0000000000143654
AUTHOR
Winfried Rief
Life goals after brain injury in the light of the dual process approach: empirical evidence and implications for neuropsychological rehabilitation.
Sequelae of acquired brain injury endanger the realisation of important life-goals. Discrepancies arise between the importance attached to a goal and the success in realising it. This study investigates goal discrepancies and their influence on patients' subjective well-being (SWB) in different rehabilitation stages. Life-goals, SWB and daily functioning were assessed in 130 neurological inpatients and 42 outpatients by self-report questionnaires. Both patient groups reported greater discrepancies between importance and success of life-goals than a normative sample of healthy controls. In multiple regression modelling, goal discrepancy predicted SWB in the inpatient sample even when control…
COMPliance and Arthralgia in Clinical Therapy: the COMPACT trial, assessing the incidence of arthralgia, and compliance within the first year of adjuvant anastrozole therapy.
5 Office-based Professional Association Gynecologic Oncologists e.V. in Germany (BNGO e.V.), Berlin; 6 Background: This prospective study evaluated the relationship between arthralgia and compliance during the first year of adjuvant anastrozole therapy in postmenopausal women with hormone receptor-positive early breast cancer. Patients and methods: COMPliance and Arthralgia in Clinical Therapy (COMPACT) was an open-label, multicenter, noninterventional study conducted in Germany. Patients had started adjuvant anastrozole 3-6 months before the study start. The primary end points were arthralgia, compliance, and the relationship between compliance and arthralgia, assessed at specific time poi…
Living with acquired brain injury: Self-concept as mediating variable in the adjustment process
Sequelae of acquired brain injury (ABI) require adjustment processes in which survivors must strive to regain subjective well-being (SWB) in the face of chronic impairment. The current study investigates whether the self-concept of achievement mediates this process. Thirty-five post-acute patients with ABI were assessed neuropsychologically for performance in memory, attention, concept formation and reasoning. Data concerning subjective complaints in applied cognition, self-concept, and SWB were collected. Patients rated their self-concept more negatively compared to a normative sample. Effects of subjective complaints in applied cognition on SWB were mediated by the self-concept of achieve…
The need for a behavioural science focus in research on mental health and mental disorders
Psychology as a science offers an enormous diversity of theories, principles, and methodological approaches to understand mental health, abnormal functions and behaviours and mental disorders. A selected overview of the scope, current topics as well as strength and gaps in Psychological Science may help to depict the advances needed to inform future research agendas specifically on mental health and mental disorders. From an integrative psychological perspective, most maladaptive health behaviours and mental disorders can be conceptualized as the result of developmental dysfunctions of psychological functions and processes as well as neurobiological and genetic processes that interact with …
Screening for DSM-5 Somatic Symptom Disorder: Diagnostic Accuracy of Self-Report Measures Within a Population Sample.
OBJECTIVE The new DSM-5 somatic symptom disorder was introduced to improve the diagnosis of persons experiencing what used to be called somatoform disorders. So far, it is unclear whether existing self-report measures are useful to detect the new somatic symptom disorder. This study investigates the diagnostic accuracy of three self-report questionnaires that measure somatic complaints (15 item Patient Health Questionnaire [PHQ-15]) and psychological features (7-item Whiteley Index [WI-7]; Scale for Assessing Illness Behavior [SAIB]), in detecting somatic symptom disorder. METHODS A nationally representative general population survey was performed resulting in 250 participants (minimum age …
Why DSM-III was right to introduce the concept of somatoform disorders.
From the Psychological Institute, University of Mainz; and the Psychological Institute, University of Marburg, Marburg, Germany. Address correspondence and reprint requests to Dr. Hiller, Psychological Institute, University of Mainz, Staudingerweg 9, D-55099 Mainz, Germany; hiller@mail.uni-mainz.de (e-mail). Copyright 2005 The Academy of Psychosomatic Medicine. An interesting debate about the adequacy of the somatoform disorders as a diagnostic and clinical concept has begun. The debate is stimulated by the announcement of APA’s preparation of DSM-V, which is likely to follow DSM-IV as the world’s most influential classification system for defining the terminology and diagnostic definitions…
AB1394 Compliance and arthralgias in clinical therapy (compact): Assessment of the incidence of arthralgia, therapy costs and compliance within the first year of anastrozole therapy
Background Aromatase inhibitors (AI) are well established as adjuvant endocrine treatment for postmenopausal women with hormone receptor-positive (HR+) early breast cancer (EBC). Drug-induced myalgia or arthralgia is among the most frequently reported adverse drug reactions to AIs. Objectives Little is known about the pathomechanism by which AIs cause muscle and joint injury. The literature on skeletal muscle complaints with AIs is confusing, in part because of a lack of clear definitions. Myalgia/arthralgia is defined as muscle/joint pain and is likely to affect patients’ quality of life and compliance with AI medication . We designed a prospective trial to collect real world data on the e…
Compliance and arthralgias in clinical therapy (COMPACT): Assessment of the incidence of arthralgia, therapy costs, and compliance in the first year of adjuvant anastrozole.
