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Self-criticism is a stable personality trait identified as a serious risk factor for psychopathology and weight-related health problems. Therefore, it is relevant to epidemiological research, which requires a relatively brief instrument for measuring trait self-criticism in the general population. The current study introduces a brief measure of self-criticism and presents empirical results that inform on its reliability and validity. Based on the six-item version of the

Symptoms of Adjustment Disorder after an accidental injury: risk and protective factors Objectives: The identification of protective and risk factors for symptoms of adjustment disorder (AD) after an accident injury. Methods: In this prospective long-term study, data from 73 patients with ankle and lower leg fractures were analyzed. Symptoms of AD were assessed at enrollment (T0), 1 month (T1) and 12 months (T2) after injury. In addition, questionnaires regarding adverse childhood experiences, coping strategies and the number of stressors during the last year were obtained. The Structured Clinical Interview for DSM-IV (SCID) was conducted at T1 and T2. Results: 4.1 % of patients met the criteria for AD at T1 and 2.7 % at T2. Acceptance coping predicted a lower level of AD symptoms 1 year after the injury (β = -.42, p

We investigated stability and change of plasma and urinary oxytocin as well as OXTR DNA methylation patterns through psychotherapy. Furthermore, we explored the potential impact of inpatient psychotherapy on oxytocin-related biomarkers and vice versa by differentiating patients who remitted from depression versus non-remitters. Blood and urine samples were taken from 85 premenopausal women (aged 19–52), 43 clinically depressed patients from a psychosomatic inpatient unit, and 42 healthy control subjects matched for age and education at two points of time. Serum and urine oxytocin were measured using standard ELISA, and DNA methylation of the OXTR gene was assessed using bisulfite sequencing at the time of admission (baseline) and at discharge and from controls at matched time points. Oxytocin plasma levels were not associated with depression and were influenced by neither time in healthy controls nor psychotherapy in patients. Non-remitting depressed patients had significantly lower oxytocin urine levels before and after psychotherapy treatment. We found significantly lower exon 1 OTXR methylation in depressed patients over time and these differences were driven by patients remitting due to psychotherapy. A reverse pattern — higher levels of methylation in remitters — was found for exon 2 OXTR DNA methylation. Plasma oxytocin, urinary oxytocin, and OXTR DNA methylation patterns were intrapersonally relatively stable. OXTR-related factors were seemingly unaffected by inpatient psychotherapeutic treatment, but we found significant differences between remitting and non-remitting patients in urinary oxytocin and OXTR DNA methylation. If replicated, this suggests that OXTR-related markers may predict inpatient treatment outcomes of clinically depressed patients.

Background Depression, the most frequent and harmful mental disorder, has been associated with specific somatic diseases as the leading cause of death. The purposes of this prospective study were to predict incident chronic diseases based on baseline depressive symptoms and to test sex-dependent effects. Methods In a representative German community sample of over 12 000 participants, baseline depressive symptoms (assessed using the Patient Health Questionnaire-9) were tested as a predictor of new onset of cardiovascular disease (CVD), chronic obstructive lung disease, diabetes, cancer, and migraine at 5-year follow-up. To study disease incidence, we created subsamples for each chronic disease by excluding participants who already had the respective disease at baseline. Potential confounders were included in logistic regression models and sex-specific analyses were performed. Results Controlling for demographic characteristics and loneliness, in men and women, baseline depressive symptoms were predictive of CVD, chronic obstructive lung disease, diabetes, and migraine, but not of cancer. When we additionally adjusted for metabolic and lifestyle risk factors, there was an 8% increase of chronic obstructive lung disease and migraine per point of depressive symptoms. There was a trend for CVD (4%; p = 0.053). Sex-sensitive analyses revealed trends for the relevance of depressive symptoms for CVD in men (p = 0.065), and for diabetes in women (p = 0.077). Conclusions These findings underscore the need to implement screening for depression in the treatment of major somatic illnesses. At the same time, depressed patients should be screened for metabolic and lifestyle risk factors and for somatic diseases and offered lifestyle interventions.

