An investigation of reactance, coping, quality of life, and well -being

Psychological reactance (reactance) is a personality variable receiving a great deal of attention. Reactance has been defined as the motivational force aroused in an individual when a behavioral freedom is lost or threatened (Brehm, 1966). The current study assessed the interrelationships among psychological reactance, coping, quality of life, and well-being. A total of 353 participants were analyzed for this study. Participants completed four self-report instruments: (1) the Therapeutic Reactance Scale, (2) the Coping Styles Questionnaire, (3) the Overall Quality of Life Scale, (4) the General Well-Being Schedule, and a demographics questionnaire. Significant gender differences existed for reactance, detachment coping, emotional coping, and anxiety well-being; therefore males and females were analyzed separately. As hypothesized, psychological reactance and coping were related. Specifically, emotional coping and detachment coping predicted levels of reactance in males. Emotional coping predicted reactance in females. Likewise, as hypothesized psychological reactance was related to quality of life. A negative relationship was found between reactance and quality of life indicating that as reactance increases quality of life decreases for both males and females. A relationship was found between psychological reactance and well-being indicating that as individuals become more reactant their well-being decreases and they become more self-controlling. This was true for both males and females. As hypothesized, psychological reactance moderated the relationship between reactance and quality of life for males but the specific nature of the relationship could not be determined. For females, psychological reactance moderated the relationship between detached coping and quality of life. Finally, psychological reactance moderated the relationship between coping and well-being but the exact nature, direction, and intensity could not be determined. These findings, in conjunction with future research, may enhance the process of therapy, therapist-client relations, doctor-patient relations, and employer-employee relations both theoretically and practically

Zum Einsatz von Geoinformationssystemen in Geschichte und Archäologie

In recent years the interest in the use of computer- aided Geographic Information Systems (GIS) in archeology and history has increased. In contrast to traditional printed maps all information in a GIS-based map is linked to certain information contained in a database. By using different layers combined with thematic maps and specific SQL-queries on the data stored in the databases each user of GIS is able to create new maps according to personal interests. “Hassia Exploranda”, a project being developed in Marburg, uses the wide range of applications GIS provides to visualize the remains of Roman presence in the area of the German federal state of Hesse. The aim of this project is to design a GIS that can be used mainly by teachers and pupils to learn about Roman presence in Hesse by creating their own maps (e.g. showing all locations of a special date). Furthermore it can be helpful for the planning of lessons and for preparing trips to archeological sites

Der unglückliche Mack

ABSTRACT NUR IN PRINTAUSGABE

Well-being therapy: Conceptual and technical issues

Abstract Well-being therapy is a short-term, well-being-enhancing psychotherapeutic strategy. It is based on Carol D. Ryff's multidimensional model of psychological wellbeing, encompassing environmental mastery, personal growth, purpose in life, autonomy, self-acceptance and positive relations with others. Its conceptual and technical issues are described. It may be applied as a relapsepreventive strategy in the residual phase of affective (mood and anxiety) disorders, as an additional ingredient of cognitive behavioral packages, in patients with affective disorders who failed to respond to standard pharmacological and psychotherapeutic treatments, in body image disorders and in psychosomatic medicine. The first validation studies appeared to be promising. The technique is in its preliminary stage of development and may undergo major changes in the next years. It is hoped it may herald a new trend of psychotherapy research and practice in the current symptom-oriented settings

Prediction of psychological and physical morbidity after critical illness and intensive care unit stay

