anpassung (Instruktion und Items) sowie in Durchführung und Auswertung offen. Die Einleitung und Darstellung des Antwortformates erwies sich als in ihrem Aufbau zu überfüllt und in einigen Fällen irritierend. Die Hinleitung zu den Items und einige Items selbst zeigten sich in einzelnen Aspekten noch zu unklar. Verbesserungsvorschläge wurden entwickelt. Diskussion: Viele Menschen mit geistiger Behinderung haben durch fehlende oder eingeschränkte Ausdrucksmöglichkeiten Probleme, sich ausreichend verständlich zu machen. Dabei kann die durch den Betroffenen erfolgende Einflussnahme auf die Einschätzung einer depressiven Symptomatik direkten Einfluss auf die Motivation für anschließende (Therapie-) Maßnahmen haben. Mit der vorliegenden Arbeit wurde ein Verfahren zur Schweregradbestimmung von Depressivität weiterentwickelt. Eine weitere Evaluation des auf Grundlage dieser Arbeit adaptierten Verfahrens wurde als logische Folge erkannt und ist in Vorbereitung.
Die Hämodialyse sichert täglich Menschen mit einem terminalen Nierenversagen das Überleben. Gleic... more Die Hämodialyse sichert täglich Menschen mit einem terminalen Nierenversagen das Überleben. Gleichzeitig belasten diese chronische Erkrankung und die daraus resultierenden Einschränkungen die Betroffenen enorm. Ziel dieser Studie war daher die Untersuchung der gesundheitsbezogenen Lebensqualität und deren Veränderung im ersten Jahr einer Hämodialyse. Material und Methode: 25 Patienten (m=14, w=11) im Durchschnittsalter von 66 Jahren (±11) bearbeiteten zu jeweils 2 Zeitpunkten (Abstand 6 Monate) das Profil der Lebensqualität chronisch Kranker (PLC) [SBJ96]. Die Durchführung erfolgte in 2 ambulanten Dialyse-Zentren in Halle an der Saale und Merseburg. Das PLC erfasst auf 6 Skalen (I Leistungsvermögen, II Genuss-und Entspannungsfähigkeit, III Positive Stimmung, IV Negative Stimmung, V Kontaktvermögen, VI Zugehörigkeitsgefühl) die somatische, psychische und soziale Ebene der Lebensqualität. Skaliert sind die Antworten von 0-4, ein hoher Wert umschreibt eine hohe Lebensqualität. Die statistische Auswertung umfasste t-Tests sowie varianzanalytische Modelle. Ergebnisse: Die Ergebnisse wurden mit den Mittelwerten der Normstichprobe [LSSB01] gesunder deutscher Testpersonen verglichen. Zu t1 zeigte sich die Lebensqualität der Dialysepatienten signifikant schlechter als die der Normstichprobe (Ausnahme war Skala VI). Zu t2 hingegen konnte kein Unterschied mehr nachgewiesen werden. Der simultane Vergleich der Mittelwerte der sechs Skalen zu beiden Erhebungszeitpunkten (t1; t2) zeigte eine deutliche Erhöhung der Werte zu t2 [F(6,13) = 11,2, p<,0001, ²=,84]. Nachgeschaltete Einzelvergleiche ergaben für die Skalen Effektstärken zwischen Cohens d = 0,68 (Skala I) und d = 0,88 (Skala IV) im mittleren bis hohen Bereich. Für die Skala VI konnte kein statistisch signifikanter Unterschied gefunden werden (p<,09). Diskussion: Für die Untersuchungsstichprobe zeigte sich im zeitlichen Verlauf eine Erhöhung der Lebensqualität. Es kann vermutet werden, dass zu Beginn der Hämodialysetherapie die körperlichen Symptome der Niereninsuffizienz nachlassen und eine Adaption an den Dialysealltag gelingt. Langzeitstudien sind notwendig um den exakten Zeitpunkt innerhalb der Dialyse zu bestimmen, an dem die Lebensqualität abermals sinkt. Dazu sollten die psychodiagnostischen Möglichkeiten in der Dialyse verbessert werden [Ba08]. Mit diesem Wissen würde es dem Dialyseteam leichter gelingen der Verschlechterung der gesundheitsbezogenen Lebensqualität entgegen zu wirken. Normwerte 50-80 J. N=759-868 T1 n=25 t-Test * p<,01 T2 n=19 t-Test * p<,01
Obesity is a widespread illness in Western industrialized countries, causing a high financial bur... more Obesity is a widespread illness in Western industrialized countries, causing a high financial burden for the health systems. Several studies could demonstrate the positive effects of bariatric surgery on psychological and psychosocial parameters. Twenty patients with morbid obesity (BMI &gt; or =40 kg/m(2)) answered two questionnaires, the SCL-90-R, assessing psychological distress, and the IIP-D, measuring interpersonal problems, before and 6 months after gastric banding. Six months after surgery an additional questionnaire measuring subjective feelings was administered, too. Seventy-five percent of the patients were dissatisfied with therapy and outcome. They reported a lack of psychological support as well as new surgery-related physical and psychological symptoms. This study pointed out the necessity for psychotherapeutic help after surgery to manage already existing or new psychological needs due to gastric banding.