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Depression has been associated with increased inflammation. However, only few large-scale, prospective studies have evaluated whether inflammation leads to new cases of depression and whether this association can be found in men and women. Longitudinal data of N = 10,357 adult participants with no evidence of depression at baseline (based on Patient Health Questionnaire (PHQ-9), lifetime diagnoses, and current antidepressant medication) were evaluated for depression 5 years later. Multivariate logistic regression models were used to predict the onset of depression based on C-reactive protein (CRP) and white blood cell count (WBC). We used interaction terms and separate analyses in men and women to investigate gender-dependent associations. Based on both markers, inflammation was predictive of new cases of depression 5 years later, even when adjusting for sociodemographic, physical health, health behavior variables, and baseline depression symptoms. As established by interaction terms and separate analyses, inflammatory markers were predictive of depression in men, but not in women. Additional predictors of new onset of depression were younger age, loneliness, smoking (only in men), cancer and less alcohol consumption (only in women). The study indicates gender differences in the etiology of depressive disorders within the community, with a greater role of physical factors in men.

Sprunggelenkfrakturen haben viele kurz- und langfristige Konsequenzen fur die Patienten. Neben der operativen Versorgung spielen deshalb auch psychosoziale Faktoren eine Rolle fur den Behandlungserfolg. Ziel dieses Artikels ist, einen Uberblick uber psychologische Aspekte im Kontext einer Fraktur sowie Erklarungsmodelle fur den unterschiedlichen Umgang mit dieser zu geben. Auserdem soll ein Uberblick zur empirischen Datenlage bezuglich psychologischer Einfluss- und Outcome-Faktoren bei Frakturen der unteren Extremitaten – speziell Sprunggelenkfrakturen – geschaffen werden. Die aktuelle Forschungslage weist darauf hin, dass psychosoziale Faktoren einen entscheidenden Einfluss auf das physische und psychische Outcome haben.

Background Loneliness has been increasingly recognized as an important determinant of mental health. The purposes of this study were to (1) determine the degree of loneliness of women and men across different age groups, (2) explore its association with distress, (3) psychometrically evaluate the Three-Item Loneliness Scale, (4) provide norm values. Methods The Three-Item Loneliness Scale was applied in a representative survey of the German population (N=2527; 14–95 years). Standardized scales were used measuring distress (depression and anxiety symptoms, perceived stress, hopelessness, suicidal ideation, fatigue, life satisfaction). Factor structure and measurement invariance across gender and age groups were analyzed using exploratory and confirmatory factor analysis. Results In the sample, 30% were not lonely at all, 44% were rarely lonely, and 26% reported some degree of loneliness. Loneliness was highest in the oldest (>70 years), followed by the age groups of 14–19 and 50–59 years. Loneliness was higher in women, except for middle age (40–49 years), when men's loneliness peaked. Results indicated scalar invariance across gender and age. Loneliness was associated with diverse forms of distress. Limitations Limitations refer to the cross-sectional study design and the use of short screening questionnaire assessing depression and anxiety symptoms. Conclusion Data indicate varying degrees of loneliness in women and men across the life span. Loneliness has broad negative ramifications with regard to well-being. Findings supports the validity of the scale providing an economic tool for assessing loneliness in population-based surveys. Differentiated norm values are provided for gender and age, which are necessary for comparative analyses.

