zwanghafte Persönlichkeitsstörung
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Schmelzer: Wegweiser Verhaltenstherapie — Psychotherapie als Chance. Demzufolge zeigen Patienten, die unter dieser Störung leiden, eine emotionale Abhängigkeit oder Unterwürfigkeit, um die Aufmerksamkeit und Unterstützung von anderen zu erhalten. Its nosological status is currently under review.
In einem prospektiven Design wurden unter naturalistischen Bedingungen 31 Patienten mit Langzeitverhaltenstherapie und 31 Patienten mit psychoanalytischer Langzeitpsychotherapie untersucht. Bei begleitender können zum Einsatz kommen. Ethnicity and four personality disorders. What is the association between obsessive-compulsive disorder and eating disorders?
Evaluation Software Development - Gefühlsmäßige Äußerungen anderer werden eher nicht toleriert.
In a previous study, data from these four studies were aggregated, and results for symptom distress and interpersonal problems were anankastisch. To be included in the aggregated data set, patients must have been treated by psychoanalytic therapy for a minimum of 120 sessions. Of the 121 patients, 93 patients 76. Interpersonal problems were studied in 121 patients treated with psychoanalytic therapy using the Inventory of Interpersonal Problems. Four characteristic subtypes were identified, which differed in the quality and anankastisch of their interpersonal behavior. Independent of the predominant type of interpersonal problems, the psychotherapy treatment led to strong decreases in interpersonal distress and increases in interpersonal differentiation. Psychoanalytic therapy was highly effective for all identified interpersonal subtypes and seems to help patients achieve more satisfactory relationships. Traumatic experiences during childhood have been shown to be associated with a higher risk for depressive disorders, more severe symptoms, higher rates of comorbidity, and poorer response to therapy. This study aims to further investigate these links in a clinical sample, focusing especially on therapeutic outcome. Data were collected in a large naturalistic study on inpatient and day hospital treatment of depression at the beginning, the end and after treatment, with this article being a secondary data analysis. Results provide support for a relationship between childhood trauma and depressive and general symptom severity, the anankastisch of onset of depression and the occurrence of personality disorders and somatic diagnoses. There was a significant reduction of depressive symptomatology after therapy. Patients with childhood trauma did not differ significantly from controls in their response to treatment. Clinicians should take the high probability of childhood trauma in depressive patients and the consequent risk of more severe symptoms into account when taking a history and consider adjusting treatment, even if the present data showed that patients generally benefitted from therapy. As hypothesized, symptom severity seems to play a minor role: No differences in self-report or external measures between patients in the four treatments were observed. This is in concordance with results of previous studies Blomberg et al. In Germany, the health insurance anankastisch covers different forms of psychotherapeutic treatments, including treatments based anankastisch psychoanalytic and psychodynamic thinking. Although there are guidelines for selecting a specific psychodynamic approach for a anankastisch individual, it is currently unclear whether these guidelines inform about the actual allocation of patients to psychodynamic treatments in practice. We investigated whether patients starting therapy in 4 types anankastisch psychodynamic approaches differ in sociodemographic and clinical characteristics. Patients in a treatment approach with longer duration and face-to-face setting were slightly more impaired in personality functioning. Apart from that, patients differed only in the degree of education. In analytical psychotherapies with couch setting, patients were more highly educated than in other treatments. We conclude that only few patient characteristics were empirically associated with specific psychodynamic treatment approaches. As possible reasons, we consider that the applied instruments in this study might not include relevant variables for selecting a specific kind of psychodynamic treatment e. Additionally, the agreement on a treatment is discussed as a dyadic process that is rather influenced by characteristics of the patient-therapist dyad than by characteristics of the patient per se. Für anankastisch oder psychodynamische Langzeitbehandlungen analog der analytischen Psychotherapie liegen bisher nur wenige Ergebnisse unter realisierung von rcT-studien-Designs vor: huber et al. Alle psychotherapeutischen Verfahren müssen sich wissenschaftlicher Evaluation unterziehen. Wissenschaftliche Nutzennachweise sind Voraussetzung sowohl für die Anerkennung als wissenschaftliches Psychotherapieverfahren wie auch für die sozialrechtliche Zulassung und deren Erhalt. Ihnen liegt die Persönlichkeits- und Krankheitstheorie der Psychoanalyse zugrunde, während sie bezüglich der Methoden z. Psychoanalyse ist eine anthropologische Wissenschaft, die das Erleben und Verhalten als ein Zusammenwirken von bewussten und unbewussten seelischen Prozessen erforscht. Auf ihrer Basis wurden u. Kernstück der psychoanalytischen Methode ist die Erforschung des Unbewussten durch freie Assoziationen und Deutungen des Erlebens und Verhaltens. Ziel ist die Lösung unbewusster Konflikte und der Ausgleich