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Biomedical subjects

H Kordy

Publications and source records attributed to H Kordy.

At least 19 recordsLinked to original sources
PubMed2001

Norms, normality, and clinical significant change: implications for the evaluation of treatment outcomes for eating disorders.

OBJECTIVE: The implications of the use of national norms of the Eating Disorders Inventory (EDI) are investigated. METHOD: A German version of the EDI was administered to a representative national sample (n = 650), a repeatedly measured community sample (n = 207), and a national inpatient sample with primary diagnoses of anorexia or bulimia nervosa (n = 959). Resulting scale distributions were compared with those of North American samples of the handbook. RESULTS: Normal ranges on several scales markedly differed when German community norms were used. When estimates of rates of clinical significant changes were based on German norms instead of on North American norms, rates were markedly lower for scales measuring core diagnostic features (e.g., binging/purging, Drive for Thinness) and higher for those measuring correlates (e.g., Maturity Fears, Interpersonal Distrust). DISCUSSION: Neglecting differences in national norms can lead to substantial misinterpretation of empirical findings in the diagnosis of eating disorders and the evaluation of treatment outcome.

Adolescent↗
PubMed2001

Computer-assisted feedback-driven quality management for psychotherapy: the Stuttgart-Heidelberg model.

The authors present the Stuttgart-Heidelberg Model for quality management of psychotherapy. The system is characterized as an active internal approach with external support from researchers. Problem-solving activities are initiated and maintained by computer-assisted feedback on possible treatment shortcomings. The system provides support for the 3 key tasks of quality management: (a) monitoring of relevant quality criteria in the clinical routine, (b) standardized assessment that allows comparison with established standards at various levels of service provision, and (c) transfer of information on achieved quality to those whom it concerns. The central function of the system is an alarm function, signaling a possible deficit of the provided psychotherapy on the basis of the standard evaluation of treatment outcome for individual patients. In this article, the main system components are described and data on its feasibility and validity are presented.

Feedback↗
PubMed1999

[Validation of the Inventory for Interpersonal Problems (IIP). Results of a representative study in East and West Germany].

The Inventory of Interpersonal Problems (IIP) was developed in the USA in the late 1970s and in the mean time has become a well-established instrument applied in numerous clinical studies in German speaking countries under the name "Inventar zur Erfassung interpersonaler Probleme". The test manual was published in German in 1994, but without the corresponding standardisation for a German-speaking population. The present study fills this gap. In a representative study the IIP was completed by 2025 West Germans and 1022 East Germans aged 14-92 years. The representative norms are given and the psychometric dimensions of the questionnaire adjusted for this sample. As a contribution to testing validity the results were also related to the scores of a number of other tests completed by the same sample (Giessen Test--GT; Giessener Beschwerdebogen--GBB; Fragebogen zur Lebenszufriedenheit--FLZ; Angstbewältigungsinventar--ABI and the Fragebogen zum erinnerten elterlichen Erziehungsverhalten [FEE]). The relevant results will be reported.

Adolescent↗
PubMed1992

[Psychotherapy research and therapeutic management].

The history of psychotherapy research has been closely allied with the development of clinical practice, as this review demonstrates. Empirical psychotherapy research aims at the scientific evaluation of existing practice and at the discovery of new fields of application. The early phases of psychotherapy research were concerned with scientific justification and societal legitimation. These questions changed with the extension of possible indications, the growing differentiation of treatment procedures and the progressive implementation of psychotherapy within the health-care system. The early issue "does psychotherapy work at all?" has been replaced by the questions "to whom is psychotherapy helpful?" and "how does psychotherapy work?". As an established part of the health-care system, psychotherapy is now faced with the same urgent problems as other medical specialties: therapeutic goals and economic conditions have to be brought in balance. Thus the perspectives of psychotherapy research have to encompass the individual patient as well as the system of care. These demands create new questions which enlarge the approaches of traditional psychotherapy research; new structural and logistic methodologies are asked for. We conclude by referring to a multicenter study on the psychodynamic treatment of eating disorders that has been initiated by the Center for Psychotherapy Research in Stuttgart as a prototype form of the new look in psychotherapy research.

Anorexia Nervosa↗
PubMed1992

[Quality assurance: clarification of a provocative and trendy expression].

