The Pathological Narcissism Inventory (PNI) is a multidimensional measure for assessing grandiose and vulnerable features in narcissistic pathology. The aim of the present research was to construct and validate a German translation of the PNI and to provide further information on the PNI's nomological net. Findings from a first study confirm the psychometric soundness of the PNI and replicate its seven-factor first-order structure. A second-order structure was also supported but with several equivalent models. A second study investigating associations with a broad range of measures ( DSM Axis I and II constructs, emotions, personality traits, interpersonal and dysfunctional behaviors, and well-being) supported the concurrent validity of the PNI. Discriminant validity with the Narcissistic Personality Inventory was also shown. Finally, in a third study an extension in a clinical inpatient sample provided further evidence that the PNI is a useful tool to assess the more pathological end of narcissism.

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The Health of the Nation Outcome Scales (HoNOS) is an internationally-established clinician-rating instrument for the differential assessment of the severity of patients with mental disorders. The aim of this study was to examine the validity of the German version of the HoNOS (HoNOS-D). Evaluation of validity, including factor validity, convergent and discriminant validity and sensitivity to change, was conducted on a large, virtually representative, clinical sample of patients with mental disorders in inpatient psychotherapy (Study 1, N = 3169). Additional assessment of criterion-based validity was completed using another clinical sample of patients with mental disorders (Study 2, N = 55). Although factor validity of the HoNOS-D and its total score could not be confirmed as expected, the majority of single items of the HoNOS-D proved to be valid in terms of convergent validity, criterion-based validity and sensitivity to change. Hence, single items, rather than the total score of the HoNOS-D, can be recommended for obtaining a picture of the impairment of patients with mental disorders in the clinical setting.

Within a multisite study, including 289 inpatients from six different hospitals who underwent interpersonal-psychodynamic group psychotherapy, associations among attachment characteristics, therapeutic factors, and treatment outcome were investigated. Attachment characteristics were assessed with an interview-based measure (Adult Attachment Prototype Rating [AAPR]) as well as an attachment self-report (Bielefeld Questionnaire of Client Expectations [BQCE]). Therapeutic factors were measured retrospectively with the Dusseldorf Therapeutic Factors Questionnaire and treated as an individual- as well as a hospital-specific characteristic. On an individual level, only the group climate factor independently predicted treatment outcome (i.e., Symptom Checklist-90-R Global Severity Index and Inventory of Interpersonal Problems mean). If simultaneously but separately included into a path model, analyses revealed independent significant effects of AAPR-Security and BQCE-Security on group climate. If modeled as a latent variable (common attachment security), a substantially higher proportion of group climate variance could be explained. Further analyses revealed interactions between particular therapeutic factors and attachment characteristics, indicating a particular importance of these therapeutic factors for different attachment categories.

Personality disorders (PD) are prevalent, underdiagnosed and affect clinical trajectories of psychiatric patients. The SASPD has been developed as a screening tool for PD severity according to the dimensional model of the initial ICD-11 proposal. We show that the SASPD total score might be useful as an indicator for a heterogeneous mixture of PD features, but less as a unidimensional measure of PD severity.

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Background: Attachment has increasingly received attention in psychotherapy and has been used as a predictor of process and outcome. Studies investigating changes of attachment styles during psychotherapy are very rare. Method: Forty women with either borderline (BPD) or avoidant personality disorders (AVPD), treated as inpatients, were investigated using an attachment interview (interpersonal relations assessment (IRA)), and questionnaires to determine therapy outcome at the beginning and after seven weeks of therapy. The IRA uses similar questions as the adult attachment interview (AAI) and is used as the basis for the adult attachment prototype rating (AAPR), a procedure to assign individuals to prototypical categories of attachment. Results: The study showed that the therapy in general was effective. In contrast to other studies, we did not find many women classified as secure at the end of their therapy. Comparisons of pre-post-ratings revealed instead that clients within both subgroups received higher ratings for the avoidant prototypes at the end of therapy, indicating deactivation of attachment. Changes from ambivalent to avoidant attachment were linked with better outcome among women with borderline personality disorder (BPD). Conclusions: This study adds further evidence to the result that attachment styles do not change dramatically during a time-limited psychological treatment of personality disorder. Instead, the study showed that features of preoccupied/ambivalent attachment were less significant after seven weeks of therapy. For women with BPD, these changes were linked with a more favourable outcome which might reflect a more structured and deactivated attachment status as a result of inpatient therapy.

Bei Patienten mit Posttraumatischen Belastungsstörungen (PTB) und zusätzlicher komplexer Thematik erfolgt in Deutschland im stationären Setting überwiegend eine Stabilisierung. Angenommen wird dabei, dass die erfolgreich Stabilisierten in einer ambulanten Folgetherapie mit einem traumakonfrontativen Verfahren behandelt werden. Die hier vorliegende Arbeit hat zwei Ziele: Erstens soll eine quantitative Literaturübersicht zum Thema Stabilisierung und Konfrontation bei komplex Traumatisierten gegeben werden. Hier zeigte sich, dass Stabilisierung überwiegend kleine bis mittlere Effekte erzielt und dass kognitiv-verhaltenstherapeutische Interventionen insgesamt erfolgreicher erscheinen. Zweitens soll die Inanspruchnahme von Folgebehandlungen nach stationärer Stabilisierung erfasst werden. Dazu wurden 147 sexuell traumatisierte Frauen, die eine stationäre, vorwiegend stabilisierende integrative Behandlung erhielten, nachuntersucht. Während sich die allgemeine psychische Belastung am Ende des stationären Aufenthalts stark verbesserte, zeigten sich nur kleine bis mittlere Effekte im Bereich der posttraumatischen Symptomatik. Nur ein geringer Teil der Stichprobe erhielt eine Traumakonfrontation in den vier Jahren nach der stationären Behandlung. Daraus und aus der Literaturübersicht kann abgeleitet werden, dass das stationäre Setting für Traumabearbeitung genutzt werden sollte.