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Biomedical subjects

K Hahlweg

Publications and source records attributed to K Hahlweg.

At least 19 recordsLinked to original sources
PubMed2004

[Prevalence of psychiatric symptoms and comorbid conditions in 3- to 5-year-old children: results of the Braunschweig Kindergarten Study].

OBJECTIVES: To analyze the frequency of behavioral and emotional problems and comorbidity of kindergarten children in Braunschweig as rated by their parents. METHOD: The analysis is part of the Braunschweiger Kindergartenstudie. In a sample of N = 809 children aged three to six the parents rated their children using a modified version of the Child Behavior Checklist/CBCL 4-18. RESULTS: The prevalence rates range from 0.5% to 5.0%. The most frequent behavioral problems in kindergarten children were aggressive behavior and attention problems, followed by social problems. The study also provides bidirectional comorbidity rates. CONCLUSION: Finally the prevalence rates and the implications of the findings for prevention of behavioral problems in children are discussed.

Affective Symptoms↗
PubMed2001

Effectiveness of targeted intervention and maintenance pharmacotherapy in conjunction with family intervention in schizophrenia.

A sample of 85 patients with schizophrenia, of whom 34 later dropped out, received randomised treatment. There were no significant differences between treatment-takers and drop-outs in the variables assessed. Patients received either standard-dose maintenance neuroleptic treatment or targeted maintenance pharmacotherapy and all patients received behavioural family therapy. Measures of psychopathology, social adjustment, side-effects, family burden, and expressed emotion were assessed at baseline and then periodically over an 18-month period. The study was designed to compare the two alternative pharmacological maintenance approaches, each of them supported by psychosocial intervention. Any evaluation of the impact of behavioural family treatment on relapse rates and other outcome criteria is exclusively descriptive. A significantly higher rate of relapse was observed at 18 months in patients randomised to targeted treatment compared to those randomised to standard-dose treatment (35% vs 4%). Although patients assigned to the targeted maintenance group received significantly lower mean doses of neuroleptics, there were no significant differences between the two groups with regard to side-effects, global measures of social function, and overall psychopathology. Family burden was higher in the targeted-treatment group at six months, but did not differ at the one-year and eighteen-month time points. However, both groups improved significantly from baseline to 12 or 18 months in almost all variables assessed. Thus, the behavioural family approach did not compensate for the problems associated with the targeted medication strategy.

Adolescent↗
PubMed2001

Short- and long-term effectiveness of an empirically supported treatment for agoraphobia.

This study examined the effectiveness of individual high-density exposure (2-3 weeks, all day) for panic disorder with agoraphobia (PDAG). Participants were 416 unselected patients with a primary diagnosis of PDAG who were treated by 52 therapists in 3 outpatient clinics of the Christoph-Dornier Foundation of Clinical Psychology in Germany. Results 6 weeks after the end of therapy and at the 1-year follow-up showed highly significant reductions in anxiety symptoms, anxious cognition, agoraphobic avoidance, general symptomatology, and depressive symptoms. Results did not differ significantly between the 3 outpatient clinics and are comparable with the average effect sizes reported by meta-analytic studies of controlled efficacy research, using selected patients and specifically trained therapists. Effectiveness was not dependent on duration of disorder, number of treatment sessions, and therapist experience. The study suggests that high-density exposure can be transported from research settings to the mental health field.

Adolescent↗
PubMed1999

Principles and results of family therapy in schizophrenia.

There is growing evidence that social factors contribute significantly to the course and outcome in schizophrenia. In particular, the relationship between high EE and schizophrenic relapse has been documented by many investigators. Since 1980, several psychoeducational family management programs have been evaluated showing a significant reduction in relapse when compared to standard psychiatric care. To prevent tardive dyskinesia, alternative medication strategies have been introduced, e.g. low dose and targeted medication. In the Munich treatment study the combined effects of behavioral family management (BFM) and standard dose (SD) or targeted neuroleptic medication TM) on relapse and social functioning of the patient as well as coping and burden of the family have been investigated. N = 51 patients with 73 relatives were randomly assigned to the two groups (BFMSD = 27, BFMTM = 24). Relapse rates at 18 month were: BFSD = 3.9%, BFMTM = 33.8%. In summary, psychoeducational family management in combination with standard dose medication proved to be highly effective in preventing relapse in schizophrenia. These results are in line with findings of anglo-american studies and call for a more widespread application of these new psychosocial approaches in order to provide the best services available for the chronically ill schizophrenic patient and their families.

Antipsychotic Agents↗
PubMed1999

Cortisol responses to marital conflict depend on marital interaction quality.

