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N Hartkamp

Publications and source records attributed to N Hartkamp.

14 recordsLinked to original sources

[Specific countertransference experience and interpersonal problem description in psychodynamic psychotherapy].

In psychodynamic psychotherapy, countertransference and its professional use is seen as an important means to identify central difficulties of patients. The present study examines the correspondence of countertransference and interpersonal difficulties in 30 therapist-patient couples in day hospital psychodynamic psychotherapy. Interpersonal problems were recorded using the inventory of interpersonal problems (IIP) and countertransference was measured using the impact message inventory (IMI). Correspondence was measured as the correlation of IIP data from the patients and IMI data from the therapists. Data were collected at the start of therapy, after 4 weeks of treatment, and at the end of treatment. Over the course of the therapy, an increase in the correspondence of interpersonal problems as reported by patients and countertransference could be observed, starting with r = 0.22 at the beginning of therapy and continuing through r = 0.47 after 4 weeks to r = 0.58 at the end of therapy. The mean correlation was slightly above that of a control group of 20 nonclinical couples associated for at least 6 months.

Adult↗

The Symptom Check-List-90-R (SCL-90-R): a German validation study.

The Symptom Check-List-90-R (SCL-90-R) is a widely used psychological status symptom inventory. The properties of the German SCL-90-R version were studied in two clinical samples: psychosomatic outpatients and primary care patients. The data were compared with a German community sample. The internal consistency, measured by Cronbach's alpha coefficients, was found to be high, for the global scale and all original subscales. Mokken scale analysis indicated hierarchical structure for most of the subscales. Concurrent validity, evaluated by studying the relationship between the SCL-90-R subscales and the Inventory of Interpersonal Problems (IIP-C) and the General Health Questionnaire (GHQ-12) was also high. On the basis of receiver operating characteristic (ROC) analyses, it was found that the SCL-90-R was able to differentiate between subjects known to have a given psychological disorder and those who do not. Results of exploratory and confirmatory factor analysis failed to support the original nine factor model and two subsequent factor models. The strong interdependence of the original subscales and the strong first unrotated factor of the exploratory factor analyses raised concern regarding the multi-dimensionality of the SCL-90-R subscales. We concluded that the SCL-90-R is a useful tool for measuring psychological status, measuring change in outcome studies, or screening for mental disorders.

Adult↗

Comparison of the standard and the computerized versions of the Symptom Check List (SCL-90-R): a randomized trial.

OBJECTIVE: The purpose of this study was to examine whether computer administration of the Symptom Check List (SCL-90-R) is equivalent to paper-and-pencil originals. METHOD: 282 psychosomatic outpatients were randomly assigned to computer or paper-and-pencil conditions. Statistical equivalence tests were used to examine psychometric equivalence for the means. Reliabilities and correlations were compared for the two methods of administration. RESULTS: No systematic differences were observed in group means for most of the subscales. Subjects of the computer-administered group scored higher on the SCL-90-R subscale 'Obsessive-Compulsive' and 'Anger-Hostility' than the control subjects. Gender and administration mode interaction was observed for one subscale, while age and administration interaction was observed for another subscale. CONCLUSION: Using computer-administered tests makes administration and scoring of tests more efficient. The differences between the two administration modes were small, although noticeable. Further research is needed to determine whether computer environment, computer experience and age may influence the test results.

Adult↗

[Not Available].

Inpatient psychotherapy is characterized by a combination of different therapeutic approaches. Research on psychotherapeutic processes in inpatient psychotherapy uses often only a single observer's perspective, based on the assumption that there exists a unitary process underlying the total process of inpatient psychotherapy. This assumption is investigated in the present study of two single psychotherapy cases. The process is documented by means of Intrex-questionnaire of both therapist and patient, and by the SASB-coded videotaped and transcribed interactions. The results show a marked incongruence of the process as seen from the perspective of independent raters and from the questionnaire based self-report of therapist and patient. These findings put the commonly described process models of inpatient psychotherapy into question.

Inpatient psychotherapy↗

Assessing clinically significant change: application to the SCL-90-R.

A Symptom Checklist (SCL-90-R) is a potentially useful measure of psychological distress; it is frequently used in psychotherapy research and clinical practice. The purpose of this study was to illustrate the use of the SCL-90-R for determining statistically reliable change and clinical significance outlined by Jacobson and Truax in 1991. This paper describes the concepts of statistical and clinical significance of change. A proposal for obtaining and characterizing samples is made. Then a clinician's perspective is taken. Reliable change estimates and cut-off scores are chosen based on outcome data. Selected data from a single psychotherapeutic process and outcome study then were used to test the estimates of change and cut-off scores.

Adult↗

Computerized administration of the Symptom Checklist (SCL-90-R) and the Inventory of Interpersonal Problems (IIP-C) in psychosomatic outpatients

This study investigated whether the method of administration (computer vs. paper-and-pencil) influenced mean scores on the Symptom-Checklist (SCL-90-R) and the Inventory of Interpersonal Problems (IIP-C). The performance of 32 psychosomatic outpatients on the computerized version was compared with the performance of a matched control group on the paper-and-pencil version. No systematic differences were observed in group means.

Journal Article↗

[The Dusseldorf short-term dynamic psychotherapy project (DKZP)].

