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M Beutel

Publications and source records attributed to M Beutel.

36 records · Page 2Linked to original sources
PubMed1995

[Coping with fetal death: complications, risk factors and potential physician support].

Only recently a stillbirth has been recognized as a major loss for the majority of women. Based on psychotherapeutic experience and clinical investigations, symptoms and risk factors of normal and pathological courses of grief are delineated and illustrated by a case vignette. Risk factors for complicated grief refer to quality of inpatient care, partner support, previous depression, anxiety or unresolved strain. Recommendations for inpatient care include validating the loss, making it real, enabling the bereaved parents to make informed decisions. Ambulatory after care should provide for monitoring and supporting the grief process.

Adaptation, Psychological↗
PubMed1994

[Long-term psychological sequelae of spontaneous abortion: do medical management, recent pregnancy and delivery really help in coping with grief?].

86 patients with spontaneous abortion were interviewed and followed up in a longitudinal study with an interview and standardised questionnaires shortly after the D&C at 7, 13 and 24 months later. Our results indicate profound and long-term adverse psychological sequelae. For most of the patients, a spontaneous abortion was considered to be of major importance. Without regard to the gestational age or ultrasonographic image, the embryo is represented early in fantasies and dreams as a child. The severity of grief reactions following abortion did not correlate well with gestational age or a new pregnancy. Mourning is still present 24 months after the abortion. While grief decreases continuously during the first 7 months following abortion, despair remains constant and self-reproachful coping shows even a statistically significant increase between months 13 and 24. The reason is, because 20% of patients develop a pathological grief reaction with an increase in depression, self-reproachful coping and physical complaints. This risk group of patients, who needs closer and more detailed observation and guidance, may be recognised as early as at the time of abortion.

Abortion, Spontaneous↗
PubMed1993

[Chronic grief after spontaneous abortion: results of a longitudinal study after 13 months].

Presented are follow-up results on coping with spontaneous abortion. Although the majority of women feel that this is a significant negative life event, their grief gradually decreases within 7 to 13 months. Compared to population standards they are neither depressed nor do they suffer from increased physical complaints. A subgroup of women is identified with chronic ("pathological") grief based on increased or rising levels of grief (PGS), depression (SCL-90) and physical complaints (BL). Independently from a following pregnancy these women (about 20%) report a high importance of their abortion, painful feelings in seeing pregnant women and babies and fears of another abortion even after 13 months. Scores immediately after the abortion permit a good discrimination of patients with chronic grief and uncomplicated course: Patients who later develop chronic grief report a high level of negative feelings during the pregnancy leading to the loss, extensive preparations for the expected baby, an unsettled vocational and family situation and intensive strains and despair immediately thereafter. Conditions and ways of grieving with this specific loss are discussed.

Abortion, Spontaneous↗
PubMed1992

[Grief, depression and anxiety after spontaneous abortion--a study of systematic evaluation and factors of influence].

Recent studies demonstrate profound and long-lasting adverse psychological and family sequelae of a spontaneous abortion. However, decisive issues of quality, course and determinants cannot be answered sufficiently due to shortcomings of research (e.g. lack of representative samples and adequate measures, reliance on cross-sectional study designs). Grief reactions and their determinants are differentiated in relation to depressiveness and anxiety in 86 patients from a longitudinal study, employing the Perinatal Grief Scale (Thoedter et al. 1988) and standardized symptom checklists. For the majority of the women, around the 10th week of gestation, the embryo is psychologically represented in fantasies, dreams and concrete arrangements in reality. Immediately after the abortion, these women react with painful feelings of "active grief" and "despair". Additional stresses in the pregnancy and lack of social support predict "self-reproachful coping". Women with recurrent abortions who have no children show depressive reactions. Retrospectively, these also present more anxiety and depressive moods during pregnancy. Results support reliability and validity of the grief scale. Implications for counselling and psychotherapy of women after a spontaneous abortion are discussed with respect to these risk constellations.

Abortion, Spontaneous↗
PubMed1991

[Psychobiology of grief and loss processing--recent immunologic and endocrinologic approaches and findings].