Question: Comorbidity, i.e., additional psychological distress in patients already suffering from... more Question: Comorbidity, i.e., additional psychological distress in patients already suffering from chronic somatic diseases (e.g., orthopedic conditions) is of growing importance. The quality of analyzing and interpreting the often used Brief Symptom Inventory (BSI) used with orthopedic patients should improve by employing a new “case definition” of four groups (instead of two) of differentially psychologically distressed patients instead of two groups as before.Methods: Four groups with the different psychological distress definitions of “no,” “mild,” “remarkable,” and “severe” were to be analyzed from a group of 639 orthopedic patients in inpatient rehabilitation clinics. The BSI is transformed into T values (M=50, SD=10). There is “no” distress if no T [two scales] is ≥60 and “mild” distress if T [two scales] and/or T [GSI] is ≥60 and <63. If T [two scales] and/or T [GSI] is ≥63 and <70, it is “remarkable,” and if T [two scales] and/or T [GSI] ≥70, it speaks for “severe” psy...
Praxis der Kinderpsychologie und Kinderpsychiatrie, 2017
Healthy Siblings of Children with Autism Spectrum Disorders. A Mixed-methods Pilot Study Healthy ... more Healthy Siblings of Children with Autism Spectrum Disorders. A Mixed-methods Pilot Study Healthy siblings of chronically ill and/or disabled children may have an increased risk of developing behavioral problems; this is particularly given for siblings of children with Autism Spectrum Disorders (ASD). Quality of life and distress of five siblings (12-15 years) of children with ASD were examined using self- and parent-proxy-reports. Guideline-based interviews were conducted with the siblings and their parents and analyzed according to Mayring. Quality of life described by the children resembled the KINDLR´s standardized range of scores, but parents described a decreased quality of life. Both siblings and parents reported low to medium distress. Interviews revealed healthy children are asked by their parents to take responsibility for their siblings with ASD. Parents assumed their healthy children are less affected by the ASD of the sibling. The healthy siblings described being "a...
Objectives: Psychometric instruments are commonly applied in psychotherapeutic research and care ... more Objectives: Psychometric instruments are commonly applied in psychotherapeutic research and care for the baseline assessment of symptoms, the planning of therapeutic interventions, the assessment of the longitudinal course of symptoms and outcomes of therapeutic interventions as well as quality management of care. Psychometric properties as well as economic aspects should be considered in the selection of specific instruments. It is assumed that users of psychometric instruments face a great variety of instruments and related information. For that reason, it seems challenging to absorb the current knowledge and to integrate it into clinical practice and research. Thus, it is likely that well-known, established and easily accessible instruments are commonly used, while new developed instruments might not be disseminated in research and healthcare. Methods: Based on available international review models, the working group &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Psychometrics and Psychodiagnostics&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of the German College of Psychosomatic Medicine (DKPM) has developed and tested a review model specifically tailored for psychotherapeutic research and care. Results: The different steps of development, as well as the final review model based on the consensus of the working group are presented. The review model contains 6 generic terms (reliability, validity, objectivity, reference groups and aspects of application) with 21 different criteria to be assessed with 0-3 asterisks (*). The criteria are clearly operationalized and the practical use of the review model is explained and discussed. Conclusions: With the review model for the assessment of psychometric instruments a well-defined evaluation system is made available for research and clinical practice which has been developed by an expert group. The review model facilitates systematic, transparent and comparative evaluation of psychometric instruments along clearly defined criteria. It also supports the selection of psychometric instruments in research and care. Next, the working group aims at disseminating and implementing the review model as well as the application and publication of reviews for different psychometric instruments based on the review model.
