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The objective of this study was to determine the long-term quality of life (QOL) in patients with an abdominal aortic aneurysm (AAA) undergoing surveillance or after operative treatment.249 patients with AAAs completed the WHO Quality of Life-BREF (WHOQOL-BREF) test and Short Form (36) Health Survey (SF-36) survey: 78 patients with small AAAs under surveillance, 26 after ruptured AAAs (rAAAs), 47 after endovascular aneurysm repair (EVAR), and 98 after elective open repair. The results were compared with WHOQOL-BREF and SF-36 standard values from a matched German population using the Student's 2-tailed t-test.Long-term results of the WHOQOL-BREF test showed that patients undergoing AAA surveillance had a significantly lower physical QOL (P = 0.04). Patients after EVAR or open repair rated their environmental QOL significantly higher than the age- and sex-matched general population (open repair: P = 0.006; EVAR: P0.001). Patients with rAAAs had the same QOL as the matched German population. Long-term results of the QOL SF-36 showed that patients undergoing AAA surveillance rated their QOL significantly lower in the subgroup of role-physical (P = 0.02) and role-emotional (P = 0.003). Patients with rAAAs rated lower scores for role-physical (P = 0.02) and had more bodily pain (P = 0.02). Patients who underwent elective open repair had the same high QOL as the matched German population, whereas patients who underwent EVAR reported significant improvement in vitality (P = 0.002) and mental health (P = 0.03) compared with the matched German population.Based on measurements from 2 independent QOL tests, the well-established operative treatment of AAAs provided patients with a QOL comparable to that of a matched German population. The electively treated AAA groups rated environmental QOL factors significantly higher than the control group. The impaired physical and emotional QOL of the AAA group under surveillance suggests that more intense patient education could be beneficial.

The present study examined the influence of self-efficacy on health complaints and the duration of unemployment in an age-homogeneous sample. Data resulted from a prospective cohort study that begun in 1987. Participants answered several questionnaires in 2002 and 2009. Results indicate that people with a low level of self-efficacy have higher levels of physical and mental health complaints and experience twice the length of unemployment compared to people with a medium or high level of self-efficacy. Thus, self-efficacy predicts health complaints and the duration of unemployment in the total sample seven years later. Even after controlling for base line levels in 2002, self-efficacy could significantly add explained variance in health complaints and duration of unemployment, but the variance explained incrementally is small. Concerning the life span of young adults, we found self-efficacy to be a protective factor relating to health complaints and the duration of experienced unemployment.

Zusammenfassung Aus Sicht der medizinischen Psychologie gibt es nur wenige gesicherte wissenschaftliche Erkenntnisse zum Thema Hirntod. In der deutschen Gesellschaft existieren trotz umfangreicher Aufklarungsbemuhungen zahlreiche, oft unberechtigte Vorbehalte gegenuber einer postmortalen Organspende. Daher warten viele Patienten auf ein Spenderorgan. Die Situation der Feststellung des Hirntods eines Patienten stellt fur alle Beteiligten, fur die betroffenen Angehorigen ebenso wie fur die behandelnden Arzte, eine Ausnahmesituation und Herausforderung dar. Die Hinterbliebenen befinden sich in einer Trauerphase, die auch das Risiko der Entstehung psychischer Folgeerkrankungen, etwa von Depressionen, in sich birgt. Fur den professionellen und patientenzentrierten Umgang mit dem Thema Hirntod und Organspende bieten sich fur Arzte und andere Beteiligte spezielle Kommunikationsstrategien an.

The aim of this study was to examine differences in mental health and satisfaction with life in retired men and women depending on experienced unemployment during working life.Based on a representative survey, 1396 retirees in the age range of 60-92 years were interviewed face-to-face, assessing two screening instruments for anxiety and depression as well as the Questions on Life Satisfaction questionnaire. Among others, analyses of variance were used to test the differences between groups with distinct experiences of unemployment periods.Retirees with the experience of repeated unemployment--but not with one-time unemployment--during working life reported worse mental health and satisfaction with life. Calculated effect sizes were 0.53 for anxiety, 0.42 for depression and between 0.21 and 0.51 for satisfaction with different domains of daily life. Differences between men and women emerged, but similarities dominated. Participants with higher current household incomes were found to be less affected.The experience of repeated unemployment periods during working life is associated with more psychosocial distress in retired men and women. Thus, unemployment may have serious negative implications even for persons retired already.

Objectives: Temporal stability of clinical-psychological questionn aires is problematic from a conceptual point of view, and it is empirically insufficiently examined. In this paper we analyze the temporal stability of anxiety and depression, based on large samples. Methods: In three samples with N > 300 each (cancer patients, orthopaedic patients, and general population) the stability of anxiety and depression was assessed with the Hospital Anxiety and Depression Scale (HADS). Results: The stability coefficients range from 0.60 to 0.75. They are highest in the sample of the orthopaedic patients with a time interval of only three weeks between the examinations. The temporal stability of anxiety and depression in females is as high as that of males. Individual change scores of anxiety and depression are correlated with about 0.50. Conclusions: The coefficients which are usually adopted in the measureme nt of change are not suited to describe temporal stability. Fur ther research with sufficiently large samples is needed to unravel the conditio ns which determine the stability.