Recent studies demonstrate the importance of social relationships for maintaining health. As mechanisms remain hidden in ongoing relationships, much of our knowledge comes from the deleterious health consequences of loss or separation. Despite the central importance of object loss in psychosomatic models of disease, physiological links have hardly been explored. After a short review of psychological processes of mourning, recent psychoimmunological and endocrinological studies are discussed. These show fairly consistent immunosuppressive effects of depressive disorders and of impending and actual loss of the partner and endocrinological changes, also related in magnitude to depression. First results of intervention studies show favorable endocrinological and immunological changes presumably due to promotion of social relations and reduction of distress. Despite manifold methodological problems this approach provides a promising access towards understanding the meaning of social relations for physiological regulation. Decisive issues of the relationship of immunological and endocrinological changes and their clinical relevance must await further longitudinal studies which should include a more detailed psychological analysis of mourning and object relations.

Adaptation, Psychological↗
PubMed1990

[Adaptation of permanent bovine kidney cells to serum free hormone supplemented cell culture media].

The examinations show, that it is possible to adapt MDBK-cells (ATCC CCL 22) to serum-poor (0.1% fetal calf serum) and to serum-free, adequate supplemented media. Morphology of the cells remained unchanged. The components of the serum-free medium are a 50:50 mixture of Dulbecco's modified Eagle's medium and HAM's F12 medium, supplemented with insulin (5 micrograms ml-1), transferrin (10 micrograms ml-1), thyroglobulin (10 micrograms ml-1), prostaglandin E1 (50-100 ng ml-1). Seeding cells at a density of 26.10(3) cm-2 at day 0 resulted in better multiplication than a higher seeding density.

Animals↗
PubMed1989

[What protects health? On the research status and importance of personal resources in managing daily stresses and life change events].

In recent developmental and psychosomatic studies the focus shifts from pathogenic to health protective factors. Literature on coping with daily stresses, life events and biographic determinants is reviewed. Despite conceptual (negative health definitions, divergent theoretical backgrounds and values) and methodological problems (reliance on self-report and trait measurement) moderate, however consistent health protective affects of personal resources are shown. These are mainly generalized attitudes of persons toward self and their environment (e.g. optimism, internal locus of control, self-efficacy, commitment). Contrasting influential concepts (sense of coherence, hardiness) the bias toward self-reliant, internal control as health protective resource is criticized and a plea is made for conjoint consideration of health-protective influences of social relationships.

Adaptation, Psychological↗
PubMed1988

[Alcoholism--development and treatment from the psychoanalytic viewpoint].

Based on psychoanalytical explanatory models 4 groups of alcoholics can be distinguished: 1. Alcoholics with severe character disorder use their drug as a mean of self-punishment by self-destruction. 2. Alcoholics with low ego strength use alcohol as a stimulus barrier in an attempt at self-healing. 3. In predominantly neurotic patients alcohol consumption is considered as a regression to an oral level of drive satisfaction. 4. Alcoholism as a reaction to adverse life events is not adequately taken into account by classical analytical theory. Depending on the predominant level of personal pathology differential treatment indications are recommended.

Alcohol Drinking↗
PubMed1985

Approaches to taxonomy and measurement of adaptation in chronic disease.

The concept of adaptation has gained central importance in research on chronic disease. The article reviews recent developments in the major theoretical concepts, coping, defense and social support. A schema for classification is introduced distinguishing coping and defense processes at the individual (cognitive-emotional and behavioral), interpersonal and institutional levels. Some often neglected aspects of the evaluation (concerning temporal orientation, level, areas and perspective of rater) are pointed out. Underlying methodological aspects are briefly reviewed. Applying conceptual demands of theories of adaptation to research on chronic disease shows major research deficits, especially a lack of accepted definitions of adjustment, a preference for static, one-dimensional and cross-sectional research and a lack of adequate assessment procedures. Desiderata for future research are suggested.

Adaptation, Psychological↗
PubMedDate not supplied

Grief and depression after miscarriage: their separation, antecedents, and course.