Objective: The SCL-90 and the SCL-90-R are the most applied measures regarding psychological dist... more Objective: The SCL-90 and the SCL-90-R are the most applied measures regarding psychological distress. To reduce and prevent an overload to of the individuals, the Brief Symptom Inventory with 18 items (BSI-18) was developed based on the SCL-90. Since psychological disorders more frequently occur at an older age, there is a growing need for efficient instruments to measure distress in the elderly. However, the BSI-18's psychometric properties, norm values, and factorial structure have not yet been investigated in this age group. Methods: The aim of this study was to evaluate the BSI-18 in a sample of elderly people and to establish norm values for this specific population. Subsequently, demographic information and BSI-18 results were collected from a sample totaling 884 (55% female, mean age of 70.75 years, SD = 7.08, age range = 60-95 years). The questionnaire contains three six-item scales: somatization (SOMA), anxiety (ANX), and depression (DEPR), which form a general symptom index (GSI). Results: We found an acceptable to good model fit for a three-factor-model with a general GSI factor. The BSI-18's psychometric properties were satisfactory. Strict measurement invariance was shown for age and gender. Additionally, we found differences in psychological distress based on sociodemographic variables. Conclusions: These findings underline the growing need for preventive mechanisms for elderly people such as, e.g., (re)activating their social networks and strengthening their physical and psychological well-being.
Quality of life (QOL) of patients in opioid substitution treatment (OST) is increasingly being ad... more Quality of life (QOL) of patients in opioid substitution treatment (OST) is increasingly being addressed in research. However, no disease- or treatment-specific instrument is available to assess the QOL of this target population. The purpose of this project was to develop the first QOL instrument for OST patients. Focus groups with 60 OST patients were analyzed using thematic analysis to elicit key QOL themes as perceived by patients. Identified themes were developed into items and refined through pilot testing and cognitive debriefing. The resulting 82 items were tested in a large sample of OST patients (n = 577). Principal component analysis with varimax rotation was performed to explore a possible factor structure and reduce the number of items. Psychometric properties were assessed. Factor analysis revealed 6 subscales accounting for 46.1% of the variance: Personal Development, Mental Distress, Social Contacts, Material Well-being, Opioid Substitution Treatment, and Discriminati...
The Health Regulatory Focus Scale (HRFS) is a short scale which measures an individual's prev... more The Health Regulatory Focus Scale (HRFS) is a short scale which measures an individual's prevention and promotion focus in a health-specific context. The main objective of this study was to examine the psychometric properties of the newly translated German version of the HRFS. Reliability and item characteristics were found to be satisfactory. Validity of both subscales toward other psychological constructs including behavioral approach and avoidance, core self-evaluations, optimism, pessimism, neuroticism, as well as several measures of physical and mental health was shown. In addition, invariance of the measure across age and gender groups was shown. Exploratory as well as confirmatory factor analyses clearly indicated a two-factorial structure with a moderate correlation between the two latent constructs. Differences in health promotion and prevention focus between socio-demographic groups are discussed. The HRFS is found to be a valid and reliable instrument for the assessme...
Background: International studies have revealed that gay and bisexual men present more mental hea... more Background: International studies have revealed that gay and bisexual men present more mental health problems than the general male population. Furthermore, there is evidence that minority stress predicts mental health problems in gay and bisexual men. The aim of the present study is to provide initial data on mental health differences in Germany and to analyze the effect of minority stress. Methods: Mental health data on n = 1903 German gay and bisexual men and n = 958 men from a populationbased sample were assessed using a shortened version of the SCL-90-S. The mental health of the two samples was compared. Furthermore, a linear regression was conducted for the gay and bisexual sample: mental health was used as the criterion and minority stressors as predictors. Results: As compared to our population sample, gay and bisexual men demonstrated more mental health problems with a moderate effect size. In the regression, minority stress predicted mental health problems in the gay and bisexual sample. Conclusions: We observed pronounced mental health differences between gay and bisexual men versus the population sample. These differences could be at least partly due to the minority stress gay and bisexual men face. Research should focus on how to reduce and cope with minority stress.
