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Biomedical subjects

Elmar Brähler

Publications and source records attributed to Elmar Brähler.

At least 19 recordsLinked to original sources
PubMed2006

The prevalence of body dysmorphic disorder: a population-based survey.

BACKGROUND: Body dysmorphic disorder (BDD) is a highly distressing and impairing disorder characterized by a preoccupation with imagined or slight physical defects in appearance. Well designed studies on its prevalence and on base rates for diagnostic criteria are rare. Therefore this study aimed to reveal prevalence rates of BDD in the general population and to examine clinical features associated with BDD. METHOD: Of 4152 selected participants 2552, aged 14-99 years, participated in this German nationwide survey. Participants were carefully selected to ensure that the sample was representative; they were visited by a study assistant who provided instructions and help if needed. Participation rate was 62.3%. DSM-IV criteria for BDD, as well as subthreshold features (e.g. individuals who consider some part(s) of their body as ugly or disfigured, but do not fulfill all BDD criteria) were examined. We also assessed suicidal ideation associated with the belief of having an ugly body part, as well as the desire for cosmetic surgery. Furthermore, somatization symptoms were assessed. RESULTS: The prevalence of current BDD was 1.7% (CI 1.2-2.1%). Individuals with BDD reported higher rates of suicidal ideation (19% v. 3%) and suicide attempts due to appearance concerns (7% v. 1%) than individuals who did not meet criteria for BDD. Somatization scores were also increased in individuals with BDD, relative to those without. BDD was associated with lower financial income, lower rates of living with a partner, and higher rates of unemployment. CONCLUSIONS: Our study shows that self-reported BDD is relatively common and associated with significant morbidity.

Adolescent↗
PubMed2006

Ambivalent attitudes towards pre-implantation genetic diagnosis in Germany.

BACKGROUND: Pre-implantation genetic diagnosis (PGD) is a modern technique in reproductive medicine which can be used to diagnose genetic disorders of an embryo. PGD is currently not legal in Germany, still there are debates being held regarding the issue of legalization. Both the internationally "accepted" indications and new or alternative approaches can lead to complex ethical dilemmas. The attitudes towards PGD have rarely been assessed in the general population. METHODS: In our study, 2110 persons aged 18-50 years were interviewed about their attitudes towards PGD and related topics. We assumed that religion, world views and the evaluation of PGD would influence the attitude a person has towards this procedure. RESULTS AND CONCLUSIONS: In our survey, the majority of respondents would agree to a restricted legalization of PGD in Germany. Our results also confirmed some of our assumptions but religion did not have the expected influence. The evaluation of costs and benefits of PGD and the feelings associated with this technique explained more of the final attitude whether PGD should remain prohibited in Germany or not. The agreement to a restricted legalization may be connected to an overall rejection of prohibitions made by the state concerning the individual reproductive autonomy.

Adolescent↗
PubMed2006

[The Quality of Life Questionnaire EQ-5D: modelling and norm values for the general population].

The EQ-5D is a short questionnaire for measuring health related quality of life. The aim of the present study is to test psychometric properties of this instrument when applied to the general population. 2022 subjects between 16 and 93 years of age were randomly selected and tested with the EQ-5D. 60 % of the sample reported no health problems in all items, that is, there was a great ceiling effect. The comparison between two models with preference based index measurement and one simple sum score showed that the sum score is at least as appropriate as the two other more sophisticated models. The visual analogue scale of the EQ-5D proved to be practicable and useful for the application in the general population. Norm values for the visual analogue scale and the EQ-5D are presented.

Adolescent↗
PubMed2005

Hazardous alcohol consumption and sense of coherence in emergency department patients with minor trauma.

BACKGROUND: The concept of sense of coherence (SOC) measures the extent to which people are able to cope with stressful life events. Since excessive alcohol consumption may be, in part, the result of failed coping strategies, further investigations between hazardous alcohol consumption and SOC are necessary. METHODS: Survey in an Emergency Department in an inner city university hospital. Overall, 1,833 patients were screened for hazardous alcohol consumption, illicit drug use, smoking status, socioeconomic status and sense of coherence. RESULTS: Mean age of participants was 34+/-12 years and 62% were male. Overall, 23% of patients showed a pattern of hazardous alcohol consumption, 23% had abused illicit drugs and 46% were smokers. Mean SOC score was 48.9+/-8.6 points, with no difference between genders. Lower SOC-quartiles were associated with significantly higher prevalence of hazardous alcohol consumption as well as illicit drug abuse and smoking. Lower SOC-quartiles were associated with significantly lower values on socioeconomic variables (e.g. lower income, less education). The negative association between SOC and alcohol consumption was independent of age, gender, smoking, illicit drug use and all socioeconomic variables. CONCLUSION: SOC and hazardous alcohol consumption were significantly associated. Our data support Antonovsky's original concept of increased alcohol consumption as a result of failed coping strategies.

