The perception of one's own body through external sensory channels, understood as exteroception, is a central component of various psychological processes and has been associated with different mental disorders. The Exteroceptive Body Awareness Questionnaire (EBA-Q) is an instrument for assessing the ability to perceive one's own body based on exteroceptive signals and to correctly evaluate changes. As no validated German-language version is currently available, the aim of the study was to psychometrically test the German-language version of the EBA-Q.

The pilot study presented here examines young adults who, according to their own statements, have committed sexually motivated crimes but have not been legally convicted for them. The objectives of this study are (1) to understand how the participants experience the processing of sexual boundary violations they have committed, to (2) derive implications for the psychotherapeutic assistance of these processes. Special attention is paid here to the investigation of feelings of guilt and shame, cognitive dissonance, defense mechanisms and coping as well as the influences of the participants' early biographical relationship experiences and political attitudes.The study was conducted by interviewing clients of a counseling center for minors and young adults with sexually deviant and boundary violating behavior between the ages of 20 and 29. Four qualitative interviews were administered and analyzed using Interpretative Phenomenological Analysis.The participants report disparate effects of feelings of guilt and shame, as well as cognitive dissonance, regarding their experiences and behavior during the processing of their sexual boundary violations. Feelings of guilt and shame are involved in both the increase and decrease of motivation for change in different phases of the process. Participants report dissonant cognitions regarding their self-worth, moral values, and political attitudes, which appear to be evoked particularly by strong self-stigmatization. To reduce associated feelings of cognitive dissonance, participants utilize certain defense strategies such as avoidance, rationalization or suppression and coping mechanisms such as self-reflection, acceptance, taking responsibility or doing self-care.The results suggest that the consideration of the factors assessed in this study could contribute to promoting active engagement and individual responsibility-taking in working with sexually delinquent individuals. A sensitive and professional framework for processing sexual delinquency based on these criteria could help identify and reduce potential disruptions in the therapeutic process early on, detecting stigmatizing judgments, aversive emotions and dysfunctional defenses.

This article examines the challenges and opportunities arising from the increasing digitization of data in medical research and care, focusing on psychosomatics. The aim is to shed light on the advantages and disadvantages of collecting, standardizing, evaluating, and using extensive health data, for example, for Artificial intelligence (AI) applications. The article highlights patient consent using "broad consent" as a central aspect. In the context of digital sovereignty, it is crucial to focus on and empower both patients and practitioners. This is the only way to ensure that the future of psychosomatic medicine is shaped by all involved in a value-based and responsible manner.

The aim of this explorative study was to quantify psychosocial distress, needs and resources among German intensive care unit (ICU) healthcare professionals.An anonymous online survey was used to collect data from N=73 healthcare professionals working in German ICUs. Various stress factors and resources were recorded on an individual, interpersonal, work-related and structural level, using validated questionnaire measures (PSC-4, TAA-KH-S, irritation scale, COPSOQ), among others. In addition, needs for psychosocial support measures were determined using self-developed items and in free text format.For more than 50% of respondents, the PSC-4, the subscales of the TAA-KH-S and the irritation scale were in the marginal or critical range. Regarding the COPSOQ, there were meaningful differences to the overall population on the subscales Emotional Demands, Hiding Emotions, Work-Privacy Conflicts, Dissolution and Recognition, indicating increased stress in our sample. With regard to desired support measures, the demand for psychological support on and off the ward was evident in two thirds of respondents. Over 90% rated the establishment of a team-integrated psychologist as somewhat or very useful.Increased stress is particularly evident at an individual, work-related and structural level, while existing resources were primarily expressed at an individual and interpersonal level. There is a great desire to expand structural, psychosocial support measures among the majority of respondents.The results underline the need for action identified by professional associations regarding the expansion of support services.

