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This empirical study undertakes a categorization of the core concept of Control Mastery Theory: mostly unconscious testing of pathogenic beliefs that patients exhibit in relating to their therapist to work on their problems. The focus lays on latent meanings of manifest tests. We qualitatively analyze transcripts of 172 psychotherapy sessions with 23 patients for sequences in which significant patient-therapist interactions occur, and systematize identified tests into thematic categories based on what tests intent to achieve (ICC =.68). Guided by theory, the analysis is attending to complexity, individuality, and the unconscious. Tests circle around striving for independence, deserving/self-worth, acceptance, and entitlement. Individual tests have various underlying meanings, are interrelated, and may be multidimensional. Meanings of tests must be confirmed within the psychotherapeutic process. Incorporating the treating clinician thus seems important. [ABSTRACT FROM AUTHOR]

Abstract Background Although aging is accompanied by diminished functioning, many elderly individuals preserve a sense of well-being. While the concept of "successful aging" has been popular for many decades, little is known about its psycho-physiologic and endocrine underpinnings. KORA-Age is a population-based, longitudinal study designed to determine the prevalence of successfully aged men and women between 65 and 94 years old in the MONICA/KORA Augsburg cohort of randomly selected inhabitants. Specifically, we aim to identify predictors of successful aging and to elucidate bio-psychosocial mechanisms that maintain mental health and successful adaptation despite adverse experiences of life and aging. Methods/Design Components of successful aging were assessed in a telephone survey of 4,127 participants (2008-2009) enrolled in the MONICA/KORA cohort, on average, 13 years earlier. Psychosocial, somatic and behavioural predictors are used to determine factors that contribute to successful aging. An age-stratified random sub-sample (n = 1,079) participated in a personal interview where further psychological mechanisms that may underlie successful adaptation (resilience, social support, attachment) were examined. The interactions among neuroendocrine systems in the aging process are investigated by studying the cortisol/dehydroepiandrosterone-sulfate ratio, the level of insulin-like growth factor I, and oxytocin. Discussion Longitudinal determinants of successful aging can be assessed based on a follow-up of an average of 13 years. A comprehensive analysis of biological as well as physio-psychological information provides a unique opportunity to investigate relevant outcomes such as resilience and frailty in the elderly population.

Empirical evidence for the effectiveness of long-term psychodynamic psychotherapy (LTPP) in patients with mood disorders is growing. However, it is unclear whether the effectiveness of LTPP is due to distinctive features of psychodynamic/psychoanalytic techniques or to a higher number of sessions. We tested these rival hypotheses in a quasi-experimental study comparing psychoanalytic therapy (i.e., high-dose LTPP) with psychodynamic therapy (i.e., low-dose LTPP) and cognitive-behavioural therapy (CBT) for depression. Analyses were based on a subsample of 77 subjects, with 27 receiving psychoanalytic therapy, 26 receiving psychodynamic therapy and 24 receiving CBT. Depressive symptoms, interpersonal problems and introject affiliation were assessed prior to treatment, after treatment and at the 1-, 2- and 3-year follow-ups. Psychoanalytic techniques were assessed from three audiotaped middle sessions per treatment using the Psychotherapy Process Q-Set. Subjects receiving psychoanalytic therapy reported having fewer interpersonal problems, treated themselves in a more affiliative way directly after treatment and tended to improve in depressive symptoms and interpersonal problems during follow-up as compared with patients receiving psychodynamic therapy and/or CBT. Multilevel mediation analyses suggested that post-treatment differences in interpersonal problems and introject affiliation were mediated by the higher number of sessions, and follow-up differences in depressive symptoms were mediated by the more pronounced application of psychoanalytic techniques. We also found some evidence for indirect treatment effects via psychoanalytic techniques on changes in introject affiliation during follow-up. These results provide support for the prediction that both a high dose and the application of psychoanalytic techniques facilitate therapeutic change in patients with major depression. [ABSTRACT FROM AUTHOR]

The study aims at the development of an adherence scale (APP) for psychoanalytic therapy (PA) and psychodynamic therapy (PD) with high discriminant ability to differentiate between these 2 treatments. The development of the APP scale comprises 6 steps. Nine trainees underwent an intensive rater training. After reaching an interrater reliability of ICC [2.1]>0.60, seven trainees participated as raters in the psychometric study. The reliability of the APP Scale was ICC [1.1]=0.58 and ICC [1.3]=0.81 (PA subscale), and ICC [1.1]=0.67 and ICC [1.3]=0.86 (PD subscale) indicating sufficient to excellent reliability. The discriminant ability of the APP Scale based on audiotaped PD- and PA-sessions was d=1.04 (PA subscale) and d=1.48 (PD subscale) indicating large effect sizes, respectively. Thus, the APP scale applied by trained psychology students and postgraduates, discriminates reliably the conceptually overlapping treatments, provided that the raters were trained intensively by experts in PA and PD., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: This study explores patients' utilization of psycho-oncologic support and the effectiveness thereof., Methods: At the hospital in Munich-Harlaching, 51 patients were recruited following their first admission to the breast centre, 27 of whom utilized the psycho-oncologic service. They were compared to 24 decliners of the service. All patients completed self-rating questionnaires (Distress-Thermometer and Patient Health Questionnaire) at admission and at release. Group differences were calculated statistically by chi-square- and t-tests., Results: We found no significant differences between users and decliners concerning socio-demographic and somatic data, but there were significant group differences in mental health. Users reported more mental distress and more depressive and anxiety symptoms. Psycho-oncologic interventions showed small to large effect sizes., Conclusions: Although this study corresponded more to external than to internal validity standards, it did yield provisional empirical evidence that psycho-oncologic interventions are effective in the treatment of the mental symptoms of breast cancer patients.

