Adjustment disorder as proposed for ICD-11: Dimensionality and symptom differentiation
Although Adjustment Disorder as a diagnostic category is widely used in clinical practice it is critically discussed that it has not been conceptualized as a category with unique symptoms. Hence, the conceptualization of Adjustment Disorder is subject to substantive change in ICD-11 including core symptoms and additional features in a uni-faceted concept. Adjustment Disorder was assessed with a self-rating instrument in a representative sample of the German general population (N=2512). Confirmatory factor analyses (CFA) were applied to test the dimensionality of symptoms according to the new diagnostic concept. Latent class analysis (LCA) was applied to test whether there are distinguishabl…
Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population.
Abstract Background Recently, the two item version of the Cambridge Depersonalization Scale (CDS-2) has been validated in a clinical sample and has demonstrated that it is a useful tool for the detection of clinically significant depersonalization (DP). In order to provide a framework for the interpretation of the CDS-2 scores the aim of this study was to achieve normative data of a representative sample of the German population and to evaluate the associations with depression, anxiety and sociodemographic characteristics. Methods A nationally representative face-to-face household survey was conducted during the mid of 2009 in Germany. The sample comprised N = 2512 participants. The survey …
Frequency of somatic symptoms in the general population: Normative values for the Patient Health Questionnaire-15 (PHQ-15).
The PHQ-15 is widely used as an open access screening instrument for somatic symptoms in different health care settings. The objectives of the study were to contribute to the construct validity and to generate normative data for the PHQ-15.The survey was conducted in the general population in Germany from August 2011 to November 2014 (n=9250). All participants underwent an extensive core assessment including a set of questionnaires.Men reported significantly less (p0.001) physical symptoms than women (4.6 [SD=3.6] vs. 6.3 [SD=4.1]). The PHQ-15 total score was strongly correlated with the physical component of quality of life (r=-0.58), fatigue (r=0.56), anxiety (r=0.54) and sleep problems (…
Cross-cultural measurement invariance of the General Health Questionnaire-12 in a German and a Colombian population sample
While the General Health Questionnaire, 12-item version (GHQ-12) has been widely used in cross-cultural comparisons, rigorous tests of the measurement equivalence of different language versions are still lacking. Thus, our study aims at investigating configural, metric and scalar invariance across the German and the Spanish version of the GHQ-12 in two population samples. The GHQ-12 was applied in two large-scale population-based samples in Germany (N = 1,977) and Colombia (N = 1,500). To investigate measurement equivalence, confirmatory factor analyses were conducted in both samples. In the German sample mean GHQ-12 total scores were higher than in the Colombian sample. A one-factor model …
Konfirmatorische Prüfung der Skalenstruktur des SF-12 Version 2.0 in einer deutschen bevölkerungs-repräsentativen Stichprobe
Zusammenfassung. Der Short Form Health Survey SF-12 Fragebogen ist die Kurzform des krankheitsübergreifenden Short Form SF-36 Health Survey, der zur generischen Erfassung der gesundheitsbezogenen Lebensqualität eingesetzt wird. Die 12 Items des SF-12 erlauben die Bildung eines körperlichen und eines psychischen Summenwertes. Mittels konkurrierender konfirmatorischer Strukturmodelle wurden auf Basis der Daten einer für Deutschland repräsentativen Normstichprobe von N = 2 524 Personen 3 theoriebasierte bzw. in der Literatur berichtete Modellvarianten geprüft. Nach Modifikation des Messmodells des psychischen Faktors konnte eine gute Datenpassung des zweidimensionalen Modells erreicht werden …
Long-term effects on adult attachment in German occupation children born after World War II in comparison with a birth-cohort-matched representative sample of the German general population.
Children born of war are a phenomenon of every conflict. At the end of World War II and thereafter, approximately 400,000 children were fathered by foreign soldiers and born to local women in Germany. Quantitative research on psychosocial consequences of growing up as German occupation child (GOC) has been missing so far.This study examines adult attachment and its association with current depression in GOC (N = 146) using self-report instruments: Adult Attachment Scale, Patient Health Questionnaire. Data were compared to a birth-cohort-matched representative sample of the German population (BCMS; N = 786).GOC differ in both attachment dimensions (less comfortable with closeness/intimacy, l…
Minimization of childhood maltreatment is common and consequential: results from a large, multinational sample using the childhood trauma questionnaire
Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale-originally designed to assess a positive response bias-are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ's MD scale: 1) its prevalence; 2) its latent struc…
Depression, Somatization, and Posttraumatic Stress Disorder in Children Born of Occupation After World War II in Comparison With a General Population.
