Janine Becker

Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer.

Background. A randomized controlled trial was conducted to investigate the efficacy of classical massage treatment in reducing breast cancer‐related symptoms and in improving mood disturbances.

Evaluation of a computer-adaptive test for the assessment of depression (D-CAT) in clinical application.

In the past, a German Computerized Adaptive Test, based on Item Response Theory (IRT), was developed for purposes of assessing the construct depression [Computer‐adaptive test for depression (D‐CAT)]. This study aims at testing the feasibility and validity of the real computer‐adaptive application.

An evaluation of patient-reported outcomes found computerized adaptive testing was efficient in assessing stress perception

OBJECTIVES This study aimed to develop and evaluate a first computerized adaptive test (CAT) for the measurement of stress perception (Stress-CAT), in terms of the two dimensions: exposure to stress and stress reaction. STUDY DESIGN AND SETTING Item response theory modeling was performed using a two-parameter model (Generalized Partial Credit Model). The evaluation of the Stress-CAT comprised a simulation study and real clinical application. A total of 1,092 psychosomatic patients (N1) were studied. Two hundred simulees (N2) were generated for a simulated response data set. Then the Stress-CAT was given to n=116 inpatients, (N3) together with established stress questionnaires as validity criteria. RESULTS The final banks included n=38 stress exposure items and n=31 stress reaction items. In the first simulation study, CAT scores could be estimated with a high measurement precision (SE<0.32; rho>0.90) using 7.0+/-2.3 (M+/-SD) stress reaction items and 11.6+/-1.7 stress exposure items. The second simulation study reanalyzed real patients data (N1) and showed an average use of items of 5.6+/-2.1 for the dimension stress reaction and 10.0+/-4.9 for the dimension stress exposure. Convergent validity showed significantly high correlations. CONCLUSIONS The Stress-CAT is short and precise, potentially lowering the response burden of patients in clinical decision making.

Functioning and validity of a Computerized Adaptive Test to measure anxiety (A-CAT).

Background: The aim of this study was to evaluate the Computerized Adaptive Test to measure anxiety (A‐CAT), a patient‐reported outcome questionnaire that uses computerized adaptive testing to measure anxiety. Methods: The A‐CAT builds on an item bank of 50 items that has been built using conventional item analyses and item response theory analyses. The A‐CAT was administered on Personal Digital Assistants to n=357 patients diagnosed and treated at the department of Psychosomatic Medicine and Psychotherapy, Charité Berlin, Germany. For validation purposes, two subgroups of patients (n=110 and 125) answered the A‐CAT along with established anxiety and depression questionnaires. Results: The A‐CAT was fast to complete (on average in 2 min, 38 s) and a precise item response theory based CAT score (reliability>.9) could be estimated after 4–41 items. On average, the CAT displayed 6 items (SD=4.2). Convergent validity of the A‐CAT was supported by correlations to existing tools (Hospital Anxiety and Depression Scale‐A, Beck Anxiety Inventory, Berliner Stimmungs‐Fragebogen A/D, and State Trait Anxiety Inventory: r=.56–.66); discriminant validity between diagnostic groups was higher for the A‐CAT than for other anxiety measures. Conclusions: The German A‐CAT is an efficient, reliable, and valid tool for assessing anxiety in patients suffering from anxiety disorders and other conditions with significant potential for initial assessment and long‐term treatment monitoring. Future research directions are to explore content balancing of the item selection algorithm of the CAT, to norm the tool to a healthy sample, and to develop practical cutoff scores. Depression and Anxiety, 2008.

Entwicklungsschritte für einen computeradaptiven Test zur Erfassung von Angst (A-CAT1)

Zusammenfassung. Die empirische Erfassung psychischer Merkmale erfolgt in der Regel mit Instrumenten, die auf der Grundlage der klassischen Testtheorie entwickelt wurden. Seit den 60er Jahren bietet sich hierzu mit der Item Response Theory (IRT) eine Alternative an, die verschiedene Vorteile verspricht. Auf ihrer Grundlage konnen u.a. computeradaptive Tests (CATs) entwickelt werden, welche die Auswahl der vorgelegten Items dem Antwortverhalten der Patienten anpassen und damit eine hohere Messgenauigkeit bei reduzierter Itemzahl ermoglichen sollen. Wir haben verschiedene Schritte zur Entwicklung eines CAT zur Erfassung von Angst unternommen, um zu prufen, ob sich die theoretischen Vorzuge der IRT auch in der praktischen Umsetzung bestatigen lassen. In dem vorliegenden Beitrag wird die Entwicklung der zu Grunde liegenden Itembank dargestellt. Hierfur wurde auf Daten von N = 2348 Patienten zuruckgegriffen, die an der Medizinischen Klinik mit Schwerpunkt Psychosomatik der Charite zwischen 1995 und 2001 im Rah...

Patients with Overt or Covert Self-Harm: Differences in Optimism and Self-Efficacy

Background: Self-harming behavior seems to aim at reducing states of tension and/or reestablishing a sense of self-control. Following this assumption, it is hypothesized that self-destructive patients, especially those with overt self-harm of the skin, have reduced levels of optimism and self-efficacy. Patients and Methods: 854 general hospital patients referred to a psychosomatic-psychotherapeutic liaison-consultation service or to the outpatient department participated in the study. Using an expert rating assessment, 63 patients exhibiting selfharm (overt or covert) could be identified. For comparison, 63 patients without self-destructive behavior and 63 healthy controls were matched for age and sex. Generalized expectancies were assessed by a validated self-rating questionnaire measuring optimism and self-efficacy. Results: No differences were found between patients with or without self-destructive behavior. Yet, patients with overt self-harm had significantly lower values of optimism and self-efficacy than those who concealed their behavior. We discuss whether the self-efficacy of covertly self-destructive patients might be enhanced by perceived long-term positive effects of their behavior.