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Biomedical subjects

Elmar Brähler

Publications and source records attributed to Elmar Brähler.

At least 55 records · Page 3Linked to original sources
PubMed2003

[The psychometric quality of the Nottingham Health Profile (NHP) in the general population].

The Nottingham Health Profile (NHP) is a questionnaire that assesses health related quality of life. The aim of this paper is to test the psychometric quality of the instrument based on a subject sample which is representative for the German population. The sample consisted of 1996 persons with ages between 18 and 92 years. They were asked to fill in several questionnaires including the NHP. The results show that the NHP does not differentiate between subjects in the range of low and medium levels of complaints. Only one half of the subject sample agreed to at least one of the 38 items. All six subscales showed significant age and sex effects which were proved with nonlinear regression analyses. The validity was assessed through correlations with other health related questionnaires. It can be concluded that the use of the NHP cannot be recommended when studies in the general population are conducted.

Adult↗
PubMed2003

[Attitudes towards professional euthanasia in the range between grement in the society and personal preferences--results of a representative examination of the German general population].

Several surveys of the German population concerning the attitude towards euthanasia in patients with terminal illness yielded contradictory results, ranging from high acquisition to high refusal rates. After a critical discussion of the methodological concepts of these investigations, we present the results of a representative study of 1957 German persons (age range: 14 - 96 years) which was performed by the institute USUMA in February 2001. Four different types of euthanasia were included in the study: active, passive, and indirect euthanasia as well as physician's assisted suicide. The affirmative response categories were "declared will and unbearable pain", "declared will", "referred will", and "in the responsibility of the physician". Additionally, we asked to state the personal preference in the case of an own incurable illness. The resulting frequency distributions stress the autonomy of the patients (declared will) and the legal forms of professional euthanasia (passive and indirect euthanasia), independent from the degree of pain. The rank order of the hypothetic personal preferences was: passive euthanasia (26.1 %), active euthanasia (21.1 %), indirect euthanasia (13.1 %) and assisted suicide (6.2 %). For each category the hypothetic personal will to utilize euthanasia personally is markedly lower than the consent to legalize euthanasia in the society. This points to a diminished readiness of the population to seek for euthanasia. Persons aged 60 years and above deny all types of euthanasia significantly more often than younger persons. Persons with subjectively bad health status prefer the category "in the responsibility of the physician" more often than healthy subjects. The representative study proves that there is no polarized public opinion concerning euthanasia, rather there is a picture of high complexity.

Adolescent↗
PubMed2003

[Psychosomatic and medical psychology: shift and drift of the publication practice of the academic representatives].

The publication practice of the medical-psychological and psychosomatic chairs was the subject of a systematic investigation for the period 1992-1996 in this journal. The background was the discussion about quality and qualification of the academic newcomers. Now, most of the German university medical schools spend the budget--among other criteria--in accordance with the publication practice of the academic representative and their coworkers. The question arises, whether and how the chairs have changed their publication practice in comparison for the period 1998-2002.

Bibliometrics↗
PubMed2002

[Representative survey of german people concerning enlightenment and patient directive in a case of terminal illness].

The basic principles dealing with euthanasia (1998) as expressed by the German Association of Doctors states that in advance written directives are of "substantial help for the doctor in his or her actions". This requires, however, wide proliferation of patient directives. Hence it was important to ascertain the prevalence of such directives in the German population, as well as the relationship to the wish for enlightenment in terminal illness and diseases in their final stages. This was accomplished in December 1998 using 2050 people obtained with the Random-Route-Procedure (1024 from the new German states, 1013 from the old German states). The sample was obtained from the opinion research institute USUMA with ages ranging between 14 - 92. The main results from this representative survey represent an important record of the status quo with respect to opinion shaping of patient autonomy. 16 % of this survey expressed the wish not to be fully enlightened in the case of a terminal illness or they wished for a clarification to be given to the family only. This result shows that part of the population still holds on to their right of no knowledge. 59.1 % expressed the wish for a complete and immediate enlightenment. The other 24.9 % desired a careful step-by-step presentation of information. The high percentage of those who desired information and enlightenment is in contradiction to the small 2.5 % of patients who have actually written advance directives. These empirical results are consistent with the clinical experience of many doctors and represents the decision of the "representational" doctors for the current ethical regulation of patient directives as an ideal idea. Since 71.9 % of those surveyed had never before thought about this issue conclusions are drawn regarding patient consultations. Gender and East/West differences are also shown.

Adolescent↗
PubMed2002

[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].

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.

Adult↗
PubMed2002

[Recalled parental rearing and the wish to have a child - are there associations?].

