Giessen Test Research Articles

First all-Germany standardization of the brief form of the Gissen Complaints Questionnaire GBB-24

At the end of 1994 a shortened version of the Giessen Subjective Complaints List (GBB-24), was standardised using a sample of 2182 subjects aged 18 to 60 years, representative of the population of re-unified Germany (720 from East Germany, 1462 from West-Germany). The item norms are given for the whole group, while the scale norms are also subdivided according to gender, age (18-30, 31-40, 41-50 and 51-60 years) and place of residence (East/West). The dependence of physical complaints on age and gender has diminished significantly since 1975, whereas the factor structure and the internal consistency of the scales have changed only slightly. The relative influence of further socio-demographic variables (education, income, partnership status, town/country, unemployment) and attitudes health on the scale scores of the GBB-24 are described. The results were also correlated with data from Giessen-Test (GT) and a questionnaire on life satisfaction (Fragebogen zur Lebenszufriedenheit FLZ), collected at the same time. As expected, significant relationships were found between Scale 4 (Depression) of the Giessen-Test and all scales of the GBB-24, particularly Scale 1 "Exhaustion". A significant relationship with life satisfaction was also found, i.e. absence of complaints corresponded with greater life satisfaction. As anticipated, this relationship became most evident in the area of physical health.

Correlation between chronic urticaria and depression/somatization disorder

In a multicenter study, 100 patients with chronic urticaria were examined with a standardized personality test (Giessen test), a standardized symptom questionnaire (Giessener Beschwerdebogen) and a specially developed questionnaire concerning symptoms, history and behaviour during symptomatic periods. Almost one third of the patients showed elevated scores both for depression and for symptoms that are often associated with depression. It therefore seems worth-while examining such persons more specifically and possibly treating them by psychosomatic methods. The present results do not allow the classification of chronic urticaria as a somatization disorder. Since one-third of the patients had symptoms of depression, combined dermatological and psychosomatic approach may make it possible to offer them an appropriately targeted treatment.

Einfluss psychischer Faktoren in der Schwangerschaft auf die entstehendeEltern-Kind-Beziehung

In a longitudinal prospective study on 38 couples and their first child, we examined the influence of prenatally assessed psychological factors of the parents on somatic and psychic aspects of birth, the quality of the newly established parent-child relationship and the early development of the baby. Half-standardized psychoanalytic interviews with the couple (pre- and postnatally conducted, video-recorded), the Giessen test for couples, an evaluation of the parents' birth narratives and a parent questionnaire about functional symptoms of the baby were used. We found a high continuity between the pre- and the postnatal measurements of the partnership and the emotional experiences of the parents. Somatic complications of the birth event were not correlated with prenatally assessed psychological factors. But there exists a highly significant correlation between the mental representations and the relationships of the parents and the emotional experiences of birth, the early relationship between the parents and their baby and manifestations of functional disorders of the newborn. Relevant psychological and psychosocial aspects should be included in the medical care of pregnant women. One should listen to the imaginations and expectations of the parents about the future parentship, including ambivalent feelings. The father should also be seen for psychological assessment.

Behavioural and psychosocial sequelae of severe closed head injury and regional cerebral blood flow: a SPECT study

Thirty six patients (31 male, 5 female) who had suffered severe closed head injury were re-examined at an average of 39.3 (SD 12.8, range 7-66) months after the injury. Behavioural symptoms were measured using the Giessen test. The relatives' reports were used for data analysis to ensure that results were valid. The neurophysical impairment subscale of the Glasgow assessment schedule was completed by two neurologists, and the number connection test was completed by each patient. The adjective mood scale was completed by each relative. All patients were investigated by single photon emission computerised tomography (SPECT). Exploratory factor analysis using the principal components method was carried out separately for SPECT results and psychological measures and correlations were sought between the resulting factors. Factor analysis of the data from the Giessen test identified social isolation, disinhibition, and aggressive behaviour as major components of post-traumatic personality changes; it indicates that these behavioural features are independent of the level of neurological and neuropsychological impairment, which loaded on a single independent factor. Relatives' psychic health seemed to be relatively resistant to physical and cognitive disability and was mainly affected by disinhibitive behaviour. The highest correlation was between frontal flow indices and disinhibitive behaviour (p less than 0.01): the severity of disinhibition increased with lower frontal flow rates. There was a significant but somewhat weaker correlation (p less than 0.05) between flow indices of the left cerebral hemisphere and social isolation. Low flow values of the right brain regions were related to aggressive behaviour (p less than 0.05). Neurological and cognitive impairment correlated negatively with the thalamus; worse neurological and cognitive performance indicate by raised scores on the neurophysical scale and on the number connection test was associated with low thalamic flow values. The results support the importance of lesion location in the production of post traumatic behavioural disorders.

