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Dieser Beitrag berichtet über eine im Sommer 2015 in der Anwaltschaft durchgeführte empirische Studie. Sie hat überprüft, ob und in welchem Ausmaß das Anliegen des Mediationsförderungsgesetzes aus dem Jahr 2012, die Mediation in Deutschland stärker zu etablieren, bereits Auswirkungen auf dem Rechtsdienstleistungsmarkt zeigt.

Abstract. Background: Despite being affected by a severe disease with increased morbidity and mortality, alcohol-dependent individuals often experience stigmatizing situations in the health care system. This study aimed to investigate medical students' attitudes towards alcoholism and their readiness for cutbacks in health care expenditures for alcohol-dependent individuals. Methods: In total, 2253 students of all federal states in Germany took part in this study. Attitudes towards alcoholism, sociodemographic variables, and motives for studying medicine were assessed with an online questionnaire. Students' readiness for cutbacks in health care expenditures of alcohol-dependent individuals was measured in relation to the other diseases, including psychiatric conditions (e. g. depression, schizophrenia), potentially stigmatized non-psychiatric disorders (e. g. AIDS), and potentially lifestyle-related acute (e.g. myocardial infarction) or chronic (e. g. diabetes) conditions. Data were analyzed with hierarchical logistic regression models. Results: Compared to other medical and mental diseases, alcoholism was by far the most frequently chosen condition with a potential for financial savings. In multivariate analyses, the preference for cutbacks was associated with the increased wish for social distance, high internal attribution of responsibility, low perceived severity and personal vulnerability, the absence of alcoholism in participants' social environment, and certain motives for studying medicine. Discussion: Since the majority of alcohol-dependent individuals avoid seeking addiction-specific help, physicians in primary care are often the only contact person in the health care system who can initiate health-related behavioral changes. However, persisting prejudges may affect the physician-patient-relationship and therapy adherence. Interventions aimed at reducing stigmatizing attitudes should be implemented at an early stage of medical education.

Abstract: Aim: Studies on brief interventions for Internet use disorders (IUD) are lacking. In this pilot study we tested the feasibility and preliminary efficacy of an approach applying Motivational Interviewing and elements of cognitive behavioral therapy. Methods: Clients in four job centers and the job agency in Lübeck, Germany, were approached for a proactive screening in order to identify problematic Internet use or IUD with the Compulsive Internet Use Scale (CIUS). Screening-positives were checked in a clinical interview for fulfilling three or more criteria according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Participants were randomized into intervention (personal counselling and up to three counselling sessions via telephone) and control group. A two-month follow-up was conducted. Results: Of all 3,600 clients approached, 1680 clients could be screened and 298 were screening-positive (17.7%). After a diagnostic interview 36 participants could be allocated to intervention and control group. In the two-months follow-up, decrease of problematic Internet use was higher in the intervention group, although not statistically significant (p=.216) (0.216) a small to medium effect size could be observed. Conclusion: The feasibility of this early intervention approach was evident. Larger sample sizes are needed to examine the efficacy of similar interventions. Findings of this study are promising and suggest future research. Evidence of effectiveness of such short interventions could enhance the impact and magnitude of measures and make an important contribution to preventative efforts.

Zusammenfassung. Einführung und Zielsetzung: Die COVID-19 Pandemie und die entsprechenden Lockdown-Maßnahmen verdeutlichen, dass besondere Strategien der Verhaltens- und Verhältnisprävention für Online-Verhaltenssüchte notwendig sind. Begründung: Die Wahrscheinlichkeit ist hoch, dass die COVID-19 Krise und die begleitenden Maßnahmen zu deren Eindämmung die Risiken für die Entwicklung von Verhaltenssüchten erhöht haben. Dazu tragen Faktoren wie Fortfall von terrestrischen Angeboten, soziale Isolation und erzwungene Inaktivität sowie Bedeutungsgewinn von Online-Angeboten bei. Gleichzeitig können als Folge bei bereits bestehenden Störungen die Schwere zu- und Remissionschancen abgenommen haben. Auch von einem erhöhten Rückfallrisiko kann ausgegangen werden. Schlussfolgerung: Es sind epidemiologische Studien notwendig, um veränderte Prävalenzen, Versorgungsbedarfe und geänderte Risikofaktoren zu erfassen. Es besteht die Notwendigkeit, Maßnahmen der Verhältnis- und Verhaltensprävention zu entwickeln und umzusetzen. Die Identifizierung von Risikoverhalten wäre durch Tracking des Online-Verhaltens möglich und könnte Ausgangspunkt für Maßnahmen wie Spiel- oder Anwendungspausen, Warnhinweise und Verbraucherschutzinformationen sowie konkrete Angebote der Frühintervention oder weitergehende Hilfen sein. Die Anbieter stehen hier in der Pflicht, Verantwortung für ihre Produkte zu übernehmen, das Risiko von Verhaltenssüchten zu minimieren und Maßnahmen von Frühentdeckung und Intervention zu ermöglichen und bereitzustellen.