Bereavement is a major risk factor for physical illness, grief, depression, and anxiety. In contrast to recent tendencies in the psychiatric literature to equate grief and depression, we propose that a careful discrimination between the two must be made for diagnostic, therapeutic, and investigative purposes. We report the results of a longitudinal study of a frequent but neglected event, miscarriage early in pregnancy, to make this point. Clinical criteria for differentiating grief and depressive reactions were developed based on phenomenological criteria and theoretical considerations. We hypothesized that the detrimental psychological and physical consequences occur only when the miscarriage was not mourned and resulted in a depressive reaction, but not in a grief reaction. In a controlled, representative study, 125 consecutive women were assessed shortly after their miscarriage (before the 20th week of gestation) and 6 months (N = 94) and 12 months (N = 90) later. Assessments included standardized questionnaires for life events, depression, physical complaints, anxiety, and a specific, multidimensional grief scale (Munich Grief Scale) that we had developed previously. Immediately after the miscarriage, the average anxiety and depression scores were elevated when compared with 80 pregnant and 125 age-matched community controls. Twenty percent of the patients who had miscarried showed a grief reaction, 12% showed a depressive reaction, and 20% responded with a combined depressive and grief reaction. The remaining women (48%) reported no changes in their emotional reactions. As predicted, longer-lasting psychological, social, and health status changes followed the initial depressive, but not the grief reactions. Depressive reactions were predicted by a history of previous depression, a lack of social resources, and an ambivalent attitude to the lost fetus. The grief measures were reliable and made it possible to discriminate between grief and depression.

Abortion, Spontaneous↗
PubMedDate not supplied

[Work and vocational integration of psychosomatic patients--utilization and indications for a workload tryout program].

The effect of a professional workload test was assessed in a longitudinal study with 80 patients psychosomatic rehabilitation during and following their. In a second study indication criteria were tested with 358 consecutive patients. Participants in the workload program show an improvement of their work ability and job performance according to self-appraisal, superior appraisal and medical assessment. Work ability was still maintained 7 months after treatment. Patients with lasting work disability and unemployment not only show negative work-related attitudes, but also elevated psychological symptoms and a reduced quality of life. The program participants show high levels of psychological strain but also a stronger disposition to change the professional situation. Negative work-related and psychological consequences of lasting disability and unemployment deserve more attention in inpatient psychosomatic treatment.

Adult↗
PubMedDate not supplied

[Assessment of grief exemplified pregnancy loss: development and initial results on the validity of the Munich Grief Scale].

Bereavement research is hampered conceptually by confounding of grief and depression, methodologically by a lack of generally agreed-upon measures. Therefore we developed the Munich Grief Scale (MGS) based on the Perinatal Grief Scale (PGS, Potvin et al. 1989) and results from a previous study. Validation included comparisons with standardized self-report scales of depression, anxiety and physical symptoms. It was based on a follow-up study of 125 patients who had miscarried and 3 comparison groups who either suffered from a miscarriage or a stillbirth. Self-reports were compared to expert ratings of grief and depression. The MGS is a economical, reliable self- and expert rating scale after pregnancy loss. The applicability of the grief measures to other kinds of bereavements remains to be determined.

Abortion, Spontaneous↗
PubMedDate not supplied

[Mutual stress and support in couples with one cancer patient].

Sources of distress and support were assessed in a prospective study covering 149 couples with a cancer patient on outpatient chemotherapy, with an overall equally high impact of disease. Distress levels in spouses were found as high as in patients, showing a moderate relation within couples. From multivariate regression analyses spouses' distress proved predominantly determined by characteristics of illness. When broken down according to gender, factors contributing to couples' distress varied. Couples' distress was found more closely related to each other with female patients, with spouses relying more on their ill wives, compared to couples with male patients. Whereas female patients' distress was determined by the degree of role limitations, male patients appeared more vulnerable to the psychological impact of illness. Though couples' estimated social support from various sources was estimated greatly helpful, no effects were found on patients' and spouses' distress, respectively. Conclusions in respect of family-oriented interventions are discussed.

Adaptation, Psychological↗