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H J Grabe

Publications and source records attributed to H J Grabe.

18 recordsLinked to original sources
PubMed2002

[The "AMDP-rating scale for obsessive-compulsive symptoms": The 2nd version].

The "Association of Methodology and Documentation in Psychiatry" (AMDP) has developed the 2nd version of a new observer-rated scale for a quick and precise assessment of obsessive-compulsive symptoms. The first version of the scale comprised 20 items on the dimensions "description", "distress and impairment" and "emotion and cognition". The item pool of the 2. version was enlarged to 44 items to accomplish a differentiated assessment of obsessions and compulsions and to assess the associated passive avoidance behaviour. The results of an empirical study (n = 141) demonstrated excellent internal consistency (Cronbach's alpha = 0,93), a split-half reliability of 0,83 (Spearman-Brown), a test-retest reliability of r = 0,84, a high interrater-reliability, a high differential validity and good convergent validity with the Hamburger Zwangsinventar (HZI) and the SCL-90-R. The results are presented and their implications on the final steps of the development of the scale will be discussed.

Adult↗
PubMed2001

Lifetime-comorbidity of obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in Northern Germany.

OBJECTIVE: Inspite of the worldwide relevance of obsessive-compulsive disorder (OCD), there is a substantial lack of data on comorbidity in OCD and subclinical OCD in the general population. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years, living in a northern German region. RESULTS: In both genders, high rates of comorbid depressive disorders were found in OCD and subclinical OCD, whereas somatoform pain disorder was only associated with OCD. In female subjects, OCD was additionally associated with social and specific phobias, alcohol, nicotine and sedative dependence, PTSD and atypical eating disorder. CONCLUSION: Due to low comorbidity rates, subclinical OCD seems to represent an independent syndrome not restricted to the presence of other axis-I diagnoses. Comorbidity patterns show a disposition to anxiety and to depressive disorders in OCD and subclinical OCD. A broad association with obsessive-compulsive spectrum disorders could not be confirmed in our general population sample.

Adult↗
PubMed2001

Neurotrophic factor S100 beta in major depression.

Disturbances in the serotonergic system are considered to be implicated in the pathophysiology of depressive disorders. The possible role of the neurotrophic factor S100 beta, which is suspected to regulate regeneration of serotonergic synapses, has not been investigated in depressive disorders. The S100 beta concentration in the cerebrospinal fluid was measured in 11 patients with the current diagnosis of mild or moderate depressive episodes (DSM-IV) and in 11 matched control patients. Using the t test for paired samples, the presence of a depressive episode was significantly associated with an elevation of the cerebrospinal fluid concentration of S100 beta (t = 2.6, d.f. = 10, p = 0.024). Replications of this finding in severely depressed patients are necessary to confirm the association between neurotrophic factor S100 beta and depressive disorders.

Adult↗
PubMed2000

Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany.

BACKGROUND: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years living in a northern German region. Specific DSM-IV based criteria for subclinical OCD were used. RESULTS: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. CONCLUSION: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.

Adolescent↗
PubMed2000

Symptoms of eating disorders in obsessive-compulsive disorder.

OBJECTIVE: Despite some empirical evidence suggesting an association between primary OCD and eating disorder (ED) within the 'obsessive-compulsive spectrum', the relationship at a symptomatological level has not been investigated. METHOD: First, comparisons of Eating Disorder Inventory (EDI) scores between 61 patients with primary OCD and 288 control subjects were performed. Secondly, the associations between EDI subscores and Hamburg Obsessive-Compulsive Inventory (HZI) dimensions in OCD patients were investigated by multiple regression analyses, controlling for the impact of general psychopathology. RESULTS: The OCD patients showed significantly higher EDI-scores than controls. However, only distinct OCD symptom dimensions were significantly associated with the core symptoms of ED in females. CONCLUSION: Our results point to a differential gender and symptom-specific relationship between OCD and ED, calling into question a simple dimensional conceptualization of the 'obsessive-compulsive spectrum'.

Adult↗
PubMed1999

Dissociative experiences and psychopathology in conversion disorders.

The concepts of dissociation and conversion are historically linked with the first psychodynamic ideas on hysteria. However, the abolition of "hysterical neurosis" from current nosology has led to independent developments of these theoretical models. Recent studies found a high degree of somatization in dissociative disorders. However, little is known about dissociation in conversion disorders. We assessed 72 patients with conversion disorders for their dissociative and general psychopathology using the German version of the Dissociative Experience Scale (DES) and the Symptom Check List (SCL-90-R). They were compared with a control group of 96 psychiatric patients suffering from various neurotic disorders, who were matched for gender and age. Dissociative symptoms were significantly more frequent in conversion disorder patients than in controls. There were no differences in the SCL-90-R scores between the two groups. Our findings support the theory of similar psychological processes underlying conversion and dissociative disorders despite their descriptive differences.