At the end of World War II and during the first decade after the war, roughly 200,000 children were fathered in intimate contacts between German women and foreign soldiers. The experiences of these German occupation children (GOC) have been so far described in case reports and from historical perspective only. Research on psychosocial consequences of growing up as a GOC has been missing so far. This study examined traumatic experiences, posttraumatic stress disorder, somatization, and depression in GOC (N = 146) using self-report instruments: Posttraumatic Diagnostic Scale and Patient Health Questionnaire. Findings have then been compared with a representative birth cohort-matched sample fr…
Life satisfaction, distress, and resiliency across the life span of women.
Objective: This study aimed to determine (1) the relationship between life satisfaction, mental disorders, and aging in the female community and (2) to identify the impact of vulnerability factors, personal (resilience, self-esteem), and social resources on life satisfaction and distress. Methods: A stratified random sample of the German female population (N = 2,540) was investigated using standardized questionnaires of life satisfaction (Questions on Life Satisfaction), depression, anxiety (Patient Health Questionnaire), resilience scale (RS-11), and self-esteem (Rosenberg Self-Esteem Scale). Results: When participants were divided into six age groups (18-30, 31-40, 41-50, 51-60, 61-70, an…
Evaluation of the revised sense of coherence scale in a representative German sample.
Background and objectivesTo evaluate the Revised Sense of Coherence (SOC-R) scale in a large representative German sample.DesignA nationwide household survey involving a total of 2510 face-to-face interviews.MethodsIn addition to the SOC-R, childhood trauma and maltreatment (CTM), lifetime traumatic events (Childhood Trauma Questionnaire, CTQ, and the Life Events Checklist for DSM-5, LEC-5), and mental health (Patient Health Questionnaire, PHQ-4) were assessed.ResultsThe final sample consisted of N = 2373 participants (52.3% females; M = 48.24 years). Confirmatory factor analyses confirmed a three-factor structure for the SOC-R ('manageability', 'balance', 'reflection') with acceptable indi…
Association of Physical Morbidity and Health-Related Quality of Life in a Representative Sample of Older German People
Abstract. The association between health-related quality of life (HRQoL; Short-Form Health Survey-12; SF-12) and patient-reported morbidity-related symptoms measured by the Patient Health Questionnaire-15 (PHQ-15) is analyzed in a representative sample of older people in the general German population. Data from 1,659 people aged 60 to 85 years were obtained. Latent class analysis identified six classes of patients, which optimally categorize clusters of physical symptoms the participants reported: musculoskeletal impairments (39.8%), healthy (25.7%), musculoskeletal and respiratory/cardiac impairments (12.8%), musculoskeletal and respiratory impairments, along with bowel and digestion prob…
Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample.
