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Background: For the treatment of the symptoms of post-COVID-19 syndrome, no causal therapy is currently widely recommended according to evidence-based criteria. The overarching goal of the intervention study over a 3-year period (Q1-2021–Q4-2023) was to evaluate the changes in the key symptoms of fatigue and sensorimotor instability through individualized stress-controlled training therapy and through intensified cognitive behavioral therapy. Material and methods: In the 3‑year period 407 vaccinated nucleocapsid positive patients were treated at the Post-COVID-19 Center Lausitz (Senftenberg). In 78 (around 19%) fatigue/immunometabolic depression and sensorimotor instability were identified as the leading syndromes. The evaluation of the individualized stress-controlled training therapy was based on the specific post-COVID-19 syndrome and motor fatigue parameters. The secondary psychosomatic syndrome was assessed using cognitive fatigue parameters and cognitive behavioral therapy instruments. The investigation of -parameters influencing behavior took place in Q2-2023–Q4-2023 with a guide-supported qualitative interview among the participants. Results: The post-COVID-19 key symptoms "fatigue," "sensorimotor instability," "neuropsychiatric symptoms," "cardiac/autonomic dysfunction," and "pain" improved significantly in the overall cohort and in the gender-specific analysis. A deterioration occurred in "secondary psychosomatic symptoms". A therapeutic effect was demonstrated for all motor fatigue parameters for the entire cohort using the Cohen's d value. An intensification of cognitive behavioral therapy achieved positive effects through an increasing development of the patients' own activity and their self-control using persuasion and gamification. [ABSTRACT FROM AUTHOR]

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Abstract:Background: The original developers of motivational interviewing (MI) describe the foundation of their therapeutic method in the person-centered tradition of Carl Rogers. Although MI is sometimes interpreted as a cognitive-behavior therapy (CBT), it did not derive from learning theory and has from the beginning been understood and expounded as a person-centered approach (PCA). Method: Narrative and conceptual review. Results: As with Rogers's original method, the development of MI has been guided by empirical science based on the close observation of clinical practice. It is a behavioral approach in the broad sense of behavioral science. The underlying attitude or spirit with which MI is practiced is unambiguously humanistic in emphasizing partnership, acceptance, compassion, and empowerment. MI focuses on specific observable elements of therapeutic relationship that predict better client outcomes. Various behavioral scientists have distinguished MI from CBT both conceptually and with distinct clinical procedures. The psychological content of MI overlaps substantially with PCA practices such as accurate empathy and also with therapist skills often described as common or nonspecific factors in psychotherapy. Its component processes are engaging, focusing, evoking, and planning. The evoking process of MI distinguishes it from both CBT and nondirective PCA, involving MI-specific technical skills focused on specific client language known as change talk and sustain talk. Conclusions: Like PCA more generally, MI has found broad applications in helping professions well beyond counseling and psychotherapy such as health care, education, pastoral care, conflict resolution, and leadership. Possible historic reasons for confusing MI with CBT are explored. [ABSTRACT FROM AUTHOR]

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Background: Virtual reality (VR) is increasingly used in psychotherapy, and the speed of development of therapeutic VR tools is continuously increasing. Objective: This narrative review provides an overview of the state of the art regarding VR applications for psychotherapy. Material and methods: The current state of VR therapy research for anxiety disorders and posttraumatic stress disorder (PTSD) is summarized. The focus lies on VR exposure therapy. Current developments in the field are outlined. Results: For anxiety disorders, especially phobic disorders, there are already positive recommendations in the current German S3 guidelines. For PTSD, the development of VR therapy tools is still in a relatively early stage. Conclusion: The development of mobile cost-effective VR solutions in recent years has enabled entirely new applications for VR. The empirical challenges of these new developments are considerable. Nevertheless, the chances for an improvement of psychotherapeutic routine care are good. [ABSTRACT FROM AUTHOR]

Adopting psychotherapeutic technique as a technological matter in which something is learnt, deployed and applied, the article considers how the relationship between therapist and client is increasingly dominated by thinking of a technical manner. By exploring this notion through an existential lens, the conversation is expanded beyond our usual practical use of technique as a technology of change, and instead considers the implications of systematising conversations to yield outcomes and maximise results. In essence, the paper explores how we condition inquiry, and how this inquiry may in turn condition us. Bringing to the forefront, the importance of acknowledging our relationship with method and technique, as part of an ethical engagement with our practice. [ABSTRACT FROM AUTHOR]

