Comment on "Novel public key encryption technique based on multiple chaotic systems".
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Biomedical subjects
Matthias Franz
Publications and source records attributed to Matthias Franz.
[Impact of attachment style, social support and the number of implantable cardioverter defibrillator (ICD) discharges on psychological strain of ICD patients].
OBJECTIVE It is well known fact, that the life of ICD patients is often affected by anxiety and depression. The number of ICD discharges is only a contributing factor explaining the variance of anxiety and depression. There have to be other factors that have more influence on the physical strain of ICD patients. In this study we examined the impact of attachment style and social support in addition to the number of ICD discharges. METHODS 119 out-patients at an out-patient ICD unit were examined consecutively with the following self report scales: (1) the State-Trait-Anxiety Inventory (STAI), (2) the Beck Depression Inventory (BDI), (3) a short form of a social support questionnaire (F-SOZU), (4) the Bielefeld Partnership Expectations Questionnaire (BFPE) and (5) a specifically designed questionnaire for the assessment of sociodemografic data. To determine the frequency and timing of the ICD discharges we analysed the ICD data. RESULTS 38 % of the ICD patients reported enhanced anxiety levels and 37 % reported enhanced depression levels. Only 38 % of the ICD patients received discharges at all. Elevated levels of anxiety and depression were found in patients who showed insecure attachment styles, low social support, long-term treatment in hospital and a higher number of ICD discharges. To explain the variance of anxiety we found social support, attachment style, and the number of ICD storms to be contributing factors. To explain the variance of depression we found social support and time spent in hospital in the previous year to be contributing factors. CONCLUSIONS Almost half of the ICD patients suffer considerably from anxiety and/or depression. These patients have to be identified and treated psychotherapeutically. Patients who show insecure attachment styles, receive low social support, undergo long-term treatment in hospital and receive a higher number of discharges, especially so called ICD storms, bear the highest risk to develop psychological strain. Attachment style and social support have even more impact on the development of anxiety and depression than the number of ICD discharges. It has to be shown in future studies whether psychotherapy can improve the quality of life of ICD patients.
Aged↗
Striatal dopamine transporter density in drug naive patients with attention-deficit/hyperactivity disorder.
BACKGROUND AND AIM: Dopamine transporters are the target of psychostimulants used for treatment of attention-deficit/hyperactivity disorder (ADHD). Therefore, the present study aimed to evaluate striatal dopamine transporter density in adult patients with ADHD. METHODS: Twenty patients (11 female, nine male; mean age 35+/-7 years) and 20 control subjects (11 female, nine male, mean age 32 +/- 8 years) were examined with SPECT using the specific radiotracer 123I-FP-CIT. The ratio of striatal to cortical radioactivity concentration was used for semiquantitative evaluation of dopamine transporter binding potential (V3''). There was a significant influence of age (P < 0.001) and a trend towards an influence of gender (P = 0.053) on V3''. An ANCOVA with these covariates showed a slightly higher V3'' in the patients than in the control subjects (4.24 +/- 0.48 vs. 4.03 +/- 0.56; P = 0.02). CONCLUSION: This study provides further in-vivo evidence for an involvement of the dopamine transporter in ADHD. However, compared to previous studies, the increase of dopamine transporter density in the patient group is less pronounced here.
Adolescent↗
[Alexithymia in a clinical sample].
OBJECTIVES: The Toronto Alexithymia Scale (TAS-20), is currently the most widely used measure of alexithymia. An alternative measure of alexithymic characteristics is the Levels of Emotional Awareness Scale (LEAS). Aim of the study was to investigate, wether LEAS and TAS-20 scores are associated with interpersonal problems, sociodemografic variables, and psychological strain in a construct conform direction. METHODS: 146 psychosomatically ill in-patients completed the TAS-20, the LEAS, the Symptom Check List (SCL-90-R) and the inventory for the assessment of interpersonal problems (IIP-D). RESULTS: Low emotional awareness (LEAS) was associated with male gender, absence of a stable partnership and low educational level. In contrast to LEAS, TAS-20 was significantly correlated with the majority of the SCL-90-R and IIP scales. CONCLUSIONS: The correlations between TAS-20 and IIP scales may be an indication for the validity of the measurement. The association between low emotional awareness and sociodemografic variables are costructconform and indicate a strong relationship between LEAS and variables, that represent real life.
Adult↗
A new analyzing method for quantification of abrasion on the Bruxcore device for sleep bruxism diagnosis.