Adult↗
PubMed1999

The influence of clozapine and typical neuroleptics on information processing of the central nervous system under clinical conditions in schizophrenic disorders: implications for fitness to drive.

The present study investigates the psychomotor performance of schizophrenic inpatients receiving neuroleptic medication and comedication according to their clinical demands in regard to their fitness to drive. The hypothesis was tested that even under polydrug medication, the clozapine-treated patients (n = 10) would have a superior performance compared to the patients taking classical neuroleptics (n = 18). The data were collected by technical equipment (Act and React Testsystem) measuring reaction time, vigilance, visual perception and stress tolerance. The patients' driving ability turned out to be equally impaired in both treatment groups; 11% of the patients passed all tests without major impairment; 32% of the patients showed some impairments that required individual evaluation of their driving ability; 57% were considered to be severely impaired and driving could not be recommended. Except for one test, no significant group differences in psychomotor reaction performance were obtained. These results are discussed concerning limitations and consequences.

Adult↗
PubMed1999

Relationship of dissociation to temperament and character in men and women.

OBJECTIVE: This study approaches the question of nature and nurture of dissociative phenomena. Within Cloninger's concept of personality, character traits are thought to develop in response to environmental stimuli and conditions during childhood and adolescence, whereas temperament traits are considered to be genetically predisposed. The hypothesis is tested that dissociative symptoms are associated with distinct character traits but not with temperament dimensions. METHOD: Psychiatric patients (N = 191) and healthy subjects (N = 41) were evaluated for dissociative symptoms (Dissociative Experience Scale), temperament and character (Temperament and Character Inventory), and current psychopathology (SCL-90-R). Regression analyses for women and men were calculated separately. RESULTS: For both genders, the character traits of self-transcendence and self-directedness were significant and independent predictors for dissociation. CONCLUSIONS: These results support the hypothesis that dissociative symptoms are caused by environmental factors and point against a genetic predisposition in the development of dissociative symptoms.

Adolescent↗
PubMed1999

[Not Available].

This review summarizes from biological research in obsessive-compulsive disorder. In particular, functional brain imaging studies investigating the effects of Symptom provocation, of behavioral and pharmacological treatment on brain activity and findings from neurochemical studies are presented with regard to the serotonergic System. We discuss a neurobiological model integrating the findings from brain imaging, functional anatomy and behavioral concepts which favors a functional imbalance within the orbitofrontal - basal ganglia - thalamus ciruit and focus on hypothesis for further research.

Functional anatomy↗
PubMed1999

[Not Available].

Though the use of elaborated and standardized behavioral therapy strategies has been successful in treatment evaluation and in areas of neurobiological research, numerous psychoanalytically orientated therapists will exhibit fear and avoidance behavior while facing terms like "standardization", "treatment evaluation studies" and "neurobiology". In our comment, we aim to initiate a successful therapeutic process by intensified reality testing and repeated exposure therapy.

Neurobiology↗
PubMed1999

[Organization of telephone counseling for psychosocial emergencies. An evaluation after 12 months].

OBJECTIVE: To improve the community-based health care in the area of Bonn a telephone consulting service and a mobile crisis intervention service have been established during a two year pilot project. The regional needs and structural demands have been assessed. RESULTS: During the first 12 months the number of calls increased from 15 in November 1996 to 76 in October 1997. In all, 432 calls were received. Most calls lasted from 10 to 30 minutes. 89% of the callers were female, 77% were in the age range between 30 and 45 years. Two-thirds of the callers had prior psychiatric treatments. Most callers suffered from loneliness and deficient coping strategies. CONCLUSION: The prove regional demands have led to a continuation of the project and an extension of the mobile crisis intervention service.

Adult↗
PubMed1998

[Development of the AMDP module for identification of obsessive- compulsive symptoms. Conceptualization and empirical results].

Results of epidemiology and comorbidity studies have recently demonstrated the psychopathological relevance of obsessive-compulsive symptoms. Therefore the "Arbeitsgemeinschaft für Methodik und Diagnostik in der Psychiatrie" (AMDP) has started to develop a rating scale for a quick and precise assessment of obsessive-compulsive symptoms. The actual version of the scale comprises 20 items on the dimensions "description", "distress and impairment" and "emotion and cognition". The results of a first empirical study (n = 137, psychiatric in- and outpatients) demonstrated excellent internal consistency (Cronbach's alpha = 0.92), a split-half reliability of 0.89 (Spearman-Brown), a test-retest reliability of r = 0.86 and good convergent validity with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Hamburger Zwangsinventar (HZI). The factor-analytical distribution of the 20 items revealed a 4-factor structure of the scale. The results are presented and their implications on further steps of the development of the scale are discussed.