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Background: Cognitive behavioral therapy (CBT) and pharmacotherapy with antidepressants are both a highly effective treatment for agoraphobia and/or panic disorder; however, a combination of CBT and antidepressants is under debate due to potentially unfavorable interference effects. The associations of existing antidepressant medication with panic and agoraphobia symptom burden and their change in the context of a structured 5‑week day hospital and exposure-focused treatment in a naturalistic setting were investigated. Methods: Out of a total of n = 488 patients medication use during treatment was retrospectively determined for n = 380: n = 100 (26.3%) were taking antidepressants of different drug classes. Calculations were performed using multiple linear regression analysis, t‑tests, response analyses, and χ2-tests. Results: Patients with existing antidepressant medication more often met the criteria for comorbid depressive disorder (p < 0.001). The measure of symptom change and treatment response rates did not differ between patients with and without antidepressants with respect to anxiety symptoms. Discussion: In the context studied, patients with and without existing antidepressant medication benefited equally from CBT with respect to anxiety symptoms. [ABSTRACT FROM AUTHOR]

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Anxiety disorders are frequent, with a 12-month prevalence of 14%, tend to be chronic, and display a high comorbidity with substance abuse disorders. Anxiety and substance abuse disorders are associated with a pronounced individual as well as socioeconomic burden. This article reviews the epidemiological, etiological, and clinical aspects of the dual diagnosis of anxiety and substance abuse disorders, with a particular focus on alcohol and cannabis. The treatment comprises nonpharmacological strategies, mainly cognitive behavioral therapy combined with elements of motivational interviewing (MI) and pharmacological management with antidepressants; however, the use of selective serotonin reuptake inhibitors (SSRI)/serotonin and noradrenaline reuptake inhibitors (SNRI) is not unreservedly recommended. The use of gabapentinoids requires careful risk-benefit consideration because of their potential for abuse and dependence in substance abuse disorders. Benzodiazepines are reserved exclusively for crisis management. Rapid diagnosis and treatment initiation targeting both disorders are essential for successful treatment of comorbid anxiety and substance abuse disorders. [ABSTRACT FROM AUTHOR]

People with a disorder of intellectual development (German draft of the ICD-11, which came into force on 1 January 2022) suffer more frequently from mental illnesses. According to the international treatment guidelines multimodal approaches should include not only psychopharmacological treatment, but also disorder-specific psychotherapeutic methods. These psychotherapeutic interventions have to be adapted to the communicative and cognitive abilities (performance diagnostics with IQ tests) as well as the emotional developmental stage (developmental diagnostics, e.g., with the scale of emotional development, short version, SED-S 2; [1]). To ensure this, the rules of simple language should be observed and when appropriate relatives or caregivers should be involved in the therapeutic process. The effectiveness of cognitive behavioral therapy has received most scientific attention, especially for affective disorders. Posttraumatic stress disorders can be validly treated with eye movement desensitization and reprocessing (EMDR). There is also good evidence for exposure therapy with reinforcement in the treatment of anxiety disorders. [ABSTRACT FROM AUTHOR]

Hintergrund: In aktuellen deutschsprachigen Leitlinien zur Behandlung von Menschen mit Schizophrenie wird für kognitive Verhaltenstherapie (KVT) die höchste Evidenzstufe angegeben. Jedoch weist vergangene Forschung darauf hin, dass nur ein geringer Teil eine entsprechende Behandlung erhält. Methode: Um Zugangsbarrieren für Menschen mit psychotischen Störungen vonseiten der Psychotherapeut_innen zu identifizieren, wurden in der vorliegenden Studie 215 Psychotherapeut_innen in einer Online-Umfrage unter anderem nach ihren Einschätzungen zur Indikation und Schwierigkeiten in der Bewilligung einer Psychotherapie, ihrer Ausbildung hinsichtlich psychotischer Störungen so-wie Vorschlägen zur Verbesserung der Zugänglichkeit von Psychotherapie für Menschen mit Psychose befragt. Ergebnisse: Als größtes Hindernis wurde unzureichende Ausbildung hinsichtlich der Behandlung von psychotischen Störungen berichtet. Jedoch wird die Bewilligung einer Psychotherapie von einigen Befragten als erschwert eingeschätzt. Diskussion: Die zentralen Verbesserungen, einschließlich aktueller symptomspezifischer KVT-basierter Ansätze zu Wahn oder Halluzinationen, werden als Perspektive zur gezielten Weiterbildung diskutiert. [ABSTRACT FROM AUTHOR]