e11040^ Background: Aromatase Inhibitors (AI) are well established as adjuvant endocrine treatment for postmenopausal women with HR+ early breast cancer (EBC). However, clinical trial data show higher frequently of arthralgia with AI than tamoxifen. As arthralgia may be greatly influencing compliance to adjuvant therapy, we designed a prospective trial to collect real world data on the effects of AI-associated arthralgia on patient compliance, patient outcomes and treatment costs of arthralgia. Methods: COMPACT is an open, prospective non-interventional study (NCT00857012) assessing the incidence of arthralgia, therapy costs, and compliance within the first year of adjuvant anastrozole (AN…
Toward empirically based criteria for the classification of somatoform disorders
Abstract There is a major need for an empirical evaluation of classification criteria for somatoform disorders. The present study analyzes psychometric properties of the existing criteria for somatization disorder. The full sample consisted of 324 patients seeking help because of “psychosomatic problems.” Data from a subsample of carefully diagnosed patients with somatization syndrome (n=76) and a clinical comparison group (n=32) permitted the analysis of the discriminative power of items. Twenty-one somatic symptoms adopted from DSM-IV and ICD-10 criteria did not exhibit the necessary psychometric characteristics (item probability, item-total correlation, etc.). Thirty-two somatic symptoms…
Differentiating hypochondriasis from panic disorder
Hypochondriasis and panic disorder are both characterized by prevalent health anxieties and illness beliefs. Therefore, the question as to whether they represent distinct nosological entities has been raised. This study examines how clinical characteristics can be used to differentiate both disorders, taking the possibility of mixed symptomatologies (comorbidity) into account. We compared 46 patients with hypochondriasis, 45 with panic disorder, and 21 with comorbid hypochondriasis plus panic disorder. While panic patients had more comorbidity with agoraphobia, hypochondriasis was more closely associated with somatization. Patients with panic disorder were less pathological than hypochondri…
A controlled treatment study of somatoform disorders including analysis of healthcare utilization and cost-effectiveness.
Abstract Objective: The purpose of this prospective study was to evaluate the effects of cognitive-behavioral treatment (CBT) on mental health status and healthcare utilization in patients with somatoform disorders (SFD) of a specialized tertiary care center. Methods: According to DSM-IV interviews, 54 patients had somatization disorder (SD), 51 abridged somatization syndrome (SSI-8) and 67 other defined SFD. A clinical non-SFD comparison group consisted of 123 patients. Treatment effects were controlled against the waiting list. Cost calculations for the 2-year periods before and after treatment were based on medical and billing records from health insurance companies. Results: The SFD pat…
Cognitive and emotional variables predicting treatment outcome of cognitive behavior therapies for patients with medically unexplained symptoms: A meta-analysis.
Cognitive behavior therapy (CBT) is the best-evaluated psychological approach to treat patients with medically unexplained symptoms (MUS). We still need a better understanding of what characterizes patients with MUS who benefit more or less from CBT. This systematic review aimed to identify patients' cognitive-emotional characteristics predicting the outcome of CBT for MUS.A systematic literature search (PubMed, PsycINFO, Web of Science) revealed 37 eligible studies, 23 of these provided data for meta-analyses. Mean correlation coefficients between predictor variables and the outcomes (symptom intensity, physical or social-emotional functioning) were calculated using a random-effects model.…
Advancing psychotherapy and evidence-based psychological interventions
Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom-based mental disorders as a result. (2) Psychotherapy research still lack…
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…
Searching for a Gastrointestinal Subgroup Within the Somatoform Disorders
The authors examined whether patients suffering from functional gastrointestinal symptoms constitute a separate group within the broader concept of the somatoform disorders. The authors compared 103 patients with a severe gastrointestinal syndrome, 220 patients with a somatization syndrome according to DSM-IV, and 250 clinical control subjects with nonsomatoform mental disorders. The gastrointestinal group showed more catastrophizing thinking, complained more about autonomic sensations, felt bodily weaker, was less tolerant towards bodily discomfort, had developed more hypochondriacal fears and behaviors, was more depressed, and was more severely disabled in different areas of psychosocial …
Importance of Psychotherapy motivation in patients with somatization syndrome
Abstract Low motivation for psychotherapy presents a special challenge to effective therapy in patients with multiple somatoform symptoms. As part of a controlled treatment study, the authors examined the extent to which patients’ initial level of psychotherapy motivation has an effect on long-term treatment outcome. After admission to a cognitive–behavioral treatment center, 161 inpatients with somatization syndrome were diagnosed using a structured clinical interview and completed measures of somatoform symptomatology, general psychopathology, and motivation for psychotherapy. To test the relationship between motivation and treatment outcome, the patients’ initial motivational characteris…
Effektivität einer stationären Gruppentherapie für Patienten mit multiplem somatoformen Syndrom:
Zusammenfassung. Theoretischer Hintergrund: Obwohl somatoformen Störungen eine erhebliche klinische und sozioökonomische Relevanz zukommt, liegen bislang nur wenige kontrolliert-randomisierte Therapiestudien vor. Fragestellung: Wir untersuchten daher a.) die kurz- und langfristige Effektivität eines stationären verhaltensmedizinischen Behandlungsprogramms und überprüften b.) die differentielle Wirksamkeit einer begleitenden kognitiv-behavioralen Gruppentherapie für Patienten mit multiplem somatoformen Syndrom. Methode: In einer psychosomatischen Fachklinik wurden 191 Patienten mit multiplem somatoformen Syndrom randomisiert den Interventionen (1) Standardbehandlung plus Gruppentherapie Som…