The BSI-18 contains the three six-item scales somatization, depression, and anxiety as well as th... more The BSI-18 contains the three six-item scales somatization, depression, and anxiety as well as the Global Severity Index (GSI), including all 18 items. The BSI-18 is the latest and shortest of the multidimensional versions of the Symptom-Checklist 90-R, but its psychometric properties have not been sufficiently clarified yet. Based on a representative sample of N = 2516 participants (aged 14-94 years), detailed psychometric analyses were carried out. The internal consistency was good: Somatization α = .82, Depression α = .87, Anxiety α = .84 and GSI α = .93. Confirmatory factor analysis supported the three scales as second-order and GSI as first-order factors. The model fit based on RMSEA is good but that model fit based on CFI and TLI are too low. Therefore, it is a very short, reliable instrument for the assessment of psychological distress. The BSI-18 can be used to reliably assess psychological distress in the general population. However, further studies need to evaluate the use...
Menschen mit einer geistigen Behinderung erkranken bis zu dreimal häufiger an einer psychischen S... more Menschen mit einer geistigen Behinderung erkranken bis zu dreimal häufiger an einer psychischen Störung als die Allgemeinbevölkerung. Depressive Erkrankungen treten dabei mit einer Prävalenz von 15-20% mehr als doppelt so häufig in Erscheinung. Bislang fehlt ein Screeningverfahren zur Erfassung von Depressivität, das an die Besonderheiten von Menschen mit Intelligenzminderung angepasst ist. Die vorliegende Praktikabilitätsstudie beschreibt Defizite und notwendige Bearbeitungsgebiete sowie Verbesserungsvorschläge eines Ansatzes zur Erfassung depressiver Symptome mittels eines modifizierten Selbstbeurteilungsverfahrens, der Skala Depressivität der SCL-90®-S. Methodik: Es wurden Daten von N=11 Patienten auf der Station für Verhaltenstherapie für Menschen mit geistiger Behinderung des AWO Fachkrankenhauses Jerichow erhoben. Den Teilnehmern wurden die Items der Skala Depressivität der SCL-90®-S im Original sowie die Items einer in Bezug auf besseres Verständnis und erweiterte Unterstützungsmöglichkeiten adaptierten Version vorgelegt. Weiterhin erfolgte die strukturierte Erfassung von Verständnisschwierigkeiten der Teilnehmer und des Grades der notwendigen Unterstützung durch den Testleiter. Ergebnisse: Die Patienten waren durchschnittlich 34 Jahre alt (SD=12; 64% männlich) und zeigten einen durchschnittlichen Gesamt-IQ von 59. Die Prüfung der Praktikabilität belegte insgesamt eine gute Akzeptanz und legte Schwächen in der Umsetzung der Anpassung (Instruktion und Items) sowie in Durchführung und Auswertung offen. Die Einleitung und Darstellung des Antwortformates erwies sich als in ihrem Aufbau zu überfüllt und in einigen Fällen irritierend. Die Hinleitung zu den Items und einige Items selbst zeigten sich in einzelnen Aspekten noch zu unklar. Verbesserungsvorschläge wurden entwickelt. Diskussion: Viele Menschen mit geistiger Behinderung haben durch fehlende oder eingeschränkte Ausdrucksmöglichkeiten Probleme, sich ausreichend verständlich zu machen. Dabei kann die durch den Betroffenen erfolgende Einflussnahme auf die Einschätzung einer depressiven Symptomatik direkten Einfluss auf die Motivation für anschließende (Therapie-) Maßnahmen haben. Mit der vorliegenden Arbeit wurde ein Verfahren zur Schweregradbestimmung von Depressivität weiterentwickelt. Eine weitere Evaluation des auf Grundlage dieser Arbeit adaptierten Verfahrens wurde als logische Folge erkannt und ist in Vorbereitung.