In 2020, prescription-based digital interventions were introduced in Germany. These digital courses have to meet safety and data privacy requirements and must prove positive effects on symptoms and/or other outcome parameters. Interventions are available for a range of mental disorders. For patients with panic disorder and agoraphobia, several applications based on cognitive behavioral therapy have been developed. Within these digital courses, patients can typically access psychoeducational content and practice psychotherapeutic strategies such as exposure therapy. Recent meta-analyses prove the effectiveness of such interventions when compared with waitlist control conditions. According to current German guidelines, digital courses can be used to prepare psychotherapy and as an accompanying tool during psychotherapy. In Germany, physicians and psychotherapist can prescribe digital interventions for outpatients and as a post-hospital treatment.. [ABSTRACT FROM AUTHOR]

Background: The analysis of the efficacy of evidence-based psychotherapy for patients with psychotic disorders has mostly been carried out in the outpatient field. In the inpatient field the efficacy is sometimes difficult to assess due to different healthcare systems. Objective: The aim of this narrative review is to summarize international guidelines and meta-analyses on the efficacy of inpatient psychotherapeutic treatment strategies for patients with psychotic disorders. Based on this, recommendations for disorder-specific ward concepts for acute and postacute fields are formulated. Methods: The German S3 guidelines, international guidelines, current meta-analyses and primary studies on psychological interventions in the treatment of psychotic disorders were included. Based on the results, recommendations for the inpatient psychotherapeutic treatment in various phases of treatment were formulated (acute phase and postacute phase). Results: In the acute phase a combination of cognitive behavioral therapy (CBTp) in the individual setting and family interventions in the group setting as well as metacognitive training (MCT acute) is effective and recommended. In the postacute phase, in addition to individual and group CBTp and family interventions, psychoeducation, social skills training and cognitive remediation have been shown to be effective and are recommended. Discussion: The suggested recommendations for concrete interventions in various treatment phases and the evidence base are critically discussed and recommendations for the structure of wards are presented. [ABSTRACT FROM AUTHOR]

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Mentalizing Behavioral Therapy (MVT) is a further development of the Strategic Behavioral Therapy SBT. Two new modules will be added to their therapy modules: Emotion Tracking - an adaptation of Albert Pesso’s microtracking for use in cognitive behavioral therapy (CBT) - and Mentalization Promotion - an adaptation of the MBT questioning technique. While the mentalization-based therapy MBT is a psychoanalytically based therapy method within psychodynamic therapy, the mentalization module of the MVT is a cognitive-behavioural instrument for building a reality-based theory of mind (TOM). These two modules have become the core of the MVT and are therefore one General psychotherapeutic basic competence, which in our opinion should not be missing in any therapy. The treatment progresses from Module 1: establishing a secure attachment in the therapeutic relationship to Module 2: extracting the dysfunctional survival rule from childhood injuries and transforming it into a permission-giving rule of life, on to Module 3: noticing and accepting feelings through mindfulness: Then come the two new modules mentioned (emotion tracking and mentalization promotion), followed by the two development modules (6. Development from the affect to the thinking level and 7. Development from the thinking to the empathy level, the goal of which is functional affect regulation and relationship skills in the Sense of empathy and compassion. [ABSTRACT FROM AUTHOR]