Amyotrophic lateral sclerosis (ALS) is associated with elevated distress, but evidence on psychosocial interventions is limited. We tested the feasibility of a psychotherapy for palliative cancer patients in ALS patients.We applied CALM (Managing Cancer and Living Meaningfully), an effective psychodynamic short-term therapy for advanced cancer patients, within a pre-post study among patients with ALS. We provided patient flow and formal treatment information. Based on the treatment protocols, the therapist reflected on the applicability of the treatment structure, specifics in the psychosocial work with ALS patients and suggestions for treatment modification.Among 15 eligible patients, five participated. Three patients completed the treatment, two patients provided complete study data. The trial was prematurely stopped due to issues in feasibility. Six (22%) sessions were conducted via telephone, 10 (37%) were attended by family caregivers. The structure showed limited applicability largely because fear-laden topics including suffering and death were extensively avoided. Compared to palliative cancer patients, ALS patients fluctuated more strongly in their psychological and physical symptom burden and were more strongly distressed by disease-related practical issues. Recommendations included a multi-professional team, booster sessions and a direct support for caregivers.A psychotherapy effective for cancer patients showed features that limit its applicability among ALS patients. Some of these limitations are treatment-inherent and thus hard to adapt. Rather than modifying the program, we suggest to develop a specific supportive psychotherapeutic intervention within a participatory approach.

The aim of this qualitative study is to investigate the views of hospitalized dermatology patients on a psychosomatic early detection measure.This qualitative study comprises a nurse-led psychosomatic screening followed by consultation on dermatology wards at the University Medical Center Hamburg-Eppendorf, Germany. For an initial screening, the Patient Health Questionnaire-4 (PHQ-4) was used by nurses during patient admission. All patients were interviewed once during their inpatient stay and once at least four weeks after discharge. The interviews were analyzed using thematic analysis.Nine patients (M=50.1 years; 4 women, 5 men; 18-84 years) who were positively screened for depressive symptoms or anxiety using the Patient Health Questionnaire-4 as part of a psychosomatic screening process were recruited for the study. Qualitative analysis identified seven themes, including appreciation of holistic care, stigma, barriers to psychological treatment and the structure of the screening process. In general, all patients appreciated the additional psychosomatic care, but also pointed out some barriers, such as long waiting times for therapy and stigmatization of psychosomatic illnesses.The qualitative results underline the positive attitude of dermatologically treated inpatients towards psychosomatic screening as an early detection measure in somatic care: On the one hand, the holistic care approach was welcomed, on the other hand, the combination of early detection measures and subsequent psychosomatic consultation was appreciated. Stigmatization of psychosomatic illness and systemic barriers were seen as challenges. Future studies should increase the sample size and extend the research question to other disciplines.

Many of those who were politically persecuted in the GDR still suffer from the health, economic and psychosocial consequences to this day. Little research has been carried out into the after-effects of the state's deliberate stigmatization, through which people were assigned negative stereotypes, socially excluded and politically delegitimized. It can be assumed that structural stigmatization processes in particular continue to exist in institutional practices after the system change. Discrimination and different treatment of those affected can have far-reaching consequences, particularly in healthcare. In addition to a theoretical introduction to stigma research, the question of the extent to which those affected are still exposed to structural disadvantages in the healthcare system, what hurdles they experience and how they perceive them will be explored.As part of the qualitative study, 20 guided interviews with a high narrative component were conducted, transcribed in terms of content and semantics and then analysed using MAXQDA software and grounded theory methodology.The results make it clear that those affected by GDR injustice anticipate or experience structural stigmatization in the context of healthcare. In addition to the perception of general care problems, specific hurdles and requirements resulting from the experience of injustice in the GDR were described. In particular, competence barriers are mentioned in contact with professionals. Individual consequences for those affected can be seen on a psychological, emotional and behavioral level.The results make it clear that the health burdens experienced by those affected cannot be attributed solely to the injustice experienced in the GDR, but can also be exacerbated by the structural stigmatisation processes currently experienced in healthcare. Limitations and practical implications are discussed.There is an urgent need to sensitize professionals to these connections, also with regard to intersectional attributions of characteristics.

