Bullying girls - Changes after brief strategic family therapy: A randomized, prospective, controlled trial with one-year follow-up

Background: Many girls bully others. They are conspicuous because of their risk-taking behavior, increased anger, problematic interpersonal relationships and poor quality of life. Our aim was to determine the efficacy of brief strategic family therapy (BSFT) for bullying-related behavior, anger reduction, improvement of interpersonal relationships, and improvement of health-related quality of life in girls who bully, and to find out whether their expressive aggression correlates with their distinctive psychological features. Methods: 40 bullying girls were recruited from the general population: 20 were randomly selected for 3 months of BSFT. Follow-up took place 12 months after the therapy had ended. The results of treatment were examined using the Adolescents' Risk-taking Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Results: In comparison with the control group (CG) (according to the intent-to-treat principle), bullying behavior in the BSFT group was reduced (BSFT-G from n = 20 to n = 6; CG from n = 20 to n = 18, p = 0.05) and statistically significant changes in all risk-taking behaviors (ARBS), on most STAXI, IIP-D, and SF-36 scales were observed after BSFT. The reduction in expressive aggression (Anger-Out scale of the STAXI) correlated with the reduction on several scales of the ARBS, IIP-D, and SF-36. Follow-up a year later showed relatively stable events. Conclusions: Our findings suggest that bullying girls suffer from psychological and social problems which may be reduced by the use of BSFT. Expressive aggression in girls appears to correlate with several types of risk-taking behavior and interpersonal problems, as well as with health-related quality of life. Copyright (c) 2006 S. Karger AG, Basel

Pregnant women with bronchial asthma benefit from progressive muscle relaxation: A randomized, prospective, controlled trial

Background: Asthma is a serious medical problem in pregnancy and is often associated with stress, anger and poor quality of life. The aim of this study was to determine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters, heart rate, anger and health-related quality of life in pregnant women with bronchial asthma. Methods: We treated a sample of 64 pregnant women with bronchial asthma from the local population in an 8-week randomized, prospective, controlled trial. Thirty-two were selected for PMR, and 32 received a placebo intervention. The systolic blood pressure, forced expiratory volume in the first second, peak expiratory flow and heart rate were tested, and the State-Trait Anger Expression Inventory and Health Survey (SF-36) were employed. Results: According to the intend-to-treat principle, a significant reduction in systolic blood pressure and a significant increase in both forced expiratory volume in the first second and peak expiratory flow were observed after PMR. The heart rate showed a significant increase in the coefficient of variation, root mean square of successive differences and high frequency ranges, in addition to a significant reduction in low and middle frequency ranges. A significant reduction on three of five State-Trait Anger Expression Inventory scales, and a significant increase on seven of eight SF-36 scales were observed. Conclusions: PMR appears to be an effective method to improve blood pressure, lung parameters and heart rate, and to decrease anger levels, thus enhancing health-related quality of life in pregnant women with bronchial asthma. Copyright (c) 2006 S. Karger AG, Basel

Why are some cases not on track? An item analysis of the assessment for signal cases (ASC) during inpatient psychotherapy

Within the Routine Outcome Monitoring System “OQ‐Analyst”, the questionnaire “Assessment for Signal Cases” (ASC) supports therapists in detecting potential reasons for not‐on‐track trajectories. Factor analysis and a machine learning algorithm (Lasso with 10‐fold cross‐validation) were applied and potential predictors of not‐on‐track classifications were tested using logistic multilevel modelling methods. The factor analysis revealed a shortened (30‐item) version of the ASC with good internal consistency (α = 0.72 – 0.89) and excellent predictive value (AUC = 0.98; +PV = 0.95; ‐PV = 0.94). Item‐level analyses showed that interpersonal problems captured by specific ASC items (not feeling able to speak about problems with family members; feeling rejected or betrayed) are the most important predictors of not‐on‐track trajectories

Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors

<p>Abstract</p> <p>Background</p> <p>Little is known about the social context of girls with conduct disorder (CD), a question of increasing importance to clinicians and researchers. The purpose of this study was to examine the associations between three social context domains (neighborhood, family characteristics, and parenting behaviors) and CD in adolescent girls, additionally testing for race moderation effects. We predicted that disadvantaged neighborhoods, family characteristics such as parental marital status, and parenting behaviors such as negative discipline would characterize girls with CD. We also hypothesized that parenting behaviors would mediate the associations between neighborhood and family characteristics and CD.</p> <p>Methods</p> <p>We recruited 93 15–17 year-old girls from the community and used a structured psychiatric interview to assign participants to a CD group (n = 52) or a demographically matched group with no psychiatric disorder (n = 41). Each girl and parent also filled out questionnaires about neighborhood, family characteristics, and parenting behaviors.</p> <p>Results</p> <p>Neighborhood quality was not associated with CD in girls. Some family characteristics (parental antisociality) and parenting behaviors (levels of family activities and negative discipline) were characteristic of girls with CD, but notll. There was no moderation by race. Our hypothesis that the association between family characteristics and CD would be mediated by parenting behaviors was not supported.</p> <p>Conclusion</p> <p>This study expanded upon previous research by investigating multiple social context domains in girls with CD and by selecting a comparison group who were not different in age, social class, or race. When these factors are thus controlled, CD in adolescent girls is not significantly associated with neighborhood, but is associated with some family characteristics and some types of parental behaviors. However, the mechanisms underlying these relationships need to be further investigated. We discuss possible explanations for our findings and suggest directions for future research.</p