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Zusammenfassung: Anliegen dieser Arbeit ist es, mittels explorativer Auswertungen verschiedene Verlaufstypen bipolarer Störungen und den damit verbundenen Merkmalen zu differenzieren und dabei insbesondere die Rolle von Bipolar-1- und Bipolar-2-Störung sowie den Einfluss der rezidivprophylaktischen Interventionen im Rahmen einer randomisierten, kontrollierten Therapiestudie zu klären. Es konnten 274 der ursprünglich 305 eingeschlossenen Personen untersucht werden. Patienten nahmen entweder an einer kognitiv-verhaltenstherapeutischen (SEKT) oder unterstützenden, patientenzentrierten (FEST) Gruppentherapie teil, welche sich über 4 Therapietage (entspricht 16 Doppelstunden) in monatlichem Abstand erstreckte. Depressive und manische Symptomatik wurde anhand des LIFE jeweils für die zurückliegenden 6 Monate bezogen auf jede Woche vor und nach der Interventionsphase sowie 6 und 12 Monate katamnestisch beurteilt. Die Effekte beider Gruppentherapien erwiesen sich als vergleichbar. Statistisch signifikant wurden in einem multivariaten Proportional-Hazards-Modell jedoch der Faktor Bipolar 1 und 2 sowie die Interaktion von Therapie mit Bipolar 1 und 2. Insbesondere profitierten Bipolar-2-Patienten von der SEKT-Intervention deutlich schlechter als von FEST. Es ergaben sich 3 Cluster, die Bipolar 1 (SEKT, keine Komorbidität, mehrheitlich keine Rezidive, jüngere Patienten) von Bipolar 2 (FEST, keine Komorbidität, mindestens 1, oft 2 Rezidive, ältere Patienten) und von einer heterogenen Gruppe (beide Interventionen, Komorbidität) trennten. Die Unterscheidung von Bipolar-1- und Bipolar-2-Störung ist wichtig und bislang unzureichend berücksichtigt. Bipolar-2-Störungen zeigen generell einen schlechten Verlauf und sprechen auf eine kognitive Verhaltenstherapie (SEKT) besonders schlecht an. Eine offene, unstrukturierte, unterstützende, patientenzentrierte Psychotherapie (FEST) ist generell wirksam. [ABSTRACT FROM AUTHOR]

In 2022, the first revised version of the S3 guidelines on obsessive-compulsive disorder will be published under the auspices of the German Society for Psychiatry, Psychotherapy and Psychosomatics (DGPPN). This article contains a summary of the most important recommendations for therapy in a condensed form. There were no major changes in the central basic therapy recommendations compared with the first version of the guidelines, as the evidence base has not fundamentally changed since then. Cognitive behavioral therapy (CBT) with exposure and response management is the most effective form of therapy for this clinical picture and therefore the therapy of first choice. Regarding pharmacotherapy, selective serotonin reuptake inhibitors are the first-line medications. They are indicated when CBT with exposure is not available or has not been effective, when CBT is rejected by the patient and in the patient's personal preference for medication, or to increase the readiness for CBT with exposure. New recommendations include, e.g., the use of Internet therapy, and recommendations for the use of CBT and exposure, e.g., also in group format, including video conferencing if appropriate as well as in intensive format. [ABSTRACT FROM AUTHOR]

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Achtsamkeitsbasierte Interventionen (AI) stellen mittlerweile eine zentrale Säule der dritten Welle der Kognitiven Verhaltenstherapie dar. In den letzten Jahren wurden AI bei Patient*innen mit psychotischen Störungen implementiert und deren Wirksamkeit im Rahmen von einer kleineren Anzahl von randomisiert-kontrollierten Studien (RCTs) gezeigt. Der vorliegende narrative Übersichtsartikel stellt den aktuellen Stand der Forschung zur Effektivität, sowie zentrale As-pekte der klinischen Anwendungen von AI bei der Behandlung von Patient*innen mit Schizophrenien und primären psychotischen Störungen dar. Aus aktuellen Metaanalysen lässt sich trotz der Heterogenität der Studienergebnisse schlussfolgern, dass AI im Rahmen von RCTs des Vergleichs einer Kontrollgruppe mit einer gewöhnlichen zumeist psychopharmakologischen Behandlung (treatment-as-usual, TAU) und in Prä-Post-Intervention Analysen zu einer Verbesserung der oft schwer zu behandelnden Negativsymptomatik (g = 0,56 und g = 0,75) oder Positivsymptomatik (g = 0,19 und g = 0,32) mit leichten bis großen Effektstärken führen können. Weiterhin wurden auch positive Effekte auf depressive und ängstliche Symptome (g = 0,20 und g = 0,43), sowie eine Reduktion der Rehospitalisierungsraten 12 Monate nach Entlassung und eine Verkürzung der stationä-ren Behandlungsdauer beobachtet. Im Gegensatz zur Therapieforschung aus dem Vereinigten Königreich, Australien oder Hong Kong befinden sich die wissenschaftliche Evaluation und Implementierung von achtsamkeitsbasierten Behandlungsmöglichkeiten im gesamten deutschsprachigen Raum noch in einem frühen Stadium. [ABSTRACT FROM AUTHOR]

