Zeitschrift für Medizinische Psychologie

Decisional balance and self-efficacy determine readiness for physical activity in the context of the Transtheoretical Model. We asked elderly patients with low back pain which are the barriers and benefits that make up their decisional balance. After adding frequently presented and salient items to complement existing decisional balance scales, we examined the dimensionality and the psychometric properties of the newly developed instrument. A total of 170 elderly patients with a mean age of 70.3 years (SD = 4.4, range 65–83), nearly half of whom had received a diagnosis of spondylosis, participated in diagnostic interviews that included stage of change, decisional balance, self-efficacy, and perceived function (Hanover Functional Disability Scale), as well as an objectively taken measure of mobility. A principal component analysis of the decisional balance items revealed a three-factor-solution with factor I representing the perceived advantages (10 items, α = 0.73), factor II reflecting items that indicate “fear avoidance beliefs” (5 items, α = 0.74), and factor III containing items that may be summarized as “organizational barriers” (5 items, α = 0.65). The construct validity of the scale is supported by the fact that individuals in the pre-contemplation and contemplation stages show higher fear avoidance than those in the preparation and action stages. Moreover, fear avoidance correlates negatively with self-efficacy and subjective and objective measures of physical function. The fear avoidance beliefs scale appears to be useful to supplement the traditional decisional balance scale, although its application may be limited to the study of physical activity in individuals with pain.

Objectives: The Illness-specific Social Support Scale (ISSS), originally developed by Revenson and Schiaffino (1990), has been adapted to the German language (SSUK) by Ramm and Hasenbring (2003) for N = 154 patients with malignant haematological diseases. Aim of the study is the validation of the SSUK on a considerable group of breast cancer patients.

Methods: The SSUK has been psychometrically re-examined on representative samples of N = 1181 breast cancer patients.

Results: Factor- and reliability analysis confirm the two scales Positive Support and Detrimental Interaction and show internal consistencies with Cronbachs α = 0,94 and 0,76. Validity of the SSUK was examined using the questionnaire “Fragebogen zur Sozialen Unterstützung” (F-SOZU-K22) i. a., which showed significant correlations with the scales Positive Support (r = 0,74, p < 0,001) and Detrimental Interaction (r = .0,41, p < 0,001). Correlations with other instruments, e.g. HADS-D and SF-8, refer to good construct validity.

Conclusion: Due to high internal consistencies as well as convincing criterion and construct validity the SSUK can be recommended for further use for chronic ill people.

The assessment of health related quality of life aims at an evaluation of the patient's perspective with regard to the consequences of a disease or to treatment outcome. Frequently, there is a focus on change over time. The outcome of measurement may reflect real change, but, on the other hand, may also be the consequence of cognitive changes such as changes in the reference system of the patient or in values and concepts about health and disease. Changes that are reflected in repeated measurements and that may not be attributed to real change in quality of life, are defined as response shifts. It is a challenge to separate change due to response shifts from those due to real change. The present article reviews research on this field and provides recommendations for future assessment procedures.

Objectives: So far, there is little research in individuals with a diagnosis of epilepsy and minor cognitive impairment on cognitions related to their illness. In the Bethel center for epilepsy patients, we developed the PESOS questionnaire that addresses the perception of illness related problems as an aspect of the patients’ quality of life (PErformance, SOciodemographic aspects, Subjective estimation).

Methods: 106 residents with epilepsy of the Bethel institute participated in face-to-face interviews with the PESOS and two screening instruments for psychopathology, the depression scale D-S’ by von Zerssen and the BSI by Derogatis. PESOS-data were analyzed with regard to reliability and validity.

Results: The statistical analysis of the PESOS reveals good psychometric properties that allow its application for research purposes. There was a co-variation of PESOS-scores with seizure frequency and perceived side-effects of medication. Patients in residential care score low on problems directly related to epilepsy. On the other hand, there is a high proportion of individuals with scores that indicate psychopathology.

Conclusion: The PESOS questionnaire appears to be a useful instrument for the detection of epilepsy-related problems in patients with slight intellectual disturbance. Reliable assessment of these problems are a precondition for the provision of adequate treatment. It is not designed to measure psychopathology. Therefore, it should be part of a comprehensive clinical assessment.

The article is devoted to critical reconsideration of the logic of modern brain-mind studies. The classical distinction between two experimental approaches should be kept in mind: (1) the psychophysiological approach, in which mind and behavior represent a set of independent variables, and brain represents a set of dependent variables; and (2) the biopsychological approach, in which, to the contrary, the brain represents a set of independent variables, and mind, that of dependent variables. For studying neurophysiological basis of mind and consciousness, the use of the former approach alone can frequently lead to absurd conclusions. The same is true for the modern functional neuroimaging (FNI) because it follows the same experimental logic, in which it regards the pattern of brain activation as the dependent variable and the experimental task as the independent variable. Only the second approch may permit correct conclusion regarding brain mechanisms of mental activity. The belief that the high precision of FNI allows to overcome this limitation is an illusion, because the limitation is of logical nature and not caused by insufficient precision of a measurement technique. In contrast, FNI is extremely useful in elucidating psychological problems in the proper sense and in exploring important issues of psychological theory. Therefore, psychologists, rather than neurophysiologists, should be the main beneficiaries of FNI.