Validation of the Scale for the Assessment of Illness Behavior (SAIB) in a community sample of elderly people.

The aim of this study was to evaluate the construct validity of the SAIB in a community sample of elderly people. The SAIB was administered to a large community sample representative of the German population aged 60-85 years (n=1593). The original model was assessed and then refined through confirmatory and exploratory factor analyses. Criterion validity was evaluated by comparing SAIB scores with external criteria in 3 categories: subjective health, chronic illness and health care utilization. The originally suggested five factor structure of the SAIB yielded a comparative fit index (CFI) of 0.70 and the weighted root mean square residual (WRMR) was 3.68. A shortened questionnaire with 13 items and four factors resulted in better model fit (CFI 0.97 and WRMR 1.3). Correlations between subjective health and the new scales ranged from 0.06 to 0.33. Effect sizes (Cohens d) of mean differences in factor scores between those with and without healthcare system contact varied by healthcare type, ranging from 0.05 to 0.94; effect sizes were largest in relation to contact with psychotherapy and alternative medicine practitioners. We propose a shortened version of the SAIB with a different scale structure, which resulted in better model fit with our data. Neither the original nor revised SAIB appeared to discriminate well in terms of health care use, suggesting that the illness behavior as currently conceptualized may not fully explain the increased use of healthcare in the elderly

Regular and problematic leisure-time Internet use in the community: results from a German population-based survey

In our study, we attempted to identify systematically the use of Internet applications in the German population in order to derive risk factors for problematic use. In a representative survey of the German population, we queried 1,401 women and 1,111 men between the ages of 14 and 94 years by specific questions and standardized questionnaires on depression, anxiety (HADS), and depersonalization (CDS-2). The majority of the German population (55%) used the Internet in their leisure time. Users were younger and had a higher socioeconomic status (education, employment, income). Leisure-time use included e-mail and information search, as well as shopping. Chatting, online communities, games and sex were domains of young, mostly male adults. Overall, 9.3% reported at least one negative consequence of Internet use, especially neglect of recreational activities and problems with family/partner, work or education, and health. Problematic use was associated with longer average daily online times, avoidance of negative emotions, preference for certain applications (gaming, gam- bling, online sex) and an increased rate of depersonalization. The extent of Internet use per se is not sufficient as an addiction criterion and other negative consequences; rather, specific adverse consequences need to be identified. If the Internet is used excessively to cope with negative affect states and alternative means of coping (e.g., social support, health-promoting behavior) are diminished, a vicious cycle may ensue with increasing stress and reliance on the reinforcing properties of certain online activities that may finally lead to addictive behaviour

Posttraumatische Belastungsstörungen in Deutschland: Ergebnisse einer gesamtdeutschen epidemiologischen Untersuchung

Zusammenfassung: In einer repräsentativen Bevölkerungsstichprobe (n=2426) über ein breites Alterspektrum (14-93Jahre) wurden die Prävalenz traumatischer Ereignisse, des Vollbildes der posttraumatische Belastungsstörung (PTBS) und partieller PTBS-Syndrome geschätzt. Ein standardisiertes Interview mit einer Traumaliste des Composite International Diagnostic Interviews (CIDI) und eine PTSD-Symptomliste nach DSM-IV (modifizierte PTSD-Symptomskala) wurden eingesetzt. Die Einmonatsprävalenzrate lag bei 2,3% für das PTBS-Vollbild sowie 2,7% für die partiellen PTBS-Syndrome. Während sich keine Geschlechtsunterschiede hinsichtlich der Prävalenz ergaben, zeigten sich Altersgruppenunterschiede: Die über 60-Jährigen hatten eine Prävalenz bez. des PTBS-Vollbildes von 3,4%, während diese bei den 14- bis 29-Jährigen 1,3% und bei den 30- bis 59-Jährigen 1,9% betrug. Die partiellen PTBS-Syndrome zeigten ebenfalls einen Altersgipfel mit 3,8% in der Gruppe der Älteren sowie 2,4% bei Mittelalten und 1,3% bei jungen Erwachsenen. Die Ergebnisse entsprechen weitgehend denen anderer internationaler Studien, wenn Kriegsauswirkungen für bestimmte Altersgruppen als nationale Besonderheiten berücksichtigt werden. Erstmals konnte unsere repräsentative Studie eine - wahrscheinlich durch den 2.Weltkrieg mitbedingte - relativ hohe Prävalenz der PTBS in der höchsten Altersgruppe der deutschen Bevölkerung aufzeige

Risk perception and emergency experience: comparing a representative German sample with German emergency survivors