Objectives: This study investigates the stability of symptomatic and interpersonal changes after inpatient psychodynamic psychotherapy., Methods: 437 patients were assessed 3 to 5 years after discharge with the Symptom Checklist (SCL-90-R), the Inventory of Interpersonal Problems (IIP), global assessment of effectiveness and utilization of posttreatment psychotherapy. The therapist's perspective was evaluated by the Impairment Severity Score (BSS), the Global Assessment of Functioning Scale (GAF), and the Clinical Global Impressions (CGI)., Results: Patients improved in all SCL-90-R scales significantly. The Global Severity Index (GSI) effect size was 0.81 posttreatment and 0.82 at follow-up. All IIP scales improved significantly; effect size of IIP total score was 0.40 at posttreatment and 0.60 at follow-up. There were substantial gains in BSS,GAF, and CGI. 84% of the patients were in psychotherapy after dismissal., Discussion: Posttreatment results were in accordance with comparable studies. The results are stable on a symptomatic level and improve further on an interpersonal level.

Objectives: In the present paper, data from four German studies on the efficacy of outpatient psychoanalytic long-term psychotherapy were examined for symptom reduction (SCL-90-R) and reduction of interpersonal problems (IIP-D). Specifically, the research question addressed the efficacy of long-term therapy in specific diagnostic groups and was was compared with that of a parallel group who underwent shorter-term psychodynamic therapy., Methods: Data from four German studies addressing the efficacy of outpatient psychoanalytic long-term therapy were collected. Evaluation of these data was carried for specific diagnostic groups allowing for comorbid diagnoses. The effects of psychoanalytic therapy were assessed by pre-post and pre-follow-up comparisons using paired t-tests. Additionally, effect sizes were calculated. Psychoanalytic long-term psychotherapy and shorter-term psychodynamic therapy were compared by using a repeated measure ANOVA: Pretreatment vs. posttreatment/follow-up (two-levels) with the between subject factor "therapy conditions" (two levels)., Results: The results showed that in terms of improvement of symptoms and interpersonal problems, psychoanalytic long-term therapy was at least as effective as shorter term psychodynamic therapy with regard to the following ICD-10 diagnostic groups: affective disorders (F3), anxiety disorders (F40; F41; F42), personality disorders (F60; F61; F62), and a group of mixed neurotic disorders (F43; F50; F51; F1; F55). Effect sizes were large and remained stable at follow-up., Conclusions: The authors emphasize the clinical relevance of the examined diagnostic groups and relatively large effects achieved by the psychoanalytic treatment. Furthermore, the occurrence of comorbid diagnoses and their consequences are discussed. The authors stress that the specific effects of psychoanalytic therapy can only be very insufficiently tapped by the outcome measures referring to symptoms and interpersonal problems.

Objective: The aim of this study was to explore, using a simple qualitative design, how community mental health staff in Austria perceive their job., Method: 195 community-based mental health professionals answered seven open questions on how they perceive their job. The main areas covered were the most important tasks of the job, skills necessary to perform these tasks, as well as positive and negative aspects of the job. Answers were subjected to thematic content analysis., Results: For most professionals, contact with clients and team colleagues were the major rewards of the job. Aspects experienced as stressful were the clients' illness, role ambiguity, team conflicts and lack of time. Necessary skills many respondents did not feel competent in were specialised knowledge and psychosocial skills., Conclusions: It might be useful to revise existing forms of collaboration within multiprofessional teams. The responsibility for difficult patients may be shared by several members of the team, who should contribute their specific knowledge. Training should be tailored towards the needs of the different professional groups and focus on those skills that are required in community mental health care.

Objective: The aim of this study was to explore job satisfaction, professional role and burnout among community mental health staff in Austria., Methods: The Minnesota Job Satisfaction Questionnaire, the GHQ-12, the Maslach Burnout Inventory and a questionnaire exploring staff's professional role and team identity were administered to 195 community-based mental health professionals in two Austrian regions. Staff's job perception was assessed in open questions. Predictors of burnout scores were identified in multivariate analyses., Results: While the mental health professionals had elevated scores on the GHQ-12, their levels on the three burnout subscales were low. Social workers and psychologists showed the lowest job satisfaction, social workers also had low role identity scores. Being in the current job for a short time and disposing of psychosocial skills were predictors of high job satisfaction. High burnout scores were predicted by the lack of basic psychosocial competence and a lack of general knowledge in mental health care. The effect of caseload on psychological well-being was positive as well as negative., Conclusions: Even if the mental health professionals in our study show high levels of general stress, they seem to have less emotional problems resulting from extensively dealing with troubled individuals. Improving basic psychosocial competence and general expertise in mental health care might have a protective effect against developing a burnout syndrome.