Adult↗
PubMed1998

The influence of polypharmacological antidepressive treatment on central nervous information processing of depressed patients: implications for fitness to drive.

Antidepressive medication may cause impairment of psychomotor functioning relevant to psychosocial adaptation and fitness to drive. This impairment seems to be less severe by activating antidepressants (SSRI, MAOI). In clinical settings, however, polypharmacological treatment of depressive disorders is frequent. This study evaluates the influence of antidepressants and common comedications on central nervous information processing concerning the ability to drive. Inpatients (n = 44) with major depression (ICD-10) were investigated under steady state plasma level condition. The data were recorded by the Act & React Testsystem ART-90 and analyzed according to medication, severity of illness and age. 88.6% of the patients failed to pass all the tests. With respect to different groups of antidepressants, no differences in psychomotor reaction performance were observed in polydrug treatment. The impact of these results on the patients' fitness to drive is discussed.

Adult↗
PubMedDate not supplied

The relationship between dimensions of alexithymia and dissociation.

BACKGROUND: The study investigated the following hypotheses: (1) Alexithymia is significantly associated with dissociation. (2) Pathological versus nonpathological dissociation is associated with alexithymic traits. METHODS: Psychiatric in- and outpatients (n = 173) and nonclinical subjects (n = 38) were investigated with the Toronto Alexithymia Scale (TAS-20), the FDS (German version of Dissociation Experience Scale) and the Symptom Check List (SCL-90-R; GSI). Correlation analyses followed by MANOVA and logistic regression were performed. RESULTS: Significant correlations and partial correlations, controlling for GSI, were observed between dissociation and alexithymia. The MANOVA demonstrated significantly higher scores for the two TAS-20 dimensions 'difficulty identifying feelings' and 'difficulty expressing feelings' in the group with pathological dissociation. On the basis of the TAS-20 subscores, logistic regression analysis correctly classified 72.5% of the cases into the pathological and the nonpathological dissociation group. CONCLUSIONS: These results support our hypothesis that pathological traits of dissociation are highly associated with alexithymia. A model is discussed in which alexithymic characteristics may contribute to the development of pathological dissociation and stress-related disorders such as posttraumatic stress disorder.

Adult↗
PubMedDate not supplied

Dissociative symptoms in obsessive-compulsive dimensions.

Previous studies have described co-occurrence between obsessive-compulsive disorder (OCD) and dissociation. We intended to evaluate the phenomenological association between different obsessive-compulsive and dissociative symptoms more precisely. Seventy patients with OCD (DSM-IV) were evaluated with the Hamburg Obsessive-Compulsive Inventory (HZI) and the Dissociation Experience Scale. Correlation and discriminant analysis were performed. The dimensions 'Checking' and 'Symmetry and Ordering' were significantly related to dissociative symptomatology. A clear-cut lack of association was found in 'Washing and Cleaning', 'Counting and Touching' and 'Aggressive Impulses and Fantasies'. HZI dimensions significantly discriminated patients with high from patients with low dissociative symptomatology. Psychodynamic and therapeutical aspects of these findings are discussed.

Adult↗
PubMedDate not supplied

Alexithymia and the temperament and character model of personality.

OBJECTIVE: In our study we explored the associations between alexithymia (Toronto Alexithymia Scale 20, TAS-20) and the dimensions and subscales of Cloninger's theoretically based and empirically validated psychobiological model of personality to further clarify the relationship between alexithymia and personality traits. METHODS: Psychiatric in- and outpatients (n = 254) were investigated with the TAS-20, the Temperament and Character Inventory (TCI) and the Symptom Check List SCL-90-R to control for the severity of current psychopathology. Correlation and regression analyses were performed. RESULTS: The regression analysis identified the TCI dimensions low self-directedness (SD), low reward dependence (RD) and to a minor degree harm avoidance (HA) as independent predictors for alexithymia. At the level of subscales, interpersonal detachment (RD3), low resourcefulness (SD3), low responsibility and blaming (SD1) and shyness with strangers (HA3) were predictors for alexithymia. The degree of explained variance of the TAS-20 scores by the TCI dimensions and subscales ranged between 43 and 45% whereas the inclusion of the general severity index into the regression models accounted for an additional 5% of the variance. CONCLUSIONS: Alexithymia is best explained by a mixture across different dimensions and subscales within Cloninger's psychobiological model of personality. However, alexithymia is captured only partly by current concepts of personality, and additional contributing psychological and biological factors need to be identified to understand alexithymia more extensively.

Adult↗