A sample of 80 couples were videotaped discussing a marital conflict and were then grouped in 3 types according to their interaction behavior: both partners displaying predominantly negative behavior ( N = 36 couples); both partners showing positive behavior ( N = 26); and couples showing asymmetric behavior (one positive, one negative; N = 16). Positive o r negative in this context refers to the empirically defined quality of speaker and listener skills by the Kategoriensystem Partnerschaftlicher Interaktion. Psychophysiological responses were measured 5 times, both before and after the conflict discussion. Participants rated their overall marital quality, the number of marital problems, and their actual cognitions and emotions. Overall responses to the conflict revealed a greater cortisol response in women than in men. Couples grouped according to their interaction style showed significant differences in cortisol responses: In couples with positive interaction, cortisol increased markedly, whereas couples with negative interaction showed a nonresponse, that is, a slight decrease expected with diurnal variation, although they rated the actual conflict discussion as "stressful" like the other groups of couples. We conclude that marital interaction directly affects physiological responses to a conflict depending on interaction quality.

Journal Article↗
PubMed1998

The efficacy of a compact psychoeducational group training program for married couples.

There is a lack of psychoeducational programs for married couples who, although subjectively concerned about their marriages, do not seek marital therapy. In this study, the efficacy of a cognitive-behavioral program delivered on a weekend by 2 trainers for groups of 4 couples was investigated. Couples (n = 67) were recruited by newspaper announcements, then randomly assigned to the intervention program or a waiting-list control group. The program consisted of communication and problem-solving training, couples' discussions to clarify their relationship expectations, and exercises to enhance their sensual or sexual relationship. At postassessment, intervention couples emitted more positive verbal and nonverbal communication behaviors during a conflict discussion task than did control couples, who reported significantly more relationship problem areas and displayed more negative communication behaviors. At the 1-year follow-up, intervention couples reported fewer problem areas in comparison with preassessment.

Adult↗
PubMed1994

Deliverability of psychoeducational family management.

As part of an open clinical trial currently underway at the Max Planck Institute of Psychiatry in Munich, the feasibility of behavioral family management (Falloon et al. 1984) for schizophrenia in combination with two different neuroleptic medication strategies was investigated. The treatment approaches were psychoeducational family management with a standard dose or with targeted medication. In this article the following questions were addressed: (1) What proportion of the total schizophrenia population admitted as inpatients might be eligible for psychoeducational family treatment (assessment based on n = 411 over a 33-month period)? (2) How representative of this population are the patients who were randomized to the experimental groups? (3) How many patients dropped out of treatment after entering the trial? The results show that about 60 percent (247) of the patients were eligible for a psychoeducational treatment approach. Of these, 34 percent (85) participated in the trial and were randomized to the treatments. Only 4 percent of the relatives but 20 percent of the patients refused to take part in the study. The 85 trial patients did not differ from the total eligible on the numerous socioeconomic and symptom variables assessed. The treatment dropout rate was 11 percent. Those patients who accepted treatment did not differ from those patients who dropped out on socioeconomic or illness variables. The results indicate that early identification of dropouts is not possible at least with the methods used in this study.

Adolescent↗
PubMed1994

[Detection of early warning signs in schizophrenic patients. Possible applications in prevention of recurrence].

In the treatment of schizophrenia, two new strategies have been developed with the aim of adequate relapse prevention accompanied by lowest possible risk of side-effects. One strategy is to have the patient continue to take medication at a highly reduced dosage (10-20% of the standard dose). The other is to gradually stop neuroleptic medication after remission and to reinstitute medication only in the case of prodromal symptoms (termed targeted or intermittent treatment). According to Herz and Melville [13] many schizophrenic patients show signs of relapse well before recurrence of overt psychotic features. Monitoring to detect prodromal symptoms is especially important in targeted treatment because, otherwise, neuroleptic medication often cannot be initiated in time. In the present study of 51 schizophrenic patients we were able to replicate the results of Herz & Melville in the German-speaking countries. Prior to acute exacerbation of psychosis, most patients experience alterations of feelings and behaviour. These alterations may also be recognized by family members. Such early warning signs of relapse mainly consist of non-specific, non-psychotic symptoms: tenseness and nervousness, eating less, trouble concentrating and sleeping, depressive mood and seeing friends less. Furthermore, the regular monitoring and use of early warning signs specific to each patient in the aftercare of schizophrenic patients seems to be practicable, especially in psychoeducative family therapy.

Adult↗
PubMed1991

Cross-national reliability, concurrent validity, and stability of a brief method for assessing expressed emotion.

The Five-Minute Speech Sample (FMSS; Magana et al., 1986) is a brief method designed to assess the "expressed emotion" (EE) status of a respondent. The FMSS-EE rating is derived from statements made by a patient's key relative during a 5-minute monologue, with codes similar to those used in the original EE rating system (e.g., criticism and emotional overinvolvement). Rating is done from the audiotape and takes about 15-30 minutes. The article reports on the results of a cross-national study carried out in Germany using the FMSS with a sample of 60 relatives of schizophrenic patients. Results indicated that (1) German investigators could readily learn the system and could achieve a high degree of interrater reliability; (2) the association with the original index of EE, the Camberwell Family Interview, was comparable to that found by Magana et al.; and (3) the method yields very stable data over a 4-5 week retest period.