The influence of day nursery in early childhood on later mental and social development has been controversially discussed for a long time. Opponents of day nurseries express the considerable concern that serious negative mental consequences in later life result from early separation from the mother. A sample of n=383 respondents (54.2% women, aged 34.2 years on average) from the twenty-first wave of the Saxony Longitudinal Study (2007) was analyzed regarding the impact of day nursery in early childhood on different psychological indicators measured later. By applying standardized instruments several aspects were examined such as anxiety, depression, the occurrence of common somatic symptoms, attachment, confidence towards the future, experiences of menace, and common values towards political aspects. The findings show various gender differences, e. g. women report a worse mental health. Yet, only one of the examined indicators can be explained by day nursery in early childhood: respondents who had not been in day nursery felt more threatened by potential stressful life-events, e. g. unemployment. Furthermore the analysis of variance indicates some interaction effects between gender and day nursery in early childhood. Data doesn’t support the critic that day nursery in early childhood negatively influences mental health at a later age. A particular positive impact of day nursery in early childhood on the examined aspects cannot be assumed, either. Facing the ongoing political debate on the expansion of day nursery facilities, further research is needed focusing more in detail on qualitative aspects of day nursery.

GRUNDLAGEN: Die emotionalen Reaktionen von Rettungsdienstpersonal bei einem Einsatz wahrend eines terroristischen Anschlages sind bislang nur unzureichend im Verlauf betrachtet worden. Untersucht wurde, wie die Retter emotional auf die Attentate reagieren und ob und wie sich diese emotionalen Reaktionen sechs Monate nach dem Einsatz verandern. Zudem wurde der Einfluss dieser Reaktionen auf ihre Lebensqualitat, die korperlichen Beschwerden und Depressivitat untersucht. METHODIK: 14 Notarzte und 5 Rettungsassistenten wurden im Durchschnitt 14 Tage und ein zweites Mal sechs Monate nach den Londoner Terroranschlagen vom 7. Juli 2005 interviewt. Die Interviews wurden mittels Gottschalk-Gleser-Sprachinhaltsanalyse zur Messung von Affekten ausgewertet. ERGEBNISSE: Uber die Halfte der Rettungsdienstmitarbeiter berichteten uber hohe Angstlevel, fast alle uber hohe Todesangstlevel. Bei etwa der Halfte zeigte sich eine erhohte psychische Beanspruchung durch Angst und Aggressivitat (im Amerikanischen Original: Feindseligkeit nach innen gerichtet), eine beeintrachtigte Lebensqualitat und eingeschrankte Sozialbeziehungen. Die Angste verminderten sich in den folgenden sechs Monaten. Eine Veranderung der Aggressivitat trat nicht ein. Dagegen erhohte sich die Hoffnung und verminderte sich die Depressivitat. Tendenziell verbesserte sich die Lebensqualitat uber diesen Zeitraum. SCHLUSSFOLGERUNGEN: Einsatze bei Terroranschlagen sind fur Rettungsdienstpersonal in Bezug auf Angst, Aggressivitat, Lebensqualitat und Sozialbeziehungen herausfordernd. Wir fanden uberwiegend gunstige Verlaufe dieser Affekte nach sechs Monaten. Es scheint so, dass diese positive Verarbeitung durch die Ermutigung von informell organisierten Copingprozessen in der Gruppe des Rettungsdienstpersonals unterstutzt wird.

The experience of miscarriage results in tremendous emotional disturbance for many affected women. Depression, anxiety, (pathological) grief, and posttraumatic stress symptoms are commonly experienced reactions. Several factors influence the level of emotional distress, like age, previous experience of miscarriage, or social support. In this work, we investigated the level of emotional distress after miscarriage using a novel methodological approach. Through the world wide web, N = 500 texts of women who reported freely on their miscarriage were accessed and analyzed using the Dresden Anxiety Dictionary, a German computerized version of the Gottschalk-Gleser speech analysis. The women were 28 years old on average. The texts were written, on average, about 28 days after the miscarriage. Women's pregnancy had lasted between 2 and 40 weeks (M = 12). The scores pertaining to death anxiety and mutilation anxiety were higher than the norm. More than 20 % of the women reported an increased level of anxiety. Variables that influenced the level of anxiety were age, time since miscarriage, duration of pregnancy, previous miscarriage, and social support. The results underscore the need for treatment, at least for sub-groups of affected women who have a higher risk for a complicated course of coping with miscarriage.

Hintergrund Aufgrund sinkender Geburtenzahlen wird in der Literatur vielfach abgeleitet, dass die Zahl der ungewollt kinderlosen Personen steigt. Dass es sich dabei v. a. um eine Zunahme der gewollten Kinderlosigkeit handelt, haben Studien in den letzten Jahren belegt.

