Thomas Heidenreich

Die Erfassung sozialer Phobie durch die Social Interaction Anxiety Scale (SIAS) und die Social Phobia Scale (SPS)

Zusammenfassung. Die vorliegende Arbeit berichtet erste Analysen zur Reliabilitat und Validitat sowie klinische cut-off-Werte der deutschen Bearbeitung der Social Interaction Anxiety Scale und der Social Phobia Scale (Mattick & Clarke, 1989). Die Skalen wurden 43 Patienten mit Sozialer Phobie, 69 Patienten mit anderen psychischen Storungen und 24 Kontrollpersonen ohne psychische Storungen vorgelegt. Die ermittelten Werte fur die innere Konsistenz und Test-Retest-Korrelation sprechen fur eine sehr hohe Reliabilitat. Hinweise auf eine konvergente Validitat ergaben sich aus hohen Korrelationen mit konstruktnahen Mesinstrumenten zur Sozialen Phobie, wahrend die Korrelationen zu Depressions- und Angstmasen erwartungsgemas geringer ausfielen. Die beiden Skalen diskriminieren Soziophobiker sehr gut von Personen ohne psychische Storung und Angstpatienten, wahrend die Diskriminationsleistung von depressiven Patienten geringer ausgepragt ist. Die ermittelten cut-off-Werte liegen deutlich unter den amerikanischen We...

Embodiment of Sadness and Depression—Gait Patterns Associated With Dysphoric Mood

Objective: To analyze gait patterns associated with sadness and depression. Embodiment theories suggest a reciprocal relationship between bodily expression and the way in which emotions are processed. Methods: In Study 1, the gait patterns of 14 inpatients suffering from major depression were compared with those of matched never-depressed participants. In Study 2, we employed musical mood induction to induce sad and positive mood in a sample of 23 undergraduates. A Fourier-based description of walking data served as the basis for the computation of linear classifiers and for the analysis of gait parameters. Results: Gait patterns associated with sadness and depression are characterized by reduced walking speed, arm swing, and vertical head movements. Moreover, depressed and sad walkers displayed larger lateral swaying movements of the upper body and a more slumped posture. Conclusion: The results of the present study indicate that a specific gait pattern characterizes individuals in dysphoric mood. ANCOVA = analysis of covariance; BDI = Beck Depression Inventory; DSM = Diagnostic and Statistical Manual of Mental Disorders; MANOVA = multivariate analysis of variance; MDD = major depressive disorder; SCID = Structured Clinical Interview for DSM-IV; SNRI = serotonin noradrenalin reuptake inhibitors; SSRI = selective serotonin reuptake inhibitors.

Mindfulness predicts relapse/recurrence in major depressive disorder after mindfulness-based cognitive therapy.

Empirical evidence for the effectiveness of mindfulness-based cognitive therapy (MBCT) is encouraging. However, data concerning the role of mindfulness in its relapse preventive effect are lacking. In our study, 25 formerly depressed patients received MBCT. Mindfulness was assessed before and immediately after MBCT using the Mindful Attention and Awareness Scale. Mindfulness significantly increased during MBCT, and posttreatment levels of mindfulness predicted the risk of relapse/recurrence to major depressive disorder in the 12-month follow-up period. Mindfulness predicted the risk of relapse/recurrence after controlling for numbers of previous episodes and residual depressive symptoms. The results provide preliminary evidence for the notion that mindfulness is an important factor in relapse prevention in major depression.

Achtsamkeitsbasierte Stressreduktion in der klinischen Anwendung

In the context of an increasing interest in mindfulness-based approaches both in clinical application as well as in the field of research the present paper introduces MBSR (Mindfulness-based Stress Reduction), illustrates the theoretical background of mindfulness practice and reviews the procedures during the cultivation of mindfulness and possible impacting factors. The article also reviews Mindfulness-based Cognitive Therapy (MBCT), which was specifically developed to prevent relapse in patients with depressive disorders. The paper ends with a conclusion for clinical practice.

Mindfulness-based cognitive therapy for persistent insomnia: a pilot study.

188 gic antidepressant aminpetine, 55% still had at least some type of sexual dysfunction after 6 months compared to 4% in the control group treated with aminpetine alone [13] . More studies are needed to address the frequency, severity and nature of this problem before its neurochemical etiology can be addressed. These case studies have important clinical implications. They suggest that when patients develop sexual dysfunction as a side effect of SSRIs, clinicians should be alert to the possibility that restoration of sexual function may not correlate temporally with medication cessation. Patients are often willing to continue taking SSRIs despite sexual side effects, but the possibility of increasing the probability of dysfunction remaining after discontinuance should be taken into consideration. Such persistent side effects could even worsen the long-term prognosis of depression [14] .

