No abstract

For the purpose of retrospective assessment and characterization of childhood trauma in adults, the factorial validity of the short form of the Childhood Trauma Questionnaire (CTQ-SF) in Germany was evaluated by conducting confirmatory factor analyses for three samples including 1,524 adult psychiatric patients, 224 inmates, and 295 university students. In addition, sex-specific confirmatory factor analyses were performed within each sample. Because several authors have suggested a different factor structure than that originally proposed in the manual, two competing models focusing on the Physical neglect subscale were examined. In psychiatric patients and inmates, the fit indices were reasonable to good. Among the students, factor loadings were markedly lower, and fit indices were poor. Sex-specific analyses did not indicate sex differences. Comparing the original and the alternative models revealed better fit indices of the original factor structure. The present findings indicate that the German version of the CTQ-SF has factorial validity in psychiatric patients and inmates, but not in students.

Luck in forensic psychiatry may mean a fair treatment for the affected person, safety for the society and satisfying work for the clinician. There has been great progress in forensic psychiatry. A high quality forensic treatment consists of a professional attitude, which preserves the personal integrity and identity. The principles of RNR (Risk-Need-Responsivity) are essential. There are very promising treatment approaches like the "Good lives model" or the "Community Reinforcement Approach" (CRA-Concept), which consider the personal aims and the pursuit of happiness of the patient as a starting point and resource. The most recent legislative changes will probably cause a shorter duration of stay in forensic clinics and will require a more intense and well connected aftercare. The risk of a relapse is not a matter of luck. It can be calculated and reduced. However, further research is needed to improve effectiveness of the follow-up care.

We present the concept of an extended documentation of psychiatric-psychotherapeutic treatment with the patients being in the center of information. Apart from a short treatment report for the outpatient therapist, we write a detailed letter to the patients themselves including informations and backgrounds of their psychiatric and medical history, psychopathological findings, diagnose(s), course of the current treatment and recommendations for the future. This procedure is in agreement with the tradition of psycho-educative approaches and self-management concepts. It intends to support patients to be self-conscious and responsible partners during and after the treatment process. We performed a pilot study for a predominantly descriptive evaluation of the concept in the day clinic setting. A standardized questionnaire in 30 previously treated patients and three case studies yielded a high acceptance and positive appraisal of the received letters with a substantial subjective impact for coping with the disorder and a positive option for dealing with family members and friends.