A large proportion of survivors of critical illness and intensive care unit stay suffer from post- intensive care syndrome (PICS), consisting of psychological, physical and cognitive problems. These problems can persist for months to years and impede the return to life as it was prior to falling ill. Psychological problems such as depression, anxiety and post- traumatic stress (PTS), can also affect informal caregivers to ICU patients. In order to detect and hopefully treat these problems, an increasing number of hospitals are offering follow-up in the months after ICU stay. Resources for ICU follow-up are limited and it is unknown which patients are at the highest risk of developing PICS. ICU length of stay longer than 3-4 days is currently the most commonly used and recommended method for selection of patients for follow-up, but evidence is lacking regarding the accuracy of this method in finding patients with the highest risk for PICS. The aim with this thesis was to assess risk factors for psychological and physical sequelae after ICU stay, and to develop instruments to predict individual patients’ risk of these adverse outcomes, as well as investigate the effect of patient outcome on the wellbeing of their informal caregivers. Study I is a multicenter prospective observational cohort study assessing risk factors for psychological problems (PTS, depression and anxiety) three months post-ICU in order to develop a discharge screening instrument for identification of patients for psychological ICU follow-up. We included 572 patients at ten ICUs in Sweden, Denmark and the Netherlands. Among 404 (78%) responders, 20% developed significant symptoms of any of the assessed psychological entities. After univariable and multivariable logistic regression modeling, the remaining predictors for adverse psychological outcome three months post-ICU were: age (with the highest risk in ages 49-65 years), lack of social support, symptoms of depression and traumatic memories at ICU discharge. The area under the receiver operating characteristics curve (AUC) for the screening instrument was 0.76 (95% CI 0.70-0.81). Study II is a multicenter prospective observational cohort study assessing risk factors for new-onset physical disability three months post-ICU in order to develop a discharge screening instrument for identification of patients for physical ICU follow-up. Included patients are the same as in study I. Among the 404 responding ICU survivors, 19% reported new-onset physical disability. After univariable and multivariable logistic regression modeling, the sole remaining predictor for an adverse outcome was physical status at ICU discharge, with an AUC of 0.68 (95% CI 0.61-0.76). Study III is a single-center prospective observational cohort study evaluating the predictive value of an early psychological assessment one week after ICU discharge on three-month psychological outcome regarding symptoms of PTS, depression and anxiety. Among 132 included patients, there are follow-up data on 82 (62%). In our cohort, 13% suffered from clinically significant symptoms of PTS, 21% from symptoms of depression and 16% from symptoms of anxiety at three months. Correlation between early scores in the ward and three months scores were moderate to strong. The predictive value of the early screening as assessed with the AUC was 0.90 (95% CI 0.81 to 0.99) for symptoms of PTS, 0.80 (95% CI 0.64 to 0.95) for symptoms of anxiety and 0.75 (95% CI 0.64 to 0.87) for depressive symptoms. Study IV is a multicenter prospective observational cohort study including cohabiting informal caregivers to 62 ICU survivors included in study I/II. The primary outcome was to assess whether an adverse psychological or physical patient outcome was associated with a higher degree of caregiver burden three months post-ICU. Response rate was 89% (n=55). Of included patients, 17 (33%) had an adverse outcome. Caregiver burden was significantly higher in caregivers to patients with an adverse outcome, caregiver burden scale score mean (±SD) 52 (11) compared to caregivers caring for patients without an adverse outcome, mean 41 (13), p=0.006. A higher caregiver burden also correlated with a reduced caregiver mental health-related quality of life. This thesis developed methods for prediction of psychological and physical sequelae in ICU survivors three months post-ICU, as well as assessed the effect of an incomplete patient recovery on caregiver burden and mental health problems in informal caregivers. The results of this thesis provides clinicians with tools to better anticipate the trajectory of recovery for their patients in order to initiate early interventions in high-risk patients and their informal caregivers and potentially reduce long-term suffering. This triage of patients also allows for enrichment of high-risk cohorts for future interventional studies of ICU follow-up interventions

Effekte und Nutzen altersgerechter Assistenzsysteme (ENAS): Leitfaden für die Planung und Durchführung von Studien zur Evaluation neuer technischer Assistenzsysteme in Forschungs- und Entwicklungsprojekten

Dieser Leitfaden entstand im Rahmen des Projektes ENAS („Effekte und Nutzen altersgerechter Assistenzsysteme – praktikable Vorgehensmodelle, Evaluationsmethoden und Werkzeuge“), welches durch das Bundesministerium für Bildung und Forschung (BMBF) gefördert wurde. Dieser Leitfaden soll Akteuren in konkreten Forschungs- und Entwicklungsprojekten im Bereich der Mensch-Technik-Interaktion zur Unterstützung von Menschen mit Hilfsbedarf eine Orientierungshilfe zur Verfügung stellen