Hintergrund: Die Körperdysmorphe Störung (KDS) ist eine schwerwiegende psychische Störung, die mit starker Scham sowie Leidensdruck und Funktionseinschränkungen einhergeht. Kognitive Verhaltenstherapie stellt die aktuell wirksamste evidenzbasierte Behandlungsmethode dar. Aufgrund zahlreicher Behandlungsbarrieren kommen KDS-Betroffene jedoch selten in der psychotherapeutischen Behandlung an, weshalb niedrigschwelligen Behandlungsmethoden (z.B. aus dem Bereich E-Mental-Health) eine wichtige Rolle zukommen könnten. Erste internationale Studien weisen auf die Wirksamkeit von E-Mental-Health-Angeboten bei KDS hin. Material und Methoden: Dieser Beitrag gibt eine Übersicht zur bisherigen Umsetzung und Evidenz von E-Mental-Health-Angeboten für KDS und stellt die ins Deutsche übersetzte Version des BDD-NET-Programms, eines internetbasierten, manuali-sierten, therapeutenbegleiteten Interventionsprogramms, für die KDS vor, welches aus dem Englischen für den deutschen Sprachraum übersetzt und adaptiert wurde. Ergebnisse: BDD-NET umfasst acht Module, die binnen einer 12-wöchigen Behandlung online bearbeitet werden. Die Online-Plattform bietet für die Patienten die Möglichkeit, mit dem BDD-NET-Therapeuten mittels persönlicher Nachrichten zu kommunizieren. Sämtliche Materialien wurden aus dem Englischen übersetzt und vor allem in kultureller Hinsicht adaptiert. Schlussfolgerungen: BDD-NET könnte ein wichtiger Baustein in der Versorgung von KDS-Betroffenen sein. Die Evaluation steht für den deutschen Sprachraum noch aus. Auf Besonderheiten des Settings (z.B. Störungseinsicht als möglicher Behandlungsfokus) sowie praktische Implikationen wird eingegangen. Zudem werden Voraussetzungen und Rahmenbedingungen für eine perspektivische Dissemination diskutiert. [ABSTRACT FROM AUTHOR]

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Hintergrund: Die psychotherapeutische Behandlung von Kindern und Jugendlichen mit geistiger Behinderung unterliegt einer Vielzahl von Barrieren. Fallbericht: Der hier vorgestellte Behandlungsfall illustriert die erfolgreiche Anwendung kognitiver Verhaltenstherapie bei einem 10-jährigen Mädchen bei Entwicklungsstörung und Intelligenzminderung. Nach einer medizinisch notwendigen Untersuchung entstanden ausgeprägte Angstsymptome und Verhaltensprobleme. Infolge einer bekannten Epilepsie war der Einsatz expositionsbasierter Techniken fraglich. Die kognitive Verhaltenstherapie umfasste 64 Behandlungseinheiten. Das Vorgehen zur Selbstbeobachtung, Rationalvermittlung und Angstbewältigung war stark handlungsbezogen und wenig kognitiv orientiert und fand im häuslichen Setting mit Einbezug der Familienmitglieder statt. Nachfolgend wurden – auch aufgrund der zunehmenden Reifung des Kindes – kognitiv anspruchsvollere Techniken eingesetzt. Zur 38. Behandlungseinheit wurden zuvor angstbesetzte Situationen dem Entwicklungsstand angemessen und selbstständig bewältigt. Eine nachfolgende medizinische Untersuchung ähnlich der Auslösesituation wurde therapeutisch vorbereitet und sicher bewältigt. Zu Behandlungsende waren die Alltagskompetenzen maßgeblich erweitert. Schlussfolgerungen: Entgegen der Vorannahmen bedurfte es nur weniger Anpassungen an das Setting und die Behandlungstechniken im Vergleich zum Vorgehen bei ähnlicher Symptomatik ohne geistige Behinderung. Durch die psychotherapeutische Behandlung konnte kurz- und langfristig eine Manifestation (Eskalation) von weiterem Problemverhalten verhindert werden. Das Erkennen und die Auseinandersetzung mit dem "Anderssein" infolge der geistigen Behinderung und verfügbarer Alltagskompetenzen bergen Entwicklungsrisiken und -chancen, die durch eine psychotherapeutische Begleitung gut bewältigt werden können. [ABSTRACT FROM AUTHOR]