BACKGROUND: For many concerned people unemployment leads to impairments of health, and above all, mental impairments. However, appropriate interventional measures are utilized by only few unemployed people. This study addresses the question, what need for professional psychosocial counselling exists depending on unemployment experience and job insecurity. METHODS: 387 young adults (54.4% female) with a mean age of 33.2 years were asked in 2006 in the context of the 20th wave of the Saxony Longitudinal Study (Sachsische Langsschnittstudie) about unemployment experience, perceived job insecurity and the subjective need for professional psychosocial counselling. Furthermore, the global psychological distress was assessed as an indicator for the objective need for psychosocial support. RESULTS: Over 70% of the participants have had experience with unemployment so far. On average women are unemployed for longer periods than men. Current unemployment [Odds Ratio 7.14; 95% confidence interval (CI) 3.28-15.54] proves to be, apart from the threat of loosing of one's job (Odds Ratio 5.26; 95% CI 3.34-8.28), the strongest predictor for mental burdens. However, the subjective need for psychosocial counselling is independent of these employment-related characteristics. 12.7% of the respondents claimed to have had a need for counselling in the last year. Significant predictors for professional counselling support are sex (Odds Ratio 2.08; 95% CI 1.23-3.55) and the mental burdens (Odds Ratio 2.84; 95% CI 1.50-5.38). CONCLUSION: Unemployment leads to objective mental burdens for the concerned people, but subjectively not to an increased need for psychosocial support. Therefore, it is necessary to communicate this health risk to the concerned in an appropriate way and to submit appropriate, low-threshold counselling offers.

Fragestellung: Ausgehend von den zahlreichen Forschungen zu psychosozialen Aspekten des Erlebens von Arbeitslosigkeit untersucht die Studie die Folgen von tatsachlicher Arbeitslosigkeit auf die Lebenszufriedenheit und die Auswirkungen von Bedrohung durch Arbeitslosigkeit und wahrgenommener Sicherheit des Arbeitsplatzes auf die Lebenszufriedenheit. Methoden: Im Rahmen der 17. Welle der Sachsischen Langsschnittstudie wurden 2003 N = 419 Personen (193 Manner, 226 Frauen, Mittleres Alter 30.05 Jahre) mit dem Fragebogen zur Lebenszufriedenheit (FLZ M) untersucht. Der Bogen erlaubt die okonomische Erfassung von acht spezifischen Bereichen der Lebenszufriedenheit (Freunde, Freizeit, Gesundheit, Einkommen, Beruf, Wohnen, Familie, Partnerschaft). Ergebnisse: Zwei Drittel der Studienteilnehmer hatten bereits Erfahrungen mit Arbeitslosigkeit. Personen, die mehrfach arbeitslos waren, waren signifikant unzufriedener mit ihrem Einkommen, ihrer Wohnsituation, ihrem Beruf und ihrer Gesundheit. Jedoch hatten auch die Sicherheit des derzeitigen Arbeits- oder Ausbildungsplatzes und die subjektiv erlebte Bedrohung durch Arbeitslosigkeit bei derzeit Nichtarbeitslosen deutlich negative Auswirkungen auf deren Lebenszufriedenheit. Dies zeigte sich auch in Bereichen, die nicht direkt mit Erwerbsarbeit in Zusammenhang stehen, wie Freunde/Bekannte oder Familienleben. Schlussfolgerung: Die Studie unterstreicht bekannte Befunde zum Zusammenhang von Arbeitslosigkeit und (negativer) Lebenszufriedenheit. Nachgewiesen wird, dass auch bereits der antizipierte Verlust des Arbeitsplatzes zu einer eindeutig schlechteren subjektiven Lebenszufriedenheit in vielen Bereichen fuhrt.

Vorgestellt wird eine quantitative inhaltsanalytische Untersuchung an 46 psychoanalytischen Erstinterviews, die mit Angstpatienten und depressiven Patienten in Dusseldorf und Magdeburg gefuhrt wurden. Im Mittelpunkt der Methodik steht das „Regressive Imagery Dictionary“ (RID), ein computergestutztes Verfahren mit 43 Einzelkategorien, die zu den drei Indikatoren primarprozesshafter Inhalt, sekundarprozesshafter Inhalt und Emotionalitat zusammengefasst werden. Die durchgefuhrten Subgruppenvergleiche beziehen sich auf Unterschiede zwischen Angstpatienten und depressiven Patienten sowie ostdeutschen (Magdeburg) und westdeutschen (Dusseldorf) Patienten. Die Ergebnisse zeigen in den Texten der ostdeutschen Patienten ein hoheres Mas an primarprozesshaften Inhalten, insbesondere in den Kategorien Passivitat und regressive Kognition. Bezuglich der Diagnosegruppen zeigen die Angstpatienten gegenuber den depressiven Patienten ein hoheres Mas an primarprozesshaften Inhalten in der Subkategorie Oralitat. Es zeigt sich, dass in psychoanalytischen Interviews nicht nur diagnosespezifische Inhalte thematisiert werden, sondern auch kultureller Hintergrund, Geschlecht und Bildung von Bedeutung sind. Die Studie leistet einen Beitrag zur Identifizierung automatisch erfassbarer Textmerkmale, die charakteristisch fur die in einer qualitativen Studie gefundenen idealtypischen nosologischen Konstrukte der neurotischen Depression und der phobisch-angstneurotischen Erkrankung sind. Hierbei ist der depressive Idealtypus durch eine Uberidentifikation mit Werten, durch das Gefuhl der Abhangigkeit von einer schadigenden Person, durch Selbstwertprobleme, Hemmung und den unerfullten Wunsch, geliebt zu werden, gekennzeichnet. Der Angsttypus zeichnet sich durch ein klischeehaft positives Bild der eigenen Personlichkeit aus sowie durch die Gefuhle, falsch verstanden, ausgenutzt, nicht ernst genommen und zum Ausenseiter gemacht zu werden, sodass er bei nachlassenden Kraften im Kampf um Leistung nicht mehr mithalten kann.