Depersonalization (DP), or feelings of detachment from one’s self or one’s surroundings (i.e., derealization, DR), is considered a maladaptive stress response, frequently occurring in anxiety disorders, depression or as a primary disorder. However, the pathogenesis of DP/DR symptoms is little understood. The present study aimed to elucidate the influence of unresolved attachment status and the oxytocin receptor gene (OXTR) rs53576 polymorphism on DP/DR symptoms. The study sample consisted of 84 women, including 43 depressed patients and 41 control subjects, aged 19–52. DP/DR symptoms were measured with the Cambridge Depersonalization Scale; unresolved attachment status was assessed with the Adult Attachment Interview. OXTR rs53576 genotypes were obtained from blood samples. We found a highly significant gene–environment interaction: Individuals with unresolved attachment status were significantly more depersonalized when they carried the GG-allele than A-allele carriers than not unresolved subjects. There was no statistically significant main influence of OXTR genotypes or unresolved attachment status on DP/DR symptoms. We suggest that the GG-allele and unresolved attachment status might be considered as risk factors in the etiology of DP/DR symptoms. Replication is needed in larger samples including male subjects.

Fragestellung: Burnout ist ein Erschopfungssyndrom im Zusammenhang mit mangelnder Verarbeitung von arbeitsbezogenem Distress. Wir untersuchten, inwieweit unsichere und unverarbeitete Bindungsmodi bei Patienten mit Burnout haufiger vorkommen als bei gesunden Personen. Methoden: Von 60 konsekutiven Burnout-Patienten nahmen 50 an der Studie teil und wurden mit dem Adult Attachment Interview, dem Fragebogen zur Erfassung des Emotionserlebens und der Emotionsregulation und mit burnout-spezifischen Fragebogen untersucht. Die Vergleichsgruppe bestand aus einer Bevolkerungsstichprobe. Ergebnisse: Burnout-Patienten waren haufiger unsicher gebunden und wiesen haufiger einen unverarbeiteten Bindungsstatus bzgl. Verlust und Trauma auf als Personen der Kontrollgruppe. Burnout-Patienten mit unsicherer Bindungsreprasentation gaben eine geringere subjektive Bedeutsamkeit der Arbeit an, Patienten mit unsicher-vermeidender Bindungsreprasentation ein hoheres Ausmas an Depersonalisation. Patienten mit unverarbeitetem Verlust/Trauma erlebten weniger soziale Unterstutzung und zeigten ein starker passiv-negatives Emotionserleben und eine durch Externalisierung gekennzeichnete Emotionsregulation. Schlussfolgerung: Die Ergebnisse weisen darauf hin, dass unsichere und unverarbeitete Bindungsmodi einen individuellen Risikofaktor fur Burnout darstellen.

Background We explored in a sample of clinically depressed patients the influence of attachment security and unresolved trauma on psychotherapeutic outcome as well as changes in attachment representation through psychotherapeutic intervention. Methods The sample consisted of 85 women (aged 19–52), 43 clinically depressed patients from a psychosomatic inpatient unit, and 42 healthy control subjects matched for age and education. Average length of hospitalization in the patient group was eight weeks. Attachment representations were assessed with the Adult Attachment Interview at the time of admission (baseline) and at discharge. Depressive symptoms were measured using the PHQ-9 at T1 and T2. Results Insecure attachment representations were overrepresented in depressed patients. Treatment effects were moderated by baseline attachment representation: patients with higher attachment security scores at admission benefited more from the inpatient treatment and were less depressed at time of discharge than less secure patients ( η 2 =.07). Generally, attachment security increased ( η 2 =.19) and depressive symptoms decreased ( η 2 =.23) after inpatient psychotherapy treatment in the patient group. No significant effects for unresolved symptoms were found. Limitations The study is not a randomized controlled study, but used a quasi-experimental matched control group design with female subjects only. Conclusions Our results suggest that attachment representations play a major role in both the development and treatment of clinical depression. Baseline attachment security may influence psychotherapeutic outcome, perhaps through relational factors such as therapeutic working alliance. Inpatient psychotherapy may also need to address psychological issues associated with depression such as attachment insecurity.

