Why are some cases not on track? An item analysis of the Assessment for Signal Cases during inpatient psychotherapy.

Within the Routine Outcome Monitoring system "OQ-Analyst," the questionnaire "Assessment for Signal Cases" (ASC) supports therapists in detecting potential reasons for not-on-track trajectories. Factor analysis and a machine learning algorithm (LASSO with 10-fold cross-validation) were applied, and potential predictors of not-on-track classifications were tested using logistic multilevel modeling methods. The factor analysis revealed a shortened (30 items) version of the ASC with good internal consistency (α = 0.

[The OPD conflict questionnaire].

Unlabelled: The OPD conflict questionnaire Background: To date, no self-report measure is available to assess modes of coping with unconscious conflicts according to Operationalized Psychodynamic Diagnosis (OPD). The OPD conflict questionnaire (OPD-CQ) developed here thus intends to close this gap.

Methods: To select the items for the OPD-CQ, expert ratings and psychometric criteria based on a sample of 534 persons were combined.

Facial Behavior During an Attachment Interview in Patients With Complicated Grief.

The present study investigated differences in various aspects of facial behavior among female patients with complicated grief (CG; n = 18) and healthy controls (n = 18) during the assessment of their attachment representation using the Adult Attachment Projective Picture System. All patients were classified with an unresolved attachment status. On a behavioral level, they demonstrated longer gazing behavior away from the interviewer and the picture stimuli, more speech pauses, less smiling toward the interviewer, and more crying, especially in response to stimuli portraying the theme of loss.

[Development of a 12-item version of the OPD-Structure Questionnaire (OPD-SQS)].

Objectives: Screening for personality dysfunction is relevant to treatment planning in psychotherapy, psychosomatic medicine and psychiatry. This makes short versions of field-tested approaches such as the OPD Structure Questionnaire (OPD-SQ) necessary.

Methods: With the aim of developing a screening version, the original sample of the OPD-SQ was divided into two subsamples.

[The OPD structure questionnaire captures the general features of personality disorder].

Introduction: The alternative DSM-5 model of personality disorder (PD) links general criteria and severity of PD to impairments in self and interpersonal functioning. This approach is very similar to the Level of Structural Impairment Axis of the Operationalized Psychodynamic Diagnosis (OPD-2). In this study we investigate the relationship of these 2 approaches based on 2 new self-report questionnaires.

Extreme deviations from expected recovery curves and their associations with therapeutic alliance, social support, motivation, and life events in psychosomatic in-patient therapy.

Objectives: Within the clinical support tools (CST) of the OQ-Analyst, the "Assessment for Signal Cases" (ASC) evaluates the therapeutic alliance, social support, motivation, and life events. We investigated whether the ASC covers domains of importance in treatment weeks with extreme deviations from expected recovery curves (ERCs).

Methods: Psychosomatic in-patients were monitored weekly with the ASC and the "Outcome Questionnaire" (OQ-45).

Providing patient progress feedback and clinical support tools to therapists: is the therapeutic process of patients on-track to recovery enhanced in psychosomatic in-patient therapy under the conditions of routine practice?

Objectives: In previous studies of patients on-track to recovery (OT) involving therapists receiving only patient progress feedback without clinical support tools (CST) inconsistent results were found. Possible effects of combining patient progress feedback with CST on OT patients remain unclear.

Methods: At intake (t1), 252 patients of two in-patient psychosomatic clinics were randomized either into the experimental group (EG) or the treatment-as-usual control group (CG).

Feedback on patient progress and clinical support tools for therapists: improved outcome for patients at risk of treatment failure in psychosomatic in-patient therapy under the conditions of routine practice.

Objectives: Although psychosomatic in-patient treatment is effective, 5-10% of the patients deteriorate. Providing patient progress feedback and clinical support tools to therapists improves the outcome for patients at risk of deterioration in counseling, outpatient psychotherapy, and substance abuse treatment. This study investigated the effects of feedback on psychosomatically treated in-patients at risk of treatment failure.

[Changes in self-referent emotions during inpatient psychotherapy: the role of mindfulness and acceptance].

Objectives: Current theoretical and clinical approaches conceive the avoidance and acceptance of emotions as critical factors in the maintenance and alleviation of psychological problems. This study investigates the role of mindfulness, experiential avoidance (EA), and positive and negative meta-emotions (emotional reactions towards the emotional self) on the symptoms and psychological well-being of inpatients.

Method: Changes of mindfulness measured during a 6-week stay at a psychosomatic clinic were explored in a sample of 293 inpatients with diverse psychological problems.

[Functional-aesthetic rhinosurgery patients: psychometric parameters].

Background: The aim of this study was to acquire psychometric parameters in patients desiring functional-aesthetic nasal surgery.

Material And Methods: Over a 1-year period, 101 patients were consecutively examined at the ENT department of the University of Ulm. Septoplasty or septorhinoplasty was indicated in all cases.

[Psychometric analysis of the Turkish speaking version of the "Hamburg Modules for the Assessment of Psychosocial Health" (T-HEALTH-49)].

