Biomedical subjects

H Krauthauser

Publications and source records attributed to H Krauthauser.

7 recordsLinked to original sources

PubMed1997

[The randomization problem in psychotherapy studies].

In a research project comparing inpatient and outpatient psychotherapeutic treatment for patients suffering from anxiety disorders, 132 subjects were allocated to both treatments by means of randomisation. Because of the patients' voluntary agreement or refusal of the proposed treatment, the subsamples are markedly affected in their homogeneity. It seems that more disturbed patients agreed to inpatient psychotherapy, whereas less disturbed patients refused that form of treatment. Bias toward or against a given form of treatment turned out to be the most potent predictor in multivariate analysis. The influence of this distortion of the samples is discussed with regard to the generalisation of the results. Proposed countermeasures have their shortcomings, and in the end it seems that randomisation should be avoided in psychotherapeutic research.

Adult↗

PubMed1997

[Illness-specific control issues in patients with vertigo as the main symptom].

The study explored the relationship between health locus of control and anxiety in 90 patients with the chief complaint of dizziness/vertigo. The patients were subjected to a neurological examination, including standardised history, physical examination, electronystagmography with caloric testing and posturography, auditory and visually brainstem-evoked responses, masseter reflex, vertebrobasiliar transcranial Doppler, optional: cranial imaging (CCT/MRI), cardial diagnostic, and a psychiatric-psychodynamic examination (including psychometric tests: STAI-G X2, KKG, SBA-S). The whole group of patients (psychogenic and organic dizziness) had a specific pattern of health locus of control: "double health external" (Type IV-Wallston and Wallston 1982). Patients with psychogenic dizziness showed a higher score of external locus of control (chance) compared with the patients with organic dizziness. High anxiety scores were accompanied by high scores of external locus of control (powerful others and chance) above all in the patients with psychogenic dizziness. Implications for therapy are discussed.

Adolescent↗

PubMed1996

[Vertigo and anxiety disorders--results of interdisciplinary evaluation].

BACKGROUND: Vertigo is a common symptom that often remains unexplained despite extensive medical evaluation. Psychiatric and psychosomatic disorders are usually considered after all somatic causes of vertigo have been ruled out. METHODS: Eighty-three patients referred to neurological or psychosomatic outpatient treatment received an extensive neurootologic and psychosomatic evaluation: one (or two) diagnostic psychiatric psychodynamic exploration(s), a structured interview, psychometric tests (SCL-90-R, STAI-G X2 and GBB). The patients were divided into four diagnostic groups: psychic causes only (psychogenic group), neurootologic causes only (somatic group), both diagnoses (psychosomatic group), neither diagnosis (group IV). RESULTS: Twenty-three patients had organic vertigo, thirty-nine patients had psychogenic vertigo and in seventeen cases a vestibular lesion initiated the development of a neurotic disorder, particular anxiety disorder. Most of the patients of the psychogenic and psychosomatic group had anxiety or phobic disorders. The patients with psychogenic or psychosomatic symptoms of vertigo generally report a higher level of subjective distress; the periods of disability are significant longer. CONCLUSIONS: The study suggests that assessment of psychiatric and psychosomatic symptoms should always accompany, not follow, neurootologic evaluation of vertigo. An early interdisciplinary therapy should be started to prevent the chronicity of the symptomatology.

Adult↗

PubMed1996

[Evaluation of the therapeutic process in inpatient psychotherapy with the Repertory Grid technique].