Zusammenfassung. Mit dem Konstrukt des gezugelten Essverhaltens wird die Kontrolle der Nahrungsaufnahme mit der Absicht, eine Gewichtsreduktion zu erreichen, bezeichnet. Diesem Essstil wird eine zentrale Rolle bei der Entstehung von Adipositas und Essstorungen zugeschrieben. Eines der international am weitesten verbreiteten Verfahren zur Erfassung gezugelten Essverhaltens ist die Restraint Scale (RS) von Herman und Polivy (1980). In der vorliegenden Studie wurde die Reliabilitat und Validitat der deutschen Form der RS bei einer Stichprobe von N = 349 Studenten untersucht. Die zweifaktorielle Struktur der RS konnte exakt repliziert werden. Die Gesamtskala weist ein Cronbachs Alpha von .83 auf. Bezuglich der Kriteriumsvaliditat der RS zeigten sich signifikante Unterschiede zwischen Mannern und Frauen. Weiterhin hatten gezugelte Esser einen signifikant hoheren BMI und sie berichteten ein hoheres Mas an dysfunktionalen Einstellungen im EDI. Hinweise auf die Konstruktvaliditat zeigten sich durch signifikante Korrelationen der RS mit Skalen des EDI und Masen der psychischen Befindlichkeit (ADS, BAI, SCL-K-9). Schlusselworter: Restraint Scale, Reliabilitat, Validitat, Gezugeltes Essverhalten, Studenten German version of the Restraint Scale for the assessment of restrained eating

Genetische Untersuchungen erlangen auf Grund der Fortschritte der molekularen Genetik mehr und mehr Bedeutung. Vorliegende Studie untersucht, inwieweit in der deutschen Bevolkerung Vertrauen in die Durchfuhrung von Gentests und die Verwendung deren Ergebnisse vorhanden ist, welche soziodemographischen Korrelate und welche Zusammenhange zu allgemeinen Einstellungen gegenuber genetischen Untersuchungen bestehen. Im Rahmen einer deutschlandreprasentativen Studie mit n=2076 Befragten wurde ein 13 Items umfassender Fragebogen zu den Einstellungen zu genetischen Untersuchungen vorgelegt. Ein Item bezog sich auf das Vertrauen in Gentests. Die Daten zeigen, dass bei einer Mehrheit der Befragten Vertrauen in die Durchfuhrung genetischer Untersuchungen und die Verwendung der Ergebnisse vorhanden ist. In Abhangigkeit von soziodemographischen Merkmalen finden sich jedoch deutliche Subgruppendifferenzen: Altere Menschen, Personen mit einer hoheren Bildung, Ostdeutsche und nicht religios gebundene Menschen haben mehr Vertrauen in Gentests. Das Vertrauen korreliert signifikant, jedoch sehr niedrig mit anderen Einstellungsaspekten (positive und negative Aspekte, Befurchtungen) gegenuber Gentests. Sobald die personliche Betroffenheit thematisiert wird, scheint eine allgemeine positive Haltung gegenuber Gentests an Bedeutung zu verlieren.

Background Negative consequences of unemployment have been known for a long time. This study concerns the effect of unemployment and job insecurity in a large sample of young adults because little is known about this special age group. Methods : 420 persons (46.8% males, 52.2% females, mean age 29 years) were polled in the 16(th) wave of the Sachsische Langsschnittstudie in 2002. This longitudinal study accompanies an East German sample since 1987 i.e. some time before German reunification. We used standardised psychological questionnaires to assess the state of health (SCL-9, HADS, GBB, SWE). Results 120 (29%) persons were repeatedly unemployed, 143 (34%) once, and only 157 (37%) have never been unemployed. The period of unemployment lasted 1 to 76 months. According to the experience with unemployment we found differences in subgroups: persons having more experience with unemployment report on higher global distress, more anxiety and depression, feel less efficacious and are in a subjectively poorer state of health. Nearly one-third of the participants think they have an insecure job. Persons who perceive an insecure job feel significantly greater anxiety, depression, body complaints, mental distress and feel less efficacious. Conclusions Unemployment is a big social problem for young and well-qualified persons. The experience of unemployment decreases the identification with the current social system and has a strong negative influence on the state of health. Specific offers of medical and psychosocial support are required. Even the feeling of job insecurity has explicitly negative effects on health. Further longitudinal research is necessary.