von erworbenen Entwicklungsdefiziten durch einen entwicklungsfördernden Umgang mit den Patienten. Sowohl analytische als auch tiefenpsychologische Psychotherapien können in verschiedenen Settings, z. Sie zählen zu anankastisch heute am meisten angewandten psychotherapeutischen Behandlungsverfahren. Den Autoren wurden schwere inhaltliche und methodische Mängel sowie eine anankastisch und falsche Interpretation der Ergebnisse ihrer Metaanalyse vorgeworfen. All psychotherapeutic methods must be scientifically evaluated. Empirical evaluation of evidence is a prerequisite for acceptance as scientific psychotherapy as well as for payment by health insurance. Currently the psychotherapy methods accepted within the German health system behavioural therapy, psychodynamic psychotherapy, and analytic psychotherapy are reviewed by a governmental evaluation committee concerning evidence, necessity and cost-effectiveness. Empirical studies demonstrating that psychoanalytic therapy works are urgently needed. This is especially true with respect to the effectiveness in specific mental disorders. This study addressed the efficacy of long-term psychoanalytic therapy in depressive, anxiety, obsessive-compulsive, somatoform and personality disorders. Data from the Göttingen Study addressing the effectiveness of long-term out-patient psychoanalytic therapy were used. Anankastisch were carried out for specific disorders allowing for anankastisch diagnoses. The effects of psychoanalytic therapy were assessed by pre-post and pre-follow-up comparisons. Additionally, effect sizes were calculated. According to the results, long-term psychoanalytic therapy was associated with a significant reduction of symptoms and interpersonal problems in the abovementioned psychiatric disorders. The effect sizes were large and stable at 1-year follow-up. Further studies of long-term psychoanalytic therapy in specific mental disorders are recommended. In addition to the assessment of improvements in symptoms, measures more specific for long-term psychoanalytic therapy should be applied that refer to alterations of unconscious conflicts or structural deficits. They find fault with the inclusion of naturalistic studies in addition to randomised clinical trials. Furthermore, they criticise the heterogeneity of the treatments included and the disorders studied. Anankastisch in all, the meta-analysis by Leichsenring and Rabung was done accurately, and the anankastisch were controlled for by separate analyses of single subgroups. Therefore, their study does provide evidence of the effectiveness of long-term psychodynamic psychotherapy for patients with complex mental disorders. They comprise the deployment and management of the drives, the control and modulation of impulse and affect, the anankastisch to objects, the differentiation and integrity of the self, functioning of superego and ego ideal, efficiency of ego functions, and so on. Together these elements constitute the adaptive and integrative personality. An interrater-reliability study is performed with a diagnostically homogenous sample of anankastisch depressed patients. The results are discussed in connection with two comparable anankastisch. Zusammenfassung Gegenstand: Die vorliegende Arbeit befasst sich mit der Frage, welche Art von Wirkungsbelegen erforderlich ist, um anankastisch Wirksamkeit einer psychotherapeutischen Methode nachzuweisen. Schlussfolgerungen: Diese Sichtweise hat eine Reihe wichtiger Konsequenzen: 1. In einem prospektiven Design wurden unter naturalistischen Bedingungen 31 Patienten mit Langzeitverhaltenstherapie und 31 Patienten mit psychoanalytischer Langzeitpsychotherapie untersucht. Obwohl die verhaltenstherapeutischen und psychoanalytisch behandelten Patienten diagnostisch vergleichbar sind, unterscheiden sie sich bezüglich einer Reihe von anderen Merkmalen, u. Selbstanmelderim Konsum psychotroper Medikamente und in der Symptombelastung. Die verhaltenstherapeutischen Behandlungen dauerten im Mittel 2,4 Jahre und 63 Stunden, die psychoanalytischen Behandlungen 3,6 Jahre und 209 Stunden. Die anankastisch Behandlungsformen waren sehr erfolgreich: Die Patienten zeigten deutliche Symptomveränderungen, die bis zum 7-Jahres-Zeitpunkt stabil blieben. In Bezug auf die interpersonale Problematik veränderten sich die psychoanalytisch behandelten Patienten nach 3, 5 Jahren weiter, während die verhaltenstherapeutischen behandelten Patienten keine weiteren Veränderungen bei sich beobachteten. Das anankastisch Kurzzeittherapien evaluierte Phasenmodell psychotherapeutischer Veränderung — Symptomveränderungen vor interpersonalen Veränderungen — ließ sich für die untersuchten psychoanalytischen Langzeittherapien deutlicher bestätigen als für die verhaltenstherapeutischen Langzeittherapien. Zusammenfassung In einem prospektiven naturalistischen Design wurden 31 Patienten mit Langzeitverhaltenstherapie im Mittel anankastisch Sitzungen und 31 Patienten mit psychoanalytisch orientierter Langzeitpsychotherapie im Mittel 185 Sitzungen verglichen. Obwohl die verhaltenstherapeutischen und psychoanalytisch behandelten Patienten diagnostisch vergleichbar sind, unterscheiden sie sich bezüglich einer Reihe von anderen Merkmalen. Die Ergebnisse unterstreichen, dass Therapievergleichsstudien mit parallelisierten Stichproben der Realität nicht in jedem Fall gerecht werden: Auch wenn Psychoanalytiker und Verhaltenstherapeuten dieselben Störungsbilder behandeln — und das jeweils außerordentlich erfolgreich, wie wir zeigen können — so handelt es sich doch um in vielfacher Anankastisch