Persönlichkeitsmerkmale von Patienten mit Kontaktgranulom

Particular features of the personality of patients with vocal cord granuloma have been reported in the literature based on intuitive observation of individual cases in clinical examination. The present study was designed to examine systematically a larger number of patients with vocal cord granuloma by means of a psychosomatic interview and with objective standardised personality inventories. The aim was to investigate characteristics of personality structure, the extent and form of psychosomatic complaints, and the psychosocial self-image of these patients. 33 patients with the diagnosis of vocal cord granuloma participated in the study. They underwent a psychodynamic psychosomatic interview and filled in the Giessen test, a standardized personality inventory, the Giessener Beschwerdebogen, a somatic complaints list, and a social questionnaire. Descriptive statistics were computed. Psychodynamic diagnostics revealed two types of the functional level of personality: narcissistic and psychosomatic structures were almost equally represented. With respect to the drive organisation of personality structure, mainly compulsive and to a lesser extent depressive dominant features were found. The structure of somatic complaints in our patient group with vocal cord granuloma was different from that of the norm population as well as that of a group of psychosomatic-psychoneurotic outpatients. With regard to the extent of somatic complaints, the scores of our patients were in the middle between the norm values and those of psychosomatic patients. In the self-image of their personality and their psychosocial relations, patients with vocal cord granuloma deviated from the values of the norm population in all scales into the direction of the scores of psychosomatic-psychoneurotic outpatients.(ABSTRACT TRUNCATED AT 250 WORDS)

Psychosomatic evaluation of patients with congenital penile deviation. A postoperative catamnestic follow-up.

Thirty-three patients with congenital penile deviation were examined by a semi-structured interview and psychodiagnostic tests (Giessen test, Giessen complaint sheet) prior to undergoing surgery according to the Nesbit-Kelâmi technique. A prognosis was then made to determine the extent to which the problems and disturbances reported by the patient or uncovered by the examiner could be improved by the operation. This prognostic assessment was then verified in a subsequent catamnestic examination (N = 20), at an average of 21.3 months after the intervention. An attempt is made to identify and define preoperative indicators that permit to predict the postoperative course.

Behavioural and psychosocial sequelae of severe closed head injury and regional cerebral blood flow: a SPECT study.

Thirty six patients (31 male, 5 female) who had suffered severe closed head injury were re-examined at an average of 39.3 (SD 12.8, range 7-66) months after the injury. Behavioural symptoms were measured using the Giessen test. The relatives' reports were used for data analysis to ensure that results were valid. The neurophysical impairment subscale of the Glasgow assessment schedule was completed by two neurologists, and the number connection test was completed by each patient. The adjective mood scale was completed by each relative. All patients were investigated by single photon emission computerised tomography (SPECT). Exploratory factor analysis using the principal components method was carried out separately for SPECT results and psychological measures and correlations were sought between the resulting factors. Factor analysis of the data from the Giessen test identified social isolation, disinhibition, and aggressive behaviour as major components of post-traumatic personality changes; it indicates that these behavioural features are independent of the level of neurological and neuropsychological impairment, which loaded on a single independent factor. Relatives' psychic health seemed to be relatively resistant to physical and cognitive disability and was mainly affected by disinhibitive behaviour. The highest correlation was between frontal flow indices and disinhibitive behaviour (p less than 0.01): the severity of disinhibition increased with lower frontal flow rates. There was a significant but somewhat weaker correlation (p less than 0.05) between flow indices of the left cerebral hemisphere and social isolation. Low flow values of the right brain regions were related to aggressive behaviour (p less than 0.05). Neurological and cognitive impairment correlated negatively with the thalamus; worse neurological and cognitive performance indicate by raised scores on the neurophysical scale and on the number connection test was associated with low thalamic flow values. The results support the importance of lesion location in the production of post traumatic behavioural disorders.

Perceived Parental Rearing and State versus Trait Aspects of Adult Depression

In a pilot study of 72 psychiatric inpatients, relationships between state versus trait aspects of depression and perceived parental rearing have been investigated. It appeared that trait aspects (assessed by the mood scale of the Giessen test) yielded the most frequent and highest correlations with the factors rejection, emotional warmth and overprotection of the EMBU (Egna Minnen av Barndoms Uppfostran--My Memories of Upbringing) questionnaire of parental rearing. Particularly rejecting maternal rearing behaviour during childhood seems to constitute a risk factor for the development of trait depression during adulthood.