Following the ruling of the Federal Constitutional Court, the number of assisted suicides in Germany has been increasing. However, the psychological and psychosocial burden experienced by relatives in this context remains insufficiently explored. This study aims to examine specific stress factors and the motivations for seeking support from a specialized counseling center for relatives of individuals who are considering or have undergone assisted suicide.This cross-sectional study analyzes baseline data from relatives (=23). In addition to sociodemographic characteristics, the study examines psychological stress factors, decision-making processes, and concerns of the relatives, as well as the illnesses and motives for assisted suicide of the individuals seeking to end their lives. Depressive symptoms were assessed using the Patient Health Questionnaire. Data were collected through structured questionnaires and qualitative free-text responses, which were analyzed using qualitative content analysis.The majority of relatives (83%) sought support during the period preceding the assisted suicide, particularly when a fixed date for the death had already been set. Among the participants, 30.4% exhibited moderate depressive symptoms, while 47.8% showed mild depressive symptoms. Key stress factors included ambivalent feelings between offering support and maintaining distance, moral conflicts, uncertainty about one's own role, anticipatory grief, and navigating the planning process leading up to the assisted suicide, including the day of death. Additionally, relatives reported experiencing social stigmatization and difficulties discussing assisted suicide with others. The most commonly cited reasons for assisted suicide among the individuals seeking to end their lives were the desire for control over their own death, fear of dying in an undignified manner, and loss of autonomy.The results showed that family members of individuals who choose assisted suicide are exposed to significant emotional distress. In particular, anticipatory grief and the awareness of a predetermined time of death led to a complex emotional experience marked by feelings of guilt and helplessness. Moreover, there is a high need for counseling, especially regarding emotional processing, legal uncertainties, and social support after the loss.These findings highlight the considerable emotional burden experienced by those close to individuals who undergo assisted suicide and emphasize the need for targeted psychosocial support. Future research should further explore effective counseling approaches to address anticipatory grief, moral conflicts, and social stigmatization in this context.

For many psychotherapists, the suicide of a patient is accompanied by strong emotional and professional effects. The aim of the present study was to investigate the processing of such an event by affected practitioners.An online study was conducted with a focus on various potentially influencing factors, such as the subsequent receipt of supervision, the (professional) exchange with team colleagues and friends, as well as the anticipated predictability and avoidability of patient suicide. It was also analyzed to what extent the level of experience of the practitioners and the age of the suicidal person had an effect on the stress experienced by the practitioners after a patient suicide. The Impact of Event Scale (IES-R) was used as a key indicator of the stress experience.The study involved n=117 practicing practitioners, predominantly psychological and medical psychotherapists and psychotherapists in training. A key finding of this study was that female (p<0.001) and less experienced (p=.018) practitioners reported a significantly higher level of distress after a patient suicide.An important implication for practice is that prospective psychotherapists should be better prepared for possible patient suicides as part of their training. Furthermore, the data situation and the state of research on this topic should be expanded, particularly in German-speaking countries.

ALS is a terminal illness that places significant burden on caregivers due to the intensive care demands. Little research exists on the specific design of psychological support programs for caregivers of ALS patients. This study aims to identify psychosocial needs of caregivers, specific therapeutic topics and structural requirements for tailored support programs.The study is based on a subset of qualitative data from a participatory mixed-methods observational study. Semi-structured, one-hour interviews were conducted with caregivers of ALS patients, either online or in person. The transcripts were analyzed using Mayring's qualitative content analysis.Four caregivers participated in the study. They reported a high need for psychological support, especially immediately following the diagnosis. Key themes included emotional relief through dialogue with psychologists, strategies for emotion regulation, and fostering self-care. Practical needs highlighted the importance of clear guidelines for caregiving organization, assistance with medical devices, and the development of supportive programs to help manage life and plan for the future during challenging circumstances. Participants emphasized that support programs should be flexible, easily accessible, and personalized. Individual sessions with the option of in-person or online formats were preferred. Caregivers highlighted the necessity of continuous support throughout the disease trajectory, particularly during critical phases.The results of our study highlight the psychosocial challenges faced by caregivers of ALS patients. The findings emphasize the need for comprehensive support systems that address both the emotional and practical needs of caregivers.

The study aimed to develop a questionnaire that captures the key effectiveness factors of the Communicative Movement Therapy (KomBT) method.A group of experts developed five content-related scales in an explorative and deductive manner to map specific factors of the method's effectiveness. The Inventory for Process Assessment of Treatment with Communicative Movement Therapy (IP-Kom) contains 62 items and was completed by 211 patients after a KomBT therapy session. The data was analyzed using cluster and factor analysis to check the assignment of the items to the scales. In addition, an artificial neural network was used to validate the predictive power of the item statistics for the subjective benefit of the therapy.The cluster analysis confirmed a 5-factor solution, and the subsequent factor analysis confirmed the five factors of the questionnaire: positive body experience, cohesion, inhibition, positive development and emotionality, and positive experience of closeness. The reliability of the individual factors was between α=0,73 and α=0,93, which indicates a high level of internal consistency. Factor analysis was used to reduce the number of items from 62 to 22 (IP-Com22) and to clarify the content of the statements in the scales. Whether the KomBT procedure is experienced as helpful could not be attributed to one factor alone. The assessment only correlated with the sum of all factors surveyed in the IP-Kom22.The IP-Kom22 is an economical questionnaire for the assessment of group and body psychotherapeutic factors that can be used both in routine clinical practice and in further scientific studies.