Objective To examine the psychological, social, behavioural and injury-related factors impacting functional outcome in patients with ankle or lower limb fracture one year post-operation. Methods In this prospective study 66 patients with ankle or lower leg fracture were recruited and followed up one year post-operation. Possible associations between predictors and functional outcome were explored by regression analyses. Functional outcome was assessed with the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results Linear regression models revealed that smoking and elevated symptoms of adjustment disorder were associated with lower functional outcome one year post-operation. Fracture type, depressive symptoms and quality of relationship had no effect on functional outcome. A second linear regression revealed that preoccupations were correlated with functional outcome. Conclusion Smoking and symptoms of adjustment disorder, specifically preoccupations, are associated with functional outcome one year post-operation in patients recovering from ankle or lower leg fractures. The results support the notion that differences in functional recovery are attributable to psychological and behavioural factors rather than to fracture type. Psychological, fracture-specific, symptoms play a role in functional recovery rather than general affective symptoms.

Ankle fractures have many short and long-term consequences for patients. For this reason, psychosocial factors also play a role in the success of the treatment in addition to the surgical treatment. The aim of this article is to give an overview of the psychological aspects in the context of fractures as well as explanatory models for the different ways of coping. In addition, an overview of the empirical data with respect to psychological influences and outcome factors in lower extremity fractures, specifically ankle fractures, is given. The current research indicates that psychosocial factors have a decisive influence on the physical and psychological outcome.

Background/objectives Depression and anxiety are highly prevalent in cardiovascular patients. Therefore, we examined whether the 4-item Patient Health Questionnaire (PHQ-4, measuring symptoms of depression and anxiety) predicts all-cause mortality in outpatients with long-term oral anticoagulation (OAC). Methods The sample comprised n=1384 outpatients from a regular medical care setting receiving long-term OAC with vitamin K antagonists. At baseline, symptoms of anxiety and depression were assessed with the PHQ-4 and the past medical history was taken. The outcome was all-cause mortality in the 24month observation period. The median follow-up time was 13.3months. Results N=191 patients from n=1384 died (death rate 13.8%). Each point increase in the PHQ-4 score was associated with a 10% increase in mortality (hazard ratio [HR] 1.10, 95% confidence interval [95% CI] 1.05–1.16) after adjustment for age, sex, high school graduation, partnership, smoking, obesity, frailty according to the Barthel Index, Charlson Comorbidity Index and CHA 2 DS 2 -VASc score. The depression component (PHQ-2) increased mortality by 22% and anxiety (GAD-2) by 11% respectively. Neither medical history of any mental disorder, nor intake of antidepressants, anxiolytics or hypnotics predicted excess mortality. Conclusions Elevated symptoms of depression and, to a lesser degree, symptoms of anxiety are independently associated with all-cause mortality in OAC outpatients. The PHQ-4 questionnaire provides valuable prognostic information. These findings emphasize the need for implementing regular screening procedures and the development and evaluation of appropriate psychosocial treatment approaches for OAC patients.

Introduction The unlimited access to sexual features in the World Wide Web has raised concerns about excessive and problematic online-sex use. However, little is known about antecedents of internet-sex use of different intensity. Based on a representative German sample of 2,522 participants between the ages of 14 and 97 years, the aims of the present study were (1) to determine the prevalence rates of online-sex users with the short version (ISSTGSV) of the Internet Sex Screening Test and (2) to associate online-sex use with anxious vs. avoidant partner attachment patterns and “Big Five” personality traits as potential antecedents. Results The ISST is a brief, one-dimensional and reliable measure of online-sex activities (rtt = .69). Overall, 14.7% of respondents reported occasional and 4.2% intensive online-sex use. In multivariate analysis, online-sex use was significantly positively associated with male sex, younger age, unemployment and an anxious partner attachment pattern and negatively with conscientiousness and agreeableness. Conclusions Arousal and satisfaction by virtual enactment of sexual phantasies may be attractive for anxiously attached persons who find it difficult to commit to a real life relationship due to fear of rejection or low self-esteem. More knowledge about the individual antecedents of intensive online-sex use may also be helpful for the development of consultation and treatment strategies for excessive and addictive online-sex use.