Validation of a Turkish Version of the ICD-10 Symptom Rating (ISR)

Numerous psychiatric and psychosomatic clinics in Turkey and Germany use the Symptom Checklist 90 Revised (SCL-90-R) developed by Derogatis (1977) or the validated Turkish version by Dag (1991) for assessing psychological symptoms. Many patients informed us during numerous studies and visits to these clinics that this test with its 90 questions took too long and that they were unable to sufficiently concentrate on it. In the meantime, the much more economical ICD-10 Symptom Rating (ISR) (Tritt et al., 2008) self-rating questionnaire, comprising 29 questions, has been developed in Germany in 2008. In 2008 and 2009 we therefore decided to translate the ISR into Turkish, to analyse it for its reliability and validity and compare it with the SCL-90-R and the BDI. In an analysis of 277 Turkish subjects – 127 of whom were inpatients, 36 outpatients and 104 clinically unremarkable healthy participants – very good psychometric characteristics were achieved in terms of high internal consistency of individual, additional and overall scales. The results of the factor analysis conducted showed that the ISR Measure has satisfactory construct validity. In a random sample of inpatients, the Cronbach’s alpha values ranged from 0.66 (scale: Compulsive syndrome) to 0.93 (overall scale). The advantage of this instrument over BDI and SCL-90-R lies in its shorter processing time. The German version of the ISR promises lesser use of time and good empirical quality, which we double-checked with a translated Turkish version tested on persons of Turkish origin in Germany

La psychothérapie positive: Une méthode de thérapie brève incluant une gestion de qualité par ordinateur