An overview of eating and feeding disorders according to the future criteria of the International Classification of Diseases (ICD-11) is presented, including information on differential diagnosis, epidemiology, etiology, pathogenesis as well as therapy. Binge-eating disorder is new and the most frequent eating disorder. While anorexia nervosa and bulimia nervosa mostly affect women, the gender ratio in binge-eating disorder is more balanced. Concerning etiology, socio-cultural, biological and psychological factors are discussed. Cognitive behavioral psychotherapy is the best-validated treatment for all three eating disorders. According to the German guidelines for treatment (2019), focal psychodynamic psychotherapy is also a treatment option for anorexia nervosa. Evidence for the positive effect of psychopharmacologic drugs in the treatment of anorexia nervosa is still lacking. Fluoxetine has been shown to have a limited effect in the treatment of bulimia nervosa. [ABSTRACT FROM AUTHOR]

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Work-related stress, as a potential cause of burnout, can lead to higher cognitive and emotional hyperarousal, which are themselves central elements of the vicious circle model of chronic insomnia. Therefore, the relationship between sleep disorders (e.g., insomnia) and work-related stress or burnout becomes obvious. In this review original studies, dealing with sleep and burnout are summarized and their limitations are discussed. In general, research results indicate a negative cross-sectional relationship between sleep quality and burnout. Although there are a large number of cross-sectional studies in this field, the generalizability of the findings is limited due their focus on health-related professions. In contrast, the findings of the few longitudinal studies are very heterogeneous. Therefore, it remains an open question whether insufficient sleep quality or sleep disorders might predict burnout or vice versa. In sum, previous findings indicate a significant relationship between sleep quality and burnout, which should be considered in therapeutic settings. Besides psychoeducative interventions, cognitive behavioral therapy of insomnia in the case of burnout with sleep disorder and a general reduction of work-related stress by short- and long-term strategies are recommended. [ABSTRACT FROM AUTHOR]

Background: The term "coronasomnia" is used in popular science to describe sleep disorders associated with the COVID-19 pandemic. These disorders may also affect part of the population in the aftermath of the pandemic. Early scientific evidence suggests that COVID-19-associated insomnia and insomniac symptoms can become chronic and will continue to preoccupy the sleep medicine community even after the pandemic has ended. Methods: A literature review was conducted in Medline and Google Scholar using the following combination of keywords: "insomnia and COVID-19", "insomnia and long COVID", "insomnia, PTSD and COVID-19", and "fatigue and insomnia in long COVID". In addition, the authors reviewed several recent articles published by members of the European Insomnia Network. Results: Studies on insomnia and COVID-19 show significant associations between acute infection and insomnia in affected individuals. The prevalence of insomnia symptoms in COVID-19-affected individuals was 36 to 88%, which is significantly higher than the estimated 10 to 40% prevalence of insomnia in the general population. Conclusion: Digital therapy as a current treatment option for insomnia can be offered to patients regardless of physical distance. Accordingly, not only early approval of therapy apps, but also person-led, digital therapy options for insomnia would be recommended. The inclusion of personalised and sleep-coaching measures in the area of occupational health management is encouraged. [ABSTRACT FROM AUTHOR]

Personality traits act as a predisposing factor in the development of insomnia. In this context, neuroticism, low conscientiousness and perfectionism appear to be of particular interest. Prior research indicates that personality traits contribute to a poorer sleep quality via several underlying mechanisms and coping strategies. On a cognitive level, these mechanisms include rumination, worry and dysfunctional beliefs about sleep and on an emotional level, these mechanisms include emotion dysregulation. Empirical findings suggest that such processes may make patients vulnerable to arousal before going to bed. Besides, it remains unclear whether interindividual differences in personality traits impact the effectiveness of cognitive behavioural therapy for insomnia (CBT-I). Based on findings in this area, however, CBT‑I could be more individualized. With high neuroticism, the focus could be on reducing ruminating and worrying as well as improving emotion regulation. If patients are less conscientious, the focus may be more on sleep hygiene rules, such as adhering to regular sleep times. Perfectionist patients could be encouraged to question a possible pressure to achieve concerning their sleep quality. Further research is needed to empirically validate these hypotheses. [ABSTRACT FROM AUTHOR]