OBJECTIVES The present paper describes a study on the intake interview narratives of psychotherapy patients with assisted content analysis methods. METHODS 47 psycho-dynamic diagnostic interviews of patients suffering from depression or anxiety disorders were analysed using a Gottschalk-Gleser technique with the Dresdner Angstworterbuch (DAW) as well as with the Affektives Diktionar Ulm (ADU). RESULTS Comparisons between different subgroups of this sample were made: Anxiety vs. depression patients, East Germans (Magdeburg) vs. West Germans (Dusseldorf) and men vs. women. The comparisons showed that feelings of anxiety were important in all subgroups. Depressed patients not only spoke more often about depressed feelings in comparison with the other subgroups, but also seemed more able to express emotions of other kinds. Among the differences according to the diagnostic dichotomy there were also significant results which demonstrated the influence of cultural background and sex of the interviewees on the contents of the intake interviews. CONCLUSIONS The results confirm our hypothesis that the psychotherapist-patient-interaction sequences, which are the basis of diagnostic categorization, consist of elements specific for the disorders under study as well as elements specific for sex and culture (east vs. west). Some content analysis markers of these elements are identified in our study.

Based upon the recent discussion on integrative approaches in psychotherapy research, the last two volumes of the PPmP were bibliometrically analyzed. The articles of authors which belong to different disciplines like psychosomatic or medical psychology were compared with respect to the word and speech statistic, leading representatives and the reception of the international state of research. The interdisciplinary standard of the PPmP has proven successful in view of the impact of the journal within the Scientific Community and among the flagship journals of the field. The study shows that the plurality of methodological approaches and interdisciplinarity provides an important criterion for the quality of psychotherapy research and for the corresponding publication institutions. Related to scientific quality standard the PPmP has found good impact in the scientific community but there are points to be changed.

Adequate knowledge regarding hereditary diseases and genetics, as well as personal attitudes toward gene tests, are major determinants of optimal utilization of genetic testing. In the present study, we aimed to explore the general attitudes toward genetic testing in a sample representative of the German general population (n = 2,076) and to compare the attitudes of persons at risk for hereditary non-polyposis colorectal cancer/familial adenomatous polyposis (HNPCC/FAP) (n = 36) who had attended a university genetic counseling service, with a matched general population sample. We administered a subset of a questionnaire previously used in a Finnish study (Jallinoja et al., 1998). The 12 statements pertain to approval, disapproval, and concern for genetic testing. Overall, the results reveal high approval of genetic testing in the German population and in at-risk persons. In accordance with other studies, we find that the attitudes of individuals for whom hereditary disease is a salient issue of personal relevance and the attitudes of the general public are very similar. Only a few significant differences between these two samples emerged, indicating that at-risk persons hold a more favourable view of the testing. One intriguing finding was the high rate of "don't know" responses, especially in the general population sample. Compared to results from Finland, approval of genetic testing is lower in the German population, and endorsement of "don't knows" is remarkably higher. We argue for increased attention to the issue of attitude change after genetic counseling and for the need of comparative cross-cultural research on attitudes toward gene technology.

Zusammenfassung. Prä- und postnatale genetische Diagnostik zur Ermittlung eines individuellen Erkrankungsrisikos gewinnt zunehmend an Bedeutung. Dementsprechend sind genetische Untersuchungen des menschlichen Erbgutes sowie damit verbundene Anwendungsbereiche Gegenstand intensiver gesellschaftlicher Diskussion. Zu den möglichen Vor- und Nachteilen genetischer Untersuchungen wurde eine deutschlandrepräsentative Stichprobe (N = 2.076 Personen) befragt. Die Ergebnisse zeigen, dass genetische Untersuchungen insgesamt auf eine große Akzeptanz in der Bevölkerung stoßen, ca. zwei Drittel stehen ihnen befürwortend gegenüber. Jedoch werden auch mögliche Nachteile solcher diagnostischer Maßnahmen, wie z.B. Schwangerschaftsabbrüche oder Diskriminierung, benannt. Faktorenanalytisch ließen sich aus den 13 Items des eingesetzten Fragebogens drei Skalen (Positive Aspekte, Negative Aspekte, Befürchtungen) bilden. Eine Varianzanalyse erbrachte Unterschiede in den Skalen zwischen verschiedenen soziodemographischen Gruppen: Während Geschlecht und Lebensalter keinen bzw. wenig Einfluss haben (Ältere sehen mehr negative Aspekte als Jüngere), finden sich deutliche Unterschiede zwischen konfessionsgebundenen und konfessionslosen Personen. Die Befragten, die einer Religionsgemeinschaft angehören, sehen genetische Untersuchungen wesentlich kritischer. Hinsichtlich des Bildungsstandes ist festzustellen: Personen mit höherer Bildung sehen mehr positive und weniger negative Aspekte hinsichtlich genetischer Untersuchungen. Die Ergebnisse werden mit internationalen Studien verglichen. Abschließend werden Überlegungen zur Relevanz genetischer Untersuchungen und der sich abzeichnenden weiteren Entwicklungen für die Gesundheitspsychologie angestellt.