Self-image and personality

This study attempts to relate the self-image scales (derived from the Giessen Test) constructed on the basis of psychoanalytical and sociopsychological theory, and the personality dimensions, Psychoticism, Extraversion and Neuroticism (EPQ-R). Factorial analysis revealed that two major self-descriptive factors emerge from the GT sub-scales labelled social anxiety and ‘conformism’. Psychoticism and Social Desirability were intimately related to Dominance and Self-control, variables which loaded on the higher order dimension, ‘Conformism’. Underlying mood (hypomanic-depressive) social (im) potency and submissiveness were related to Neuroticism. Extraversion was associated with positive affect, reflected in elevated scores on the scales, Dominance, Permeability and Social potency. The implications of these findings are discussed.

Vaginal Agenesis and Congenital Adrenal Hyperplasia Psychosocial Sequelae of Diagnosis and Neovagina Formation

Eleven patients with Mayer-Rokitansky-Küster syndrome (MRK) and 7 patients with adrenogenital syndrome (CVAH) were interviewed and tested pre- and postoperatively. MRK subjects were operated on with a modified Vecchietti procedure, CVAH subjects underwent genitoplastic and clitoroplastic operation. Psychosocial sequelae of and coping with malformation and treatment were assessed with semistructured interviews and the Giessen test. Anatomical and functional results of the vaginoplastic operation were excellent, and sexual satisfaction correlated with coping. 7/11 MRK patients were capable of good to fair adaptation to the malformation, whereas CVAH patients suffered severe distortions of body image. The malformation caused narcissistic damage in all cases. Circumstances of diagnosis, prevailing defense mechanism and consequences for counselling are discussed.

Results of concomitant psychosomatic studies of IVF patients

The in vitro fertilization (IVF) treatment is very stressful for the couple. The emotional tension (waiting, hoping) plays a greater role than the bodily complaints (stimulation, follicle puncture). Sometimes the wish to get a child is very strong and is the motivation for IVF treatment. Psychological investigations show that IVF patients have fewer psychological complaints compared with other sterility patients; in the psychoanalytically oriented Giessen test there are no differences compared with other sterility patients. The aim of a treatment for IVF patients is the individual, medically and psychologically oriented therapy - sometimes involving the renunciation of a further IVF therapy.

Aspects of personality in patients with pituitary adenomas.

In 24 patients suffering from pituitary tumours, aspects of personality as covered by the FPI (Freiburger Personality Inventory), the Giessen test and the STAI (State-Trait-Anxiety Inventory) were investigated in order to find out changes or problems which demand special treatment. The most interesting result concerns state- and trait-anxiety scores being increased pre-surgically and normalizing to some extent after treatment. Most of the other explored aspects did not show but tendencies which demand further investigation. Relationships between hormone levels and tumour size could not be shown. As a result of this investigation, special psychological treatment should be considered in acromegaly and Cushing's disease.

Psychosocial situation of married couples prior to artificial insemination with donor sperm

57 couples who attended our outpatient department for artificial insemination with donor sperm (AID) had a detailed semistandardized interview prior to treatment. The Giessen Test was used as personality test, as well as a questionnaire concerning the sexual and partner relationship. We found that it was the woman who had to bear the major part of the intrapsychic burden and who primarily suffered because of the problem which was actually caused by male sterility. However, 54 of 57 couples had no psychological difficulties to overcome the sterility problem. These couples developed individual and partnership strategies to deal with the burden of unwanted childlessness. They preferred AID rather than adoption, because for the woman this alternative offers the chance of real parenthood. AID seems to provide a medico-technical solution for couples with sterility problems: the reproductive process at the biological level was regarded as distinctly separated from their future role as parents which they considered to be a social task.

Success and failure in psychotherapy: hypotheses and results from the Heidelberg Follow-Up Project.

Within the Heidelberg Follow-Up Project all treatments of the clinic regardless of the type of psychodynamic technique used are investigated. The outlet is both prospective and retrospective. There are four points of investigation: (1) immediately after the first contact with the hospital (2) at the beginning; (3) at the end of therapy, and (4) after a 2-year follow-up period. Immediately after the first contact with the patient a test battery (Giessen Test, Holzman Inkblot Technique, Gottschalk-Gleser Method, symptom checklist) is administered. This is repeated after a waiting period at the beginning of therapy, where in addition the therapist formulates a psychodynamic hypothesis and defines 3-5 individual treatment goals in connection with the individual pathology of the patient. At the end of the therapy the tests are repeated and the therapist assesses the success or failure of the therapy with regard to symptoms, object relations and psychodynamic change, while the patient fills out a special questionnaire dealing with his personal view of the therapy, the therapist and his own treatment experiences. The first results of about 100 combined inpatient and outpatient psychotherapies are presented (third test-round at the end of treatment). The results are discussed on the basis of the involved tests and ratings with respect to success and failure in the view of patients, therapists and independent clinical experts. Since the study is still under way, reports of the follow-up data are not yet evaluated.