Tiergestütztes Kompetenztraining (MTI) im stationären Drogenentzug

Soziale und emotionale Kompetenzen sind wichtige Schutzfaktoren, die mit problematischem Substanzkonsum und mit der Wahrscheinlichkeit mit Drogen in Kontakt zu kommen, in Zusammenhang stehen (Baumeister et al., 2003; Beck et al., 1997; Wills et al., 1995). Die eigenen Emotionen erkennen zu können und sie zu regulieren, gelten bei Substanzabhängigkeit als häufig genannte Defizite (Kasarabada et al., 1998; Lieb & Reichert, 1982; Stenbacka, 2000). Umso wichtiger ist es, diese Kompetenzen im Rahmen von Kompetenztrainings zu schulen und zu üben. In der vorliegenden Studie wurde die multiprofessionelle tiergestützte Intervention (MTI), als ein hundegestütztes Kompetenztraining zur Förderung sozialer und emotionaler Fähigkeiten, im stationären Drogenentzug auf ihre Wirksamkeit evaluiert. Zum einen wurden vor und nach dem Training unterschiedliche Indikatoren für emotionale und soziale Kompetenz mittels Fragebögen (ROPELOC und SDQ III) erhoben. Außerdem wurde diese Gruppe (MTI STAT) mit den Daten von Stetina und Forschungsteam (2010a, 2010b) verglichen, die die MTI bei drogenabhängigen Straftätern untersucht haben. Des Weiteren wurde eine Gruppe mit einbezogen, die keine MTI erhielten, sondern nur eine Basisbehandlung erhielten. Zusätzlich wurden alle zwölf Einheiten einer systematischen Verhaltensbeobachtung unterzogen. Die statistische Analyse erfolgte mit SPSS 17.00. Wie sich bereits bei inhaftierten Drogenabhängigen (Stetina et al., 2010a, 2010b) gezeigt hat, trägt die MTI auch bei Personen, die das Programm “Therapie statt Strafe” in einer stationären Drogeneinrichtung durchlaufen, zu einer deutlichen Verbesserung und Stärkung des Selbstkonzepts und des Selbstwerts (d = .81). Die Teilnehmer gaben zum zweiten Erhebungszeitpunkt positivere Einschätzungen zur eigenen emotionalen Stabilität (d = 1.17) an. Es zeigten sich vor allem Bereich der sozialen Kompetenz und im Selbstkonzept, dass die beiden MTI Gruppen (MTI STAT und MTI GEF) sich signifikant von der Gruppe, die keine MTI erhielt (Non MTI) unterscheiden. So besserten sich die MTI Gruppen u.a. in den Bereichen Problemlösefähigkeit (d = .59), Führungsfähigkeit in Teamsituationen (d = .405) und Stressmanagement (d = .73). Demnach konnte die vorliegende Studie, als weitere Evaluation des tiergestützten Trainings MTI, zeigen, dass die MTI eine durchaus vielversprechende Fördermaßnahme bei der Behandlung von Drogenabhängigkeit ist.Social and emotional competences are important protection factors which are often linked to drug abuse and the probability to get in touch with drugs. Deficits in Emotion recognition and emotion regulation were often shown in studies (Kasarabada et al., 1998; Lieb & Reichert, 1982; Stenbacka, 2000). As a result it is relevant to enhance those competences. The present study evaluates the effectiveness of an AAT setting (MTI), which is a twelve week animal assisted therapy program to enhance social and emotional competences, in an inpatient drug treatment. Results on research parameters, such as self-concept, obtained by the treatment group (MTI STAT), drug addicted offenders (MTI GEF) and a control group (Non MTI, baseline treatment) before and after the training, were compared using the instruments ROPELOC and SDQ III. In addition, a behavioral monitoring of the group MTI STAT during the training was conducted. Statistic analyses showed many improvements of the MTI groups (MTI STAT and MTI GEF), especially in areas of social competences. As already demonstrated among drug addicted offenders (Stetina et al., 2010a, 2010b) the present study showed the effectiveness of MTI among inpatient drug treatment. Improvements were shown regarding self-concept and self-worth (d = .81). Participants enhanced their emotional stability (d = 1.17) and improvements were shown in problem solving (d = .59), leadership ability (d = .405) and stress management (d = .73). To sum up it is possible to state generally that the animal-assisted training (MTI) is a promising funding measure in the treatment of drug addicts

Qualidade de vida auto percecionada e nível de atividade física após cirurgia bariátrica