Adult↗
PubMed2005

The 'wish to have a child', childlessness and infertility in Germany.

BACKGROUND: Based on the declining birth rates in Germany, one might assume that the number of people who unintentionally are without children is growing. However, studies over recent years have documented that the number of people who deliberately have no children is growing instead. METHODS: This report focuses on attitudes and motives which influence the realization of the desire to have a child. In a representative survey, 785 women and 795 men were questioned about their current wish to have a child, their ideal number of children and the motives for or against the decision to have a child. RESULTS AND CONCLUSIONS: Emotional aspects are the most important motives in favour of having children, and financial restraints are most frequently cited as arguments against parenthood in German society. Thus, deciding in favour or against having children still appears to be an indicator of social disparity, due to the fact that every realized child wish underlines the differences between parents and childless individuals through the increasing financial burdens. As a large number of individuals and couples in Germany postpone realization of their desire to have a child, this may lead to a change from a voluntary to an involuntary childlessness in the individual decision process. Therefore, education about fertility as a resource should be promoted.

Adolescent↗
PubMed2005

[Unemployment, job insecurity and life satisfaction: results of a study with young adults in the new German states].

OBJECTIVES: Based on research about the psychosocial aspects of experiencing unemployment, the present study analyses the effects of actual unemployment and the impact of being at risk of becoming unemployed and the influence of perceived job insecurity on life satisfaction. METHODS: In the 17th wave of the Saxon Longitudinal Study (Sächsische Längsschnittstudie) in 2003, 419 people (193 male, 226 female, mean age 30.05 years) were examined with a life satisfaction questionnaire. This questionnaire addresses eight areas of life satisfaction: friends, leisure time, health, income, job, housing, family, partnership. RESULTS: Two-thirds of the participants have had experiences with unemployment so far. People who had been unemployed several times were significantly more dissatisfied with their income, housing, profession and health. Still, considering people employed at the time of survey, the subjective job insecurity and the perceived risk of becoming unemployed had noticeably negative effects on life satisfaction. This could be also shown for areas which are not directly connected to occupation, such as friends and family life. CONCLUSIONS: The study emphasizes the known results regarding the connection between unemployment and (poor) life satisfaction. Evidence was provided that even the anticipated loss of the workplace causes a decrease in life satisfaction, affecting many areas of subjective evaluation.

Adult↗
PubMed2005

[The version 2.0 of the SF-36 Health Survey: results of a population-representative study].

OBJECTIVES: The SF-36 is an internationally approved instrument to assess subjective health. In its second version the SF-36 contains modifications to version 1.0 in several item formulations and response categories. The second version is translated in German but a psychometric analysis and standardisation are still lacking. METHODS: The SF-36, version 2.0, was administered in a representative German sample (n = 2043), analysed concerning its scale structure, reliability, dissemination characteristics and differences in traits of populations and compared to version 1.0 (German health survey). RESULTS: Version 2.0 shows high reliability in subscales and has a scale structure which is comparable to that of version 1.0. The scale values in the actual population-representative sample survey are rather distributed obliquely and effects of sex, age and residence (Eastern/Western Germany) have been found in regression analyses. CONCLUSION: The psychometric comparability of both versions is given but should interpreted with caution as regards content because of the different enquiry periods. Though the expected gain in psychometric quality and discrimination of version 2.0 to version 1.0 is evident, but does not justify a preference to version 2.0.

Adult↗
PubMed2005

[Screening for depression -- two questions practically oriented].

Despite the high epidemiological relevance of depressive disorders in daily clinical practice, they are insufficiently diagnosed. For screening, the U.S. Preventive Services Task Force proposed two questions aiming at finding depressive core symptoms: "Over the past two weeks, have you felt down, depressed, or helpless?" and "Over the past two weeks, have you felt little interest or pleasure in doing things?". We tested comparable questions in a representative sample from the German population. The correlations between the screening and validated questionnaires for depression point towards the validity of the screener. Relevant indices are satisfying: For major depression the sensitivity is 72.6% and specificity is 87.4%.

Adolescent↗
PubMed2005

[Is there a connection between right-wing extremism and social distancing from mentally ill people? Results from a representative survey among the adult German population].