Background and objectives: Sleep-related cognitions, but also sleep-related metacognitions (dealing with cognitions), play a role in insomnia etiology, especially in maintaining insomnia. So far, an English version of a questionnaire measuring sleep-related metacognitions with 60 items is available. The aim of the present study was the construction of a shorter German version showing satisfactory reliability and validity. Materials and methods: Overall, 512 patients with varying sleep disorders (264 women, 248 men; mean age: 45.04 ± 16.70 years) participated. The MCQ‑I was completed prior to the consultation in the sleep center. Results: The 20-item version showed high internal consistency (r = 0.906) and high retest reliability (r = 0.916). Patients with insomnia diagnosis had higher MCQ-I 20 sum scores compared to patients with other sleep disorders. Interestingly, patients with diagnoses of depressive disorder or nightmare disorder also reported higher values of sleep-related metacognitions. Conclusion: Sleep-related metacognitions seem to play a role in insomnia etiology. It would be very interesting to test whether metacognitive therapy can be as effective as cognitive-behavioral therapy for insomnia in alleviating insomnia symptomatology. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that occurs during childhood and adolescence. In many cases, however, the disorder persists into adulthood. In addition to the core symptoms of inattention, impulsivity and restlessness, the adult disorder is also characterized by affective dysregulation and impairment of executive functions. Patients show functional limitations in their daily lives and an increased risk of comorbid disorders. The German S3 guidelines suggest a combination of medication and psychosocial interventions. In controlled studies, cognitive-behavioral therapy (CBT) in particular showed positive effects in compensating for functional impairments and treating comorbid internalizing symptoms in adults. [ABSTRACT FROM AUTHOR]

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Background: Shift work is associated with high rates of sleep disorders. Digital cognitive behavioral therapy for insomnia (dCBT-I) might be an appropriate tool to treat this target population. Dropout rates in dCBT‑I trials are relatively high. The literature suggests that women prefer face-to-face contact in psychotherapy settings. Objectives: We implemented an online platform to provide dCBT‑I specifically for shift workers. In this secondary analysis, we aimed to examine gender differences between dropouts and completers in our trial. We hypothesized that a higher percentage of women would drop out of the study compared to men. Materials and methods: We perform post-hoc analysis (chi-square tests and t‑tests) on the data from our four-week dCBT‑I trial. Specifically, we compared dropout rates and time of dropout by gender. Results: The trial was initiated by N = 50 participants (13 female/37 male), of which 56% did not complete the program. Dropout rates are significantly higher in women (77%) than men (49%; p = 0.034). There are no significant gender differences regarding time of dropout or other sample characteristics, such as total sleep time, symptom severity, or age. Conclusions: Even though they suffer from just as many symptoms of insomnia, female shift workers may be more likely to drop out of dCBT‑I programs than their male counterparts. This highlights the need for additional research to improve engagement and adherence in dCBT‑I, specifically for women. The relatively small sample size limits the transferability of these results. [ABSTRACT FROM AUTHOR]

Copyright of Praxis der Kinderpsychologie und Kinderpsychiatrie is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Alongside depression, anxiety disorders are the most frequent reason for consulting a psychotherapist. Objective: This article describes the recent progress in understanding basic learning processes in anxiety treatment, the resulting therapeutic procedures, the current state of knowledge on the efficacy of the various psychotherapeutic procedures and on the moderators of the success of treatment. Material and methods: The English and German language literature was reviewed and compiled, with an emphasis on the last 10 years. Results: Cognitive-behavioral therapy (CBT) achieves the best and broadest level of evidence across all anxiety disorders. Initial studies have also provided emerging evidence for the efficacy of manualized short-term psychodynamic treatment. The most discussed mechanism of action is that of inhibitory learning. Augmentation strategies and personalized treatment approaches are gaining in relevance. Conclusion: Current models of inhibitory learning are rooted in basic research and foster a deeper understanding of the underlying neurobiological mechanisms. In order to optimize success of exposure treatment in vulnerable subgroups of patients, many procedural, device-based and pharmacological augmentation strategies are currently under investigation, whereby the latter are mostly still in the stage of (pre)clinical testing. [ABSTRACT FROM AUTHOR]