The present study concerns the impact of recalled parental rearing behaviour on both the intensity of the wish to have a child and on different motives to have a child. Until now there are no empirical studies as to this objective. Our study is based on a representative sample of 1509 persons aged 18 to 50 years. The statistical analyses were restricted to those subjects who lived in partnership and reported an actual wish to have a child (n = 331). The data were assessed by self-reporting scales: The Questionnaire of Recalled Parental Rearing Behaviour "Fragebogen zum erinnerten elterlichen Erziehungsverhalten, FEE", the Partnership Questionnaire "Partnerschaftsfragebogen, PFB", and the Leipzig Questionnaire of Motives to Have a Child "Leipziger Fragebogen zu Kinderwunschmotiven, LKM". A recalled parental rearing behaviour, which was characterized as having been rejective, overprotective and less emotionally warm was associated with such motives which do not promote the wish to have own children (fear of personal restrictions and a low degree of social support). Simultaneously, a negative parental rearing behaviour was correlated with a stronger desire for social recognition by an own child. The recalled maternal rearing behaviour was altogether stronger associated with motives to have a child than the paternal. On the other hand, no relevant associations could be found between the recalled parental rearing behaviour and the intensity of the wish to have a child.

Adolescent↗
PubMed2002

[The demand for integrative approaches in psychotherapy research demonstrated in an bibliometrical and speech statistic analysis of the 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.

Attitude of Health Personnel↗
PubMed2002

[Somatoform complaints in the German population].

The study presents the subjective responses of a representative sample of the German population (2050 subjects, aged 14 to 92 years) on the prevalence of somatoform complaints, using the SOMS (Screening for somatoform disorders) developed by Rief et al. (1997). The results show that somatoform disorders are widespread in the German population. The symptoms named most frequently were pains in the back, aching limbs, pains in the arms or legs, headaches, facial pains and sensations of fullness in the stomach. Women named more somatoform complaints than men and elderly suffered more than the young. The higher rate found in East Germany could be accounted for by the responses of the East German women. Of particular economic and political relevance is the health care utilization behaviour of this group of patients. High medical consultation frequencies and increasing drug consumption were found for a significant proportion of all patients with somatoform disorders. In apparent contradiction to these findings is the classification according to DSM-IV and ICD-10, which diagnose somatoform disorders in only 0.2%-0.4% of the population. Such low prevalence can be attributed to the restrictive diagnostic criteria applied by these systems which obscure the real frequency of somatoform syndromes requiring specific treatment.

Adolescent↗
PubMed2002

[Change in reproductive behavior in Germany compared with the rest of Europe].

When the processes involved in the decline of the birth rate are analysed very often no distinction is made between voluntary and involuntary childlessness. The article presents a comparative overview of the international development of fertility and highlights the consequences of this development in Europe. In the second part of this article the development of the birth rate in Germany and its consequences are discussed.

Adult↗
PubMed2000

[Testing and validation of the 26-Item Toronto Alexithymia Scale in a representative population sample]

This paper presents the authorized German version of the 26-item Toronto alexithymia scale (TAS-26). Due to the fact, that the revised version of this questionnaire (TAS-20) displays low reliability concerning the scale "external oriented thinking" in the German version, we decided to reinvestigate all TAS-26 items. In a representative sample of the German population (N=2047), the four factor structure of the original version could be reproduced and reliabilities for the four scales as well as for a pooled 5th scale (scales 1 to 3) varied satisfyingly between r=.67 to r=.84. TAS-scale no. 4 "reduced daydreaming" correlated negatively with other TAS scales in this German version also, so we can not recommend to use this construct for the study of alexithymia. Scale values proved to be independent from age and sex, whereas a clear relation with education could be detected: persons with low education scored high on alexithymia scales. To validate the German version of the TAS-26, a mood questionnaire and a body experience questionnaire were used. It could be shown that high alexithymia scores were associated with negative body image and undesirable emotions. It is discussed whether the latter correlation is due to a methodological artefact, since persons with high alexithymia scores tend to prefer middle categories of the mood questionnaire.

