Renate Soellner

Evaluation of a Short-Term Telephone-Based Cognitive Behavioral Intervention for Dementia Family Caregivers

ABSTRACT This study evaluates a short-term telephone-based Cognitive Behavioral Therapy (CBT) for family caregivers. The study goal was to analyse whether caregivers of the intervention group reported better well-being and health at post treatment than participants of an untreated control group and an attention control group (treated with progressive muscle relaxation [PMR]), and whether these benefits maintained at 6-month follow-up. Participants (n = 229) were assigned to the study groups after baseline assessment. Most were female (82.2%), with a mean age of 62 years. As outcome measurements, the study assessed depressive symptoms, body complaints, emotional well-being, and perceived health. The intervention group showed short-term effects in improving well-being when compared with the PMR and the untreated control groups. Furthermore, in comparison to the untreated controls CBT was effective in decreasing body complaints at post treatment and in improving perceived health at 6-month follow-up. Improvements for CBT in comparison to the PMR group could be shown for depressive symptoms at 6-month follow-up. CBT for family caregivers is applicable via telephone and has shown promising short and long-term effects. A prolongation of the intervention might enhance the effects.

Alcohol drinking cultures of European adolescents

BACKGROUNDnAdolescent alcohol use varies across Europe. Differences in use might be due to variations in social drinking norms. These norms become apparent, e.g. in different proportions of alcohol drinking types per country. This studys purpose is to cluster European countries according to prevalence rates of alcohol drinking habits among adolescents aged 12-16.nnnMETHODSnBased on results of previously done cluster analyses regarding alcohol use patterns in Europe, a second level hierarchical cluster analysis is performed. To do so, the proportions of each drinking pattern per country (non, mild, episodic, frequent and heavy episodic use) across 25 European countries (N = 48 423, M = 13.83 years, 48.5% male) are used as classifying variables.nnnRESULTSnThree country clusters are extracted that differentiate between eight countries with mainly non-using adolescents, six countries with adolescents who use alcohol in a mainly mild but frequent way and 11 countries that show the highest proportions of (heavy) episodic drinking adolescents.nnnCONCLUSIONSnWhen applying and developing intervention strategies, differences in adolescent alcohol drinking cultures (i.e. social drinking norms) within Europe should be focused on. Alcohol policies and prevention programs should take cultural aspects like social drinking norms into account.

Alcohol use of adolescents from 25 European countries

AimJuvenile alcohol use is a topic of major public interest. Early-onset and excessive drinking during adolescence can lead to serious problems immediately and in later life. Monitoring the prevalence of adolescents’ alcohol use is thus crucial from a public health perspective. In order to evaluate prevention programs or to compare policy strategies of different countries, cross-national monitoring studies are essential.Subject and methodsOn the basis of the Second International Self-Report Study on Delinquency (ISRD-2), alcohol use of 33,566 adolescents, aged 12 to 16, from 25 European countries is described. The findings are compared to those of the European School Survey Project on Alcohol and Other Drugs (ESPAD) and the Health Behaviour in School-Aged Children Study (HBSC), in order to learn something about the validity of the data and to draw a comprehensive picture of juvenile alcohol consumption throughout Europe.ResultsEven in a study not primarily concerned with alcohol use, more similarities than differences with respect to alcohol drinking habits across Europe were found. In sum, Northern- and Eastern-European adolescents show an alcohol affinity higher than adolescents from Western and Southern Europe. Frequent drinking is more common in Northern and Central European countries, while Northern and Eastern European Countries are leading with respect to drunkenness of lifetime users. Regarding heavy drinking, some remarkable differences for single countries (e.g. Finland, Portugal, Czech Republic) were indicated.ConclusionsGaining sound knowledge about substance-use patterns across European countries could be helpful for assessing the relevance of policies on the one hand and traditions on the other for explaining adolescents’ substance use. In order to get a deeper insight into the varying behaviour of alcohol and drug use in different countries, indicators (e.g. high frequent vs. heavy use) and their reference basis (e.g. all users vs. lifetime users) should be selected carefully.