OBJECTIVE: There are indications of a link between right-wing extremist orientation and attitudes towards people with mental illnesses. Social distance is used to investigate this. METHOD: In 2002, a representative survey was conducted among the German adult population (n = 2089). Social distance was measured using a question from the European values surveys. Right-wing extremist attitudes were measured with a scale developed by Niedermayer and Faller. RESULTS: Only a marginal link between right-wing extremism and social distance towards people with mental illnesses was found which, moreover, showed an inconsistent pattern. DISCUSSION: It would be premature to conclude from this "negative" finding that a right-wing extremist orientation has no influence on the attitude towards people with mental illnesses, especially in the light of only one form of discrimination being investigated here.

Adolescent↗
PubMed2005

[The German short version of "Profile of Mood States" (POMS): psychometric evaluation in a representative sample].

The German short version of "Profile of Mood States" (POMS) was psychometrically tested in a representative sample (1009 subjects in Eastern Germany and 1034 subjects in Western Germany). The 35 items (7 point scale, instruction "How you have been feeling during the past 24 hours?") form the following scales: Depression/Anxiety, Fatigue, Vigor, Hostility. The POMS appears to be an internally consistent instrument (Cronbach's Alpha from 0.89 to 0.95). Replication of the postulated 4 factors was limited. There are hints for convergent validity of POMS-Scales using two questions: "1. Over the past two weeks, have you felt down, depressed, or helpless?" and "2. Over the past two weeks, have you felt little interest or pleasure in doing things?"

Adolescent↗
PubMed2005

[Resilience as a protective personality characteristic in the elderly].

In a sample of elderly from the general population aged 60 years and older (N = 599, 53.6 % female; mean age 69.6 years) resilience was assessed as a protective personality factor for physical well-being by means of the resilience scale (RS; Wagnild and Young, 1993). The elderly reported lower subjective body complaints, when the amount of resilience was higher. The results of a regression analysis showed that resilience was a significant predictive variable for physical well-being besides age and sex. The amount of resilience was lower in women as in men. An age-related effect could not be found.

Aged↗
PubMed2005

[The H-index].

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Psychosomatic Medicine↗
PubMed2005

[Using content analysis in cross-cultural psychosomatic research].

The Gottschalk-Gleser-analysis, a content-analytical technique, measures anxious and aggressive affects. For decades this technique was primarily and widely implemented in psychosomatic research. Today, this technique is offered in numerous languages. Since this technique is time consuming in application and analysis, computer software has been developed for English (Psychiatric Content Analysis and Diagnosis, PCAD 2000) as well as for German contents (Dresdner Angstwörterbuch, DAW). This study compares the anxiety scale of both versions in order to evaluate their comparability in cross-cultural psychosomatic studies. The English and German version of 96 different abstracts of the German Journal for Psychotherapy, Psychosomatic Medicine and Medicine Psychology from 2003 and 2004 with a total of 31 000 words were compared. The scores of the Gottschalk-Gleser anxiety scales of both computer programs correlates between 0.21 and 0.59 (p < 0.05, only exception: shame anxiety). The means of the scores calculated by the PCAD and DAW significantly differ for all scales. Therefore, these two content analytical methods DAW and PCAD provide only limited use for cross-cultural comparisons in psychosomatic research.

Aggression↗
PubMed2005

Psychogenic urinary retention ('paruresis'): diagnosis and epidemiology in a representative male sample.

BACKGROUND: Although research interest in social phobias has expanded during the last decade, a special subtype of social phobia known as paruresis, which manifests in the inability to urinate in public rest rooms, is rarely mentioned. The aim of the present study was to achieve for the first time an estimation of point prevalence in a representative male sample (n = 1,105). METHOD: Due to the lack of well-established screening instruments for paruresis, the Paruresis Checklist (PCL) must be tested for reliability and validity. An empirically based cutoff score must be determined by using the subjective interference with everyday life as an external criterion. RESULTS: Reliability of the PCL seemed to be sufficient, and adequate evidence for validity was found. Using the empirically based cutoff score of the PCL, 2.8% of the sample was diagnosed as suffering from paruresis. In contrast to other forms of social phobia, paruresis is not associated with a lower educational or occupational level.

Adolescent↗
PubMed2004

Deep impact--evaluation in the sciences.

The purpose of the paper is to evaluate the psychometric properties of the impact factor as an assessment procedure. Detailed criteria regarding theoretical underpinnings, test administration, scoring and interpretation are applied. The impact factor appears to be of limited use for deciding which journals to subscribe. It is not suitable for evaluating achievements of individual scientists and research groups. The impact factor contains serious sources of errors and flaws resulting in strong biases against culture- and language-bound medical subspecialties and non-Anglo-American countries. Possible alternatives are discussed.

Humans↗