Search

Hintergrund: Oxytocin könnte den Erfolg psychotherapeutischer Behandlungen erhöhen, indem es die therapeutische Allianz stärkt. Der Einfluss von Oxytocin auf den psychothe-rapeutischen Prozess, insbesondere die therapeutische Allianz, ist jedoch noch wenig erforscht. Patienten und Metho-den: Im Blut von 35 Bundeswehrsoldaten, die eine fünf-wöchige, internetbasierte, traumafokussierte Psychotherapie für die posttraumatische Belastungsstörung (PTBS) in Anspruch nahmen, wurde vor Behandlungsbeginn Oxytocin gemessen. Es wurde überprüft, ob Oxytocin die Bewertung der therapeutischen Allianz, speziell der Subkomponenten Zustimmung zur Zusammenarbeit und emotionale Bin-dung, die während und nach der Behandlung erfragt wurde, beeinflusste. Der Einfluss von Oxytocin auf weitere allgemeine Wirkfaktoren der Psychotherapie und die Psycho-therapieerwartung und -bewertung wurde exploriert. Ergebnisse: Oxytocin hatte keinen signifikanten Einfluss auf die frühe Zustimmung zur Zusammenarbeit. Diese wiederum prädizierte die Symptomreduktion. Frühe emotionale Bindung wurde nicht von Oxytocin beeinflusst und prädizierte auch die Symptomreduktion nicht. Die Deskriptivstatistiken zeigten, dass die allgemeinen Wirkfaktoren der Psychothe-rapie von Patienten mit höheren Oxytocinkonzentrationen positiver eingeschätzt wurden. Die deskriptiven Zusammenhänge zwischen Psychotherapieerwartung und -bewertung und Oxytocin fielen unterschiedlich aus. Diskussionen und Schlussfolgerungen: Es wurden positive Effekte höherer Oxytocinkonzentrationen bei PTBS-Patienten beobachtet. Die Studie ist durch ihre kleine Stichprobengröße limitiert. Ihr Schwerpunkt lag auf deskriptiven Auswertungen und sie muss an größeren, unabhängigen Stichproben repliziert werden. Sie liefert jedoch erste Hinweise für einen positiven Nutzen von Oxytocin bei traumafokussierter Psychotherapie. [ABSTRACT FROM AUTHOR]

Background: The number of service members of the German armed forces suffering from deployment-related mental health problems is steadily rising. Preliminary studies have shown that less than 50 % seek professional help. There is little knowledge about the factors influencing the development of an adequate level of patient competence to cope with the complexity of the clinical picture and the care of people with operational disabilities in the interprofessional network., Methods: The article presents data gathered by semi-structured, guided interviews from 14 affected individuals analyzing salient beliefs about the perceived factors influencing their patient competence and care through the interprofessional network of supporters inside and outside the German armed forces. Data evaluation was carried out by means of content-structuring, qualitative content analysis using the method of deductive-inductive category formation., Findings: Based on the interviews conducted, we identified four groups of salient beliefs having an influence on patient competence: identify changes and limitations, recognize illness, redirect one's life, help shape one's life again, and four groups of salient beliefs having an influence on care: intangible / material support, medical supplies, psychosocial support, third-party support. All main topics could be assigned to three levels of influence (individual, individual-contextual, contextual) and stored with a total of 70 topics (codes)., Interpretation: The development of an effective "social structure" was named by those affected as an important influencing factor. Family members, comrades, superiors, and military GPs appear to have a significant impact on patient competence and care. The respondents' opinions about the importance of internal factors such as the soldier's self-image and fear of stigmatization are consistent with previous findings. Structural factors like supply procedures were mentioned as specific German armed forces phenomena., (Copyright © 2023. Published by Elsevier GmbH.)

Intervention programs for psychological stress in children of military personnel in the USA - Results of a systematic literature review with regard to transferability to Germany Abstract. Military personnel who have been deployed in war zones or other unstable regions are at an increased risk to develop mental health disorders, including posttraumatic stress disorder. Likewise, their children are at high risk to develop mental health problems as well as emotional and behavioral difficulties. Most research on prevalence of mental health problems as well as on interventions within this group was conducted in the USA. In Germany, no systematic intervention for children of military members focusing on their experiences of deployment exist. The systematic literature review aimed to analyze existing intervention programs in the USA, in particular for children of military members regarding evidence, type and addressed target group (parents, children, both). Compared to the social welfare and health care systems in the USA, the German systems are different. Hence, a second aim was to examine the transferability of these programs to the specific needs of children of German military members (Bundeswehr). 27 intervention programs could be included in the review. Programs, directly or indirectly, are addressing the needs of children of a deployed parent. They are usually focusing on the "emotional cycle of deployment" (phase of preparation of deployment, separation phase of deployment and the return of the deployed parent). The programs mainly focused on parenting skills, family reactions to stress, coping strategies of families, and the feeling of coherence within the family. Only 20 % of the interventions could be assigned to the type of indicated prevention. Nine interventions have shown positive effects (either in RCT or non-experimental designs). Several elements of the programs are transferable to the German situation of children of military members. In particular, contents which address the specific situation of families with a military member are desperately needed in Germany. Transferability is limited by the non-comparability of health care and social welfare systems in the USA and in Germany.

Theoretical Background and Objective of the Study:  Mental illness stigma is a barrier to healthcare utilization. This study is the first to research the connection between mental illness stigma and the use of healthcare by veterans of the German Armed Forces. An overview of perceived stigma components in this sample is provided that should help understand how these factors influence healthcare utilization., Methods:  43 interviews with veterans of the German Armed Forces were conducted. The resulting data were analyzed in several coding steps. It was investigated whether the stigma experience of veterans of the German Armed Forces could be well illustrated by the theory-based stigmatization model of Link and Phelan. A set of hypotheses on stigma and healthcare utilization based on the data were developed., Results:  All stigma components according to the model of Link and Phelan were found in the sample. Internalized stigma, perceived public stigmatization, vocational disadvantage and social exclusion as well as feared misunderstanding of the military past in the civilian sector were reported as main stigma-relevant barriers to the use of healthcare., Conclusions:  Recommendations for interventions are given to decrease mental illness stigma in this specific group of former soldiers., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)