Antje Gumz | Psychologische Hochschule Berlin (original) (raw)

Papers by Antje Gumz

Baseline and follow-up assessment outcomes based on least-squares mean estimates of a mixed-model... more Baseline and follow-up assessment outcomes based on least-squares mean estimates of a mixed-model analysis within the intention-to-treat sample (n = 1020 intervention participants; n = 981 control participants). (DOCX 21 kb)

Psychotherapeut, 2022

Zusammenfassung Hintergrund Die sprachlichen Äußerungen sind ein zentrales Medium in Psychotherap... more Zusammenfassung Hintergrund Die sprachlichen Äußerungen sind ein zentrales Medium in Psychotherapien, d. h., Psychotherapie wirkt im Wesentlichen über die Sprache, über das Miteinanderreden. Angesichts der Bedeutung des sprachlichen Austauschs ist es relevant, die Mechanismen, über die Sprache in Psychotherapieprozessen wirkt, genauer zu verstehen. Die linguistische Psychotherapieforschung nutzt hierfür vielfältige Methoden. Ziel der Arbeit Vorliegender Beitrag demonstriert exemplarisch 2 mikroanalytische Ansätze. Material und Methoden Eine transkribierte Psychotherapiesitzungssequenz wurde aus Perspektive der psychodynamischen Theorie inhaltlich interpretiert und bezüglich sprachlicher Merkmale mithilfe von 2 Methoden mikroanalytisch beurteilt: Die verbalen Techniken (Fokus Therapeutenäußerungen) wurden mithilfe der Psychodynamischen Interventionsliste (PIL) geratet und eine detaillierte Konversationsanalyse (Fokus Dialog) erfolgte. Ergebnisse Analysen mit der PIL zeigten, dass im ...

BackgroundA long duration of untreated illness (DUI) is an unfavorable prognostic factor in anore... more BackgroundA long duration of untreated illness (DUI) is an unfavorable prognostic factor in anorexia nervosa and often associated with chronic illness progression. The FABIANA- checklist, developed using a qualitative multi-informant approach, includes factors influencing treatment initiation which are potentially modifiable and are mentioned as being relevant by patients with AN. The study focusses on the development and evaluation of the FABIANA-Checklist and aims at providing descriptive data on DUI in a German sample.MethodsAfter cognitive pretest and revision, dimensionality of the 18-item version of the FABIANA-checklist was tested by Principal Component Analysis (PCA). For item validation we assessed support from social environment (FSozU), support in the health care system (PACIC-5A), illness perception and coping (BIPQ).ResultsWe included a sample of female patients (N=75), aged >14 years ( M = 21.4 years) with AN. Average BMI was 15.5 kg/m 2 , age of onset was 19.2 year...

Journal of Eating Disorders, 2021

Background A long duration of untreated illness (DUI) is an unfavorable prognostic factor in anor... more Background A long duration of untreated illness (DUI) is an unfavorable prognostic factor in anorexia nervosa (AN) and is associated with chronic illness progression. Although previous preventive measures aimed at reducing DUI and thus improving short- and long-term treatment outcomes have been partially successful, a better understanding of the factors involved in the sensitive phase prior to treatment initiation is needed. To date, there is no validated instrument available to assess these factors specifically for patients with AN. The FABIANA-project (Facilitators and barriers in anorexia nervosa treatment initiation) aims at identifying predictors of the DUI in order to target preventive measures better in the future. As part of this project, the FABIANA-checklist was developed, based on a multi-informant perspective and a multimodal bottom-up approach. The present study focusses on the process of item generation, item selection and psychometric validation of the checklist. Meth...

Psychotherapeut, 2020

Zusammenfassung Hintergrund Sowohl für die Erforschung von Therapeuteneffekten als auch für die A... more Zusammenfassung Hintergrund Sowohl für die Erforschung von Therapeuteneffekten als auch für die Aus- und Weiterbildung ist es von hoher Bedeutung, interpersonelle Fähigkeiten von Psychotherapeuten zu messen. Eines der wenigen dafür zur Verfügung stehenden Instrumente ist die Facilitative-interpersonal-skills(FIS)-Übung. Ziele der Arbeit 1. Vorstellung der FIS-Übung, 2. Prüfung der psychometrischen und deskriptiven Eigenschaften und 3. Untersuchung der Zusammenhänge des FIS-Gesamtwerts mit Alter, Geschlecht und Ausbildungsstand der Testteilnehmer. Material und Methoden In die Querschnittsuntersuchung wurden Psychologiestudierende und Psychologen in psychotherapeutischer Ausbildung eingeschlossen. Die Teilnehmer sollten in der FIS-Übung auf herausfordernde Therapiesituationen, die in 13 Videoclips nachgestellt sind, verbal reagieren. Die audioaufgezeichneten Reaktionen wurden von je 3 geschulten Ratern eingeschätzt. Ergebnisse Der durchschnittliche FIS-Gesamtwert der 115 Studienteilne...

