Carsten Spitzer

Carsten Spitzer
University Medical Center Rostock · Department of Psychosomatics and Psychotherapeutic Medicine

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357
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10,360
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Publications

Publications (357)
Article
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Zusammenfassung Hintergrund Empirische Befunde legen nahe, dass Bindung im Erwachsenenalter sowohl globale als auch beziehungsspezifische Aspekte aufweist. Bisher ist jedoch nicht ausreichend geklärt, inwieweit sich globale und spezifische Bindungsdimensionen in ihren Zusammenhängen mit psychischer Gesundheit unterscheiden. Methodik In einer Gele...
Article
Zusammenfassung Die hohe Relevanz früher Beziehungserfahrungen für die psychosoziale Entwicklung des Säuglings bzw. Kindes ist von der Bindungstheorie elaboriert und von der Bindungsforschung eindrucksvoll empirisch belegt worden. Auch die körperliche Reifung und Ausdifferenzierung biologischer Systeme werden von Beziehungserfahrungen geprägt. Glei...
Article
Objective: Although traumatic stress including childhood maltreatment (CM) has a profound impact on mental health, its relation to pathological skin picking (PSP) has been understudied and results remain inconclusive. Likewise, posttraumatic stress disorder (PTSD) as the most typical sequelae of traumatic stress has hardly been investigated in tho...
Preprint
The ICD-11 features a new classification of personality disorders (PD), focusing on the severity of PD. Although there are numerous self-report measures that assess PD severity, to date only the Personality Disorder Severity ICD-11 (PDS-ICD-11) is based on ICD-11’s operationalization of PD. Initial results indicated that the PDS-ICD-11 measures a u...
Article
Zusammenfassung Geschlechtsunterschiede in Bindungsmerkmalen wurden bislang wenig explizit berücksichtigt. Die vorliegende Studie widmet sich dieser Thematik, einschließlich der Vergleiche von unterschiedlichen Altersgruppen sowie von klinischen und nichtklinischen Teilstichproben. Es handelt sich um die Reanalyse von 4 Datensätzen – jeweils einer...
Article
Biological research and clinical management in psychiatry face two major impediments: the high degree of overlap in psychopathology between diagnoses and the inherent heterogeneity with regard to severity. Here, we aim to stratify cases into homogeneous transdiagnostic subgroups using psychometric information with the ultimate aim of identifying in...
Article
Objectives: The relationship between patients' attachment strategies and the effectiveness of psychotherapy is empirically well established. However, studies on outcome measures other than symptomatic change are mostly lacking. The present study investigates if attachment anxiety and avoidance predict changes in personality functioning at the end o...
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Reliability and validity of the OPD-conflict-questionnaire in an inpatient treatment sample Objectives: Unconscious conflicts are a major part of psychodynamic diagnostics. Benecke et al. (2018) developed the OPD-conflict-questionnaire (OPD-CQ) to assess unconscious conflicts according to the Operationalized Psychodynamic Diagnostics (OPD) via self...
Article
Parental stress has negative impact on parents and their children. Parental stress may be of special interest for family and child well-being due to Covid-19 pandemic. A reliable and valid assessment of parental stress would be beneficial both in research and clinical practice. The Parental Stress Scale (PSS) is internationally well established as...
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Introduction According to the World Health Organization, medication adherence is defined as the extent to which a person's behavior corresponds with an agreed recommendation from a healthcare provider. Approximately 50% of patients do not take their medication as prescribed, and non-adherence can contribute to the progress of a disease. For patient...
Article
Objective The prevalence of pathological skin-picking (PSP) has predominantly been studied in students and the community, but not yet in dermatological patients. However, those may be at increased risk of PSP because it is often triggered by the feel or look of the skin. Thus, its prevalence among patients with a physician-diagnosed dermatological...
Article
Zusammenfassung Die Funktionalität des Systems Familie spielt nicht nur in der Entwicklungspsychologie und Familienforschung, sondern auch bei vielen körperlichen Erkrankungen und psychischen Störungen eine zentrale Rolle. Trotz dieser hohen Relevanz existieren nur sehr wenige ultra-kurze, d. h. anwendungsökonomische Selbstbeurteilungsverfahren, di...
Article
Impact of dissociative phenomena on treatment outcome of inpatient psychotherapy of patients with borderline personality disorder Objectives: Although dissociative phenomena belong to the diagnostic criteria of borderline personality disorder (BPD) and are of high clinical relevance, their predictive significance with regard to the treatment outcom...
Article
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As early detection of symptoms in the subclinical to clinical psychosis spectrum may improve health outcomes, knowing the probabilistic susceptibility of developing a disorder could guide mitigation measures and clinical intervention. In this context, polygenic risk scores (PRSs) quantifying the additive effects of multiple common genetic variants...
Article
Shame and guilt are vital in borderline personality disorder (BPD), and research using explicit measures has consistently found elevated levels of these self-conscious emotions (SCE) in those with BPD. However, these measures cannot elucidate implicit processes that are equally important as they guide the perceptions of the self and influence behav...
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Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with its impact on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preven...
Article
The Reflective Functioning Questionnaire (RFQ) is an 8-item self-report measure of reflective functioning that is presumed to capture individual differences in hypo- and hypermentalizing. Despite its broad acceptance by the field, we argue that the validity of the measure is not well-established. The current research elaborates on problems of the R...
Preprint
Background The SARS-CoV-2 pandemic, with all its impacts on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preventative health behavior and, therefore, the ri...