Congruence of personality assessments within families with a schizophrenic son.

Following the phenomenological approach to interaction in psychiatrically disturbed families a personality questionnaire ('Giessen Test') was used to assess the views three family members (father, mother, son) had of themselves and of each other. These views may be regarded as quite stable results of interaction processes, so that conclusions about family interaction patterns may be drawn from the level of concordance of any two of them. Comparisons were made between families in which a son had been hospitalized for the first time with a diagnosis of schizophrenia and those in which a son had been hospitalized for surgical treatment, n = 30 in each category. The psychiatric patients did not on the whole give distorted personality descriptions. But in the index families the relationship between father and son was found characteristically different from that in the control families. This fact is interpreted as a reaction of the father to the deviant behaviour of the son, who did not conform with the male sex-role expectations of the father. The father as it is could not then identify with his son as a father usually does and perhaps necessarily should. The answers of the mothers partly confirm this conclusion. With regard to the parental dyad, the findings suggest that the fathers' needs for reciprocal consideration are not met by their wives.

Problems in interaction between patients undergoing long-term hemodialysis and their partners.

186 patients undergoing hemodialysis and their partners were examined with a personality inventory (Giessen test) and a questionnaire which was specially developed for this purpose. The instrument was used to measure the social interaction between patient and partner. The Giessen test was applied in four versions: self-description, description by the partner, referring to the present, referring to the past. One of the main interests of the analyses was in finding dependencies of the variables upon the types of hemodialysis setting (unit, private unit, and at home). Various correlations were found.

Testing cooperation in parents with children destined for home dialysis.

Ten married couples with children in the dialysis department of the University's Children Hospital of Heidelberg are examined by means of different tests (Joint Rorschach, Simfam, Giessen Test, Bales scale, Expert rating) and compared with a group of ten psychologically 'extraordinary' as well as ten psychologically 'ordinary' couples. The problem was to find out whether the emotional family atmosphere is stable enough to provide the child with home dialysis or whether the parents need psychotherapeutic preparation.

How to operationalize alexithymic phenomena - some findings from speech analysis and the Giessen Test (GT).

How to operationalize alexithymic phenomena - some findings from speech analysis and the Giessen Test (GT).

Subgroups of peptic ulcer patients

The present study reports on a population of 86 ulcer patients who had been referred preoperatively from the Surgical University Clinic, Marburg, to the Psychosomatic University Clinic, Giessen, for psychosomatic diagnosis. The examination consisted of an analytical interview and the collection of psychological test, family and social data. First the total group is described according to social characteristics and the illness behaviour and compared by the Giessen test with 3 other selected groups of patients. It emerges that the examined ulcer patients see themselves distinctly less disturbed on the psychosocial level than psychoneurotic patients, that they show a striking resemblance with low stratum patients in the Giessen test self-concept and differ distinctly from the ulcer population of a Medical Out-patient Department in their composition. Further examination of the total group according to clinico-sociological and psychological test characteristics of the GT reveals 7 subgroups which are described in detail. In the concluding discussion an attempt is made to establish a relation between the clinico-sociological and psychological traits of the total test population as well as the 7 subgroups and relevant psychodynamic and pathogenetic aspects. For this purpose the psychotherapeutic description of the examined ulcer patients is first supplemented by stressing the general performance effort, the oral dependence-independence conflict and the object loss. Subsequently cross-connexions are established between the clinico-sociological typology of this study and certain subgroups of ulcer patients formed according to psychodynamic-structural aspects and varying psychosomatic concepts.

Results of psychosocial adjustment to long-term colostomy.

114 patients with permanent colostomy for carcinoma of the rectum were compared by questionnaire and interview with 110 cancer patients, having undergone colonic resection but not bearing a colostomy. The patients' own assessment of their health was for the colostomy group even better than for the controls. The emotional state before and after surgery showed significant degrees of hopelessness, depressions and fear especially for young women awaiting colostomy. Social contacts were considered as far as visits of friends or cinema, theatre are concerned. Sexual activity decreased significantly for 75% of colostomized men. In 40% organic lesions led to impotence. The Giessen test revealed significant rates of social impotence, negative social resonance and depression for men with colostoma.