People’s perception of risk and its influencing factors has become an important element of research in past decades. The present paper investigated the influence of emergency experiences on risk perception and the impact of experience and gender on the accuracy of risk perception. A representative sample of the German population was subdivided into a general survivor group who had experienced at least one emergency previously (N = 165) and a general public group with no prior emergency experiences (N = 2248), which were compared to a German sample of survivors from the EU-funded Behavior, Security, and Culture (BeSeCu) international study of human behavior in emergency situations and evacuations (N = 201). The perceived risk of different emergencies – including larger-scale events like floods and other important but often overlooked events like domestic fires – was assessed with a questionnaire. Objective risk was also calculated for different emergencies and compared to the risk perceptions of each group to provide a measure of accuracy. The results of this study showed that emergency experiences increase perceived risk, for the experienced event in particular, and this outcome was evident regardless of whether the event was a large-scale one like a natural disaster or a smaller-scale one like a fire in one’s home. Additional data from the BeSeCu survivors identified several pre-, peri-, and post-event factors that might have influenced this outcome. Further results included the finding that gender is an important factor that moderates the accuracy of risk estimations but researchers should be mindful that the presence and pattern of any gender difference in perceived risk accuracy may vary across different types of event. Possible reasons and implications of the results are discussed

Validation of the Patient-Doctor-Relationship Questionnaire (PDRQ-9) in a representative cross-sectional German population survey

The patient-doctor relationship (PDR) as perceived by the patient is an important concept in primary care and psychotherapy. The PDR Questionnaire (PDRQ-9) provides a brief measure of the therapeutic aspects of the PDR in primary care. We assessed the internal and external validity of the German version of the PDRQ-9 in a representative cross-sectional German population survey that included 2,275 persons aged≥14 years who reported consulting with a primary care physician (PCP). The acceptance of the German version of this questionnaire was good. Confirmatory factor analysis demonstrated that the PRDQ-9 was unidimensional. The internal reliability (Cronbach's α) of the total score was .95. The corrected item-total correlations were≥.94. The mean satisfaction index of persons with a probable depressive disorder was lower than that of persons without a probable depressive disorder, indicating good discriminative concurrent criterion validity. The correlation coefficient between satisfaction with PDR and satisfaction with pain therapy was r = .51 in 489 persons who reported chronic pain, indicating good convergent validity. Despite the limitation of low variance in the PDRQ-9 total scores, the results indicate that the German version of the PDRQ-9 is a brief questionnaire with good psychometric properties to assess German patients' perceived therapeutic alliance with PCPs in public health research

Historical and regional particularities in the prevalence of traumatic events and posttraumatic stress disorder in Germany

Purpose: Research on prevalence rates of traumatic events and PTSD has shown significant differences between countries, due to their different history and socialization processes. In the case of Germany, with its history of two divided states, this is highly relevant. This study explores the prevalence of traumatic events and PTSD in formerly divided East and West Germany. Methods: We used data of four representative surveys (years 2005, 2007, 2008 and 2016) for the prevalence of traumatic events with a total of N = 9.200 respondents. For the analyses of the prevalence of PTSD we used data of three representative surveys (years 2005, 2007, 2008) with a total of N = 6676 respondents. We compared different birth cohorts as well as persons who lived in the former West vs. East using a Chi-Square-Test. Results: We found significant differences in the occurrence of traumatic events between genders, different age cohorts as well as between people who live in East and West Germany. Significant differences in the prevalence of PTSD can only be observed for different age cohorts. Most of the age effects may be due to traumatic events related to WWII. Conclusions: Our data suggests that socio-political factors may need to be considered when accounting for differences in occurrence rates of traumatic events between East and West Germany. However, we couldn’t find any differences in the overall prevalence of PTSD between the former GDR and FRG. Nevertheless, future epidemiological trauma research should take historical and regional peculiarities of countries into account

Regulation of emotions in the community: suppression and reappraisal strategies and its psychometric properties

Objective: The German Version of the Emotion Regulation Questionnaire (ERQ) has recently been published. The questionnaire investigates two common emotion regulation strategies (10 items) on two scales (suppression, reappraisal). Major aims of the study were to assess the reliability and factor structure of the ERQ, to determine population based norms and to investigate relations of suppression and reappraisal to anxiety, depression and demographic characteristics

Regulation of emotions in the community: suppression and reappraisal strategies and its psychometric properties

Objective: The German Version of the Emotion Regulation Questionnaire (ERQ) has recently been published. The questionnaire investigates two common emotion regulation strategies (10 items) on two scales (suppression, reappraisal). Major aims of the study were to assess the reliability and factor structure of the ERQ, to determine population based norms and to investigate relations of suppression and reappraisal to anxiety, depression and demographic characteristics