Biomedical subjects

Henning Schauenburg

Publications and source records attributed to Henning Schauenburg.

7 recordsLinked to original sources

PubMed2006

[Attachment patterns in psychotherapists].

OBJECTIVES: Therapist characteristics are relevant for the outcome of psychotherapies. Attachment measures related to aspects of personality are well introduced. We studied a sample of psychotherapists using attachment interviews and questionnaires. METHODS: 31 psychodynamically oriented psychotherapists who worked in two inpatient institutions were interviewed with the Adult Attachment Interview. We report the results of the distribution of attachment patterns according the Adult Attachment Prototype Rating (Strauss et al. 1999). RESULTS: 14 therapists (45.2%) showed a secure, 4 (12.9%) an insecure-ambivalent and 7 (22.6%) an insecure-avoidant attachment pattern. A comparably high proportion of therapists was rated as mixed-insecure, a pattern of clinical relevance. Discrepancies to other samples lie in the expected direction. There were no correlations with gender, experience or profession. Depression and insecure attachment did correlate; interpersonal problems showed no connection to attachment status. CONCLUSIONS: The distribution resembles the general population with a slightly lower proportion of secure subjects. Further assessments, among others, will investigate the occurrence of ,,unresolved states of mind" with respect to attachment trauma.

Adult↗

PubMed2005

[Individual therapists in inpatient psychotherapy -- a pilot study on their importance for therapeutic outcome].

OBJECTIVE: How much does the individual psychotherapist influence therapy outcome in a multimodal inpatient setting with several therapeutic relationships and the additional influence of group processes. METHODS: We studied the outcome of n = 293 psychotherapy inpatients (mean treatment duration: 11 weeks) who were treated in an integrated inpatient concept by 9 mostly psychodynamically oriented psychotherapists (professional experience 0.5 to 7 yrs, 13 to 56 patients per therapist). Patients had an extensive evaluation of process and outcome variables (e. g. SCL 90R, IIP, Global outcome rating, Helping Alliance Questionnaire - HAQ). Differences in outcome between patients of different therapists were calculated. RESULTS: Patients assigned to the participating therapists did not differ in their basic clinical characteristics, except in the clinical severity rating carried out by therapists themselves. Outcome in the SCL90R - GSI residual score and global rating differed significantly between the therapists (d (SCL-pooled SD) = 0.43 to 1.10, explained variance: 10 %). The same holds true for the therapeutic alliance (HAQ, explained variance: 45 %). Assessment of therapeutic relationship shows good correlation between patients and therapists, outcome assessment does not. Therapists differed in the degree of matching between their own and their patients' evaluations. CONCLUSIONS: We found significant therapist differences in outcome and alliance. Despite the multifaceted inpatient setting the individual therapist is an important determinant of therapeutic success.

Adult↗

PubMed2005

[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. Therefore, it is suitable for a broader range of evaluation methods linked to this model. It also contains instructions on how to draw a summary of relationship dynamics. Thus the results of the diagnostic assessment can be summarized for clinical and practical purposes and used directly for therapeutic work. In addition, a simplified version of the rating procedure enables identification of the patient's significant problematic relationship themes and his or her personal resources.

Adult↗

PubMed2004

[Attachment security and quality of life in atopic dermatitis].