Die Hämodialyse sichert täglich Menschen mit einem terminalen Nierenversagen das Überleben. Gleic... more Die Hämodialyse sichert täglich Menschen mit einem terminalen Nierenversagen das Überleben. Gleichzeitig belasten diese chronische Erkrankung und die daraus resultierenden Einschränkungen die Betroffenen enorm. Ziel dieser Studie war daher die Untersuchung der gesundheitsbezogenen Lebensqualität und deren Veränderung im ersten Jahr einer Hämodialyse. Material und Methode: 25 Patienten (m=14, w=11) im Durchschnittsalter von 66 Jahren (±11) bearbeiteten zu jeweils 2 Zeitpunkten (Abstand 6 Monate) das Profil der Lebensqualität chronisch Kranker (PLC) [SBJ96]. Die Durchführung erfolgte in 2 ambulanten Dialyse-Zentren in Halle an der Saale und Merseburg. Das PLC erfasst auf 6 Skalen (I Leistungsvermögen, II Genuss-und Entspannungsfähigkeit, III Positive Stimmung, IV Negative Stimmung, V Kontaktvermögen, VI Zugehörigkeitsgefühl) die somatische, psychische und soziale Ebene der Lebensqualität. Skaliert sind die Antworten von 0-4, ein hoher Wert umschreibt eine hohe Lebensqualität. Die statistische Auswertung umfasste t-Tests sowie varianzanalytische Modelle. Ergebnisse: Die Ergebnisse wurden mit den Mittelwerten der Normstichprobe [LSSB01] gesunder deutscher Testpersonen verglichen. Zu t1 zeigte sich die Lebensqualität der Dialysepatienten signifikant schlechter als die der Normstichprobe (Ausnahme war Skala VI). Zu t2 hingegen konnte kein Unterschied mehr nachgewiesen werden. Der simultane Vergleich der Mittelwerte der sechs Skalen zu beiden Erhebungszeitpunkten (t1; t2) zeigte eine deutliche Erhöhung der Werte zu t2 [F(6,13) = 11,2, p<,0001, ²=,84]. Nachgeschaltete Einzelvergleiche ergaben für die Skalen Effektstärken zwischen Cohens d = 0,68 (Skala I) und d = 0,88 (Skala IV) im mittleren bis hohen Bereich. Für die Skala VI konnte kein statistisch signifikanter Unterschied gefunden werden (p<,09). Diskussion: Für die Untersuchungsstichprobe zeigte sich im zeitlichen Verlauf eine Erhöhung der Lebensqualität. Es kann vermutet werden, dass zu Beginn der Hämodialysetherapie die körperlichen Symptome der Niereninsuffizienz nachlassen und eine Adaption an den Dialysealltag gelingt. Langzeitstudien sind notwendig um den exakten Zeitpunkt innerhalb der Dialyse zu bestimmen, an dem die Lebensqualität abermals sinkt. Dazu sollten die psychodiagnostischen Möglichkeiten in der Dialyse verbessert werden [Ba08]. Mit diesem Wissen würde es dem Dialyseteam leichter gelingen der Verschlechterung der gesundheitsbezogenen Lebensqualität entgegen zu wirken. Normwerte 50-80 J. N=759-868 T1 n=25 t-Test * p<,01 T2 n=19 t-Test * p<,01
Obesity is a widespread illness in Western industrialized countries, causing a high financial bur... more Obesity is a widespread illness in Western industrialized countries, causing a high financial burden for the health systems. Several studies could demonstrate the positive effects of bariatric surgery on psychological and psychosocial parameters. Twenty patients with morbid obesity (BMI &gt; or =40 kg/m(2)) answered two questionnaires, the SCL-90-R, assessing psychological distress, and the IIP-D, measuring interpersonal problems, before and 6 months after gastric banding. Six months after surgery an additional questionnaire measuring subjective feelings was administered, too. Seventy-five percent of the patients were dissatisfied with therapy and outcome. They reported a lack of psychological support as well as new surgery-related physical and psychological symptoms. This study pointed out the necessity for psychotherapeutic help after surgery to manage already existing or new psychological needs due to gastric banding.
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Papers by Gabriele Helga Franke