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Otto B Walter

Publications and source records attributed to Otto B Walter.

6 recordsLinked to original sources

Three assessment tools for deliberate self-harm and suicide behavior: evaluation and psychopathological correlates.

OBJECTIVE: The aims of this study are to adapt two validated self-report questionnaires of deliberate self-harm and suicidal behavior to German, to investigate their psychometric properties and agreement with clinician-administered ratings, and to examine their psychopathological correlates. METHODS: The Deliberate Self-Harm Inventory [Gratz KL. Measurement of deliberate self-harm: preliminary data on the deliberate self-harm inventory. J Psychopathol Behav 2001;23:253-263] and the Self-Harm Behavior Questionnaire [Guttierez PM, Osman A, Barrios FX, Kopper BA. Development and initial validation of the self-harm behavior questionnaire. J Pers Assess 2001;77:475-490] were completed by 361 patients hospitalized for depressive, anxiety, adjustment, somatoform, and/or eating disorders. A clinician-administered rating scale of self-destructive behavior was included. Psychopathological variables were assessed by standardized questionnaires. RESULTS: The self-report questionnaires demonstrated good reliability (alpha=.81-.96, split-half r=.78-.98, test-retest r=.65-.91). Reliability of the clinician-administered ratings was acceptable (interrater kappa=.46-.77, test-retest kappa=.35-.48). Intraclass correlations (ICC=.68) for all three instruments were satisfactory. Rates of self-harm and associations between self-harm and suicidal behaviors are reported. The findings support the hypotheses of a higher degree of psychiatric symptomatology in patients with self-harm behavior compared to those without. CONCLUSION: The two questionnaire adaptations are reliable and valid self-report scales for the assessment of self-harm and past suicidal behavior.

Adolescent↗

[Standardized diagnosing: computer-assisted (CIDI) diagnoses compared to clinically-judged diagnoses in a psychosomatic setting].

BACKGROUND: Within the past two decades, there has been an increasing trend towards the use of empirically-based, standardized instruments to diagnose mental disorders. The purpose of this study was to investigate the congruence between clinically-derived and standardized computerized diagnoses using the Composite International Diagnostic Interview (CIDI) in a psychosomatic setting. PATIENTS AND METHODS: N = 230 inpatients treated at the Department of Psychosomatic Medicine, Charité Berlin, were diagnosed for mental disorders by experienced clinicians and by the CIDI according to the diagnostic criteria of ICD-10 and DSM-IV. RESULTS: Congruence between computerized and clinically-derived diagnoses for all mental disorders was fair to poor (kappa = 0.0 - 0.33). The diagnostic congruence of somatoform (F45), anxiety (F40 - 41), depressive (F32 - 34), eating (F50) and dissociative disorders (F44) and disorders due to psychoactive substance use (F10 - 19) was fairly low (kappa = 0.19 - 0.33). Diagnostic congruence of diagnoses of reactions to severe stress (F43) and obsessive compulsive disorders (F42) was particularly poor (kappa = 0.0 - 0.01). CONCLUSION: Overall diagnostic congruence between computerized and clinical diagnostics was unsatisfactory. Thus, the validity of computer-assisted standardized interviews - like the CIDI - is questionable in a psychosomatic setting.

Adult↗

Development of a computer-adaptive test for depression (D-CAT).

Depression is one of the most prevalent mental health problems and measuring depressive symptoms becomes increasingly important in science as well as medical practice. Computer Adaptive Tests (CAT) based on the Item Response Theory (IRT) promise to enhance measurement precision and reduce respondent's burden. Our aim was to develop a CAT application to measure depressive symptoms. Three thousand two hundred seventy psychosomatic patients answered an overall of 11 mental health questionnaires at the University Clinic in Berlin. Three independent reviewers rated 144 items out of these questionnaires as indicative of depressive symptoms. All items underwent six empirical steps to analyze unidimensionality, local independence and item discrimination. Finally 64 items could be used to calculate item parameters applying a Generalized Partial Credit Model (GPCM). CAT scores were estimated using an 'expected a posteriori' algorithm (EAP). Two simulation experiments showed that for theta values within the range of 2SD around the mean (98% of the cases), the latent trait can be estimated out of approximately six items with a predefined standard error of [Symbol: see text] 0.32 (reliability rho [Symbol: see text] 0.90). The CAT-scores correlated high with scores of all depression items (r = 0.95), with the Beck Depression Inventory (r = 0.79) and with a CES-D 8 item short form (r = 0.76). We conclude that the Depression-CAT measures depressive symptoms with high precision and low respondent burden.