AIMS: To evaluate a newly developed semi-automatic computer-based method to analyze the objectivity of the Bruxcore Bruxism-Monitoring Device (BBMD) by assessing the interrater reliability. The capability of the BBMD to differentiate between sleep bruxers (SB) and healthy controls was also verified by estimating the sensitivity, specificity, and predictive values. METHODS: Forty-eight SB and 21 controls took part in this investigation. After a detailed clinical dental examination, each participant received a BBMD to be worn for 5 consecutive nights. The BBMDs were then scanned and rated by 2 independent examiners using the new method, which counted the abraded area in pixels. Interrater reliability was assessed by intraclass correlation coefficient (ICC) analyses. RESULTS: The analyses showed a very high interrater reliability of ICC = 0.99, and comparison of the mean pixel scores revealed values that were approximately 8 times higher for the SB than for the controls. With a selected pixel score cutoff point of 2900, a sensitivity of 79.2% and a specificity of 95.2% were found. The clinical diagnosis was correctly predicted in 97.4% of the SB and 66.7% of the controls. CONCLUSION: The results support the assumption that the newly developed analyzing method for the assessment of the BBMD is a clinically suitable, objective, and applicable method that seems to be able to differentiate between SB and a healthy control sample. These data, however, need to be confirmed in further investigations using polysomnographic recordings.
Adult↗
[When mothers take care alone].
This study demonstrates the difficult life situation of many single mothers and their children on the basis of important studies on the problematical social status, elevated health risks and particularly, on the mental/psychosomatic strain of single mothers. From these investigations, potential impact on the development of the children and the necessity of attachment-oriented prevention-programs in terms of a training of the intuitive parental competences are derived. In spite of the increasing number of single mothers, a sufficient amount of such offers does not yet exist in Germany. A first group-program, especially adapted to the needs and conflicts of single mothers, will be presented.
Child↗
Visual event-related potentials in subjects with alexithymia: modified processing of emotional aversive information?
OBJECTIVE: A modified autonomous response (e.g., electrodermal activity) in subjects with alexithymia (a reduced ability to identify and communicate emotions) while processing emotional information is well known. However, the functional and neurobiological bases of this impairment are unclear. Do subjects with alexithymia suffer from a primary lack of perception ("emotional blindness"), or is alexithymia based on incomplete information processing due to immature undifferentiated cognitive schemes? The study investigates if subjects with alexithymia show a modified central response as a correlate of classifying emotional aversive stimuli. METHOD: Twenty subjects with high alexithymia and 20 with low alexithymia (selected by the 20-item Toronto Alexithymia Scale) were investigated within a modified odd-ball paradigm. Three different stimulus categories were presented: aversive (probes) and affective neutral pictures (nontargets and instructed targets). Visual event-related EEG potentials and subjective data were recorded. RESULTS: All subjects showed elevated positive amplitudes or mean activity after probe presentation in the latency range: 150-260, 280-450, and 600-1500 msec. Subjects with alexithymia displayed increased positive components (especially P2) of visual event-related potentials after probe presentation than subjects without alexithymia. Subjects without alexithymia more frequently verbalized the emotional impact of these aversive pictures than subjects with alexithymia. CONCLUSIONS: These findings do not support the assumption of a primary lack of perception in alexithymia. Subjects with alexithymia show central correlates of perception and classification of aversive pictures. They may need more effort and cognitive recourses to process emotional information. Nevertheless, spontaneous verbal reference to emotional stimulus aspects is reduced.
Adult↗
[Psychosocial distress and symptoms of single mothers and their children in a large community sample].
OBJECTIVES: As in other western countries the proportion of single parent families in Germany is growing. International studies showed lower socioeconomic status and elevated psychic distress in single mothers as well as increased problem behavior in their children. This study was performed to make up for the lack of epidemiologic investigations on this issue in Germany. METHODS: The family status of a complete cohort of school beginners in Duesseldorf was screened (recruitment rate 97.5%, N = 5,048). Single mothers and their children were compared to a control group of married mothers (N = 278) with respect to social variables and psychic distress (SCL-90-R, CBCL). RESULTS: 907 (18.0%) of all children lived in single parent families. Socioeconomic status (income, education, receiving welfare) of single mothers (total N = 891) who fulfilled the inclusion criteria (N = 531) was lower, while psychic distress was significantly elevated (GSI 0.45 vs. 0.28). Single mothers without additional personal support for their child, younger as well as poor single mothers showed higher values of GSI. Statistically significant increased behavior problems were found only in boys of single mothers. CONCLUSIONS: Single mothers are socially disadvantaged. They show an elevated mean psychic distress compared to married mothers. Psychosocial support for higher impaired subgroups of single mothers should be developed.
Adult↗
[Evidence of validity of the German version of the TAS-20. Contribution to the 52nd conference of the German Board of Psychosomatic Medicine in Bad Honnef (2001)].
419 patients (psychosomatic-C/L-service unit; neurotic spectrum, somatoform and personality disorders) were investigated by collecting data of clinical and psychometrical variables (SCL-90-R, NEO-FFI, IIP-D). The aim was to evaluate whether the sum score and the three factors of the German 20-item-version of the Toronto-Alexithymia-Scale (TAS-20) postulated by Bagby correlate with other clinical variables in a convergent way. The TAS-20 sum score and the factors (F1) "Difficulties identifying feelings" and (F2) "Difficulties describing one's feelings" correlated convergently with the NEO-FFI-scales "neuroticism" and "openness for new experiences", with numerous scales of the SCL-90-R, as well as with the scales "cool/repelling" and "introverted/social avoiding" interaction style of the IIP-D. Factor (F3) "Externally oriented thinking" correlated with "Extraversion" but was not related to clinical impairment (SCL-90 R). The results could be interpreted in terms of convergent validity of the TAS-20. In addition, alexithymic patients seem to be impaired with respect to interpersonal communication and they are subjectively able to perceive appreciate this restriction.
