Annette Kämmerer

Starvation and emotion regulation in anorexia nervosa

Self-starvation, with concomitant weight loss, may serve as a dysfunctional behavior to attenuate negative affective states in anorexia nervosa (AN). A total of 91 participants composed of patients with acute AN, women recovered from AN, clinical controls with either depression or anxiety disorder, and healthy controls were tested on a measure of emotion regulation. Patients with acute AN as well as recovered patients with AN and clinical controls showed increased emotion regulation difficulties as compared with healthy controls. In patients with acute AN, a specific association between body weight and emotion regulation was found: the lower the body mass index in patients with acute AN, the lesser were their difficulties in emotion regulation. This association could only be found in the subsample of patients with acute AN but not in the control groups. Moreover, there were no confounding effects of depression or duration of illness. The findings are consistent with the hypothesis that self-starvation with accompanying low body weight serves as a dysfunctional behavior to regulate aversive emotions in AN.

Mood Regulation and Cognitive Reactivity in Depression Vulnerability

There is substantial evidence supporting the hypothesis that cognitive reactivity is an important variable in the etiology of depression. However, there is a lack of studies examining possible mechanisms that underlie cognitive reactivity. The present study tested whether two specific mood regulation processes differentially appear in vulnerable and non-vulnerable individuals, and whether they can account for differences in cognitive reactivity. In a cross-sectional experimental design, 20 formerly-depressed individuals (FD) were compared with 20 never-depressed individuals (ND). In an autobiographical memory task both groups differed concerning the use of positively and negatively toned emotion words: FD retrieved fewer positive emotion words than ND in the second phase of this task. Furthermore, FD with a high cognitive reactivity retrieved more negatively toned emotion words. In the ND group there was a different pattern: Subjects with a high cognitive reactivity retrieved less positively toned emotion words. Two different cognitive processes seem to account for cognitive reactivity in individuals who are at high versus low risk for depression.

The thinner the better: self-esteem and low body weight in anorexia nervosa.

UNLABELLED The aim of the present study was to examine the associations between self-esteem, motive satisfaction, and body weight in acute (acAN) and recovered (recAN) inpatients with anorexia nervosa (AN) and in healthy controls. Both acAN and recAN showed lower levels of self-esteem as compared with healthy controls but did not differ from each other. In acAN, decreased body weight was associated with increased self-esteem. Satisfaction of an achievement motive but not satisfaction of a superiority motive mediated this association. No such correlations could be observed in the other groups. This is the first study to show an often assumed association between decreased body weight and increased self-esteem in AN patients. These preliminary results strengthen the assumption that low body weight may foster self-esteem in patients with acAN, mainly through the satisfaction of an achievement motive. KEY PRACTITIONER MESSAGE Self-esteem should be focused very early in the treatment of AN since weight gain may deprive the patient of an important source of self-esteem. Treatment interventions should be attuned to underlying motives of threatened self-esteem; in AN patients, the enhancement of self-esteem via weight loss seems to be rather fuelled by the satisfaction of an achievement motive than by the satisfaction of a superiority motive. Specific trainings to improve self-esteem in AN patients seem to be promising as an add-on to regular treatment.

Acculturation, self-construal, mental and physical health: An explorative study of East Asian students in Germany

The present study explores acculturation and its associated aspects of two East Asian student groups with different levels of exposure to German culture (100 international students from East Asian countries [IS]; 61 second generation students of East Asian descent [SGS]). First, we investigated the relationships between acculturation, self-construal, depressive and somatic symptoms, and differences between the student groups in these variables. Second, the four acculturation types (integration, assimilation, separation and marginalization) were examined regarding their relationship to self-construal and health outcomes. The results showed that the acculturation dimensions (mainstream, heritage) were relevant to the level of depressive symptoms for IS which was not the case for SGS. Furthermore, IS reported more somatic symptoms whereas there was no difference between the two groups in the level of depressive symptoms. In the analysis of acculturation types, assimilated and integrated students were characterized by high independent self-construal, while separated and integrated students showed high interdependent self-construal. Assimilated students displayed the least depressive symptoms of all acculturation groups. This study highlights different characteristics of East Asian students in acculturation, self-construal and health outcomes, and discusses the complexity of the relationships between acculturation types and health.

