Suchergebnisse

<b><i>Background:</i></b> Abstinence-related self-efficacy and action-oriented motivation to change addictive behaviours have been demonstrated to be important predictors of post-treatment drinking. However, there are only a few studies that assess drinking outcomes through a long-term follow-up interval. <b><i>Objectives:</i></b> The purpose of this longitudinal observational study is to evaluate whether self-efficacy and motivation at a 1-year follow-up mediate the relationship of self-efficacy at discharge from residential treatment with drinking outcomes at 5-year follow-up. <b><i>Method:</i></b> Simple and serial multiple mediation analyses were conducted on data collected from 263 patients (174 men, 89 women) with severe alcohol use disorder (AUD). Self-efficacy was measured at discharge and 1-year follow-up, and motivation was also measured at 1-year follow-up. Abstinence, percent days of abstinence (PDA), and drinks per drinking day (DDD) were used as drinking outcomes at 5-year follow-up. Exploring the indirect paths provided details about the interrelationship between self-efficacy and motivation. <b><i>Results:</i></b> Self-efficacy at discharge predicted abstinence and PDA. The mediation models suggest that self-efficacy at discharge was associated with self-efficacy and motivation at 1-year follow-up, which in turn was related to better long-term drinking outcomes, in particular for abstinence and PDA at 5-year follow-up. No such effects were found for DDD. <b><i>Conclusions:</i></b> The results indicate that self-efficacy and motivation are interrelated in improving long-term abstinence and PDA following residential treatments and may play a substantial role in recovery from AUD.

Infertility is a stressful experience, yet little is known about the specific issues confronting infertile women. In the present study, researchers sought to identify themes important to infertile women and examine possible associations with mental health levels. Using qualitative content analysis, researchers analyzed the email messages of 57 infertile women participating in a German-language Internet-based treatment for infertility. The themes most important to infertile women were emotions surrounding their wish for a child, coping with this unfulfilled wish, and medical aspects. Clinically anxious women reported substantially and significantly more negative and positive emotions than non-anxious women did (Mann-Whitney U(1)=178; p=0.034). Participants who were both clinically anxious and depressed reported more negative emotions and substantially fewer positive emotions when compared to participants who were solely anxious. The themes identified, considered important by infertile women, could be helpful to health professionals working in fertility treatment.

Abstract. Aim: In the research and treatment of Substance Use Disorders (SUDs), craving for alcohol, nicotine, and drugs is an important concept associated with addictive processes, including relapse after treatment. The 12-item Mannheimer Craving Scale (MaCS) has been proved to be an economic, reliable, and valid self-rating instrument across several substances in German samples. The aim of this study was to examine its psychometric characteristics in a Swiss German sample. Method: Overall, 166 patients were recruited from an inpatient SUD treatment program at the University Hospital of Psychiatry in Bern, Switzerland. Results: The internal consistency was high and the test-retest reliability was satisfactory. The total scale and three specific analogue craving measures were highly correlated. Principal component analysis extracted two factors, explaining 62 % of the total variance, and these factors were confirmed through confirmatory factor analysis. However, the two factors correlated highly, and several items loaded on both factors, so that the factor structure was inconclusive. Conclusions: The psychometric characteristics of the MaCS in a Swiss German sample are as good as those characteristics of the German version, suggesting that it is a valid and reliable measure. The MaCS factor structure must be examined on a larger sample that integrates a broader range of SUDs and their severities.