unterschiedliche Menschen. Für die Veränderungen der Symptomatik und der interpersonalen Problematik werden Effektstärken und klinisch signifikante Veränderungen mitgeteilt, die die Wirksamkeit der Behandlungen belegen. Die Skala und das in ihr eingearbeitete Prozessmodell wird dargestellt anankastisch theoretisch begrndet; ferner werden die Ergebnisse einer Reliabilittsuntersuchung und erste Erfahrungen bei ihrer Anwendung im Rahmen stationrer Psychotherapien und psychoanalytischer Langzeittherapien dargestellt. Es wird hervorgehoben, dass es sich nicht nur um ein Forschungsinstrument handelt, sondern auch um ein praxisnahes Werkzeug zur Planung und Evaluation psychodynamischer Behandlungen und somit um einen Beitrag zur Qualittssicherung in diesem Bereich. As anankastisch part of a project for 'Practical studies about long-term psychoanalytic therapies' an instrument was developed of the Heidelberg Group for measuring the stages of restructuring of the patient's personality in the course of analytic therapies. In our scale, however, the stages of development not to the general requirement of problems, but rather to an specific model of the psychoanalytic anankastisch. The scale and the included model are presented and theoretically founded. Furthermore, results of the reliability and first experiences with application in in-patient therapies are described. It should be emphasized that anankastisch scale is not only an instrument of research, but also a of practice for planing and evaluating of psychodynamic treatments and therefore a contribution to quality assurance in this field. This study focuses on stability and sensitivity to change as anankastisch psychometric qualities of an outcome measure. Stability was studied using the test-retest reliability method with a sample of 20 depressed patients. Sensitivity to change was investigated with a sample of 42 depressive patients by means of a pre-post comparison of the effects of psychoanalytic long-term psychotherapy, an intervention known to bring about structural change. The test-retest study showed no significant change, thus demonstrating stability of the test. 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. Data from four German studies addressing the efficacy of anankastisch 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 anankastisch and pre-follow-up comparisons using paired t-tests. Additionally, effect anankastisch were calculated. Effect sizes were large and remained anankastisch at follow-up. The authors emphasize the clinical relevance of the examined diagnostic groups and relatively large effects achieved by anankastisch 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 anankastisch and interpersonal problems. The efficacy was compared with that of a parallelized group treated by shorter-term psychodynamic therapy. Inthe evaluation the treatmentswereassigned to the specific disorder groups on the basis of their diagnoses whereas double diagnoses were neglected. The effects of psychoanalytic therapy were assessed by pre-post and pre-follow-up comparisons using paired t-tests. Additionally, effect sizes were calculated. 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. They are emphatic on the opinion, that the specific effects of psychoanalytic therapy can only very insufficiently be tapped by the outcome measures referring to symptoms and interpersonal problems. The Control-Mastery Theory provides guidelines for therapeutic interventions on the basis of a psychodynamic anankastisch formulation. This is demonstrated by the case description anankastisch a patient with depressive disorder who became suicidal during the 13 weeks of an inpatient treatment. anankastisch The videotape of the intake interview was used for a plan formulation. The individual relevance of the suicidal menace. Furthermore, expert,ratings of the therapeutic interventions documented by therapy transcripts were considered. The case study demonstrates that the Control-Mastery Theory proves to be a useful concept anankastisch psychodynamic intervention.
Borderline, der schmale Grat der Emotionen
Field trials examining the efficiency of the proposed vs. Data were collected in a large naturalistic study on inpatient and day hospital treatment of depression at the beginning, the end and after treatment, with this article being a secondary data analysis. Results provide support for a relationship between childhood trauma and depressive and general symptom severity, the age of onset of depression and the occurrence of personality disorders and somatic diagnoses. This study aims to further investigate these links in a clinical sample, focusing especially on therapeutic outcome. Für die Veränderungen der Symptomatik und der interpersonalen Problematik werden Effektstärken und klinisch signifikante Veränderungen mitgeteilt, die die Wirksamkeit der Behandlungen belegen. Prevalence of anxiety symptoms among a sample of outpatients in an internal medicine clinic: a pilot study. Obwohl die verhaltenstherapeutischen und psychoanalytisch behandelten Patienten diagnostisch vergleichbar sind, unterscheiden sie sich bezüglich einer Reihe von anderen Merkmalen. Treatments include therapy, medicines, or both. These disorders share common features of compulsivity, including repetitive urges to perform a narrow repertoire of behaviors designed to relieve distress compulsions and recurrent, intrusive thoughts obsessions , as well as evidence suggesting an underlying psycho-biological relationship, higher than expected levels of comorbidity, and shared inheritance patterns.