Time-limited psychodynamic therapies in the outpatient setting are offered for a broad spectrum of psychogenic disorders. Meta-analyses prove their effectiveness mainly for neurotic disorders. We are interested in the suitability of the here applied CMP/SASB model (Tress et al. 1996) of psychodynamic short-term therapy for patients with psychosomatic and severe personality disorders. We extensively present the concept of Cyclic Mal-adaptive Pattern (CMP) in its clinically relevant parts as the core of psychogenic pathological developments. Particularly the introject, as the patient's attitude towards him- or herself, is of great importance for therapeutic change and its follow-up development. Within the DKZP (Duesseldorf Short-Term Psychotherapy Project), 36 male and female therapists, mostly interns at the local university clinic, treated 82 patients (m: 23/f: 59) with personality disorders (n = 26) and psychosomatic disorders (n = 31) as research groups and, in comparison, neurotic patients (n = 25) in a naturalistic design. 68 treatments have been completed so far, 11 patients have dropped out, the remaining 3 are still in therapy. Relevant research instruments are the Beeinträchtigungsschwere Score (BSS, an impairment score), Global Assessment of Functioning Scale (GAF), Cyclic Maladaptive Pattern (CMP), Symptom Check List (SCL-90-R), and Structural Analysis of Social Behavior (SASB) including process and content ratings, as well as the Intrex questionnaire. The treatments last 25 sessions. We carried out follow-up examinations after 6 months, 1 year, 2, and 5 years. Effect sizes for the whole sample by BSS and GAF are remarkably high, with further increase at follow-up interviews. Psychosomatic patients came off best, but personality disorders in comparison to neurotic patients profited surprisingly well. Effect sizes in self-rating (SCL and Intrex) were less high. However, in self-rating the changes of social functions are not sufficiently addressed. As a result, our form of focal therapy is well suited not only for neuroses, but also for psychosomatic disorders and personality disorders. An enlargement of the indication spectrum for this form of psychodynamic therapy to include these disorders is well founded and promising.

Adult↗

[Fine tuning an analytic supervision].

With a casuistry we tried to show how disturbances in the free-floating attention of the reporter, which take on the character of micro-symptoms, can be based on the structural similarity of experience moments of therapist and patient; we were able to show how these experience moments influenced the report of an analytic supervision group. Only after a third person joined the others, the triangular relationship within the supervision, was it possible to consciously perceive the structural similarity. Within such a triangular relationship, where the person opposite can always also be seen through the eyes of a third party, it is possible that the capabilities of self-reflection and self-evaluation, which characterize the analytic attitude, can develop via identifications.

Adult↗

[Relation between research and practice in analytic psychotherapy].

The technique of psychoanalytic treatment as an objective, operative-technological theory inevitably experiences a subjective refraction on analyst's personality and his or her own cognitive and interactional styles influencing therapeutic efficiency. Systematic clinical trials of treatment data integrating motions from psychoanalytic, social and cognitive science, reconcile the gap between research and practice, between basic science and application. It will be discussed how empirical research can delineate therapists' cognitive and perceptual skills and the process of transformation from declarative to procedural knowledge, further elaborated in reciprocal connection with practice. The models of Structural Analysis of Social Behavior (SASB) and Cyclic Maladaptive Pattern (CMP) are especially considered. We will also discuss the consequences for training in psychoanalysis.

Countertransference↗

[Diagnosis of ego functions and object relations based on rating scales].

This study investigated rater-agreement and the factorial structure of the Rating-Scales for the assessment of object-relations and ego-functions developed by Bellak and coworkers. A subset of the original scales with the modifications and translations performed by Streeck was used, altogether 19 scales consisting of sub-components of seven functions. These were applied in assessing patients with neurotic disorders, alcohol addiction and Crohn's disease (n = 25 each). Rater-agreement was not satisfactory: In almost all scales there were significant differences in central tendency; only in seven scales rater-agreement was adequate, it's height varying for diagnostic groups and functions. Results of factor-analysis showed a two-dimensional structure. Implications for further research with these scales are discussed.

Adult↗

[Some findings in infant observation and the new developmental psychology].

In psychoanalytic nosology certain disorders, especially the so-called "early pathologies" or "preoedipal disorders", are labeled in terms of traditional psychoanalytic developmental psychology. The implications of this terminology served as a starting point for the development of special psychotherapeutic approaches, which are modifications of the psychoanalytical standard technique. In the light of the results of infant observation and of recent developmental psychology some of the concepts of psychoanalytic developmental psychology need to be revised, especially those of "normal autism", the "undifferentiated selfobject matrix" and the assumptions concerning the relationship between primary process and secondary process.

Child↗

[Premature termination--a multifactoral phenomenon].

Twelve drop out cases in psychodynamic short term therapies according to the focus of cyclic maladaptive pattern by Strupp and Binder (CMP 1984) are reviewed regarding initial diagnostics, tape-recorded therapy sessions, and supervision records. Predictors of premature termination of therapy such as initially rated patients' therapy motivation, narcissistic personality traits, but also characteristics of interpersonal behavior of both patient and therapist are examined and discussed. Particularly important are the therapeutic alliance and narcissistic patients' difficulties to relate personally to their therapists instead of enacting projective dynamics of idealization and devaluation. Therapists frequently tend to respond to them by subconscious display of hostile countertransference. Four patterns of dynamics of therapy drop outs are described.

Adult↗

[Crohn disease--addiction--neurosis: comparison of ego functions].

25 neurotic patients, 25 alcoholics, and 25 patients suffering from Crohn's disease were rated with a german adaption (by Streeck) of Bellak's Ego Function Assessment scales. Crohn's disease patients showed personality characteristics similar to those of patients suffering from psychosomatic illnesses. Ego function disturbances could be found with respect to Introspection as a subfunction of Reality Testing, Creativity and Capacity for Abstraction as a subfunction of Thought Processes. The results indicated a remarkable heterogeneity of the Crohn's-patient group as well as possible influences of gender-specific personality differences in that group.

Adult↗