Petra Forthuber

Bullying Girls - Changes after Brief Strategic Family Therapy: A Randomized, Prospective, Controlled Trial with One-Year Follow-Up

Background: Many girls bully others. They are conspicuous because of their risk-taking behavior, increased anger, problematic interpersonal relationships and poor quality of life. Our aim was to determine the efficacy of brief strategic family therapy (BSFT) for bullying-related behavior, anger reduction, improvement of interpersonal relationships, and improvement of health-related quality of life in girls who bully, and to find out whether their expressive aggression correlates with their distinctive psychological features. Methods: 40 bullying girls were recruited from the general population: 20 were randomly selected for 3 months of BSFT. Follow-up took place 12 months after the therapy had ended. The results of treatment were examined using the Adolescents’ Risk-taking Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Results: In comparison with the control group (CG) (according to the intent-to-treat principle), bullying behavior in the BSFT group was reduced (BSFT-G from n = 20 to n = 6; CG from n = 20 to n = 18, p = 0.05) and statistically significant changes in all risk-taking behaviors (ARBS), on most STAXI, IIP-D, and SF-36 scales were observed after BSFT. The reduction in expressive aggression (Anger-Out scale of the STAXI) correlated with the reduction on several scales of the ARBS, IIP-D, and SF-36. Follow-up a year later showed relatively stable events. Conclusions: Our findings suggest that bullying girls suffer from psychological and social problems which may be reduced by the use of BSFT. Expressive aggression in girls appears to correlate with several types of risk-taking behavior and interpersonal problems, as well as with health-related quality of life.

Zur psychopathologischen und psychosozialen Charakteristik von Patienten, die häufig ihre Psychotherapeuten wechseln

SummaryThis study was performed on a clinic group of patients (n = 1000, 83.9% responder) to test characteristics of persons who switched psychotherapists on three or more occasions (n = 74). Compared with the group of minor variation, these patients had higher rates of psychosomatic symptoms, lower systemic operativeness, a dissatisfying sexuality, tended towards alcohol and pharmaceutical abuse, and had significantly higher exposure in infancy to violence and sexual abuse (all p < 0.01 after Bonferroni correction). Psychosocial factors including early experience in forming relationships in addition to current factors appear to play a decisive role in a persons dropout liability as well as the attitude to therapy.ZusammenfassungIn der vorliegenden Querschnittstudie an einer klinischen Stichprobe (n = 1000; Responderquote, 83,9 %) wurden die Merkmale von Patienten untersucht, die dreimal oder häufiger ihre Psychotherapeuten gewechselt haben (n = 74). Diese Personen zeigten im Vergleich zur Gruppe ohne häufigen Therapeutenwechsel u. a. signifikant mehr psychosomatische Symptome, eine unbefriedigende Lebensgestaltung und Sexualität, mangelnde Leistungsfähigkeit, neigten mehr zum Konsum von Alkohol und Medikamenten und waren in ihrer Kindheit signifikant mehr Gewalt und Missbrauch ausgesetzt (p jeweils <0,01 nach Bonferroni-Korrektur). Psychosoziale Faktoren, sowohl die frühen Beziehungserfahrungen als auch die aktuellen Faktoren, scheinen entscheidend für das Risikoverhalten zu sein und die Einstellung zur medizinischen Handlung zu beeinflussen.

Anger, Interpersonal Relationships, and Health-Related Quality of Life in Bullying Boys Who Are Treated With Outpatient Family Therapy: A Randomized, Prospective, Controlled Trial With 1 Year of Follow-up

Objective. Ten to 30% of students engage in bullying behavior. Bullies stand out on account of increased anger, poor interpersonal relationships, and poor quality of life. Our aim was to determine the effectiveness of outpatient family psychotherapy as a monotherapy for anger reduction and improvement of behavior and interpersonal relationships and of health-related quality of life in male youths with bullying behavior. Methods. Twenty-two boys with bullying behavior took part in a family therapy program for 6 months. The control group was also composed of 22 youths and took part in a placebo intervention program. Every 2 weeks, results were checked with the Adolescents Risky-Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Follow-up testing took place 12 months after treatment. Results. In comparison with the control group (according to the intention-to-treat principle), bullying behavior was reduced (family therapy group: from n = 22 to n = 6; control group: from n = 22 to n = 20). Significant changes on all ARBS scales and on the STAXI scales State-Anger, Trait-Anger, Anger-Out, and Anger-Control were observed after 6 months. In the IIP-D, significant differences were found on the scales for overly autocratic, overly competitive, overly introverted, overly expressive, and exploitable/compliant. In the SF-36, significant differences were observed in general health perceptions, vitality, social functioning, role-emotional, and mental health. The reduction in expression of anger correlated with a reduction in several scales of the ARBS, IIP-D, and SF-36. Follow-up after 1 year showed relatively stable, lasting treatment effects. Conclusion. The results of this study show that outpatient family therapy seems to be an effective method of reducing anger and improving interpersonal relationships and health-related quality of life in male youths with bullying behavior.