Interpersonal Motives in Anorexia Nervosa: The Fear of Losing One's Autonomy

OBJECTIVE This study examined the widely held but insufficiently studied hypothesis of autonomy disturbances in anorexia nervosa. METHOD A total sample of 112 participants comprising patients with acute anorexia nervosa (AN), women recovered from anorexia nervosa (REC), clinical controls (CC), and healthy controls (HC) completed measures of dependency and intimacy strivings, as well as measures of frustrations of these same strivings. RESULTS In comparison to HC and CC, AN showed a stronger motivation to avoid dependency and lower strivings for intimacy. Compared with HC, but not with CC, AN also showed stronger frustrations of the same motives. Whereas REC did not differ from AN regarding avoidance of dependency, they reported lower frustration of dependency avoidance (i.e., less actual experiences of dependency). Finally, REC reported higher intimacy motivation as well as better satisfaction of intimacy motivation as compared with AN. CONCLUSIONS The present findings suggest that a pronounced motive of avoiding dependency may be a vulnerability factor for anorexia nervosa that is disorder-specific and trait-like. Frustrations of this motive seem to be associated with psychopathology.

Vergeben: Eine Quelle von Wohlbefinden

Zunachst werden verschiedene Definitionen von Vergebung vorgestellt und die empirische Befundlage wird geschildert. Besonders aus der Sozialpsychologie liegen empirische Daten vor, die zeigen, welche Variablen auf die Vergebungsbereitschaft Einfluss haben. Eine zentrale Rolle spielt dabei die Empathiefahigkeit auf der Seite der vergebenden Person und die Haltung der schadigenden Person: Es zeigte sich, dass Entschuldigungen alleine keinen relevanten Einfluss auf die Vergebungsbereitschaft haben; vielmehr muss es eine Anerkennung des angerichteten Schadens geben und ein Angebot zur Wiedergutmachung. Danach informiert das Kapitel uber die Bedeutung von Vergebung im therapeutischen Kontext. Ein Phasenmodell des Vergebens, das in der Therapie zur Anwendung kommen kann, wird vorgestellt. Abschliesend wird die Bedeutung von Vergebung fur ein allgemeines Wohlbefinden diskutiert.

Psychosoziale Unterstützung von älteren Menschen mit einer chronischen Sehbeeinträchtigung

Zusammenfassung. Ziel der vorliegenden Arbeit war die empirische Prufung einer psychosozialen Kurzintervention bei Menschen mit altersabhangiger Makuladegeneration, der primaren Ursache von Sehverlust im hoheren Alter. Gegenuber den bisher in der Literatur vorgelegten Interventionsansatzen war die Intervention der vorliegenden Studie in starkerem Mase gesundheitspsychologisch fundiert. Sie umfasste insgesamt drei Sitzungen auf der Basis eines Gruppenansatzes mit je 4 bis 6 Patienten. Unterschieden wurde ferner zwischen einem emotions-orientierten und problemlose-orientierten Vorgehen. In die Studie einbezogen wurden n = 23 Personen mit emotions-orientiertem, n = 22 Personen mit problemlose-orientiertem Vorgehen und n = 22 Personen ohne Behandlung (Altersmittelwerte zwischen 76.1 und 77.3 Jahren). Die Behandlungsgruppen wurden vor und nach der Intervention mit eingefuhrten Skalen zur Depressivitat, zu problemorientiertem Coping und Anpassung an den Sehverlust untersucht. Die Vergleichsgruppe wurde entsprec...

Ein psychosoziales Trainingsprogramm für ältere Menschen mit altersabhängiger Makuladegeneration: Befunde einer Pilot-Evaluationsstudie