Adolescent↗
PubMed1990

Process analysis in behavioral family therapy.

Process research in behavioral family therapy (BFT) is a hitherto neglected area with the notable exception of the work of Alexander and Patterson with their colleagues. However, the development of instruments to assess therapist's behavior during the treatment session seems timely for the following reasons: (a) to investigate the relationship between therapist behavior and outcome, (b) to improve therapist training/supervision, (c) to establish treatment integrity in comparative outcome studies, and (d) to monitor treatment progress. For these purposes two sets of instruments were developed: (a) a category system to describe the content of a session, which is rated every 30 seconds and (b) several rating scales to evaluate therapist behavior, including relationship competency, ability to structure a session, didactic competence, ability to initiate behavioral probes, use of appropriate intervention strategies, use of reinforcement, and dealing with uncooperativeness. Scales are described, and data on their reliability and utility are presented.

Adult↗
PubMed1989

Maternal criticism, mother-child interaction, and bronchial asthma.

The study investigated maternal critical attitude (CA) and negative mother-child communication in families with an asthmatic child and in controls. Twenty-five children with bronchial asthma (7-13 yr) and 25 healthy children with their mothers participated in the project. Mothers were asked to describe their child (Five Minute Speech Sample; FMSS). Additionally mother and child discussed a mutual problem (Problem Discussion; PD). Videorecordings were taken. CA was assessed from the mothers' responses during FMSS. Negative verbal behavior during PD was coded for mother and child. During FMSS significantly more mothers of the asthmatic children than of the controls showed CA. During PD mothers of the asthmatic children made significantly more critical remarks than their controls. Within the asthmatic group, CA mothers showed significantly more criticisms than those with non-CA. Significantly more long sequences of negative verbal interaction occurred in mother-child-dyads with a CA mother than in those with a non-CA mother.

Adolescent↗
PubMed1989

Expressed emotion and patient-relative interaction in families of recent onset schizophrenics.

This article examines the interaction patterns of relatives of young, recent onset schizophrenic patients classified as displaying either high or low expressed emotion (EE) by two measures, the original Camberwell interview method and a recently developed brief method. The former was administered during the hospitalization period and the latter was administered approximately 2 months later when the patient was in the community. Family interactions were coded with an observational coding system that permitted sequential patterns to be analyzed as a function of the EE status of the family. No relation between the Camberwell EE rating and interactional behavior was found. However, high EE-critical relatives, defined by the brief EE method, were more negative in direct interactions than low EE relatives or high EE relatives classified as emotionally overinvolved. Sequential analyses indicated that high EE-critical relatives showed extreme negative escalation patterns. Patients' reactions to high EE-critical relatives were characterized by self-justification and negative nonverbal behavior.

Adult↗
PubMed1989

Observing client-therapist interaction in behaviour therapy: development and first application of an observational system.

A category system for coding the interaction in psychotherapy (CIP) is presented. Six therapists carried out 64 standardized intake sessions with clients presenting with chronic insomnia. The sessions were fully coded by three raters using the CIP. The 19 client categories as well as the 18 therapist categories showed sufficient reliability with kappa coefficients of 0.80 and 0.79 respectively. The frequencies of the client and the therapist categories of the first versus the second half of the interview were compared. Shifts in the behavioural patterns of therapists and clients during the course of the interviews are in accordance with the given rationale of the session. Correlations between the observational data and subjective ratings of the participants are further evidence for the utility of the CIP.

Adult↗
PubMed1988

Psychological aspects of NFP practice.

A psychological investigation was implemented to find out if NFP users are characterized by special personality traits and if there are any correlations between NFP practice and changes within the marriage partnership. A total of 258 NFP users, both women and men, were investigated with questionnaires of the type generally used in the field of personality research in the Federal Republic of Germany, and also with questionnaires concerning the partnership and attitudes toward pregnancy, sexuality, and childbirth. It was found that with respect to personality traits, the NFP user does not differ considerably from people designated as "normal population." Only their attitudes toward sexuality are more positive and uninhibited, and the women feel less subjectively helpless than the standard sample. Furthermore, there is a connection between increased NFP experience and changes within the partnership, in that there is a reduction of "dominant" attitude (in both men and women) with growing NFP experience. Couples with long NFP experience and NFP beginners have nearly the same degree of well-being between the partners, whereas couples who have just passed the learning phase show more ill-feeling between husband and wife. Factors concerning the partnership account much more for the differences in marital satisfaction than do sociodemographic variables or personality traits.

Adult↗
PubMed1986

Therapist's and client's perceptions in behaviour therapy: the development and cross-cultural analysis of an assessment instrument.

This paper describes the use of a scale to assess the therapist's perception of the client and the client's perception of the therapist within behaviour therapy. A factor analysis revealed specific therapist and client factors which describe aspects of each participant's activity within sessions. The results suggest that the therapist's interpersonal manner is important in treatment and that attention should be given to this in training behaviour therapists.

Adult↗