Chronic fatigue and indicators of long-term employment disability in psychosomatic inpatients

ZusammenfassungDas Hauptziel dieser Studie war, Indikatoren der Langzeitarbeitsunfähigkeit bei chronischer Müdigkeit zu ermitteln. Zu diesem Zweck wurde eine Querschnittuntersuchung einer randomisierten Stichprobe (n=1000, Responderquote 83,9%) aus Patienten einer Psychosomatischen Fachklinik durchgeführt. In 51,1% der Fälle (n=429) wurde eine zum Erhebungszeitpunkt als stark erlebte andauernde Erschöpfung gefunden. Sie stand ohne nachvollziehbare Relation zu tatsächlich vollbrachten Anstrengungen. 159 (37,1%) Patienten dieser Gruppe waren arbeitsunfähig. Sie bildeten die Hauptzielgruppe dieser Untersuchung. Signifikant (P jeweils<0,01) mehr Patienten der Zielgruppe arbeiteten stundenweise, waren überproportional lange arbeitsunfähig (50,9% aller Arbeitsunfähigen mehr als 6 Monate im letzten Jahr) und fühlten sich durch Konflikte mit den Vorgesetzten und/oder Kollegen belastet. Sie klagten häufiger über körperliche Beschwerden, wiesen jedoch keine signifikant häufigere Komorbidität mit psychischen Störungen auf. Subjektiv fühlten sich jedoch nicht die arbeitsfähigen Patienten mit chronischer Müdigkeit mehr belastet, sondern diejenigen, die geringeren Belastungen ausgesetzt waren. Diese hatten im Vergleich zu den Patienten, die arbeitsfähig waren, eine stärkere Fixierung auf somatische Beschwerden, keine adäquate Wahrnehmung von körperlichen und psychischen Empfindungen sowie Schwierigkeiten mit anderen Menschen und mit einer geregelten Tätigkeit zurechtzukommen (P jeweils <0,01). Eine zukünftige prospektive Untersuchung dieser Indiktoren könnte zur Formulierung von Prädiktorvariablen führen, die bei chronischer Müdigkeit Langzeitarbeitsunfähigkeit voraussagen, deren Berücksichtigung zu einer rechtzeitigen sozialmedizinischen Einschätzung und Behandlung beitragen könnte.SummaryThe major goal of this study was to determine indictors of long-term disability for psychosomatic inpatients with chronic fatigue syndrome. To this end, a cross-sectional study was performed with a random sample of patients (n=1000, response rate: 83.9%) at a psychosomatic inpatient clinic. 51.1% of the patients (n=429) reported intensely persistent exhaustion that had no logical relation to actual exertion. 159 (37.1%) patients in this group were disabled from working and these comprised the main target group of this study. Significantly more patients in the target group worked part time, were disabled for a disproportionately long period of time (50.9% of all were disabled for more than 6 months in the previous year), and felt stressed because of conflicts with their superiors and/or colleagues (in each case, P<0.01). While more frequent psychological comorbidity was not found, they reported physical complaints more often. It was not the patients fit for work who felt more burdened with chronic fatigue, but rather the employment-disabled, who were actually exposed to fewer demands. These patients had, in comparison with those fit to work, a stronger fixation on somatic complaints, inadequate perception of physical and psychic sensations, difficulties getting along with other people and in coping with a regular job (in each case, P<0.01). Prospective examination of these indicators could help detect predictor variables for long-term disability in chronic fatigue. Such predictors could contribute to timely social-medical assessment and treatment.

Anger, interpersonal relationships, and health-related quality of life in bullying boys who are treated with outpatient family therapy: a randomized, prospective, controlled trial with 1 year of follow-up

Objective. Ten to 30% of students engage in bullying behavior. Bullies stand out on account of increased anger, poor interpersonal relationships, and poor quality of life. Our aim was to determine the effectiveness of outpatient family psychotherapy as a monotherapy for anger reduction and improvement of behavior and interpersonal relationships and of health-related quality of life in male youths with bullying behavior. Methods. Twenty-two boys with bullying behavior took part in a family therapy program for 6 months. The control group was also composed of 22 youths and took part in a placebo intervention program. Every 2 weeks, results were checked with the Adolescents Risky-Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Follow-up testing took place 12 months after treatment. Results. In comparison with the control group (according to the intention-to-treat principle), bullying behavior was reduced. Significant changes on all ARBS scales and on the STAXI scales State-Anger, Trait-Anger, Anger-Out, and Anger-Control were observed after 6 months. In the IIP-D, significant differences were found on the scales for overly autocratic, overly competitive, overly introverted, overly expressive, and exploitable/compliant. In the SF-36, significant differences were observed in general health perceptions, vitality, social functioning, role-emotional, and mental health. The reduction in expression of anger correlated with a reduction in several scales of the ARBS, IIP-D, and SF-36. Follow-up after 1 year showed relatively stable, lasting treatment effects. Conclusion. The results of this study show that outpatient family therapy seems to be an effective method of reducing anger and improving interpersonal relationships and health-related quality of life in male youths with bullying behavior. Language: en