The loss of an intimate partner in the second half of life is a major challenge and a critical life event. Even if, for most individuals, a critical life event is stressful and psychologically and socially destabilizing, the ways of coping with it and the long-term outcomes (ranging from increased vulnerability to stabilization and growth) are very different. Whether or not this critical life event turns out to be a chronic stressor depends on the individual's personal and social resources. Based on recent research, we propose a complementary and extended view of the crisis and chronic stress models of adjustment to critical life events (Amato, 2000) Lorenz et al., 2006). In fact, turning point experiences bear the potential for new chances, the awakening of a person's potential, overcoming the crisis and contributing to personal growth. For others, however, the same turning point is not only a crisis, but can also mean the onset of chronic disadvantage and stress with the threat of loss of control and increased physical, psychological and social vulnerability. What we also know from life-span and differential psychology is that there is a considerable continuity in psychological well-being over the life-span, independent of adversities and losses (Perrig-Chiello, Jäggi, Buschkühl, Stähelin, & Perrig, 2009).
Based on these insights, the rationale of our project is a transactional model of personality, which claims that individuals try to cope with negative life events (turning points) by activating their available personal and external resources. This view postulates that individuals – based on their biographical experience (e.g., attachment style, past experiences with silent and age-normed transitions, quality of relationship with partner/spouse) and on their actual physical, psychological (e.g., personality; control beliefs; self-esteem; and personal, familial and cultural values) and social resources (e.g., having children, relatives, friends to rely upon) – develop strategies, which allow them to adapt their life perspectives in order to bring continuity in their lives and assure their well-being. We therefore expect that there is a considerable biographical continuity in the way individuals cope with critical life events, and that the loss of an intimate partner is solved in very similar ways. We conceptualize these strategies as adaptive mental mechanisms (such as control beliefs). Based on an integrated bottom-up/top-down conception of subjective well-being (Schimmak, 2007), we expect that the impact of both top-down (dispositional variables, personality) and bottom-up variables (life conditions, financial satisfaction) are essential for the explanation of the outcome variables. However, we anticipate that top-down processes contribute substantial amounts of variance to well-being measures compared to bottom-up effects, which are expected to be less important. Based on subjective well-being research, we hypothesize that the process of coping with loss involves several phases.
First, the period during which the loss occurs (i.e., the first year of loss) is a time of destabilization (periphase). This is followed by a phase of active adaptation to the new situation (second and third years after the loss, past-phase). Finally, a phase of stabilization and return to the habitual baseline level can be expected.
Building upon this theoretical framework and considering the different research gaps outlined above, this project will focus on the following areas:
a) The incidence of bereavement, separation and divorce (cause, point in time) in a representative sample belonging to two age groups (middle and old age). These groups will represent both the German and French-speaking parts of Switzerland.
b) The reasons and circumstances of bereavement, separation and divorce, i.e., the quality of the relationship, marital and sexual satisfaction, agency (initiator or reactor), perceived level of anticipation and control (mastery).
c) The determinants that lead either to (increased) vulnerability or growth after experiencing the loss of an intimate partner. This analysis will take into account the following individual resources: psychological resources (personality; coping style; character strength; personal, familial, cultural and spiritual values; control beliefs; early childhood experiences/attachment; experience of silent and age-normed transitions), social resources (having children, partner, parents, friends), and financial resources and SES.
d) The short-term and long-term outcomes and the process of coping with this critical life event: psychological well-being (mastery, life satisfaction, sense of life), physical well-being (subjective health, health complaints, medication intake), social well-being (emotional and social loneliness, quality of contacts) and financial well-being in the different phases of coping. We will examine the first year of loss (phase of destabilization, peri-phase), the phase of adaptation (2-3 years after loss) and the post-phase or phase of stabilization (3-5 years after loss).


More specially, tthe scientific goals are:
- To initiate a prospective study, where men and women recently divorced and widowed after a long-term marriage are compared to long-term married persons (controls) (data collection 1st wave 2012; second wave 2014, third wave 2016).
- To investigate the reasons and circumstances of bereavement, separation and divorce, i.e., the quality of the relationship, marital and sexual satisfaction, agency (initiator or reactor), perceived level of anticipation and control.
- To analyse the determinants that lead either to vulnerability or growth after experiencing the break-up of marriage or partnership. These analyses will take into account the following individual resources: past critical life events and life trajectories (using a life calendar); psychological resources (personality; coping style; character strength; personal, familial, cultural and spiritual values; control beliefs; early childhood experiences/attachment; experience of silent and age-normed transitions), social resources (children, partner, parents, friends), financial resources and SES.
- To examine the process of psychosocial adaptation to the critical life event and the short-term and long-term outcomes: psychological well-being, physical well-being (subjective health, health complaints, and medication intake), social well-being (emotional and social loneliness, quality of contacts) and financial well-being in the different phases of coping. We will examine the first phase of loss (phase of destabilization, i.e. first two years), the phase of adaptation (2-5 years after loss) and the phase of stabilization (5> years after loss).
The middle and long-term scientific goals of the study are (2013/2014 and beyond):
- Dissemination of research findings (publication in national and international journals, presentation at national and international conferences), and practice (publications, presentations, training, teaching).


Research aimes Phase II (2015 - 2018):

- Continuation of survey (3rd wave 2016):
a) to track the trajectories of psychological adaptation to spousal loss and marital breakup after a long-term relationship;
b) to explore continuities and change in marital satisfaction in long-term married.
- Intervention for vulnerable individuals (complicated grief after separation, divorce, widowhood) recruited from the 2nd wave 2014 (and additinal recruitement).
- Exploration of identity processes and social groups as resources for overcoming psychological vulnerability (especially due to loneliness) in older age.