While adverse childhood experiences have been shown to contribute to adverse health outcomes in adulthood, specifically distress and somatic symptoms, few studies have examined their joint effects with resilient coping style on adult adjustment. Hence, we aim to determine the association between resilient coping and distress in participants with and without reported childhood adversities. A representative German community sample (N = 2508) between 14-92 years (1334 women; 1174 men) was examined by the short form of the Childhood Trauma Questionnaire, the Brief Resilience Coping Scale, standardized scales of distress and somatoform symptoms. Childhood adversity was associated with reduced adjustment, social support and resilience. It was also strongly associated with increased distress and somatoform complaints. Resilient coping was not only associated with lower distress, it also buffered the effects of childhood adversity on distress. Our study corroborates the buffering effect of resilience in a representative German sample. High trait resilient subjects show less distress and somatoform symptoms despite reported childhood adversities in comparison to those with low resilient coping abilities.

The present paper looks at the potential of the Adult Attachment Interview (AAI) and its underlying basis in attachment theory for use in psychotherapeutic work. We summarize the basic tenets of attachment theory, detail the content and structure of the AAI, provide instructions for conducting the AAI, and introduce the Main et al. (2002) coding system. We then report on associations between AAI-Attachment groups and psychosomatic diseases and, finally, demonstrate applications of the AAI in clinical work and research.

The present study aimed to explore the association between the representation of early attachment experiences and personality in a representative and non-clinical German adult sample. Adult attachment was assessed by means of the Adult Attachment Interview. One hundred and sixty-seven German adults completed the NEO-FFI and the TPQ. Three important findings emerged: (1) Adults with insecure attachment representation (dismissing versus preoccupied) differ from each other in Neuroticism and Harm Avoidance, (2) attachment security is independent of personality and (3) Adults with an unresolved attachment trauma do not differ from those without with respect to personality. Our results underline the interrelation between attachment experiences, the regulation of negative emotions and self-perceived personality traits in adulthood. Moreover, our findings support theoretical assumptions of attachment theory proposing that attachment security emerges within social relationships. We suggest that unresolved attachment, at least in non-clinical samples, occurs through attachment-related traumatic experiences rather than specific personality dispositions and invite researchers to further explore biological and environmental risk factors leading to an unresolved state-of-mind.

Problematic internet use may lead to serious psychosocial dysfunction. Recent studies have found comparable prevalence in both male and female adolescents. We pursue the neglected questions how male and female adolescents differ regarding their patterns of internet use and how gender, peer attachment and patterns of use are related to pathological internet use. In 2410 adolescents (1307 girls and 1103 boys) aged 12–18 years from different types of school we assessed peer attachment, frequency and use of eight specific applications and indicators of pathological internet use. Three patterns of internet use, ‘social’; ‘sex and games” and ‘functional’ were identified and connections between variables were modeled by ordered sequences of regression. We found that problematic internet use—sex and games as well as social usage—was more prevalent in boys. Insecure peer attachment predicted problematic internet use in both sexes. Also, excessive usage of internet games and sex mediated the influence of peer attachment insecurity on problematic internet use, but only for boys. Our study identified that adolescents with insecure peer attachment are at higher risk for problematic internet use. With regard to specific types of internet use, the consumption of online games and sex was identified as risk factor in boys with increasing age. Further studies are needed to understand and possibly subgroup problematic internet use behavior in girls. Our findings suggest that increasing the quality of peer relationships may be promising approach in the prevention and treatment of problematic internet use.