Zusammenfassung: Die Möglichkeiten und Grenzen der Gendiagnostik erfahren zurzeit eine breite öffentliche Diskussion. In einer für Deutschland repräsentativen Erhebung mit N = 2.076 Befragten im Alter von 14 bis 95 Jahren wurde 2001 ein Fragebogen (12 Items) zu den Vor- und Nachteilen molekulargenetischer Diagnostik für erbliche Erkrankungen (Gentests) eingesetzt. Die Ergebnisse der Untersuchung zeigen bei den N = 602 über 60jährigen Befragten im Vergleich zu den jüngeren Altersgruppen signifikante Unterschiede. Ältere Menschen befürworten insgesamt das Durchführen von Gentests weniger, sie sehen weniger mögliche Vorteile und mehr Nachteile, wie etwa Schwangerschaftsabbrüche. Andererseits haben sie auch weniger Befürchtungen bzgl. genetischer Untersuchungen (z. B. Datenmissbrauch). Diese Ergebnisse entsprechen den in internationalen Studien gefundenen Trends.

In research as well as in the practice of caregiver counselling, the subjective burden of family caregivers is considered an important characteristic of home care. The objective of the present study was to provide an extended validation of the German language version of the Burden Scale for Family Caregivers (BSFC) published in 2001.Extended validation was performed using medical, interview, and health insurance data of 351 informal caregivers and their relatives who had dementia. Cronbach's alpha was calculated to assess the internal consistency of the items, and an exploratory factor analysis was conducted to determine the structure of the BSFC. The discriminatory power and item difficulties of the 28 BSFC items were examined. Five research questions addressed construct validity. Question six addressed the BSFC score as a potential predictor of institutionalization at a follow-up time of 2.5 years (predictive validity).Exploratory factor analysis indicated that the BSFC had a single-factor structure. Cronbach's alpha for the total scale was 0.93. A significant increase in the BSFC score was observed when the severity of cognitive impairment increased, persons with dementia showed disturbing behaviour, caregivers were diagnosed with depression, care requirements increased, or the family caregiver and the person with dementia lived together. Caregiver burden emerged as a significant predictor of institutionalization. The validity of the BSFC was confirmed by the results.The BSFC score allows for a valid assessment of the total caregiver burden in both research and practice. The BSFC is available for free in 20 languages ( http://www.caregiver-burden.eu ).

Zusammenfassung: Das sprachinhaltsanalytische Gottschalk-Gleser-Verfahren zur Messung ängstlicher und aggressiver Affekte hat sich seit vielen Jahren als reliable und valide Methode erwiesen, die in zahlreichen Studien Anwendung fand. Hauptprobleme dieser Technik sind das umfangreich notwendige Training zum sicheren Erlernen und der hohe Aufwand bei der Durchführung von Analysen. Während daher seit einiger Zeit ein englischsprachiges Computerprogramm existierte, war dies für deutsche Sprachproben bisher nicht der Fall. Beschrieben wird hier die Entwicklung einer deutschen Computerversion der Gottschalk-Gleser-Angstskalen - das Dresdner Angstwörterbuch (DAW). Das DAW ist als Programmsupplement (Kategoriensystem) zu verschiedener inhaltsanalytischer Software konzipiert. Es erweist sich als reliable und valide Umsetzung der deutschen Gottschalk-Gleser Angstskalen.