OBJECTIVE: Attachment style is an important variable of influence on general and disease specific quality of life. Insecure attachment may go along with increased autonomic vulnerability and with compromised social support and coping resources. Patients with atopic dermatitis often report interactions of the status and severity of their disease with psychic wellbeing. It was the purpose of the present study to clarify the influence of attachment style and social support on the quality of life in probands with atopic dermatitis. We hypothesized that securely attached test persons with severe skin affection feel less constrained in their quality of life, because they may "buffer" strains from the disease more successfully due to better social support deriving from more satisfying relationships. METHOD: We carried through a cross-sectional study on 124 probands with atopic dermatitis of varying severity, assessed with self report (Neurodermitis Severity Index, NSI) and in part by clinical dermatological ratings (NSI/SCORAD). Attachment style was captured with the Relationship Scales Questionnaire (RSQ), social support with the F-SOZU (K-22), and quality of life with the Skindex-29. RESULTS: We found slightly more insecurely attached individuals in the study sample than it was to be expected from representational healthy samples. Securely attached participants have no lower severity of their disease, but show a higher amount of social support. Irrespective of severity, securely attached persons feel less limited in their quality of life compared to insecurely attached participants. In their symptom based quality of life both feel equally limited. Severity predicts quality of life: contrary to our expectation of a buffering effect of attachment security this association is closer in securely attached probands. CONCLUSION: Suffering from atopic dermatitis may go along with more attachment insecurity. The unexpected stronger association between severity and quality of life in securely attached individuals can be interpreted as a more direct reaction to their skin condition in the absence of other encumbering factors (relationship problems etc.).

Adaptation, Psychological↗

PubMed2004

[Relationship experiences and therapeutic outcome in inpatient psychotherapy].

OBJECTIVES: Inpatient psychotherapy includes the patient's manifold contacts with different therapists, nurses and fellow patients. The present study investigated the association between these multiple relationships and therapy outcome. METHODS: Pre-post measures of symptom load (Brief Symptom Inventory), interpersonal problems (IIP) and self-efficacy (SEB) were used to define three groups with positive (N=129), unchanged (N=44) or negative (N=40) outcome. These groups were compared 1) by their alliance with an individual therapist, their relationship to the therapeutic team, their experience of cohesion and climate concerning fellow patients in the ward (measured weekly by the "Stationserfahrungsbogen" SEB), and 2) by their differences in mean correlations between the courses of relationship experiences and symptom load. RESULTS AND CONCLUSIONS: Cohesion and relationship to the therapeutic team were not associated with therapy outcome. Therapeutic alliance with the individual therapist and climate among fellow patients turned out to be moderate indicators of the therapeutic outcome. It is recommended to include these process parameters systematically into the process diagnostics of inpatient psychotherapy.

Adult↗

PubMed2003

[Decision-making capacity and informed consent in living organ donation--difficult constellations in the psychosomatic and medico-ethical assessment of potential donors].

Organ donation from relatives or other persons with a close relationship to the patient has become a fairly routine procedure in many countries. However, donors should be chosen carefully not only to avoid medical or psychosocial risks but also ethically questionable outcomes. Prerequisites for living organ donation are reported together with a short review of the known risks for donors. Under the central maxim of averting harm for the donor, six cases are described to illustrate typical difficulties in the psychosomatic-ethical consultation-liaison service, and our own procedures are discussed. Suggestions are made as to how to approach the information, evaluation and selection of potential donors.

Adult↗

PubMed2003

[Relapse in depressive disorders--is there a need for maintenance psychotherapy? ].

OBJECTIVES: Patients with depressive disorders who enroll in typical short-term clinical studies have a high risk of early relapse (30-70 %) and chronicity (ca. 20 %). Factors which contribute to this risk are residual symptoms at termination, previous recurrent episodes, chronic stress, etc. Pharmacological strategies offer a multitude of means of relapse prevention, while in psychotherapeutic interventions there is a dearth of such recommendations. Studies on relapse-preventing continuous contacts (maintenance therapy), for example, are very rare. METHODS: We present empirical data on risk factors for early relapse and chronic course in depressive disorders together with general strategies for relapse prevention. Results of controlled studies with maintenance psychotherapy will then be reported. RESULTS: Psychotherapeutic maintenance strategies have been shown to be successful in several controlled studies. Furthermore, recent studies show typical moderating mechanisms for better resilience against stressors in formerly depressed patients. The typical setting under study was monthly sessions over a period of at least 8 months and up to three years. In case of severe risk factors continuous pharmacotherapy also has to be taken into consideration. DISCUSSION: The issue is discussed in respect to differential indication (primarily long-term therapy vs. a rather quick change to maintenance contacts of low frequency). Moreover, the ethical questions of inadequate dependency as well as the clinical aspects of transference-countertransference dynamics are viewed.

Antidepressive Agents↗