BJPsych Open, 2019

Background Anorexia nervosa is a serious disorder, which often takes a chronic course. Early trea... more Background Anorexia nervosa is a serious disorder, which often takes a chronic course. Early treatment leads to a significantly better prognosis and prevents chronicity. However, existing evidence on facilitators and barriers in anorexia nervosa treatment initiation is scarce. Aims Against this background, the FABIANA study (ClinicalTrials.gov Identifier: NCT03713541) aims to (a) identify potentially modifiable facilitators and barriers from the perspectives of adolescent and adult patients with anorexia nervosa, carers and physicians, (b) develop and test an instrument for the combined assessment of multiple key facilitators and barriers, and (c) quantify the effect of potentially modifiable versus non-modifiable key facilitators and barriers on the duration of untreated illness (DUI) in patients with anorexia nervosa. Method FABIANA is an observational, mixed-method-study divided into three consecutive substudies each corresponding to one of the study aims. All three substudies wi...

Journal of Psychosomatic Research, 2017

PLOS ONE, 2017

Knowing which specific verbal techniques "good" therapists use in their daily work is important f... more Knowing which specific verbal techniques "good" therapists use in their daily work is important for training and evaluation purposes. In order to systematize what is being practiced in the field, our aim was to empirically identify verbal techniques applied in psychodynamic sessions and to differentiate them according to their basic semantic features using a bottom-up, qualitative approach. Method Mixed-Method-Design: In a comprehensive qualitative study, types of techniques were identified at the level of utterances based on transcribed psychodynamic therapy sessions using Qualitative Content Analysis (4211 utterances). The definitions of the identified categories were successively refined and modified until saturation was achieved. In a subsequent quantitative study, inter-rater reliability was assessed both at the level of utterances (n = 8717) and at the session level (n = 38). The convergent validity of the categories was investigated by analyzing associations with the Interpretive and Supportive Technique Scale (ISTS). Results The inductive approach resulted in a classification system with 37 categories (Psychodynamic Interventions List, PIL). According to their semantic content, the categories can be allocated to three dimensions: form (24 categories), thematic content (9) and temporal focus (4). Most categories showed good or excellent inter-rater reliability and expected associations with the ISTS were predominantly confirmed. The rare use of the residual category "Other" suggests that the identified categories might comprehensively describe the breadth of applied techniques.

Frontiers in Psychology, 2017

Psychotherapy is commonly described as a "talking cure," a treatment method that operates through... more Psychotherapy is commonly described as a "talking cure," a treatment method that operates through linguistic action and interaction. The operative specifics of therapeutic language use, however, are insufficiently understood, mainly due to a multitude of disparate approaches that advance different notions of what "talking" means and what "cure" implies in the respective context. Accordingly, a clarification of the basic theoretical structure of "talking cure models," i.e., models that describe therapeutic processes with a focus on language use, is a desideratum of language-oriented psychotherapy research. Against this background the present paper suggests a theoretical framework of analysis which distinguishes four basic components of "talking cure models": (1) a foundational theory (which suggests how linguistic activity can affect and transform human experience), (2) an experiential problem state (which defines the problem or pathology of the patient), (3) a curative linguistic activity (which defines linguistic activities that are supposed to effectuate a curative transformation of the experiential problem state), and (4) a change mechanism (which defines the processes and effects involved in such transformations). The purpose of the framework is to establish a terminological foundation that allows for systematically reconstructing basic properties and operative mechanisms of "talking cure models." To demonstrate the applicability and utility of the framework, five distinct "talking cure models" which spell out the details of curative "talking" processes in terms of (1) catharsis, (2) symbolization, (3) narrative, (4) metaphor, and (5) neurocognitive inhibition are introduced and discussed in terms of the framework components. In summary, we hope that our framework will prove useful for the objective of clarifying the theoretical underpinnings of language-oriented psychotherapy research and help to establish a more comprehensive understanding of how curative language use contributes to the process of therapeutic change.

BMC psychiatry, Aug 11, 2017

Previous prevention programs in the school context have not addressed both genders, have been tim... more Previous prevention programs in the school context have not addressed both genders, have been time-consuming, or have had deficits in the evaluation method. The aim of the present study was to evaluate the impact of a universal prevention program for female and male adolescents on eating disorder pathology and related risk factors. Between February 2012 and July 2014, 2515 students in 23 schools from 8th or 11th grade were assessed for eligibility in this longitudinal cluster-randomized controlled trial with a six months follow-up. Of those students, 2342 were cluster-randomized to the intervention condition which received a six school hours universal prevention program or to the no treatment control condition. The complete case population comprised 724 students in the intervention (54.3% female, M = 14.3 years, SD = 1.61) and 728 in the control condition (57.0% female, M = 14.7 years, SD = 1.63). Random-effects analysis of covariance on the primary outcome showed no significant dif...