Zusammenfassung.Ziel der vorliegenden Studie war die Konzeption und erste Evaluation eines psychosozialen Trainingsprogramms zur Verbesserung der Lebensqualität von Patienten mit altersabhängiger Makuladegeneration (AMD). 22 Patienten der Universitäts-Augenklinik Heidelberg im Alter von 62–80 Jahren wurden in eine Interventionsgruppe (n=14) und Vergleichsgruppe1 Da im Rahmen dieser Studie keine reine Zufallsaufteilung möglich war, sprechen wir von Vergleichs-, nicht von Kontrollgruppe ohne Intervention (n=8) aufgeteilt. Die Intervention bestand aus fünf wöchentlichen, je zweistündigen Gruppensitzungen und umfasste sechs Module: (1) Progressive Muskelrelaxation, (2) Zusammenhang von Denken—Fühlen—Handeln, (3) systematisches Problemlösen, (4) Ressourcenaktivierung, (5) Erfahrungsaustausch und (6) Informationsvermittlung. Eine Prä-/Postmessung beider Untersuchungsgruppen erfolgte unter Verwendung von standardisierten Maßen zur Erfassung von Erleben und Verhalten. Wir fanden, dass die Interventionsgruppe im Unterschied zur Vergleichsgruppe sowohl im emotionalen als auch im behavioralen Funktionsniveau deutliche Verbesserungen bzw. Vermeidung weiterer Verluste aufwies. Dies interpretieren wir als ersten Hinweis darauf, dass mit Hilfe des entwickelten Trainings die Lebensqualität von AMD-Patienten gesteigert werden kann.Summary.The purpose of this work was to develop and evaluate a psychosocial intervention aimed to improve quality of life of AMD patients. A total of 22 outpatients (age 62 to 80 years) treated in the University Eye Clinic in Heidelberg were divided into an intervention group (n=14) and a comparison group without intervention (n=8). The intervention program was based on six modules carried out in five weekly group sessions. These modules included: (1) progressive muscle relaxation, (2) exchange of disease-related experiences, (3) connection between thought, emotion, and behavior, (4) activation of available resources, (5) general problem solving skills and (6) information exchange. Pre-post assessment addressed a set of standardized emotional and behavioral outcome measures. Findings revealed that the intervention group showed improvement or prevention of additional loss in emotional as well as in behavioral outcomes, while the comparison group did not. Results are interpreted as initial evidence that the developed program is able to improve the quality of life in patients suffering from AMD.

The Thinner the Better: Self-Esteem and Low Body Weight in Anorexia Nervosa: Self-Esteem and Low Body Weight in Anorexia Nervosa

UNLABELLED The aim of the present study was to examine the associations between self-esteem, motive satisfaction, and body weight in acute (acAN) and recovered (recAN) inpatients with anorexia nervosa (AN) and in healthy controls. Both acAN and recAN showed lower levels of self-esteem as compared with healthy controls but did not differ from each other. In acAN, decreased body weight was associated with increased self-esteem. Satisfaction of an achievement motive but not satisfaction of a superiority motive mediated this association. No such correlations could be observed in the other groups. This is the first study to show an often assumed association between decreased body weight and increased self-esteem in AN patients. These preliminary results strengthen the assumption that low body weight may foster self-esteem in patients with acAN, mainly through the satisfaction of an achievement motive. KEY PRACTITIONER MESSAGE Self-esteem should be focused very early in the treatment of AN since weight gain may deprive the patient of an important source of self-esteem. Treatment interventions should be attuned to underlying motives of threatened self-esteem; in AN patients, the enhancement of self-esteem via weight loss seems to be rather fuelled by the satisfaction of an achievement motive than by the satisfaction of a superiority motive. Specific trainings to improve self-esteem in AN patients seem to be promising as an add-on to regular treatment.

Körperscham bei Jugendlichen - eine empirische Untersuchung

Zusammenfassung. Die Studie untersucht, in welchem Ausmas Korperscham im Empfinden von heutigen Jugendlichen eine Rolle spielt. Dabei wurde folgenden Fragen nachgegangen: 1. In welchem Ausmas sind Reaktionen der Korperscham im Alltag von Jugendlichen heute anzutreffen? 2. Losen bestimmte Korperschambereiche, namlich “Nacktheit”, “Sexualitat” und “Attraktivitat” (des eigenen Korpers) unterschiedlich starke Korperschamgefuhle aus? 3. Werden durch anwesende Beobachter starkere Schamgefuhle ausgelost als durch nur gedanklich vorgestellte? 4. Wird die Intensitat des Sich-Schamens durch negative Bewertungen anderer Personen gesteigert? 5. Lassen sich Unterschiede zwischen Madchen und Jungen feststellen? Die Stichprobe umfaste 60 Jugendliche (28 w, 32 m) zwischen 14 und 16 Jahren, die zum grosten Teil eine Haupt- oder Realschule besuchten. Die Datenerhebung erfolgte mit einem von den Autorinnen und Autoren entwickelten Szenarieninventar, das unterschiedliche Intensitaten von Korperscham erfast. Die Ergebnisse ze...