Journal Article↗
PubMed2000

[Utilization of the health system and acceptance of psychosocial professionals]

The study presents the results of a representative survey on the utilization of the health system and subjective attitudes to the psychosocial professions, based on the responses of 2179 subjects aged 16 to 96 years. The residents of Germany frequently seek medical and non-medical help in cases of illness or health-related problems. General practitioners are consulted most of all, but medical specialists also play a significant role. Women seek professional help more than men and the demand increases with age. Comparisons between West and East Germany reflect a few persistent qualitative differences. Doctors from the psychosocial fields (psychotherapists, psychiatrists) are consulted least of all. Utilization of psychotherapy is deficient, information about the existence of the psychosocial professions is poor and acceptance of their competence relatively low. However, the high proportion of those who have sought out a psychotherapist on the advice of a doctor demonstrates the high latent readiness to accept help in this field when needed. The particular responsibility of primary doctors in influencing attitudes here is thereby underlined.

Journal Article↗
PubMedDate not supplied

Alexithymia in the elderly general population.

Alexithymia was investigated in a random population sample of 566 people over 60 years of age (average, 69.73 years; range, 61 to 95 years) with the help of a German version of the Toronto Alexithymia Scale (TAS-26), and the results were compared with those from a group of 1,481 people under 60 years of age (average, 38.86 years; range, 14 to 60 years). The average alexithymia values in the elderly were not significantly higher than those of the younger subjects under 60 years of age. A total of 15.2% of the elderly and 18% of the younger group registered more than 1 SD over the mean value of all those sampled. This difference is also not statistically significant. Levels of alexithymia were not associated with age, gender, or education in the over-60 groups. The alexithymia scales "difficulties with identifying feelings" and "difficulties with describing feelings" correlated significantly with negative mood and negative body experience. These results confirm the assumption that there is a connection between alexithymia and depression, and correspond to the findings of other studies, that alexithymia is associated with a tendency to psychosomatic illness.

Adolescent↗
PubMedDate not supplied

[The German short version of the interpersonal guilt questionnaire--Validation in a population-based sample and clinical application].

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".

Adolescent↗
PubMedDate not supplied

[Perceived parental rearing behaviour and adult attachment patterns in intimate relationships].

Based on the assumption that the parental rearing behaviour recalled by adults can be conceptualized as a specific mental representation of attachment, the study examines the associations between these rearing-related memories and adult attachment patterns in intimate relationships. The data for this study were obtained from a large community-based sample of the German population (1509 subjects between the ages of 18 and 50 years). Both, the perceived parental rearing behaviour and the adult attachment patterns have been assessed via questionnaires (Questionnaire of Recalled Parental Rearing Behaviour [Fragebogen zum erinnerten elterlichen Erziehungsverhalten, FEE] and Bielefeld Partnership Expectations Questionnaire [Bielefelder Fragebogen zu Partnerschaftserwartungen, BFPE]). As the result of the study it could be shown that a secure adult attachment pattern in intimate relationships is associated with a parental rearing behaviour that has been perceived as positive, while on the other hand insecure attachment patterns are rather associated with more negative experiences of parental rearing.

Adolescent↗
PubMedDate not supplied

[The Adult Attachment Scale (AAS) - psychometric evaluation and normation of the German version].

Based on conceptualizations and assessment instruments of adult attachment research, the development of the adult attachment scale is outlined. The AAS scale is a self report instrument reflecting attachment-related attitudes. The dimensional scales of the AAS assess to what extent a person feels close to his partner, to what extent he is able to rely on others, and how much someone is afraid of losing an intimate partner. The German version of the AAS was normed in a representative study and its psychometric properties were investigated. The reliability of all scales was satisfactory (alpha = 0.72 - 0.79), however, the scale structure only acceptable. Thus, the current version might be integrated in studies to analyze the convergence of adult attachment measures. Findings on the convergent and discriminant validity of the scales (sociodemographic data, the SOC-S, the HADS-D, the SOMS and the Whiteley-Index were included) suggest a high prognostic relevance of the scales in the fields of health psychology and psychosomatics.

Adult↗
PubMedDate not supplied

[How useful is the calculation of total scores for questionnaires concerning health related quality of life?].

Questionnaires for health related quality of life generally comprise several subscales. These subscales can be summarized into a total score. The aim of this article is to test the justification of such an integration from a statistical point of view. By means of a representative sample of the German population (n = 1981) the correlative relationships among six questionnaires are assessed: NHP, EORTC QLQ-C30, HADS, MFI-20, GBB-24 and Whiteley index. The corrrelations between the total scores are markedly higher than the mean correlations among the subscales between the tests. Even in those cases where the subscales share the same subdimension the correlations are not higher than the correlations between these subscales and the (unspecific) total scores. The advantage of sharing a common area is as great as the disadvantage of the lower number of items. By means of the Spearman-Brown formula the relationship between the number of items and the reliability of the scale is discussed in detail. It can be concluded that the calculation of total scores is useful and justified from a statistical perspective.

Algorithms↗