Eating disorders occur in approximately 4.3% of pregnant women, with previously affected women representing a particularly high-risk group. Pregnancy and the postpartum period are characterized by profound physical, hormonal, and psychosocial changes that can increase the risk of developing, worsening, or recurring eating disorders. Body image, coping with weight gain, and the pressure to regain one's previous body shape are particularly important risk factors in all phases, from the time of conception to the postpartum period. Eating disorders can lead to menstrual irregularities and infertility in women, with hormonal imbalances and disordered eating behavior often being causes that also increase the risk of pregnancy complications. Women with eating disorders have a higher risk of pregnancy complications such as premature births, miscarriages, anemia, and hyperemesis gravidarum, although these risks vary depending on the type of eating disorder. The stigma and shame associated with eating disorders represent significant barriers to open communication and the use of therapeutic help. Therefore, therapists should choose a sensitive and appreciative approach, avoid stigmatization, and courageously but empathetically address possible eating disorders directly to enable early support.

Subjective feelings of inner emptiness represent a transdiagnostic phenomenon that plays a major role in clinical practice, but has so far been insufficiently addressed by psychometrics. The recently developed Subjective Emptiness Scale (SES) is a user-friendly measure that fills this gap. In this study, the German version of the SES was psychometrically evaluated in a rather large general population sample.Respondents from a sample representative of the German general population (N=2508) completed the SES and other instruments to measure psychological distress. The eval-uation included a confirmatory factor analysis, calculation of test statistics (e. g., item-total correlations, internal consistency) and correlation analyses of the sum score with sociodemographic and clinical variables. In addition, age- and gender-specific norm values were determined in the form of T-values.The SES demonstrated a unidimensional factor structure with good model fit (CFI=0.999; TLI=0.998) and excellent internal consistency (McDonald's ω=0.92). Corrected item-total correlation was above 0.75 in all instances. Significant positive correlations of the sum score were found with depression and anxiety symptoms, providing evidence for criterion validity. Normative T-scores were established for age groups and gender; an SES value of 11 can be considered to be markedly increased (T).The German version of the SES proves to be a reliable and potentially valid instrument for measuring subjective emptiness. For a further analysis of its clinical applicability and the definition of clinically relevant threshold values, studies in clinical samples are required.

The aim of this study was to examine the prognostic validity of the risk index for predicting the effectiveness of medical-psychosomatic rehabilitation treatments. Specifically, it was investigated whether the risk index contributes additional explanatory value beyond sick leave duration in the year preceding rehabilitation. Sociodemographic, clinical, and motivational differences between risk groups were also analyzed.This retrospective study was based on data from 725 patients treated at a rehabilitation center between September 2022 and December 2023. Participants were categorized by risk level (high, medium, low). Measures included depression severity (PHQ-9), work motivation (DIAMO), subjective return-to-work expectations (SPE), and social-medical assessments. Statistical analyses included ANOVAs, multiple and logistic regressions, and the Reliable Change Index.The high-risk group was older, more frequently female, and more likely to have been on extended sick leave. They reported poorer subjective and social-medical return-to-work expectations, lower work motivation, more avoidant behavior, and reduced participation capabilities. The risk index significantly predicted depression severity at discharge, though less strongly than prior depression levels and sick leave duration. It did not significantly predict return-to-work status at discharge.The risk index provides additional value in predicting psychological treatment outcomes, but not in forecasting work ability. Clinically relevant differences in motivation, participation assessment, and return-to-work expectations in the high-risk group underline the need for targeted early interventions. Conclusion While useful for identifying vulnerable groups, the risk index does not replace individualized assessments of occupational and psychological burdens. Early recognition and promotion of motivational and functional resources are essential for successful rehabilitation.