Maintenance Cognitive-Behavioral Therapy and Manualized Psychoeducation in the Treatment of Recurrent Depression: A Multicenter Prospective Randomized Controlled Trial

OBJECTIVE This multicenter study compared the relapse and recurrence outcomes of two active treatments, maintenance cognitive-behavioral therapy (CBT) and manualized psychoeducation, both in addition to treatment as usual, in patients in remission from depression. METHOD This was a multicenter prospective randomized observer-blinded study with two parallel groups. The authors assessed 180 patients with three or more previous major depressive episodes who met remission criteria over a 2-month baseline period and who were randomly assigned to 16 sessions of either maintenance CBT or manualized psychoeducation over 8 months and then followed up for 12 months. The main outcome measure was time to first relapse or recurrence of a major depression, based on DSM-IV criteria, as assessed by blinded observers with the Longitudinal Interval Follow-Up Evaluation. RESULTS Cox regression analysis showed that time to relapse or recurrence of major depression did not differ significantly between treatment conditions, but a significant interaction was observed between treatment condition and number of previous episodes (<5 or ≥5). Within the subsample of patients with five or more previous episodes, maintenance CBT was significantly superior to manualized psychoeducation, whereas for patients with fewer than five previous episodes, no significant treatment differences were observed in time to relapse or recurrence. CONCLUSIONS The results indicate that maintenance CBT has significant effects on the prevention of relapse or recurrence only in patients with a high risk of depression recurrence. For patients with a moderate risk of recurrence, nonspecific effects and structured patient education may be equally effective.

Depersonalization, mindfulness, and childhood trauma

Depersonalization (DP), i.e., feelings of being detached from ones own mental processes or body, can be considered as a form of mental escape from the full experience of reality. This mental escape is thought to be etiologically linked with maltreatment during childhood. The detached state of consciousness in DP contrasts with certain aspects of mindfulness, a state of consciousness characterized by being in touch with the present moment. Against this background, the present article investigates potential connections between DP severity, mindfulness, and childhood trauma in a mixed sample of nonpatients and chronic nonmalignant pain patients. We found a strong inverse correlation between DP severity and mindfulness in both samples, which persisted after partialing out general psychological distress. In the nonpatient sample, we additionally found significant correlations between emotional maltreatment on the one hand and DP severity (positive) and mindfulness (negative) on the other. We conclude that the results first argue for an antithetical relationship between DP and certain aspects of mindfulness and thus encourage future studies on mindfulness-based interventions for DP and second throw light on potential developmental factors contributing to mindfulness.

Motoric neurological soft signs and psychopathological symptoms in schizophrenic psychoses.

Motoric neurological soft signs (NSS) were investigated by means of the Brief Motor Scale (BMS) in 82 inpatients with DSM-III-R schizophrenic psychoses. To address potential fluctuations of psychopathological symptoms and extrapyramidal side effects, patients were examined in the subacute state, twice at an interval of 14 days on the average. NSS were significantly correlated with severity of illness, lower social functioning, and negative symptoms. Modest, but significant correlations were found between NSS and extrapyramidal side effects as assessed on the Simpson-Angus Scale. Neither the neuroleptic dose prescribed to the patient, nor scores for tardive dyskinesia and akathisia were significantly correlated with NSS. Moreover, NSS scores did not significantly differ between patients receiving clozapine and conventional neuroleptics. Patients in whom psychopathological symptoms remained stable or improved over the clinical course showed a significant reduction of NSS scores. This finding did not apply to those patients in whom psychopathological symptoms deteriorated. Our findings demonstrate that NSS in schizophrenic psychoses are relatively independent of neuroleptic side effects, but they are associated with the severity and persistence of psychopathological symptoms and with poor social functioning.

Die deutsche Version der Mindful Attention and Awareness Scale (MAAS) Psychometrische Befunde zu einem Achtsamkeitsfragebogen

Zusammenfassung. Theoretischer Hintergrund: Achtsamkeit ist eine bestimmte Form der Aufmerksamkeitslenkung, die durch drei Merkmale gekennzeichnet ist: (1) absichtsvoll (2), im gegenwartigen Moment und (3) nicht wertend. Therapieansatze, in denen die Forderung von Achtsamkeit eine zentrale Rolle einnimmt, werden in letzter Zeit zunehmend eingesetzt. Fragestellung: Wie gut sind die Gutekriterien der deutschen Ubersetzung der „Mindful Attention Awareness Scale” (MAAS)? Methode: Die 15 Items der MAAS wurden ubersetzt. An einer Stichprobe von 469 studentischen Versuchspersonen wurden die dimensionale Struktur, Reliabilitat und Validitat der Skala uberpruft. Ergebnisse: In Ubereinstimmung mit den Ergebnissen zur amerikanischen Originalfassung zeigte die deutschsprachige Version der MAAS eine eindimensionale Struktur, eine interne Konsistenz von α = .83 und Zusammenhange mit psychopathologischer Belastung und subjektivem Wohlbefinden. Schlussfolgerungen: Mit der deutschen Ubersetzung der MAAS liegt ein Fragebog...

The Psychometric Properties of the Kentucky Inventory of Mindfulness Skills in Clinical Populations

The Kentucky Inventory of Mindfulness Skills (KIMS) is a well-validated multidimensional questionnaire measuring dimensions of mindfulness on four scales: Observing, Describing, Act With Awareness, and Accept Without Judgment. Even though the KIMS has been used in several clinical studies no information is available about the psychometric properties in different clinical samples. The present study includes two clinical samples: a German sample of people diagnosed with borderline personality disorder, posttraumatic stress disorder, or major depression and an English sample of people diagnosed with recurrent depression. Results of confirmatory factor analysis offer good support for the hypothesized model of four correlated factors, whereas the model of one general underlying mindfulness factor as a second order construct was not confirmed. Furthermore, our analyses revealed that the KIMS scales show high internal consistency and that all KIMS scales are sensitive to change in a subsample of participants taking part in Mindfulness-Based Cognitive Therapy.