Adolescent↗

[Personality and donor-recipient relationships of potential donors before living donor liver transplantation--diagnostics with the repertory-grid technique].

BACKGROUND: Living-donor liver transplantation (LDLT) is developing into an established therapy for terminal liver diseases in adults. Potential donors are faced with the risk of postoperative complications and are subject to a high level of psychological pressure and ambivalent feelings. Our assumption is that ambivalent feelings before donation are crucially influenced by the personality and the quality of the donor-recipient relationship. In highly motivated donors we expected a positive description of the recipient and a similarity in the characterisation of the donor and recipient. METHODS: 58 potential living donors were evaluated between March 2000 and June 2001. On the basis of the clinical interview 10 were rated as unsuited for donation. Among those potential donors assessed as unsuited, we found a high level of ambivalent feelings. For 50 potential donors we gained a set of completed psychometric diagnostic questionnaires. A Repertory-grid investigation was conducted with a total of 28 potential donors. Seven of them were not recommended as living donors. The relationship between donors and recipients was analysed concerning constructs that were most important to the characterisation of the donor or recipient. By means of inter-element distances self-concept of donors and donor-recipient relation were analysed. RESULTS: Ambivalent candidates who were not recommended as living donors tended to describe the recipient negatively (selfish, carping, and unable to take criticism) and did not show a similarity in the characterisations of self and ideal-self. Whereas the highly motivated candidates were marked by a closeness of self and ideal-self concepts. Both groups saw the recipient as indifferent. CONCLUSION: Closeness between self and ideal-self-indicating satisfaction with the decision to donate seems to be one suitable criterion to distinguish between highly motivated potential donors on the one hand and ambivalent candidates on the other hand. Another criterion appears to be a description of the recipient that indicates either a functioning or ill-functioning communication between donor and recipient with respect to the donation.

Adult↗

The Perceived Stress Questionnaire (PSQ) reconsidered: validation and reference values from different clinical and healthy adult samples.

OBJECTIVE: The aim was to translate, revise, and standardize the Perceived Stress Questionnaire (PSQ) by Levenstein et al. (1993) in German. The instrument assesses subjectively experienced stress independent of a specific and objective occasion. METHODS: Exploratory factor analyses and a revision of the scale content were carried out on a sample of 650 subjects (Psychosomatic Medicine patients, women after delivery, women after miscarriage, and students). Confirmatory analyses and examination of structural stability across subgroups were carried out on a second sample of 1,808 subjects (psychosomatic, tinnitus, inflammatory bowel disease patients, pregnant women, healthy adults) using linear structural equation modeling and multisample analyses. External validation included immunological measures in women who had suffered a miscarriage. RESULTS: Four factors (worries, tension, joy, demands) emerged, with 5 items each, as compared with the 30 items of the original PSQ. The factor structure was confirmed on the second sample. Multisample analyses yielded a fair structural stability across groups. Reliability values were satisfactory. Findings suggest that three scales represent internal stress reactions, whereas the scale "demands" relates to perceived external stressors. Significant and meaningful differences between groups indicate differential validity. A higher degree of certain immunological imbalances after miscarriage (presumably linked to pregnancy loss) was found in those women who had a higher stress score. Sensitivity to change was demonstrated in two different treatment samples. CONCLUSION: We propose the revised PSQ as a valid and economic tool for stress research. The overall score permits comparison with results from earlier studies using the original instrument.

Abortion, Spontaneous↗