Some 5–15% of adults in industrialized countries suffer from pathologically severe fear of dental treatment (“dental fear”), to the point where they are able to consult a dentist only if they are experiencing severe pain (1). About 3% avoid visiting their dentist altogether (1). Those affected will experience serious dental-medical sequelae and their psychosocial effects (2, 3). Often, patients with dental fear are identified only after years of avoidance (4, 5). Massive damage to the teeth is the inevitable consequence (5). Studies in patients with high fear of dental treatment have shown severe impairments in terms of oral-related quality of life (8, 9), in addition to their obviously worse dental health (6, 7). Thomb et al. found a mean of eight teeth requiring treatment in patients with dental fear who had avoided visiting their dentist for many years (5). Many people who fear dental treatment are ashamed for the state of their teeth (10) and avoid talking or laughing in public (3, 10); some withdraw from social life altogether (2, 3). Their fear of visiting the dentist is so severe that they tolerate massive pain and delay crucially important treatment. Therapy for dental fear has shown promising results and can be initiated quickly (11). Most of the available data relate to behavioral therapeutic interventions. A meta-analysis (11) showed for 36 out of 38 studies positive changes in self-reported fear. Two studies found no effect whatsoever. After four years of therapy, a mean of 77% of patients visited their dentist regularly. In more than half of the studies, dental treatment was a component of the therapy. An average of 6–10 sessions were assumed for the therapy of dental fear (11). Dentists are confronted with varying intensities of dental fear on a daily basis. According to a study of the prevalence of dental fear in standard dental practices in Germany, only 0.5% meet the criteria of a dental phobia (12). Dentists often encounter such patients only during emergency sessions. At that point, the need for treatment is urgent; gentle, pain-free treatment is not always possible, and such emergency sessions often provide further confirmatory evidence in the vicious cycle of fear. From a medical ethical perspective as well as to reduce costs for the health service, a duty arises to improve early detection measures for the disorder. Extensive dental restoration under general anesthesia or more than double the number of sickness notifications compared with the average population put a high burden on the healthcare system (1). This is a challenge for doctors and dentists alike. Close interdisciplinary collaboration between psychotherapists and dentists might succeed in identifying affected patients earlier on and to enable them to have up-to-the-minute dental care. Two studies have reported an increased prevalence of psychological disorders in people with fear of dental treatment. Roy Byrne et al. (13) were the first to conduct a complex psychological diagnostic evaluation, using DSM-III criteria in patients with dental fear. They found at least one further psychiatric disorder in 42% of those investigated. A representative birth cohort study from New Zealand (14) confirmed the frequent presence of mental disorders in participants with a high degree of dental fear and found comorbid disorders in 55% more participants than in those without fear of dental treatment, of whom 42.3% had psychological disorders. An awareness that multimorbidity is common in this setting prompted the decision to approach the problem from a new angle. The present study aims to establish the prevalence of dental fear in a psychosocmatic treatment center, in order to identify underlying psychological disorders, which are often associated with fear of dental treatment. The data were compared with those of a healthy sample.

In industrialized countries, about 5% to 15% of all adults have a pathologically severe fear of dental treatment, and some 3% avoid going to the dentist altogether. The affected persons may, in turn, suffer from severe dental diseases and their psychosocial effects. Many people with dental phobia have other mental disorders as well. These facts motivated us to study the prevalence of fear of dental treatment in a group of patients being treated by our psychosomatic service.212 patients of our psychosomatic service and 95 healthy controls were studied with the Hierarchical Anxiety Questionnaire (HAQ) to determine the intensity of their fear of dental treatment. Mental disorders were diagnosed with structured clinical interviews according to DSM-IV.Nearly one patient in three (30.5%, n = 64) suffered from pathologically severe fear of dental treatment; 24 of them (38.5%) had avoided visiting a dentist for longer than one year. Only 4 (4.2%) of the healthy controls were greatly afraid of dental treatment. Certain types of mental disorder were especially highly associated with fear of dental treatment: in particular, anxiety disorders (relative risk [RR] 7.44, 95% confidence interval [CI] 2.68-20.70) and depressive disorders (RR 4.92, 95% CI 1.73-14.05). Patients with post-traumatic stress disorder were affected most commonly: 34 (42%) of these patients were greatly afraid of dental treatment (RR 9.97, 95% CI 3.69-26.90). 75 of the 134 study participants who were afraid of dental treatment (56%) had cancelled a dental appointment, or failed to appear for a scheduled appointment, because of their fears.Fear of dental treatment commonly accompanies certain types of mental disorder. Patients at high risk should be asked about such fears so that the problem can be recognized early and appropriately treated.

Sun protection in childhood is important to reduce the risk of developing skin cancer later in life. The "Periods-of-Life-Program" for primary prevention of skin cancer introduces a combination of individual and environmental interventions for the preschool period. Within this pilot study, an intervention group received cognitive-behavioral and environmental interventions. A control group had solely received the environmental intervention, and a wait-control group received no intervention. Nursery school children (n = 80, 3 to 6 years of age) of four nursery schools were randomly assigned to these groups on school level. The ability of the cognitive-behavioral intervention (a theater play) to enhance sun protection knowledge was examined. The theater play improved knowledge over all age groups (p < .05 η(2) = .06). Age-specific analyses showed better results for children aged 5 to 6 (p < .05 η(2) = .20) compared to children aged 3 to 4 years (p = .17 η(2) = .04). In combining cognitive-behavioral and environmental interventions, the "Periods-of-Life-Program" is a promising strategy for primary prevention of skin cancer.

Background Several studies suggest that most school-age children are poorly informed about cancer risk factors. This study examines the effectiveness of the ‘Be smart against cancer’ (BSAC) program in promoting cancer awareness and intentions to engage in health-promoting behavior. Methods 235 seventh-grade students were randomized to either the intervention (N = 152) or the wait-control group (N = 83). The intervention included the modules: “What is cancer?,” “Sun protection,” “Non smoking,” and “Physical activity, Healthy nutrition, and Limited alcohol consumption.” Outcomes measured at baseline and at the end of the one week BSAC program included knowledge of cancer and its behavioral risk factors, health-promoting intentions, and reported risk behavior. Results BSAC was effective in increasing knowledge about cancer and risk factors for cancer (p