The GRG from 1988 commits all suppliers of medical or therapeutic services in Germany to take steps to assure quality. The legislator left it in the care of the involved parties to find an agreement how to do it. This vagueness together with the emphasis put simultaneously on quality and economy turned this issue into a threat for many therapists. This tendency is supported in addition by the intensified competition between the therapeutic schools. The major goal of this review is to give some information that provide a functional discussion and hinder a misuse. The article informs about the issue of quality assurance, which is not as new as some people may consider it; the political context is pointed out, the main concepts are introduced, approaches and experiences from other countries or other fields of medicine are reported, and the conflicts between the interest groups are sketched out. Finally, some comments on central aspects are given which eventually make easier a transference into the field of psychotherapy and hopefully encourage specific approaches of quality assurance in this field.

Cost-Benefit Analysis↗
PubMed1992

[Psychological and somatic factors in the disease course of Crohn disease].

Crohn's Disease is a severe chronic illness. It is only a little known about which factors determine its course. In this study we investigate 3 somatic (firstly diagnosed vs. repeated inflammation, Crohn's Disease Activity (CDAI), anatomic localization) and 6 psychic (coping-patterns) factors in relation to the duration of the acute inflammatory phase. The sample consists of 90 patients from internistic clinical departments. Under a nomothetic perspective we apply a survival analysis and supplement this by a comparison of two single cases. The results support the thesis, that the course of Crohn's Disease is multifactorially determined. The somatic as well as the psychic (coping) factors allow an at least modest prediction. But there is a marked tendency that an "active-problemorientated", a "not-trivializing" coping and a well established compliance are the more promising predictors.

Adaptation, Psychological↗
PubMed1991

[Coping of patients with Crohn disease in relation to differential perspectives: a contribution to the discussion of specificity].

The present study may be seen as a contribution to the theory to coping with an illness. The concept of "specificity" is extended to entail a differential psychological perspective. The influence of various illness-related (extent and severity) and patient-related variables (age, sex, housing) toward coping are investigated. Methodologically, a group statistical strategy is applied which allows the variability of the investigated subsamples to be the object of research. It can be shown that experience with the illness (new vs. chronically ill) represents an important factor in coping with MC.

Adaptation, Psychological↗
PubMed1991

[Relation between illness manifestations and personality structure].

Associations between various psychoneurotic or psychosomatic illnesses and personality structures are investigated empirically in this paper. The investigation is based on the diagnoses of 9377 patients who came to the Psychosomatic Clinic of the University of Heidelberg as outpatients in the decade from 1979-1988. The answer to the proposed question is attempted by means of a statistical analysis of the routinely documented diagnoses. The relation can therefore only be investigated to the extent allowed by the more or less theory-oriented view-point of the participating diagnostician. The results confirm in part clinically known relations between certain aspects of illness and personality structures. They point to an almost obvious asymmetry which has been disregarded up to now in the clinical-theoretical discussion: whereas "typical" personality structures are diagnosed increasingly more often in certain illnesses, none of the personality structures proved "supportive" in the occurrence of a certain illness. The altogether weak interdependence between illness and personality structure (diagnoses) demonstrates that both diagnoses represent--at least in part--different dimensions.

Humans↗
PubMed1989

Empirical hypotheses on the psychotherapeutic treatment of psychosomatic patients in short and long-term time-unlimited psychotherapy.

In the Heidelberg Follow-Up Project, the results of psychoanalytically oriented treatment in a practice-oriented design are investigated. The patient sample is not homogeneous with regard to the diagnosis; the sample (n = 209) comprised primarily psychoneurotic and psychosomatic patients. All treatments were intended as long-term psychotherapies. The duration of therapy as well as the number of sessions actually realized may be regarded as one result of therapy. This situation, which is not quite ideal in the classical clinical experiment, allows us to develop the following empirical hypotheses: (1) The relationship between the therapeutic effort (e.g. treatment duration and number of sessions) and the results of psychotherapy can be mapped by a dose-effect model. The formal characteristics, especially the shape of the corresponding graphs, are similar for four different evaluation levels. Within the context of a dose-effect model, a treatment duration of about 2.5 years or respectively a number of sessions of about 160 seem to be most beneficial. (2) If we split up the total sample of patients into two subgroups (group 1: patients with psychoneurotic symptoms or non-chronified bodily dysfunctions; group 2: patients with psychosomatic illnesses or chronified bodily dysfunctions) and repeat the analysis, we obtain similar results for both groups of patients. The dose-effect graphs are of similar shape but differ in height. There is a slight tendency in patient group 2 that a treatment duration of up to 3.5 years may be associated with increased success rates.

Adaptation, Psychological↗
PubMed1989

[Criticism of the method or lost chance?].