Primary health care research & development, Jan 22, 2017

Aim This non-randomized pre-post-intervention study investigated the effect of a systemic public ... more Aim This non-randomized pre-post-intervention study investigated the effect of a systemic public health intervention on the length of time between anorexia nervosa symptom onset and contact with the health care system as well as the initiation of treatment. Although systemic public health interventions have successfully been implemented in physical and mental health fields, their effect on the early treatment of patients with anorexia nervosa remains unclear. In total, 59 anorexia nervosa patients (mean age=21.5 years, SD=7.2) were recruited before a systemic public health intervention, and 18 patients (mean age=22.2 years, SD=8.9) were recruited afterwards. Using validated self-report measures and a semi-structured interview, the duration of untreated anorexia nervosa and the duration until first contact with the health care system were investigated. Findings At the beginning of the individual treatment initiation process, participants in both samples most frequently consulted thei...

The International journal of eating disorders, Jan 3, 2016

We examined the association between disorder specific factors, comorbidity and health related qua... more We examined the association between disorder specific factors, comorbidity and health related quality of life (HRQoL) in anorexia nervosa (AN). HRQoL was assessed using the EuroQol-5D visual analog scale (EQ-VAS) in this cross-sectional study. Three regression models were estimated to determine the association between AN subtype (restrictive vs. binge/purge), duration of the eating disorder (ED), age (adolescents vs. adults), ED pathology (EDE-Q), Body Mass Index (BMI), depressive symptoms (PHQ-9), somatic complaints (PHQ-15), anxiety (GAD-7) and EQ-VAS. The sample comprised 218 female AN patients [mean age = 23.3 years (SD = 8.2); mean EQ-VAS score = 53.4 (SD = 21.4)]. A lower BMI, higher levels of depressive symptoms, and somatic complaints were significantly associated with lower EQ-VAS scores. Findings of the present study suggest that BMI and comorbidity might be more relevant to HRQoL impairments in AN than age, diagnostic subtype, duration of the ED or current psychopathology...

Eating and weight disorders : EWD, Jan 16, 2015

Medical students have been found to be vulnerable to mental health problems due to the high press... more Medical students have been found to be vulnerable to mental health problems due to the high pressures of medical school. Countries developing into industrial nations tend to adopt Western beauty ideals which might increase eating disorder risk. This cross-sectional study compared eating (Eating Disorder Inventory 2 EDI-2) and general psychopathology (General Health Questionnaire-28) in medical students from the newly formed German states with a historical sample of East German medical students examined at the time of the German reunification. Current medical students were also compared to population-based samples assessed before the German Reunification as well as recently to consider time trends in EDI scores. The current sample comprised 316 medical students (232 female) from the newly formed German states (mean age = 21.7 years, SD = 2.6). Significantly higher levels of drive for thinness as well as body dissatisfaction and higher levels of general psychopathology were displayed ...

Frontiers in Psychology, 2015

Language is one of the most important "tools" of psychotherapists. The working mechanisms of verb... more Language is one of the most important "tools" of psychotherapists. The working mechanisms of verbal therapeutic techniques, however, are still marginally understood. In part, this is due to the lack of a generally acknowledged typology as well as a gold standard for the assessment of verbal techniques, which limits the possibility of conducting studies focusing this topic. The present study reviews measures used in clinical research which assess directly observable dimensions of verbal interventions in a reliable manner. All measures were evaluated with respect to their theoretical foundation, research goals, assessment modes, and various psychometric properties. A systematic search in databases (PubMed, PsycInfo, PsycArticles, PSYNDEX, Web of Science, Embase) followed by an additional "snowballing" search covering the years 1940-2013 yielded n = 179 publications eligible for review. Within these publications, 34 measures were identified showing great heterogeneity regarding the aspects under study. Only two measures reached the highest psychometric standards and can be recommended for clinical use without any reservation. Central problems include deficiencies in the systematization of techniques as well as their partly ambiguous and inconsistent definitions. To promote this field of research, it will be important to achieve a consensus concerning the terminology, conceptions and measures of verbal interventions.