Abstract Background The Generalized Anxiety Disorder Scales GAD-7 and GAD-2 are instruments for the assessment of anxiety. The aims of this study are to test psychometric properties of these questionnaires, to provide normative values, and to investigate associations with sociodemographic factors, quality of life, psychological variables, and behavioral factors. Methods A German community sample (n=9721) with an age range of 18–80 years was surveyed using the GAD-7 and several other questionnaires. Results Confirmatory factor analyses confirmed the unidimensionality and measurement invariance of the GAD-7 across age and gender. Females were more anxious than males (mean scores: M=4.07 vs. M…
Life satisfaction, anxiety, depression and resilience across the life span of men
To determine (a) the relationship between life satisfaction, anxiety, depression and ageing in the male community and (b) to identify the impact of vulnerability factors, personal and social resources on life satisfaction and distress.A stratified random sample of the German male population (N = 2144) was investigated by standardized questionnaires of life satisfaction (FLZ(M)), depression, anxiety (PHQ), resilience (RS-11) and self-esteem (RSS).No age-related change was found regarding overall life satisfaction. Satisfaction with health decreased in midlife (51-60 years), while the importance of health increased. Importance of and satisfaction with partnership and sexuality were only reduc…
Validierung der Messung gesundheitsbezogener Lebensqualität mittels des Short-Form-Health-Survey-12 (SF-12 Version 2.0) in einer deutschen Normstichprobe
Validation of the Short-Form-Health-Survey-12 (SF-12 Version 2.0) assessing health-related quality of life in a normative German sample Objectives: Convergent and divergent validation of the Short-Form-Health-Survey-12 assessing HRQoL by analyzing its associations with depressiveness (PHQ-9), social support (OSS-3) and satisfaction with life (SWLS). Methods: A normative German sample (N = 2.524) was analyzed using correlation, regression as well as confirmatory factor analysis and structural equation modelling for ordinal data. Results: The SF-12-scale Mental Health is associated most strongly with the validation criteria (PHQ: r[scales/constructs] = -.73/-.88, OSS-3: r = .35/.55, SWLS: r =…
Is somatosensory amplification a risk factor for an increased report of side effects? Reference data from the German general population
Abstract Objective The study investigates the association between somatosensory amplification and the reporting of side effects. It establishes a German version of the Somatosensory Amplification Scale and examines its psychometric properties in a representative sample of the German population. Methods Sample size was 2.469, with 51% taking any medication. Participants answered the Somatosensory Amplification Scale, Generic Assessment of Side Effects Scale, and indicated whether they were taking any medication and the type of medication. Correlational analysis and binary logistic regression were performed. Results When examining a subsample reporting both medication intake and general bodil…
The association of adverse childhood experiences and of resilience with chronic noncancer pain in the German adult population - A cross-sectional survey.
Background Adverse childhood experiences (ACE) might predispose to and resilience might protect against chronic noncancer pain (CNCP). We studied whether ACE are positively associated with CNCP, whether resilience was negatively associated with CNCP and whether resilience buffered a potential association of ACE with CNCP. Methods A cross-sectional survey (N = 2,425) representative for the adult German general population was conducted in 2013. The following questionnaires were used: Chronic Pain Grade Questionnaire for CNCP stages; Childhood Trauma Screener for ACE; Brief Resilient Coping Scale for resilience; Patient Health Questionnaire 4 for psychological symptom burden; Giessen Subjectiv…
East vs. West: Differences in the prevalence of child maltreatment in Germany before the reunification
Sleep quality in the general population: psychometric properties of the Pittsburgh Sleep Quality Index, derived from a German community sample of 9284 people.
Abstract Background The Pittsburgh Sleep Quality Index (PSQI) is frequently used to assess sleep problems in patients. The aim of this study was to provide reference values for this questionnaire, to test psychometric properties, and to analyze associations with psychological, sociodemographic, and behavioral factors. Methods A German community sample comprising 9284 adult residents (aged 18–80 years) was surveyed using the PSQI and several other questionnaires. Results According to the generally accepted cut-off (PSQI > 5), 36% of the general population slept badly. Females reported significantly more sleep problems than males (mean scores: M = 5.5 vs. M = 4.4, respectively; effect size d …
Normierung des SF-12 Version 2.0 zur Messung der gesundheitsbezogenen Lebensqualität in einer deutschen bevölkerungsrepräsentativen Stichprobe
Zusammenfassung. Der Short-Form-Health Survey (SF-12) ist ein Screeninginstrument zur Erfassung der gesundheitsbezogenen Lebensqualität. Der Körperliche Skalenwert repräsentiert Allgemeine Gesundheitswahrnehmung, Körperliche Funktionsfähigkeit und Rollenfunktion sowie Schmerzen. Der Psychische Skalenwert bildet Emotionale Rollenfunktion, Psychisches Wohlbefinden, Negativen Affekt und Soziale Funktionsfähigkeit ab. Alternativ kann die Emotionale Rollenfunktion getrennt ermittelt werden. Die Daten entstammen einer schriftlichen Befragung einer für Deutschland repräsentativen Normstichprobe von N = 2 524 Personen. Der Körperliche Skalenwert kann mit R2 = .305 besser prädiziert werden als die …