Based on the German original questionnaire of the "Hamburger modules for measuring generic aspects of psycho-social health in the therapeutic practice" (HEALTH-49) a Turkish speaking version (T-HEALTH-49) was cross-cultural sensitively developed. The psychometric properties have been analysed by means of a clinical sample of Turkish speaking patients (N=311). The questionnaire proves to be practical, the dimensional structure and the relatively independence of the modules have been confirmed by factor analysis.

[The clinical relevance of defense mechanisms in inpatients and outpatients].

Objectives: How clearcut is the clinical significance of mature and immature defense mechanisms in psychological symptoms?

Methods: Defense mechanisms, symptoms and well-being were assessed in 293 inpatients, 316 outpatients and 157 students.

Results: The factors "mature defense" and "immature defense" predict well-being/symptoms to a substantial degree.

Discussion: The assessment of defense mechanism via self-report is clinically useful.

[First results on the reliability and validity of the OPD-2 axis structure].

Objectives: In 2006, the manual of the Operationalized Psychodynamic Diagnostics (OPD) was revised and published in its second edition (OPD-2; Arbeitskreis OPD2006). In particular the axis structure was markedly changed. This study assessed the interrater reliability and validity.

[Neurotic conflict systematics--the fundamentals of conflict diagnostics (OPD-2)].

Objective: Although a majority of psychodynamic-psychoanalytic researchers and practitioners address the issue of psychic structure, reevaluation of the nature of a neurotic conflict system and its relation to psychic structure is necessary.

Results: A comprehensive conflict system is presented in the context of operative psychodynamic diagnostics (OPD-2), based on findings confirmed thus far. The conflict levels range from conflict tension to neurotic conflicts to conflict schemata in structural disturbances.

[New diagnostic alternatives for dysfunctional relationships: the relationship axis of the OPD-2].

As a part of the new version of Operationalized Psychodynamic Diagnosis (OPD-2), the relationship axis is introduced which was developed on the basis of research and clinical work with the OPD-1. It provides a procedure indicating dysfunctional relationship patterns. The new version is characterized by the following qualities: The relationship axis is based more consequently on the circumplex model of interpersonal behaviour.

[The burn-out syndrome and restoring mental health at the working place].

This paper reviews the scientific concepts and the clinical aspects of the burn-out syndrome. According to recent studies, up to 25 % of the German working population appear to suffer from what the Amercan physician and psychoanalyst, Herbert Freudenberger, has designated in 1974 as "burn-out syndrome". Characteristic features of this syndrome are emotional exhaustion, depersonalization and low personal accomplishment.

[The connection between affective evaluation of recollected relationship experiences and the severity of the psychic impairment].

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.

[Mastery of conflictual relationship patterns in the course of a psychodynamic focal therapy].

Mastery is a psychological construct rooted in the psychodynamic psychotherapy research. The Mastery Scale provides a reliable content analytic method to measure the mastery of maladaptive interpersonal conflicts. With the help of model-sentences verbatim transcripts of relationship episodes are assessed regarding to six hierarchical so-called levels: lack of impulse-control, introjection and projection of negative emotions, difficulties in understanding and cognitive control, interpersonal consciousness, understanding of the self and self control.

Long-term morbidity following axillary dissection in breast cancer patients--clinical assessment, significance for life quality and the impact of demographic, oncologic and therapeutic factors.

Objective: This study describes in detail the surgery-related symptoms following axillary lymph node dissection in breast cancer patients and considers both their significance for long term quality of life and the impact of possible influencing factors.

Material And Methods: Three hundred and ninety six patients were studied retrospectively using a self-report questionnaire and a clinical examination. The symptoms, numbness, pain, edema, arm strength and mobility were evaluated.

Stereotypical relationship patterns and psychopathology.

Background: We explored the relationship between the consistency of relationship patterns and the severity of psychopathology.

Method: Relationship patterns were assessed by means of Relationship Anecdote Paradigm interviews rated according to the Core Conflictual Relationship Theme (CCRT) method. The repetition of the same type of CCRT components across relationship narratives indicated stereotypical patterns.

[The core conflictual relationship theme of core relationship patterns. A further methodology-critical development of the "core conflictual relationship theme" method].

The Core Conflictual Relationship Thema Method (CCRT) by Lester Luborsky is based on the analysis of narratives about relationship episodes within transcripts of therapy sessions. Wishes, responses of the other and responses of the self are identified and counted. The critical explanation with the CCRT-Method conducted to alternative methods of data analysis.

[DKPM basic documentation. A uniform basic documentation for inpatient psychosomatic treatment and psychotherapy].

The Arbeitsgemeinschaft Basisdokumentation presents the DKPM-Basisdokumentation, which is conceptualized as a uniform modul of a documentation system for the routine-like use in the in-patient psychosomatic and psychotherapy. We outline possibilities of use, aspects of the data security and the data access as well as some practical presuppositions.

[Application of the Relationship Episodes Interview].

The Core Conflictual Relationship Theme (CCRT) is a content analytic assessment developed by Luborsky that uses narratives about relationship episodes with significant others as data base to identify repetitive relationship patterns that appear in individual behavior. Luborsky's Relationship Anecdotes Paradigm (RAP) Interview for which we introduced the German expression Relationship Episodes-Interview (RE-Interview) is a method for eliciting relationship episodes independently from therapy. In this paper we give an introduction into the practice and into the possible applications of this interview form according to the experiences the Ulm CCRT-group made with the instructions of Luborsky.