Sad and anxious feelings are known to increase in the immediate postpartum period, whereas studies on new mothers' other emotional qualities such as anger are scarce. In laboratory studies, attachment security was found to be associated with effective emotion regulation in challenging situations. This study investigated attachment representations of experiences with parents and of current experiences with the partner as predictors of sad, anxious, and angry feelings across the transition to motherhood. Seventy-seven pregnant women in their third trimester were administered the Adult Attachment Interview and the Current Relationship Interview. The Differential Emotions Scale was given in pregnancy and at the infant's ages of 2 weeks, 2, 4, and 6 months, asking both mothers and fathers about maternal emotional experience. Sadness and anxiety increased 2 weeks postpartum and returned to below baseline over the following months, while anger did not change. Contrary to mothers with an insecure representation of their couple relationship, those with a secure representation reported and displayed increased sadness and anxiety 2 weeks after giving birth, from which they quickly recovered. For mothers secure in their representation of past attachment relationships with parents, an increase of low-level anger emerged 4 months postpartum, which did not occur in insecure participants and receded quickly. It can be concluded that secure representations of current and past attachment relationships help new mothers express and recover from negative emotions. These findings further elucidate the associations between attachment status and emotion regulation while adding a couple perspective.

The emerging field of epigenetics provides a biological basis for gene-environment interactions relevant to depression. We focus on DNA methylation of exon 1 and 2 of the oxytocin receptor gene (OXTR) promoter. The research aims of the current study were to compare OXTR DNA methylation of depressed patients with healthy control subjects and to investigate possible influences of the OXTR rs53576 genotype. The sample of the present study consisted of 43 clinically depressed women recruited from a psychosomatic inpatient unit and 42 healthy, female control subjects - mean age 30 years (SD = 9). DNA methylation profiles of the OXTR gene were assessed from leukocyte DNA by means of bisulfite sequencing. Depressed female patients had decreased OXTR exon 1 DNA methylation compared to non-depressed women. The association between depression and methylation level was moderated by OXTR rs53576 genotype. Exon 2 methylation was associated with OXTR rs53576 genotype but not with depression. Our findings suggest exon-specific methylation mechanisms. Exon 1 methylation appears to be associated with depressive phenotypes whereas exon 2 methylation is influenced by genotype. Previously reported divergent associations between OXTR genotype and depression might be explained by varying exon 1 methylation. In order to further understand the etiology of depression, research on the interplay between genotype, environmental influences and exon-specific methylation patterns is needed. Language: en

Background Depersonalization-derealization syndrome (DDS) is an underdiagnosed and underresearched clinical phenomenon. In Germany, its administrative prevalence is far below the threshold for orphan diseases, although according to epidemiological surveys the diagnosis should be comparable frequent as anorexia nervosa for instance. Against this background, we carried out a large comprehensive survey of a DDS series in a tertiary mental health center with a specialized depersonalization-derealization clinic. To reveal differential characteristics, we compared the DDS patients, who consulted the specialized depersonalization-derealization clinic, with a group of patients with depressive disorders without comorbid DDS from the regular outpatient clinic of the mental health center. Methods The sample comprised 223 patients with a diagnosis of depersonalization-derealization-syndrome and 1129 patients with a depressive disorder but without a comorbid diagnosis of DDS. DDS patients were described and compared with depressive outpatients in terms of sociodemographic characteristics, treatment history, treatment wishes, clinical symptomatology, prevailing psychosocial stressors, family history of common mental disorders and history of childhood trauma. Results Despite the high comorbidity of DDS patients with depressive disorders and comparable burden with symptoms of depression and anxiety, the clinical picture and course of both patient groups differed strongly. DDS patients were younger, had a significant preponderance of male sex, longer disease duration and an earlier age of onset, a higher education but were more often unemployed. They tended to show more severe functional impairment. They had higher rates of previous or current mental health care utilization. Nearly all DDS patients endorsed the wish for a symptom specific counseling and 70.7 % were interested in the internet-based treatment of their problems. DDS patients had lower levels of self-rated traumatic childhood experiences and current psychosocial stressors. However, they reported a family history of anxiety disorders more often. Conclusion In consideration of the selection bias of this study, this case series supports the view that the course of the DDS tends to be long-lasting. DDS patients are severely impaired, utilizing mental health care to a high degree, which nevertheless might not meet their treatment needs, as patients strongly opt for obtaining disorder specific counseling. In view of the size of the problem, more research on the disorder, its course and its optimal treatment is urgently required. Electronic supplementary material The online version of this article (doi:10.1186/s12888-016-0908-4) contains supplementary material, which is available to authorized users.