Eating Behaviors, 2015

We aimed to reduce the large body of factors which may be associated with the change process in t... more We aimed to reduce the large body of factors which may be associated with the change process in treatments for Anorexia Nervosa (AN) into a clinically and scientifically useful number of higher-rank dimensions. In addition, we examined the associations between the identified factors and eating disorder psychopathology and body mass index (BMI) in exploratory analyses. Within a naturalistic multicenter study we administered the Change Process Questionnaire (CPQ-AN) to inpatients with AN upon admission. The factorial structure of the CPQ-AN was explored via factor analysis. Multiple regression analyses were performed to examine the associations with BMI and eating disorder symptomatology (EDI-2). In total 233 female inpatients with AN (mean BMI=14.9kg/m(2), SD=1.7) participated. The factor analysis yielded four latent factors: basic need satisfaction, AN-specific cognitions and behavior, emotional involvement and commitment to treatment, and alliance and treatment confidence. Furthermore, greater basic need satisfaction and less AN-specific cognitions and behavior predicted lower EDI-2 scores. Higher alliance and treatment confidence were associated with higher BMI as well as a lower EDI-2 score. The associations between the newly derived dimensions and BMI and AN-psychopathology provide evidence to support the clinical relevance of the identified change process dimensions. Future investigations could provide further insights to deepen our understanding of the change process in AN.

Journal of Psychosomatic Research, 2015

Evaluation of a stepped, collaborative and coordinated health care network for somatoform and fun... more Evaluation of a stepped, collaborative and coordinated health care network for somatoform and functional disorders (Sofu-Net) M. Shedden-Mora, K. Lau, B. Gros, M. Gladigau, A. Gumz, K. Wegscheider, B. Lowe University Medical Center Hamburg-Eppendorf & Schon Clinic, HamburgEilbek, Department of PsychosomaticMedicine& Psychotherapy, Hamburg, Germany, University Medical Center Hamburg-Eppendorf, Department of Medical Biometry & Epidemiology, Hamburg, Germany

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Psychotherapie, Psychosomatik, medizinische Psychologie, 2015

As a consequence of earlier investigations, which have demonstrated that 20-25% of the students r... more As a consequence of earlier investigations, which have demonstrated that 20-25% of the students report psychological distress, the knowledge of the need and the utilization of help resulting from psychological or social problems have to be improved. Data from 366 students were collected to determine the need for advice, the utilization of help and the occurrence of psychological symptoms (SCL-27) and interpersonal problems (IIP-C). Comparisons between students and the total population as well as between students with and without need for advice were made. 23,3% of the persons surveyed, expressed the wish to receive professional help. In comparison to the total population, the students reported more psychological symptoms and consulted less frequently a general practitioner or a gynecologist. Students with need for advice experienced more psychological distress. To encourage more of the distressed students to utilize professional help, the access to professional help should be facili...

BMC Psychiatry, 2014

Background: Anorexia nervosa (AN) is a mental disorder with grave burdens for affected individual... more Background: Anorexia nervosa (AN) is a mental disorder with grave burdens for affected individuals as well as for the healthcare system. One of the strongest predictors of a poor outcome is a long Duration of Untreated Illness (DUI), which is defined as the time between the onset of the disease and treatment initiation. Reducing the DUI is an important step to optimize care of individuals with AN. In order to achieve this aim, systemic public health interventions are necessary. Objective of this study is to evaluate a systemic public health intervention at Community level aiming to reduce the DUI in individuals with AN. Methods/design: The intervention includes the establishment of a network of health care professionals within the area of eating disorders (EDs), the development of an internet-based treatment guide, the presentation of informative short-films about EDs in cinemas and a corresponding poster campaign as well as a special outpatient clinic. For the evaluating study a pre-post between-subject design is chosen. The DUI, and the duration until first contact (DUC) with a health care professional, ED pathology as well as comorbidity are assessed before and after the systemic intervention is carried out. Discussion: The study attempts to provide evidence of the effectiveness of an ED-related systematic public health intervention. Additionally, the study will lead to a better understanding of the DUI, which is essential in order to improve care of individuals with AN.

BMC Psychiatry, 2015

Background: There are a high number of adolescents who are at risk of developing an eating disord... more Background: There are a high number of adolescents who are at risk of developing an eating disorder. There is, therefore, a strong need to implement prevention programs aimed at reducing the incidence of eating disorders at this critical age. Among other factors, successful prevention programs have been shown to be interactive, carried out by professionals, focused on educational as well as psychosocial elements and have taken risk factors as well as resources into account. The objective of this study protocol is to present the design of a new prevention program for eating disorders in schools. Methods/Design: The gender-adapted prevention program extends over six school hours. It contains interactive and educational elements about eating disorders and their treatment. Participants pass through different exercises and reflect on the influences of the media, self-esteem, body perception and individual resources. A cluster-randomized controlled trial is chosen to evaluate the program. Based on an estimated effect size of d = 0.3 a total of 1848 participants are enrolled in the study. Eating disorder risk, internalization of Western beauty ideals, body dissatisfaction, self-concept as well as anxiety and symptoms of depression are measured before and immediately after the intervention as well as at a six-month follow-up. In addition, the intervention group evaluates the different components of the program. Discussion: The study intends to test the practicability and efficacy of an interactive, gender-adapted ED prevention program in schools. Moreover, it will provide valuable information about the occurrence of eating disorder risk factors in school-aged children.