Konrad Reschke

Playing games in promoting childhood dental health

Oral health behaviour is a result of a life-long learning process, this process can best be achieved by an interdisciplinary collaboration among dentists and professionals in other areas, e.g. psychologists, teachers and kindergarten teachers. The basis of our research is a childhood dental health promotion programme which consists of a tool of games for children in the age of 3-5 years. After development by an interdisciplinary research group, the effectiveness of this teaching and behaviour modification technique should be proved. This study describes a controlled field study, in which two forms of game play activities were compared to a control groups. The results showed that the use of games and shows aimed at a childs developmental level can be more efficacious than the presentation of didactic information alone.

Posttraumatic stress disorder following high‐ and low‐ magnitude stressors in psychotherapeutic inpatients

High-magnitude stressors and posttraumatic stress disorder (PTSD) are frequently in psychiatric patients. In contrast, the role of low-magnitude stressors has rarely been studied. We assessed a consecutive series of 78 psychiatric inpatients taking part in our psychotherapy programme for potentially traumatic events and PTSD with a structured interview. All participants completed self-report questionnaires on PTSD-symptomatology, dissociative and general psychopathology (DES, SCL-90). A distressing event was reported by 48 patients (61.5%) and 27 (34.6%) met the diagnostic criteria for PTSD. Of these, 16 reported a low-magnitude stressor, while 11 had experienced a high-magnitude stressor. There were no significant differences in PTSD symptoms, dissociative and general psychopathology between patients with PTSD due to a minor trauma and those with a major trauma. Our preliminary findings suggest that low-magnitude stressors can also lead to PTSD. We discuss the possible implications with regard to psychotherapy. Copyright

The Psychosocial Consequences of Child Sexual Abuse in Ethiopia: A Case-Control Comparative Analysis:

Child sexual abuse (CSA) continues to be a pressing public health concern around the globe. Few existing reports, however, indicate the alarming rate at which the problem is increasing in sub-Saharan Africa. The present study is designed to investigate the psychosocial consequences of sexual abuse among child survivors in Ethiopia who were abused mainly through early marriage, rape, and child prostitution. Data are collected from 318 such CSA survivors—and 318 matched, non—sexually abused, normal controls— using the Children’s Impact of Traumatic Events Scale-Revised and the Rosenberg Self-Esteem Scale. The results reveal the CSA survivors to be significantly more symptomatic than the control group: They demonstrated a lower degree of social support, a lower degree of empowerment, as well as a higher degree of guilt and increased likelihood of viewing the world as dangerous. Finally, these CSA survivors show a lower degree of positive self-worth than their non—sexually abused counterparts. These findings have important implications for the formulation of appropriate preventions and interventions to be undertaken by various stakeholders ranging from family to policy makers.

Why Has the Continuous Decline in German Suicide Rates Stopped in 2007

Background Whereas German suicide rates had a clear decreasing tendency between 1991 and 2006, they increased from 2007 to 2010. Deeper analyses of suicide data might help to understand better this change. The aim of this study was to analyze 1) whether recent trends can be related to changes in specific suicide methods and diverge by gender and age; 2) whether the decrease of suicide rates before 2007 as well as the increase from 2007 to 2010 are driven by the same suicide method. Methods Analyses were based on suicide data from the Federal Statistical Office of Germany. For 1998–2010, 136.583 suicide cases of men and women with known age and suicide method could be identified. These data were analyzed by joinpoint regression analysis, allowing identification of the best fitting point in time (“joinpoint”) at which the suicide rate significantly changes in magnitude or direction. Results The national downward trend between 1998 and 2007 was mainly due to corresponding changes in self-poisoning by other means than drugs (e.g., pesticides) (annual percentage change (APC) ≤ −4.33), drowning (APC ≤ −2.73), hanging (APC ≤ −2.69) and suicides by firearms (APC ≤ −1.46) in both genders. Regarding the overall increase of age-adjusted suicide rates in Germany 2007–2010, mainly the increase of self-poisoning (e.g., by drugs) and “being overrun” (APC ≥ 1.50) contributed to this trend. Limitations The true suicide rates might have been underestimated because of errors in the official death certificates. Conclusions Increase in suicide rates in Germany since 2007 went along with corresponding changes for “being overrun” and “self-poisoning”. Copycat suicides following the railway suicide of the goalkeeper Robert Enke partly contributed to the results. Thus, prevention of Werther effects and limitation of the availability of high pack sizes for drugs are of special relevance for the reversal of this trend.

German version of the Kuwait University Anxiety Scale : Psychometric parameters

A German translation of the Kuwait University Anxiety Scale, written originally in Arabic, was prepared. A sample of 207 men and women German college students was recruited. Coefficient alpha was .88, whereas the item-remainder correlations ranged from .21 to .63, denoting good internal consistency. The correlation of the scale with the German form of the Trait Anxiety Scale was .76, indicating high criterion-related validity. Three factors were identified: General, Somatic, and Cognitive/Affective Anxiety. German students scored lower (less anxious) than students from the U.S. and 18 Arab countries. The sex difference was not significant for the German sample.