With a sample of 155 patients undergoing psychoanalytic inpatient psychotherapy, the clinical relevance of nomethetic measures derived from Repertory Grids (Role Construct Repertory Test; Kelly 1955) shall be demonstrated. Results lead to the conclusion that valuable findings concerning the psychotherapeutic process can be obtained from the grid without necessarily recurring to the framework of Personal Construct Psychology. In general, cognitive differentiation seems to diminish as therapy goes on. Successful patients start to deal with their parental imagines earlier in the therapeutic process than less successful ones. Moreover, they adapt the construction of their Self to the one of their Ideal Self, just as they construe the treating therapist increasingly similar to their Ideal Self. This points to the eminence of the therapeutic relationship for successful therapy outcome. Finally, the paper presents some possibilities to demonstrate transference processes within the scope of inpatient psychotherapy by means of grid measures. All in all, we consider the repertory grid technique as a promising tool for the evaluation of therapeutic processes, but it requires considerable expenditure to fit into clinical routine.

Adolescent↗

PubMed1995

[Which factors modify the duration of inpatient psychotherapy?].

The indication for differential duration of inpatient psychotherapy is a difficult question to answer, especially when the possible outcome-success of more severely disturbed patients (e.g. with borderline-personality disorder) is considered. Our own results showed no relevant correlation between the degree of patients' disturbance and treatment duration, neither any relevant correlation between treatment duration and therapists' evaluation of symptomatic or ego-structural improvement. The only marked effect on treatment duration was found for the patients' evaluation of their therapeutic relationship: the better they judged this relationship, the more their therapists tended to elongate inpatient psychotherapy. This finding supports a paradigm, which has been already well confirmed for outpatient psychotherapy: the specific importance of the therapeutic relationship for the therapeutic process even within the scope of inpatient psychotherapy. Another finding of our study indicates that more severely disturbed patients probably need a modified setting of inpatient psychotherapy: favorably a focus oriented interval treatment with short duration periods and alternating focus if necessary.

Adult↗

PubMedDate not supplied

[ "Weight phobia". A discussion of the problem of "atypical" and "not otherwise specified" eating and weight disorders].

A number of authors have stated that the problem of classifying patients whose diagnosis does not meet all the criteria of anorexia and bulimia nervosa has not been satisfactorily solved. The question has been asked if it is justified to regard characteristics like "weight phobia" or body image disturbance as valid diagnostic criteria. In the present study the differences observed in three groups of patients with eating and weight disorders (anorexia: n = 42; bulimia: n = 29; atypical group without "weight phobia": n = 14) were compared using the Giessen-Test. The atypical group was shown to be significantly more "tractable" on scale 2 than the main groups, which achieved a higher score on "dominance". Significant differences between the atypical group and the "uncontrolled" group of patients with bulimia were noted for scale 3, with the atypical group showing comparable results to those recorded in the anorexic group on "compulsiveness". The authors discuss the significance of the results under an epistemological aspect. The description and classification of clinical phenomena which is based on the clinical manifestation of the disorder independently of theoretical concepts is therefore indispensible for realising a uniform basis for communication by researchers worldwide. Equally indispensible is the differentiation or "extension" of the classification to allow a more detailed systematic categorisation guided along specific theoretical concepts. This requires the operational definition of psychopathological and psychodynamic criteria as, e.g. "the struggle for identy" or the "relentless pursuit of thinness". The experiences with the OPD (Operationalized Psychodynamic Diagnosis; 1996) have shown this to be a difficult but viable approach.

Anorexia↗

PubMedDate not supplied

[Inpatient psychotherapy with chronic psychogenic pain patients].

The efficacy of inpatient psychosomatic psychotherapy was proved by a naturalistic prospective study with 50 psychogenic pain patients over an average time period of 12 weeks. At the end of inpatient psychotherapy about 60% of all patients achieved pain mitigation. According to the aim of our therapeutic concept to specially improve the perception and verbalization of their own conflicts or affects about 86% of all patients judged to have an enhanced competence in problem solving. The hypothesis that depression may often occur as a consequence of several years lasting chronic pain, could not be confirmed in our study. In contrast no remarkable correlation was found between symptom duration and depressive or anxious mood respectively. Concerning prognosis it seems to be significant that an increased tendency for rationalization or intellectualization diminished clinical outcome success as well as it occurred with enhanced acute pain sensation.

Adult↗