Are psychotherapeutic effects on family caregivers of people with dementia sustainable? Two-year long-term effects of a telephone-based cognitive behavioral intervention

ABSTRACT Objectives: Evaluation of long-term effects of an individualized short-term telephone intervention (seven sessions), based on a comprehensive cognitive behavioral therapy (CBT) approach. The study goal was to evaluate the maintenance of intervention effects regarding well-being, quality of life, and health at two years post treatment. Method: Participants (n = 105) were (partly) randomized after baseline assessment in a two-arm study (intervention, control group/usual care). Depressive symptoms were assessed with the German version of the Center for Epidemiologic Studies Depression Scale (CES-D). Caregivers’ physical complaints were measured with the Gießener Beschwerdebogen (GBB-24), and quality of life with the World Health Organization quality of life -BREF (WHOQOL-BREF). Emotional well-being and perceived health status were assessed using thermometer scaling. Data were analyzed by intention-to-treat analyses, including for those who terminated the intervention prematurely but still delivered data, using ANCOVAs. Results: Long-term intervention effects were found for emotional well-being (p = 0.019). For the subgroup of caregivers who were still caring at home at follow-up, the intervention led to an increased health status (p = 0.023), fewer bodily complaints (global measure p= 0.014, rheumatic pain p = 0.027, heart trouble p = 0.042), and a higher quality of life (overall p = 0.044 and subscale environment p = 0.030). Conclusion: The short-term CBT intervention via telephone showed long-term effects two years after treatment on emotional well-being, health status, bodily complaints, and quality of life.

Adolescent Alcohol Use Patterns From 25 European Countries

This study’s purpose is to describe European adolescents’ alcohol use patterns by grouping adolescents regarding their current alcohol use by cluster analysis (CA). Discriminant and latent profile analyses (LPA) evaluate and validate the solution that will be described further by ANOVAs. From 25 European countries, 57,771 students (49.4% male, 13.87 years) are grouped using hierarchical and k-means clustering. Alcohol use is measured by frequency of drinking occasions during the previous month and number of beverages consumed on the last drinking occasion. CA suggests four drinking patterns: mild (73.6%), episodic (20.0%), frequent (3.8%), and heavy episodic use (2.5%). Discriminant analysis attests a classification reliability of 94%, and confirmatory LPA replicates the cluster solution with a satisfying model fit. Three of the found patterns fulfill criteria for heavy drinking and underline the importance of individualized indicated prevention by promoting responsible use.

Delinquency and alcohol use among adolescents in Europe: The role of cultural contexts:

This paper presents cross-cultural research using data from the Second International Self-Report Delinquency Study (ISRD-2) to evaluate the strength and characteristics of the relationship between different kinds of juvenile delinquency and alcohol use, and to investigate whether, and how, different drinking cultures may influence this relationship. The setting is a school-based survey with a self-report questionnaire in a sample of 7th, 8th and 9th grade students (comprising 12–16 year olds) from 25 European countries. After recording data on alcohol consumption among young people in different European countries, we assessed the degree to which property offences, violent offences and gang membership were associated with the use of alcohol. In addition, a multilevel analysis (MLA) was carried out to ascertain whether the association between delinquency and alcohol use was influenced by variations in drinking cultures. Different drinking patterns were observed in Mediterranean and non-Mediterranean countries. Alcohol consumption was more closely related to involvement in violent crimes than to property offences, and correlated with the frequency and seriousness of delinquent behaviour everywhere. MLA showed that gang membership increased the probability of alcohol abuse to a greater degree in non-Mediterranean countries, while involvement in delinquency proved to be associated with alcohol abuse to a similar degree in the different cultural contexts considered. With regard to cultural influences on the relationships between juvenile delinquency and alcohol use, we ascertained that cultural attitudes towards alcohol influence the delinquency–alcohol relationship at the group level rather than the individual level.