This paper is a response to Tress' methodological attempt in this journal (1988). The thesis is presented that his concept of socioempirical markers is based on his false understanding of empirical-statistical thinking with the consequence that: 1) results of empirical studies can not be adequately reported and thus misinterpretation will be promoted 2) his attempt at conveying a systematic complementary relation between operational-functional sciences and hermeneutic-intentional sciences proves to be the answer to an imagine problem. A contra-position is presented here which recognize the basic difference between empirical-statistical and clinical-hermeneutic sciences not only with regard to the methodology but also with regard to goals.

Communication↗
PubMed1988

Time and its relevance for a successful psychotherapy.

Time and the distribution of time have hardly been taken notice of up to the present although they are of great importance when considering the economic perspective. The present study reports on the results found between certain time parameters (e.g. total duration, total number of sessions, number of sessions per week, longer interruptions) and the outcome of psychoanalytic psychotherapies. The sample consists of 76 patients with neurotic, functional or psychosomatic diagnoses. The results support the thesis that not only the quantity of time (number of sessions, duration of therapy), but also the distribution throughout the therapy is associated with the success of therapy.

Adaptation, Psychological↗
PubMed1985

Latent thematic concordancy in psychotherapy sessions.

In a single case study of a psychoanalytically oriented treatment, the associative distance between patient and therapist concerning the subject of the session was rated. This distance was operationalized by the so-called 'latent thematic concordancy' (LCON) and measured after each session. With the aid of a modified form of the 'therapy session check sheet' (TSCS) of Graff and Luborsky, a constellation of low manifest and low positive transference together with high resistance was isolated which was linked with low LCON with a high prediction rate. This transference constellation resembles the resistance against transference as described by Gill. It seems to be related to a great distance between the associations of patient and therapist concerning the subject of therapy sessions.

Adult↗
PubMed1984

Indication in psychotherapy on the basis of a follow-up study.

The problem of indication is a central one of psychotherapy research. Unfortunately up to now only few scientific results contribute to a therapist's decision in selecting patients for a specific therapeutic setting. Thus, indication and outcome research should be combined. A critical view on traditional research strategies demonstrates that psychotherapy research should replace the ideal of normative and general rules by the rational investigation of one's own therapeutic practice. From this point of view some results of the Heidelberg Follow-Up Project of 110 psychotherapies which were started on an inpatient and continued on an outpatient basis are presented. Based on the therapeutic changes of these 110 patients the question is investigated whether the decisions of the indications correspond with the therapeutic goals of the treatment models. Moreover, the question is discussed what kind of success a specific treatment model offers for 'problem patients'.

Adaptation, Psychological↗
PubMed1984

[Individually oriented progress research: detection and evaluation of therapeutic effect based on individual treatment goals. 1: Is there, in research on results, a space for individually oriented procedures?].

Starting with the thesis that targets and addressees of outcome research stipulate the selection of the appropriate methods and criteria, the necessity to include individually oriented techniques in the evaluation of therapeutic outcomes is pointed out. Such a method is introduced and its "rationale" is discussed, so that the conditions of its application will become clear. In the second part, questions concerning the practice with this method will be discussed.

Adaptation, Psychological↗
PubMed1983

Success and failure in psychotherapy: hypotheses and results from the Heidelberg Follow-Up Project.

Within the Heidelberg Follow-Up Project all treatments of the clinic regardless of the type of psychodynamic technique used are investigated. The outlet is both prospective and retrospective. There are four points of investigation: (1) immediately after the first contact with the hospital (2) at the beginning; (3) at the end of therapy, and (4) after a 2-year follow-up period. Immediately after the first contact with the patient a test battery (Giessen Test, Holzman Inkblot Technique, Gottschalk-Gleser Method, symptom checklist) is administered. This is repeated after a waiting period at the beginning of therapy, where in addition the therapist formulates a psychodynamic hypothesis and defines 3-5 individual treatment goals in connection with the individual pathology of the patient. At the end of the therapy the tests are repeated and the therapist assesses the success or failure of the therapy with regard to symptoms, object relations and psychodynamic change, while the patient fills out a special questionnaire dealing with his personal view of the therapy, the therapist and his own treatment experiences. The first results of about 100 combined inpatient and outpatient psychotherapies are presented (third test-round at the end of treatment). The results are discussed on the basis of the involved tests and ratings with respect to success and failure in the view of patients, therapists and independent clinical experts. Since the study is still under way, reports of the follow-up data are not yet evaluated.

Follow-Up Studies↗