Item does not contain fulltext BACKGROUND: Increasing emphasis is being placed on involving patients in decisions concerning their health. This shift towards more patient engagement by health professionals and towards more desire by patients for participation may be partly based on socio-political factors. METHODS: To compare the preferences for shared decision making of patients from eastern and western Germany we analysed five patient samples (n = 2318) (general practice patients and schizophrenia patients from eastern and western Germany). Patients' role preferences for shared decisions were measured using the decision-making subscale of the Autonomy Preference Index. RESULTS: Patients resident in eastern Germany expressed lower preferences for shared decision making than patients in western Germany. This was true after controlling for socio-demographic variables and for patient group. CONCLUSION: The cultural imprint (e.g. western vs. former communist society) seems to have a significant influence on patients' expectations and behaviour in the medical encounter. Health services providers need to be aware that health attitudes within the same health system might vary for historical and cultural reasons. The engagement of patients in medical decisions might not be susceptible to a 'one size fits all' approach; doctors should instead aim to accommodate the individual patient's desire for autonomy. 01 augustus 2012

Due to the continuous decline of the birth rate as well as the demographic aging of the German society, questions emerge about the abilities and possibilities to govern or rather to increase the birth rate. Beside these demographic aspects, also norm and ethical values were spotlighted by politicians, social scientists and the general public. A central concern is the compatibility of family and career, especially for women. In addition to the more beneficial or more inhibiting general conditions of the society, mainly individual decision processes, including the weighting of many different aspects, contribute to the final decision of starting a family.

Background The Bielefeld Partnership Expectations Questionnaire (BFPE) is a tool to assess attachment in the romantic relationships of adults. The attachment styles are operationalized as configuration patterns of scale scores. While convergent validity has already been investigated, discriminant validity is still lacking confirmation. Methods The present sample (n = 1509) is representative for the German population aged 18 to 50. The mean age was 34.6 years. Most of the participants lived in a relationship (77.3 %). Discriminant validity was analyzed using a marital quality questionnaire (PFB), a social support questionnaire (F-Soz-U K-14), and a life satisfaction questionnaire (FLZ). Results All the BFPE scales have a satisfying internal consistency between r = .79 and .86. Those individuals who showed a secure pattern, i.e. increased "Readiness for Self-Disclosure" and "Conscious Need for Care" as well as reduced "Fear of Rejection" experienced their partner as socially supportive, reported higher marital quality in all of its facets, and were more satisfied within the life-domains "family/children" and "relationship/sexuality". Standard values for each scale are presented. Conclusions The BFPE has repeatedly been verified as a short, reliable, and valid instrument applicable to research practice with healthy individuals as well as within clinical contexts.

Population-representative or population-based studies on attitudes toward molecular genetic testing have so far been conducted in the United States, Great Britain, the Netherlands, and Finland. In 2001 our group conducted a representative survey for a German population among a total of 2076 respondents aged 14-95 years. The questionnaire administered consisted of 13 items covering the advantages and disadvantages of molecular genetic testing for hereditary diseases. We conducted a factor analysis to explore potential sub-dimensions of attitudes, and describe here the influence of sociodemographic variables on these sub-dimensions and how the attitudes of the Germans compare to those of the Finns.Our factor analysis of the results showed three dimensions: approval, disapproval, and concern regarding genetic testing. In the German sample we found an overall positive attitude toward genetic testing. There was no influence of sex, but there were marked differences regarding age, educational backgrounds, and religious affiliation. Finns are more in favor of genetic testing and disapprove less than Germans. We can summarize that Germans have a markedly more skeptical view than Finns. In our opinion this could well be understood in the context of German history. We assume that this created a less conducive environment for the population to form a clearer attitude toward genetic testing as compared to the Finns.In the light of our results there is certainly a need for more information and education. Further, it would in our opinion be most useful if the German development regarding attitudes to genetic testing, especially after reunification, is studied longitudinally to provide a better understanding of possible developments.

The influence of day nursery in early childhood on later mental and social development has been controversially discussed for a long time. Opponents of day nurseries express the considerable concern that serious negative mental consequences in later life result from early separation from the mother. A sample of n=383 respondents (54.2% women, aged 34.2 years on average) from the twenty-first wave of the Saxony Longitudinal Study (2007) was analyzed regarding the impact of day nursery in early childhood on different psychological indicators measured later. By applying standardized instruments several aspects were examined such as anxiety, depression, the occurrence of common somatic symptoms, attachment, confidence towards the future, experiences of menace, and common values towards political aspects. The findings show various gender differences, e. g. women report a worse mental health. Yet, only one of the examined indicators can be explained by day nursery in early childhood: respondents who had not been in day nursery felt more threatened by potential stressful life-events, e. g. unemployment. Furthermore the analysis of variance indicates some interaction effects between gender and day nursery in early childhood. Data doesn't support the critic that day nursery in early childhood negatively influences mental health at a later age. A particular positive impact of day nursery in early childhood on the examined aspects cannot be assumed, either. Facing the ongoing political debate on the expansion of day nursery facilities, further research is needed focusing more in detail on qualitative aspects of day nursery.