More than 35 years after the fall of the Berlin Wall, there is still a lack of representative data on the various forms of SED injustice in former East Germany. There is also a lack of answers to the question how those affected by SED injustice differ from those not affected related to psychosocial characteristics, which forms of repression occurred together and which groups of those affected can be differentiated. This is important for creating a clearer understanding of the repression during the SED dictatorship and deriving implications for further reprocessing and dealing with the past in the coming years.In a representative cross-sectional study in former East Germany a total of N=3011 individuals (response rate 45%) were surveyed between May and September 2022. First, group differences between those affected and those not affected by SED injustice were calculated for psychosocial variables. Next information provided on repression was evaluated using a latent class analysis for younger respondents who did not experience the GDR themselves, and for older respondents who were socialized in the GDR (cutoff point: date of birth January 1st, 1980). Subsequently, further analyses of group differences between the class solutions were performed.Those affected by SED injustice exhibit more anxiety, depression and somatic symptoms than those who were not affected. GDR socialization appears to be associated with more psychological symptoms and less trust in institutions, especially among those affected by SED injustice. The class analyses revealed a two-group solution for the younger respondents and a four-group solution for the older ones. The groups differed in terms of personal proximity to the repression and the total number of reported repressions. The groups showed further differences with regard to resilience factors. No group differences were found related to mental health.On the one hand, interventions should focus on the mental health of all people affected by SED injustice. On the other hand, group-specific measures should be taken into account, as e. g. interventions on (re)building trust in institutions. The reprocessing of SED injustice still plays a key role today.

Since 2020, cancer counselling centers (CCCs) have been eligible for funding from health insurance funds under the legal regulation on "Outpatient Cancer Counseling" (§65e SGB V). This article investigates the rationale for or against applying for funding and evaluates the funding option from the perspective of staff members at both funded and non-funded CCCs, as well as sponsoring organizations. The aim is to analyse the practical feasibility of the financing model.We conducted a qualitative study using guided expert interviews with employees of CCCs and sponsoring organizations. The institutions for interview participation were selected from all existing CCCs and sponsoring organizations, taking into account factors such as size, region, and funding status of the CCC through a quota-based random selection process. The interviews were analyzed using content-structural evaluation methods according to Kuckartz.The analysis is based on statements from 44 expert interviews, including 17 funded CCCs, 9 non-funded CCCs, 6 CCCs with changing status, and 12 sponsoring organizations. The funding option was generally rated positively and recognized as a significant advancement for outpatient cancer counselling. With regard to the required minimum number of consultations, it should be noted that the majority of CCCs considered this to be achievable. However, certain structural aspects were criticized, particularly regarding the allocation process, funding stability, and the requirements of financial auditing. Issues such as the remaining uncertainty of stable financing, and the insufficient recognition of essential work areas, such as group services, were highlighted, as well as the inadequate consideration of differences in service mandates, especially for CCCs in rural areas.The partial funding of outpatient CCCs by health insurance funds is an important step towards stable financing and standardization in outpatient cancer counselling. Future amendments should aim to ensure long-term security and flexibility of funding options in order to maintain comprehensive, needs-based and quality-assured cancer counselling in Germany with a growing proportion of cancer survivors, a significant proportion of whom have psychosocial problems and need counselling.

Since Russia's military invasion in February 2022, approximately 1,1 million Ukrainians have sought refuge in Germany. The displacement of people due to military conflicts and wars is often accompanied by psychopathological distress. After arrival in host countries so post-migration living difficulties can further exacerbate symptoms. Attitudes toward psychotherapy may also vary. ResearchAn assessment of psychological burdens among Ukrainian refugees is necessary to identify specific needs and to provide adequate or adapted interventions.Between July 2022 and July 2024, an online survey was conducted among Ukrainian refugees living in Germany with N=151 participants. The recruitment of participants was coordinated by Goethe University Frankfurt and the University of Greifswald. Several standardized instruments were used for the survey, including the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Scale-2 (GAD-2), the International Trauma Questionnaire (ITQ), and the Post-Migration Living Difficulties Checklist (PMLD), the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS), and the Social Activity Self-Evaluation Scale (SASS).The results indicate a clinically significant level of anxiety and depressive symptoms (91,5% at least subsyndromal symptoms). A significant correlation was also found between depressive and anxiety symptoms. Both scales were significantly related to self-assessment of social activity and were associated with increased sensitivity to stigma. Furthermore, about 50% of participants exceeded the ITQ threshold for clinical significance.The study suggests elevated depression and anxiety symptoms among Ukrainian refugees, indicating the need for tailored interventions. Concerns about stigmatization should be taken into account. Post-migration stressors should also be addressed, as they may have clinical relevance despite suspended asylum processes. Further longitudinal studies with larger samples and clinical interviews are recommended for a more comprehensive understanding.