The Tele.TAnDem intervention: study protocol for a psychotherapeutic intervention for family caregivers of people with dementia

BackgroundFamily caregivers are confronted with high demands creating a need for professional support and at the same time hindering its utilization. Telephone support allows easier access than face-to-face support because there is no need to leave the person with dementia alone or find an alternative carer. It is also independent of transport possibilities or mobility. The objectives are to evaluate whether telephone-based cognitive-behavioral therapy, which is implemented in established care provision structures, improves outcomes compared to usual care and whether it is as effective as face-to-face cognitive-behavioral therapy.Methods/DesignIf participants live in the area of one of the study centers (Jena, Berlin, Munich) and indicate that attendance of a face-to-face therapy is possible, they will be assigned to the face-to-face group. The other participants will be randomized to receive either telephone-based cognitive-behavioral therapy or usual care. Data will be collected at baseline, post-intervention, and at a 6-month follow-up. The primary outcomes will be depressiveness, burden of care, health complaints, and problem-solving ability. The secondary outcomes will be anxiety, quality of life, violence in caregiving, utilization of professional assistance, and cost effectiveness.DiscussionThis paper describes the evaluation design of our telephone-based cognitive-behavioral therapy in a randomized controlled trial. If this intervention proves to be an effective tool to improve outcomes, it will be made accessible to the public and the use of this support service will be recommended.Trial registrationGerman Clinical Trials Register DRKS00006355.

Preselection Methods Prior to the Internal Assessment Center for Personnel Selection in German Companies

Companies frequently use preselection methods in order to identify eligible candidates before conducting assessment centers (ACs). The present study was the first to investigate current practices of preselection in German companies that use ACs for internal selection. Results of a survey among 109 German companies show that companies typically apply general qualification criteria (e.g., work experience), appraisals, or unstructured interviews for preselection, but rely less on trait-oriented methods (e.g., intelligence tests) and structured interviews. In their subjective evaluations, however, companies rate structured interviews and trait-oriented methods as particularly valid methods. The results also show that the number of preselection methods used is positively correlated with company size, diagnostic skills of the responsible persons in the preselection, and DIN (Deutsches Institut fur Normierung [German Institute for Standardization]) 33430 certification status. The implications of these findings for practice and research are discussed.

Epidemiology of HIV in Intravenous Drug Users and Public Health Policy in Germany

The paper assesses AIDS and drug policy development in Germany between 1982 and 1996 and relates it to the development of epidemiological research in HIV among injecting drug users (IDUs). In a historical review, this paper outlines how results of epidemiological HIV surveillance studies among IDUs and public health responses were mutually dependent. The authors argue that a specific development in HIV policy encouraged a confounding of basic methodological concepts (validity and precision) in epidemiological research, which in turn led to misinterpretation of available data on seroprevalence trends in Germany. In order to overcome methodological shortcomings under given legal and practical restrictions, pragmatic approaches to increase validity of seroprevalence and risk factor estimations are discussed.

The Tele.TAnDem Intervention: Telephone-based CBT for Family Caregivers of People With Dementia

Background and ObjectivesnThis study evaluated the effectiveness of a telephone-based cognitive-behavioral therapy for family caregivers of people with dementia in existing health care provision structures.nnnResearch Design and MethodsnTwo hundred seventy-three family caregivers of people with dementia were randomly assigned to receive the intervention or usual care. Usual care included unrestricted access to community resources. Intervention group participants received twelve 50-min sessions of individual cognitive-behavioral therapy by trained psychotherapists within 6 months. Symptoms of depression, emotional well-being, physical health symptoms, burden of care, coping with the care situation and challenging behavior were assessed after the intervention ended and at a 6-month follow-up. Intention-to-treat analyses using latent change models were applied.nnnResultsnIntention-to-treat analyses showed improved emotional well-being (γ = 9.59, p = .001), fewer symptoms of depression (γ = -0.23, p = .043), fewer physical health symptoms (γ = -0.25, p = .019), improved coping with the care situation (γ = 0.25, p = .005) and the behavior of the care recipient (γ = 0.23, p = .034) compared with usual care. Effects for coping (γ = 0.28, p = .006 and γ = 0.39, p < .001, respectively) and emotional well-being (γ = 7.61, p = .007) were also found at follow-up.nnnDiscussion and ImplicationsnThe CBT-based telephone intervention increased mental and physical health as well as coping abilities of family caregivers of people with dementia. The intervention can be delivered by qualified CBT therapists after an 8-h training session in existing health care provision structures.