Adolescent↗
Properties of the Symptom Check List (SCL-90-R) in a psychosomatic consultation-liaison setting.
The present study aimed to assess the effect of psychological screening of medical inpatients using the Symptom Check List, SCL-90-R. A sample of 630 medical inpatients who were referred to a psychosomatic consultation-liaison service was assessed using the SCL-90-R. A clinical interview was conducted with all assessed patients. Patients referred to the consultation-liaison service showed high psychological distress. 73% of the subjects were classed as cases using the International Classification of Diseases (10th Revision) criteria and psychological impairment. The screening characteristics of the SCL-90-R were not as good as those reported for other outpatient samples. The SCL-90-R appears to have been valuable for the consultation-liaison service since subjects with mental disorders scored significantly higher on almost all the scales than subjects without mental disorders. The questionnaire can serve as a useful tool for understanding patients' current status regarding mental health problems.
Adolescent↗
[On the effects of psychoanalytic oriented psychotherapy - an inpatient multicenter study]
Whereas the efficacy of inpatient treatment in socalled psychosomatic rehabilitation clinics in Germany has been well researched and documented, studies involving large samples on the efficacy of inpatient treatment in acute hospitals are lacking. A multicentered retrospective study involving clinics for psychotherapy at three separate universities was conducted on a sample of n=495. The patients were treated on an inpatient basis between April 1990 and July 1998 in one of the clinics. The predominant approach to treatment of these clinics was psychodynamic. Other approaches such as behavioral therapy are integrated. In addition to sociodemographic variables clinical data (SCL-90-R, IIP, BSS, ICD-Diagnosis) at admission and discharge were collected. A follow-up study was not conducted. With an average effect size of 0.84 in terms of clinical scales the results demonstrate good efficacy of inpatient treatment. Effect sizes were high on the depression, obsessive-compulsive and anxiety scale of the SCL-90-R, and were low on the phobia subscale. By self report 55% of all patients indicated they had markedly improved, 22% indicated no change and 6% stated they were worse. 17% of all patients were below the chosen cut-off point of the GSI. Patients with a low level of education took benefit as well from the offered therapy. There was no clear relationship between effect size and length of hospital stay. This may be due to the particular setting of a university clinic.
Journal Article↗
[What happens with an advice to begin psychotherapy after psychotherapeutic councelling in a psychosomatic CL-Unit?]
In 1995, 285 patients had been advised by our institute to begin psychotherapy. After a period of one year they were contacted and asked if they had started or refused psychotherapy. Those who refused psychotherapy were asked about their reasons for doing so. 67,3% responded and 49,2% of the patients commencced psychotherapy. Signifiantly more younger patients as well as patients with a higher educational qualification took the advice of the institute to start psychotherapy. Gender did not influence the patient's decision to accept or refuse psychotherapy. The participants suffered more profound depression and anxiety than their counterparts. Lack of seeing a need for psychotherapy was the most common reason for refusals, accounting for 26,7% of the cases. The second miost common reason was reported to be practical and organisational in nature as well as mistakes done by the therapists. Comparing the group in view of the reasons for refusing psychotherapy no difference in age and gender was evident. However, patients with a lower educational qualification were less judicious as far as the need for psychotherapy was concerned. Less frequently they believed in a psychogenic cause for their complaints. The results of this study can help the therapist identifying patients who need to be admitted more intensely during the first diagnostic session in order to achieve a higher motivation for psychotherapy.
Journal Article↗
[Changes in alexithymia and emotional awareness during psychotherapeutic inpatient treatment].
The aim of the study was to investigate whether alexithymia and emotional awareness could be improved by psychotherapeutic inpatient treatment. The role of alexithymia and emotional awareness in predicting the treatment outcome was investigated. 48 psychosomatically ill patients completed German versions of the Toronto Alexithymia Scale (TAS-20), the Levels of Emotional Awareness Scale (LEAS), the Symptom Check List (SCL-90-R), the Global Assessment Scale of Function (GAF) and the "Beeinträchtigungs-Schwere-Score" (BSS) to assess the severity of patient psychological impairment. Psychotherapeutic inpatient treatment was associated with a decrease in alexithymia as measured by TAS-20. The expected improvement of emotional awareness failed to be statistically significant. This may be due to the smaller retest reliability of the LEAS. High scores in emotional awareness before therapy as measured by LEAS emerged as a predictor of successful psychotherapy with respect to GAF.
Adult↗