Background. Many patients with complex regional pain syndrome (CRPS) report some foreignness of the affected limb, which is referred to as “neglect-like symptoms” (NLS). Despite similarities of the NLS reports to symptoms of body image disturbances in mental disorders, no study has been conducted to examine such associations. Methods. We investigated 50 patients with CRPS and 45 pain control patients (N = 27, chronic limb pain; N = 18, migraine headache). NLS, anxiety, depression, depersonalization, and somatization were assessed using validated questionnaires. Results. Seventy-two percent of the CRPS patients reported at least one NLS vs 29.6% and 33.3% in the two patient control groups. In limb pain controls, NLS correlated with pain intensity. In CRPS patients, NLS correlated with anxiety (rho = 0.658, P

Background Exposition to tobacco smoke is among the major modifiable risk factors in the general population. There is strong evidence for a close association between smoking exposure and mental disorders. Methods Cross-sectional associations of different conditions of smoking status (former, current, and second hand smoking (SHS)) with indicators of mental distress were analyzed in a sample of N =5000 participants (aged 35–74 years) of the population-based survey “Gutenberg Health Study”. Results In the general population clinically significant depression (OR 1.59, 95%CI 1.17–2.17) and a previous diagnosis of depression (OR 1.50, 95%CI 1.16–1.94) were associated with current smoking. Each cigarette per day was associated with a 3% increase for the likelihood of clinically significant depression. We did not find a decreased prevalence for current first and second hand exposure in persons with established cardiovascular or lung disease. In this subgroup mental distress was strongly associated with SHS at home. Limitations Main limitations of the study pertain to the reliance on self-report of distress and smoking status and the cross-sectional nature of the data. Conclusions Despite public health efforts, smoke exposure is still alarmingly high in the general population, especially in persons with mental distress and with established cardiovascular or lung disease. In the management of persons with chronic cardiovascular and lung disease, enquiry of the medical history should include exposure to SHS at home and offer special counseling.

Research on psychosocial influences such as relationship characteristics has received increased attention in the clinical as well as social-psychological field. Several studies demonstrated that the quality of relationships, in particular with respect to the perceived support within intimate relationships, profoundly affects individuals' mental and physical health. There is, however, a limited choice of valid and internationally known assessments of relationship quality in Germany. We report the validation of the German version of the Quality of Relationships Inventory (QRI). First, we evaluated its factor structure in a representative German sample of 1.494 participants by means of confirmatory factor analysis. Our findings support the previously proposed three-factor structure. Second, importance and satisfaction with different relationship domains (family/children and relationship/sexuality) were linked with the QRI scales, demonstrating high construct validity. Finally, we report sex and age differences regarding the perceived relationship support, conflict and depth in our German sample. In conclusion, the QRI is a reliable and valid measurement to assess social support in romantic relationships in the German population.

Recently, the Dopamine D4 Receptor Gene (DRD4) and the Serotonin Transporter Gene (5-HTT) have been found to be candidate genes for infant attachment disorganization. The present study aimed to explore the relationship of these genes to adult attachment representations. The Adult Attachment Interview was used to assess attachment representations in 167 German adults. DNA from buccal cells was genotyped for the DRD4 VNTR Exon III and 5-HTT LPR polymorphisms with respect to the presence of the 7repeat allele and the short allele, respectively. DRD4 7repeat allele carriers were significantly more likely to be securely attached than those without 7repeat but only for subjects with unloving caregiver recollections. No association between the 5-HTT LPR polymorphism and adult attachment was found. These findings encourage further investigations to explore endophenotypical and mediating psychological processes between the DRD4 Gene and secure attachment patterns.