Early Marriage, Rape, Child Prostitution, and Related Factors Determining the Psychosocial Effects Severity of Child Sexual Abuse in Ethiopia

This study was aimed at identifying factors that determine the psychosocial effects severity of child sexual abuse. Data were collected from 318 female children in Ethiopia using the Childrens Impact of Traumatic Events Scale–Revised and the Rosenberg Self-Esteem Scale. The results revealed that respondents who survived rape and child prostitution were more symptomatic than those who were married early. Respondents for whom less time had elapsed since their first experience of abuse demonstrated a significantly higher level of post-traumatic stress disorder symptoms, negative reactions by others, self-blame, and guilt than those for whom more time had elapsed since such an experience. The respondents in an intact marital relationship were found to be less symptomatic than their never married and divorced counterparts. Implications for intervention and further investigations are discussed.

Die deutsche Version der Modified PTSD Symptom Scale (MPSS): Erste psychometrische Befunde zu einem Screeningverfahren für posttraumatische Symptomatik

Zusammenfassung. Theoretischer Hintergrund: Bisherige Selbstbeurteilungsinstrumente zur Abbildung posttraumatischer Belastungsstorungen (PTSD) berucksichtigen haufig den Symptomschweregrad nicht; auserdem setzen sie voraus, das das Trauma bekannt sein mus. Fragestellung: Wir untersuchten die psychometrischen Eigenschaften eines Screeningverfahrens, das unabhangig von einem bekannten Trauma auch die Symptomintensitat erfast. Methode: Die Modified PTSD Symptom Scale (MPSS) wurde bei 103 stationar psychiatrischen Patienten eingesetzt, die auch mit einem standardisierten Interview (DIA-X) untersucht wurden. Ergebnisse: Die Werte fur Cronbachs Alpha lagen zwischen .88 und .94. Die Ubereinstimmung zwischen MPSS-Verdachts- und DIA-X-Diagnosen lag zwischen 65% und 82%. Die innere Konsistenz ahnelt denen anderer Verfahren. Schlusfolgerungen: Fur den klinischen Kontext erweist sich die MPSS dadurch vorteilhaft, das sie die PTSD-Symptomatologie unabhangig von einem bekannten Trauma in ihrer Haufigkeit und ihrem Schw...

Long-Term Outcomes of War-Related Death of Family Members in Kosovar Civilian War Survivors

Exposure to war-related experiences can comprise a broad variety of experiences and the very nature of certain war-related events has generally been neglected. To examine the long-term outcomes of war-related death of family members, the authors investigated the prevalence rates of major depressive episode (MDE), anxiety disorders, and quality of life among civilian war survivors with or without war-related death of first-degree family members 9 years after the war in Kosovo. Compared to participants without war-related death of family members, those who had experienced such loss had significantly higher prevalence rates of MDE, posttraumatic stress disorder, and generalized anxiety disorder, and reported a lower quality of life 9 years after the war. These results indicate that bereaved civilian survivors of war experience significant mental health problems many years after the war.

Prediction of alcohol addicted patients’ smoking status through hospital tobacco control policy: A multi-level-analysis

Aims: The goal of the study was the exploration of the influence of tobacco control policies in German in-patient substance abuse treatment centres on the smoking status of alcohol-addicted patients at discharge. Method: A multi-centre field study with pre–post design was carried out in 40 in-patient treatment centres in Germany. The tobacco control policy questionnaire was answered by the director of each treatment centre (N = 40). Data from 774 alcohol addicted patients could be assessed at admission and discharge. A multi-level-analysis (HLM) was carried out to identify the predictive value of institutional tobacco control policy on smoking status post-rehabilitation. Findings: Findings uncovered that the strength of tobacco control policy lie in the areas of assessment of smokers, enforcement of smoking restrictions and restrictiveness of smoking policy. Comprehensiveness of smoking restrictions and intensity of smoking-related training of the employees are significant predictors for the variance in quit rates between the institutions. Significant individual predictors for quitting include gender, tobacco dependency and educational status. Conclusions: Results support findings from other areas like schools and public areas stating the effectiveness of restrictive smoking policies. However, this patient group is especially resistant to change, quit rates are low and effects of tobacco control policy small; the latter partly due to the distal character of policy variables for the individual.

The Psychometric Properties of the Amharic Version of the Children's Impact of Traumatic Events Scale-Revised: A Study on Child Sexual Abuse Survivors in Ethiopia

The study assessed the internal consistency and construct validity of the Amharic version of the Children’s Impact of Traumatic Events Scale-Revised (CITES-R). Data was collected from 318 female children. With few exceptions, the result revealed that the internal consistency and the construct validity of the scale were found to be in the expected directions. The mean alpha value for all the scales was 0.71. Social support and empowerment were significantly correlated with the positive self-worth component of the Rosenberg Self-Esteem Scale. Moreover, intercorrelations between the PTSD symptoms and abuse attributions demonstrated significant positive associations. In conclusion, the Amharic version of the CITES-R was found to be comparable with the original scale and previous studies that employed this instrument.