Sylvia Helbig

Computerized ambulatory monitoring in psychiatry: a multi-site collaborative study of acceptability, compliance, and reactivity

Computerized ambulatory monitoring overcomes a number of methodological and conceptual challenges to studying mental disorders, however concerns persist regarding the feasibility of this approach with severe psychiatric samples and the potential of intensive monitoring to influence data quality. This multi‐site investigation evaluates these issues in four independent samples. Patients with schizophrenia (n = 56), substance dependence (n = 85), anxiety disorders (n = 45), and a non‐clinical sample (n = 280) were contacted to participate in investigations using computerized ambulatory monitoring. Micro‐computers were used to administer electronic interviews several times per day for a one‐week period. Ninety‐five percent of contacted individuals agreed to participate in the study, and minimum compliance was achieved by 96% of these participants. Seventy‐eight percent of all programmed assessments were completed overall, and only 1% of micro‐computers were not returned to investigators. There was no evidence that missing data or response time increased over the duration of the study, suggesting that fatigue effects were negligible. The majority of variables investigated did not change in frequency as a function of study duration, however some evidence was found that socially sensitive behaviors changed in a manner consistent with reactivity. Copyright

Wartezeit für Psychotherapiepatienten - und wie sie zu nutzen ist

Waiting Time in Psychotherapy - and How to Make Use of It Even after the new psychotherapy law has been implemented, waiting times of several months remain rather common in the German mental health care system. For ethical, practical, and therapeutic reasons, however, patients who are in serious need of treatment should not be left unattended. Many practitioners therefore suggest self-help treatments such as psychoeducational information, bibliotherapy, or supportive groups to their waiting patients. The present study provides an overview on possibilities of preparing waiting psychotherapy patients for their upcoming therapy as well as implementing secondary prevention during the waiting time. As a basic, we suggest that the proposed methods should be in line with the treatment rationale of the subsequent therapy.

Hilft wenig viel? Eine Minimalintervention für Patienten während der Wartezeit auf ambulante Verhaltenstherapie*

The article describes a controlled study that explores effects of a minimal intervention for outpatients waiting for their behavior therapy to start. Methods: Patients applying for psychotherapy for anxiety disorders or depression at an outpatient psychotherapy unit, matched for age, sex and diagnosis, were assigned to either a waiting list as usual (WL) or to an active waiting group (AW) that received bibliotherapeutic materials. Attitudes towards treatment and therapy expectations were assessed before and after waiting time; consumer satisfaction and help-seeking behavior during the waiting time were assessed post waiting. Results: After the waiting time, the two groups differed only in their fear of stigmatization, which had significantly declined in the AW group, and in the subjective preparedness for waiting list and treatment. Additional analyses regarding different patient groups suggested that especially patients with anxiety disorders and patients with little knowledge about psychotherapy benefited from the intervention; on the other hand, some patients with depressive disorders reported negative effects due to the minimal intervention. Conclusions: Findings point out the need for a more sophisticated evaluation of minimal interventions for patients waiting for psychotherapy. Further studies should clarify the differential effectiveness of custom-tailored interventions addressing specific patient populations.

Implementierung, Akzeptanz und Informationsgehalt eines Ecological Momentary Assessment (EMA)-Ansatzes bei Patienten mit Panikstörung und Agoraphobie

Zusammenfassung. Theoretischer Hintergrund: Ecological Momentary Assessment (EMA) ist eine Form des ambulanten Assessments, bei der wiederholt und alltagsnah Daten zu psychologischen Parametern gesammelt werden. Trotz messmethodischer Vorteile wird EMA bei klinisch-psychologischer Forschung vergleichsweise selten eingesetzt. Ziel: Evaluation der Implementierbarkeit, der Reaktivitat und des Informationsgehalts von EMA im Vergleich zu Fragebogenverfahren. Methode: 21 Patienten mit Panikstorung und Agoraphobie wurden im Rahmen einer Studie zu Effekten einer Minimalintervention in der Wartezeit auf Kognitive Verhaltenstherapie randomisiert einer Versuchs- und einer Kontrollgruppe zugewiesen und vor sowie nach der Wartezeit mit storungsspezifischen Fragebogen sowie einer einwochigen EMA-Erhebungsphase untersucht. Ergebnisse: Hohe Compliance-Raten (87%) sprachen fur die Akzeptanz der Methode; allerdings gab es Hinweise auf Stichprobenselektionseffekte. Die Reaktivitat des Verfahrens erwies sich als gering. EMA ...