Personality and temperament embrace a wide area of both psychological and behavioral processes which are also based on disposition. A functional polymorphism in exon III of the dopamine D4 receptor gene (DRD4) has been a highly suspect genetic marker for personality in spite of ambiguous results. The present study aimed to further elucidate the relationship between DRD4, negative life events and personality in a representative nonclinical sample. Hundred sixty-seven Germans completed the NEO Five-Factor Inventory, the Tridimensional Personality Questionnaire and the California Adult Q-Sort. A factor analysis revealed 3 factors: emotional stability, social orientation and impulsivity. DNA from buccal cells was genotyped for the DRD4 variable-number tandem-repeat exon III polymorphism with respect to presence versus absence of the DRD4 7-repeat allele. Adverse life events were assessed by means of the Adverse Life Events Scale. Men carrying the DRD4 7-repeat allele were more impulsive than those without. Male 7-repeat carriers were more emotionally instable than others, but only when they experienced a large amount of negative life events. No genotype-personality relationships were found for women. The results indicate gender-specific influences of the DRD4 gene on human behavior and invite researchers to further investigate gene-environment correlations on personality traits.

Mindfulness denotes a state of consciousness characterized by receptive attention to and awareness of present events and experiences. As a personality trait, it constitutes the ability to become aware of mental activities such as sensations, images, feelings, and thoughts, and to disengage from judgment, conditioned emotions, and their cognitive processing or automatic inhibition. Default brain activity reflects the stream of consciousness and sense of self at rest. Analysis of brain activity at rest in persons with mindfulness propensity may help to elucidate the neurophysiological basis of this important mental trait. The sample consisted of 32 persons—23 with mental disorders and 9 healthy controls. Dispositional mindfulness (DM) was operationalized by Mindful Attention Awareness Scale (MAAS). Brain activity at rest with eyes closed was assessed by fluorodeoxyglucose positron emission tomography (F-18-FDG PET). After adjustment for depression, anxiety, age and years of education, resting glucose metabolism in superior parietal lobule and left precuneus/Brodmann area (BA) 7 was positively associated with DM. Activity of the left inferior frontal orbital gyrus (BA 47) and bilateral anterior thalamus were inversely associated with DM. DM appears to be associated with increased metabolic activity in some core area of the default mode network (DMN) and areas connected to the DMN, such as BA 7, hosting sense of self functions. Hypometabolism on the other hand was found in some nodes connected to the DMN, such as left inferior frontal orbital gyrus and bilateral thalamus, commonly related to functions of memory retrieval, decision making, or outward attention.

Background While loneliness has been regarded as a risk to mental and physical health, there is a lack of current community data covering a broad age range. This study used a large and representative German adult sample to investigate loneliness. Methods Baseline data of the Gutenberg Health Study (GHS) collected between April 2007 and April 2012 (N = 15,010; 35–74 years), were analyzed. Recruitment for the community-based, prospective, observational cohort study was performed in equal strata for gender, residence and age decades. Measures were provided by self-report and interview. Loneliness was used as a predictor for distress (depression, generalized anxiety, and suicidal ideation) in logistic regression analyses adjusting for sociodemographic variables and mental distress. Results A total of 10.5% of participants reported some degree of loneliness (4.9% slight, 3.9% moderate and 1.7% severely distressed by loneliness). Loneliness declined across age groups. Loneliness was stronger in women, in participants without a partner, and in those living alone and without children. Controlling for demographic variables and other sources of distress loneliness was associated with depression (OR = 1.91), generalized anxiety (OR = 1.21) and suicidal ideation (OR = 1.35). Lonely participants also smoked more and visited physicians more frequently. Conclusions The findings support the view that loneliness poses a significant health problem for a sizeable part of the population with increased risks in terms of distress (depression, anxiety), suicidal ideation, health behavior and health care utilization.