In den letzten Jahren haben die Forderungen nach einer Qualitätssicherung im Bereich der Psychotherapie von Seiten der Kostenträger zugenommen. Demnach sollte Psychotherapie effektiv und ökonomisch sein.Die von Dr. N. Peseschkian Ende der 60er Jahre begründete Positive Psychotherapie versucht, diesem Anspruch gerecht zu werden. Die Positive Psychotherapie ist eine Kurzzeitpsychotherapieform unter einem transkulturellen und interdisziplinären Gesichtspunkt und wird den tiefenpsychologisch fundierten Verfahren zugeordnet.Im Rahmen einer Wirksamkeitsstudie zur Positiven Psychotherapie, die der Wiesbadener Weiterbildungskreis für Psychotherapie und Familientherapie (WIPF), unter der Leitung von Dr. Peseschkian, in Zusammenarbeit mit der Universität Erlangen durchgeführt hat, fanden sich beeindruckende Ergebnisse:Insbesondere im Bereich des Erlebens und Verhaltens (VEV) fand sich eine Effektstärke von 1.24, was für eine deutliche Befindlichkeitsverbesserung der Patienten (n = 402) spricht.Auf der Basis der in der Studie verwendeten Testbatterie wurde zudem eine erweiterungsfähige Software entwickelt, die eine kontinuierliche Qualitätssicherung ermöglicht.Schlüsselwörter: Positive Psychotherapie, Qualitätssicherung, Wirksamkeitsstudie, Kurzzeitpsychotherapie.Positive Psychotherapy is a form of shortterm psychotherapy based on a in-depth psychological approach, resulting from cross-cultural psychotherapy. It is prepared to integrate other models of therapy into its theory. Some central elements of the study are discussed in this paper.The presentation of psychotherapy and family therapy needs a development of methods which are at the same time economical and efficient. Under the direction of Dr. N. Peseschkian, the Wiesbaden Institute for Psychotherapy and Family Therapy for Postgraduates (WIPF) and in a cooperation with the University of Erlangen-Nurnberg a study of the effects of Positive Psychotherapy with 402 patients have been started in 1995. The results of this study are impressing: Inparticular the effect size of the VEV of 1.24 shows a good development of the patients well-being. The average treatment duration for the study which is 30,5 hours. The main results correspond to the future standards of a modern psychotherapy.A user-friendly software program has been developed for clinics and practice on the basis of applied methodological instruments for investigation of the effectivity study. The program also offers the option to integrate further specific tests when they are needed and makes a current analysis of therapy-effects possibleKeywords: Positive Psychotherapy, quality assurance, effectivity, short-term-psychotherapy.Au cours de ces dernières années, les demandes de garantie de qualité formulées par les instances remboursant les traitements psychothérapeutiques n’ont fait qu’augmenter. Dans la situation actuelle, les exigences posées à une psychothérapie moderne peuvent être formulées comme suit: elle doit être brève, efficace et transparente, donc vérifiable au niveau méthodique comme au niveau théorique. La psychothérapie positive élaborée par N. Peseschkian à la fin des années soixante tente de satisfaire à ces exigences. Elle est une forme de psychothérapie de brève durée, centrée sur les ressources et placée sous le signe d’une approche transculturelle et interdisciplinaire; on la classe dans la catégorie des méthodes basées sur la psychologie des profondeurs. La perspective transculturelle et plus particulièrement interdisciplinaire qui la caractérise permet d’intégrer des formes de traitement empruntées à la psychanalyse, à la psychologie des profondeurs, à la thérapie du comportement, à la thérapie de groupe, à l’hypnothérapie et à la pharmacothérapie, ainsi qu’à la physiothérapie. La démarche se fonde sur une conception théorique dynamique, appliquant un “modèle en cinq étapes” (1. observation/distanciation; 2. établissement d’un inventaire; 3. encouragement dans le contexte situationnel; 4. verbalisation et 5. élargissement des objectifs). Le noyau théorique de la psychothérapie positive est constitué d’un recensement des contenus conflictuels à partir de la question suivante: “Quels sont les éléments communs à tous les êtres humains et quels sont ceux qui les différencient ?”. La notion de contenu conflictuel est en rapport avec deux “capacités fondamentales” qui sont considérées comme innées: une “capacité à l’amour” et une “capacité à la cognition”. Sur cette base, l’être humain acquiert tout au long de son développement des “capacités actuelles” individuelles, qui toutefois appartiennent toutes aux deux grandes catégories indiquées plus haut. Selon Peseschkian, des conflits naissent entre autres d’une disparité entre les manifestations individuelles de ces deux capacités. C’est au niveau des capacités actuelles que se situent ce que Peseschkian appelle les “microtraumatismes”. En effet, ces derniers correspondent à des blessures psychiques relativement limitées mais durables, portant atteintes aux valeurs individuelles définies par les capacités actuelles. Ils provoquent une disposition psychique à des conflits spécifiques. Peseschkian résume sa théorie en neuf thèses fondamentales; l’article présente celles-ci plus en détail. Compte tenu des exigences posées aux méthodes modernes de psychothérapie, les résultats d’une étude consacrée à l’efficacité de la “psychothérapie positive” sont présentés; le travail a été effectué par le ‘Wiesbadener Weiterbildungkreis für Psychotherapie und Familientherapie (WIPF)’, en collaboration avec l’Université d’Erlangen. L’enquête s’est intéressée à 402 patients souffrant de troubles de types névrotique et psychosomatique, pour la plupart chroniques. Des mesures pré-post ont été effectuées sur un échantillon de 110 patients, en utilisant une batterie de tests correspondant aux standards internationaux. Un groupe de réserve (n = 54) a servi de contrôle, avec un autre groupe comportant 17 patients dont le diagnostic a été formulé sur une base purement somatique et qui n’ont pas suivi de traitement psychothérapeutique. Une enquête rétrospective a été en outre menée auprès des patients (n = 231) qui avaient terminé un traitement selon la méthode de la psychothérapie positive. De ceux-ci un premier groupe (n =84 patients) a été étudié 3-10 mois après la fin de la thérapie. Un second groupe (n = 91) après une période de 10 mois à 4 ans et un troisième (n = 46) 4-5 ans après la fin du traitement. C’est au niveau du vécu et du comportement (‘Erleben und Verhaltens’, VEV) que les résultats sont particulièrement impressionnants (quotient d’efficacité 1.24). A titre de comparaison, les métaanalyses portant sur l’efficacité des traitements utilisant des méthodes de types behavioro-cognitif et dynamico-humaniste ont produit des quotients allant de 1.08 (Shapiro et Shapiro, 1993) à 0.64 (Smith et al., 1980). Concernant les symptômes (SCL 90-R) nous obtenons un chiffre de 0.48, ce qui correspond à une amélioration moyenne. Compte tenu de ces résultats, il est légitime de considérer que du point de vue de son efficacité, la psychothérapie positive ne le cède en rien aux méthodes établies. Pour tenir compte d’aspects économiques, il faut ajouter qu’en moyenne la durée des traitements menés selon cette méthode est de 30.5 séances. Une première version d’un logiciel a été développée sur la base de la batterie de tests utilisée pour l’enquête; il permet un contrôle de qualité continu