Avaliar a relação entre a qualidade de vida auto percecionada, o índice de massa corporal (IMC) e o nível de atividade física 5 meses após a cirurgia bariátrica. Método: estudo transversal de natureza quantitativa com 40 mulheres (idade = 45,18±10,98 anos) submetidas a cirurgia bariátrica. A recolha dos dados foi realizada em três períodos: dia anterior à cirurgia, 3 e 5 meses após a cirurgia. Foi realizada nos três períodos a avaliação antropométrica (peso e altura), avaliação do estado de saúde (escala SF-36) e avaliação do nível de atividade física (escala internacional de atividade física). Recorreu-se à análise estatística descritiva (m±DP), inferencial e à correlação de Pearson. Foi definido como nível de significância p < 0,05. Resultados: obteve-se uma redução de 25,4% do IMC entre a 1ª e 3ª avaliações acompanhado por melhorias significativas em todos domínios e componentes da qualidade de vida ao 5º mês pós-operatório: função física (92%); desempenho físico (63%); saúde geral (29%); vitalidade (17%); função social (4,4%); desempenho emocional (41,5%); saúde mental (18,7%); dor (30%). Verificou-se baixo nível de atividade física semanal (AFS) no pré-operatório (72,5%), maioria que prevaleceu até ao 3º mês pós-operatório (55%). Ao quinto mês pós-operatório, 32,5% da amostra referiu manter um baixo nível de AFS, adotando a restante amostra níveis moderados (47,5%) e altos (20%) de AFS. Verificou-se uma correlação negativa muito significativa entre o IMC e os domínios função física (r = -0,469, p < 0,01) e função social (r = -0,403, p < 0,01), uma correlação negativa significativa entre o IMC e os domínios desempenho físico (r = -0,337, p < 0,05) e saúde geral (r = -0,339, p < 0,05) e uma correlação positiva significativa entre o nível de atividade física semanal e o domínio saúde geral (r = 0,313, p < 0,05). Conclusões: A perda de peso e o aumento da atividade física em pacientes com obesidade mórbida submetidos a cirurgia bariátrica foram acompanhados por uma melhoria na qualidade de vida auto relatada.To evaluate the relationship between self-perceived quality of life, body mass index (BMI) and physical activity level 5 months after bariatric surgery. Method: a quantitative cross-sectional study with 40 women (age = 45.18 ± 10.98 years) undergoing bariatric surgery. The data were collected in three periods: the day before surgery, 3 and 5 months after surgery. Anthropometric assessment (weight and height), health status assessment (SF-36 scale) and physical activity level evaluation (international physical activity scale) were performed in the three periods. Descriptive statistical analysis (m ± SD), inferential and Pearson's correlation were used. The significance level was set at p <0.05. Results: a 25.4% reduction in BMI between the 1st and 3rd evaluations was obtained, accompanied by significant improvements in all domains and components of quality of life at the 5th postoperative month: physical function (92%); physical performance (63%); general health (29%); vitality (17%); social function (4.4%); emotional performance (41.5%); mental health (18.7%); pain (30%). There was a low level of weekly physical activity (WPA) in the preoperative period (72.5%), most of which prevailed until the 3rd postoperative month (55%). At the fifth postoperative month, 32.5% of the sample reported maintaining a low WPA level, with the remaining sample adopting moderate (47.5%) and high (20%) WPA levels. There was a very significant negative correlation between the BMI and the physical function domains (r = -0.469, p <0.01) and social function (r = -0.403, p <0.01), a significant negative correlation between the BMI and physical performance domains (r = -0.337, p <0.05) and general health (r = -0.339, p <0.05) and a significant positive correlation between the level of weekly physical activity and the general health domain (r = 0.313, p <0.05). Conclusions: Weight loss and increased physical activity in morbidly obese patients undergoing bariatric surgery were accompanied by an improvement in self-reported quality of life

Between the old and the new : Friedrich Gentz, 1764-1832

This dissertation reviews the life and political impact of Friedrich Gentz, who was born in Breslau, Prussia, in 1764, and died in Vienna, Austria, in 1832. Though remembered today as only a second- (or even third)- tier statesman alongside such luminaries of his day as Napoleon, Metternich, Wellington, and others, Gentz was nonetheless of importance in the shifting tides of late 18th and early 19th-century politics in Europe. The German translator of Edmund Burke, he was instrumental in bringing the conservative thinker's ideas into the conversations of Central Europe, while his writings against first the French Revolution, then Napoleon, marked him as one of the leading opponents of revolutionary ideology, and led the French emperor to dub him "that miserable scribe." But Gentz was important even beyond his anti-revolutionary polemics. As a product of the Enlightenment, he had some sympathy with the forces of modernity, and his career reflected the struggle to combine an openness to reform with hostility to revolution. In his later collaboration with Metternich to forge what became known as the Restoration, we can see just how much the post-Napoleonic conservative order in Europe was built upon a specific vision, one that rejected the quasi-feudal patterns of the ancien regime just as firmly as it did the democratic radicalism of its own day. Though it ultimately did not last, Gentz's work is clearly visible in the political contours of the 19th century. From the Enlightenment salons of Berlin to the dazzling Congress of Vienna and beyond, Between the Old and the New traces the eventful career of one of the most interesting men of letters in Revolutionary-era Europe.Includes bibliographical reference