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Full-text available
Executive functions are metacognitive capabilities that control and coordinate mental processes. In the transdiagnostic PsyCourse Study, comprising patients of the affective-to-psychotic spectrum and controls, we investigated the genetic basis of the time course of two core executive subfunctions: set-shifting (Trail Making Test, part B (TMT-B)) an...
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Die phänomenologisch heterogenen und eher unscharf definierten dissoziativen Symptome gehören nicht nur zu den diagnostischen Kriterien der Borderline-Persönlichkeitsstörung (BPS), sondern sind auch mit autoaggressiven Handlungen, erhöhtem Inanspruchnahmeverhalten und schlechteren Therapieergebnissen assoziiert. Obwohl sich die deutlich besser oper...
Article
Die phänomenologisch heterogenen und eher unscharf definierten dis-soziativen Symptome gehören nicht nur zu den diagnostischen Kriterien der Borderline-Persönlichkeitsstörung (BPS), sondern sind auch mit autoaggressiven Handlungen, erhöhtem Inanspruchnahmeverhalten und schlechteren Therapieergebnissen assoziiert. Obwohl sich die deutlich besser ope...
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Zusammenfassung Trotz der hohen Relevanz dissoziativer Phänomene bei der Borderline-Persönlichkeitsstörung (BPS) ist das Konzept der pathologischen Dissoziation bisher kaum in diesem Kontext untersucht worden. Zur Operationalisierung von pathologischer Dissoziation wurden diverse Indizes vorgeschlagen, deren klinische Nützlichkeit in der vorliegend...
Article
Das transdiagnostische Konzept der Ich- bzw. Persönlichkeitsstruktur spielt in der psychodynamischen Krankheitslehre eine zentrale Rolle, gelten doch viele psychische und psychoso-matische Störungen als Ausdruck struktureller Vulnerabilitäten und Defizite. Daher kommt der Strukturdiagnostik eine besondere Bedeutung zu, gerade unter differenzialindi...
Article
Objective: Evidence suggests that childhood maltreatment (CM) is cross-sectionally and prospectively associated with cardiovascular disease (CVD). However, its association with proxy markers of atherosclerosis has hardly been investigated. Thus, in this general population study, CM was related to carotid plaque and intima-media thickness (cIMT)....
Article
The Alternative DSM-5 Model of Personality Disorders describes the level of personality functioning, defined by impairments in self functioning (self pathology) and problems in interpersonal functioning (interpersonal pathology), as the core feature of all personality disorders. A brief self-report measure to assess the level of personality functio...
Article
Psychometric evaluation of the Experiences in Close Relationships Revised German 12-item version (ECR-RD 12) in a sample of psychotherapeutic inpatientsObjectives: The ECR-R assesses the self-description of adult attachment strategies in romantic relationships. The present study evaluates the psychometric properties of the German 12-item short vers...
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Background: Cumulative evidence suggests that both traumatic stress and posttraumatic stress disorder (PTSD) are cross-sectionally and prospectively linked to cardiovascular disease (CVD). However, their association with proxy markers of atherosclerosis has hardly been investigated. Objective: The objective of this general population study was to r...
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Background: Adverse childhood experiences (ACE) are associated with an increased risk of major depressive disorder (MDD) and hypothalamic-pituitary-adrenal (HPA) axis dysregulation. Within the HPA axis, corticotropin-releasing hormone and vasopressin (AVP) synergistically stimulate the release of adrenocorticotropic hormone, which promotes cortisol...
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While Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM-5) Section III and ICD-11 (International Classification of Diseases 11th–Revision) both allow for dimensional assessment of personality pathology, the models differ in the definition of maladaptive traits. In this study, we pursued the goal of developing a short and reli...
Article
Objective Cumulative evidence indicates that childhood maltreatment (CM) is linked to self-reported asthma and chronic obstructive pulmonary disease. However, the relation between CM and objective measures of lung function as determined by spirometry has not yet been assessed. Methods Medical histories and spirometric lung function were taken in 1...
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Zusammenfassung Hintergrund Als „pseudogesund“ gelten Patienten, deren Testwerte in symptombezogenen Selbstbeurteilungsverfahren sich nicht von Personen der Allgemeinbevölkerung unterscheiden. Dennoch nehmen die „Pseudogesunden“ psychotherapeutische Behandlungen in Anspruch. Die vorliegende Studie geht daher der Frage nach, ob, und ggf. wie, sich...
Article
Zusammenfassung Das Mentalisierungskonzept ist sowohl in der Praxis als auch der Wissenschaft breit rezipiert worden, u. a. wegen seiner hohen klinisch-therapeutischen Relevanz. Um dieses Konzept der empirisch-quantifizierenden Forschung zugänglich zu machen ist u. a. der Reflective Functioning Questionnaire mit 8 Items (RFQ-8) entwickelt worden, d...
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Zusammenfassung Während Kindheitstraumatisierungen zentrale psychosoziale Risikofaktoren für die Entwicklung einer Borderline-Persönlichkeitsstörung (BPS) darstellen, ist ihre Relevanz für die Symptomschwere der Erkrankung und das Therapieergebnis bisher unzureichend und mit inkonsistenten Ergebnissen untersucht worden. In dieser naturalistischen S...
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Introduction: From both a clinical and research perspective, it is important to determine what constitutes a perceivable change in commonly used outcome measures. Objective: We aimed to do so for the Symptom Checklist-90-Revised (SCL-90-R). Methods: Patients from a large real-world sample treated with inpatient psychotherapy (n = 4,791) rated...
Preprint
Full-text available
The Reflective Functioning Questionnaire (RFQ) is an 8-item self-report measure of reflective functioning that is presumed to capture individual differences in hypo- and hypermentalizing. Despite its broad acceptance by the field, we argue that the validity of the measure is not well-established. The current research elaborates on problems of the R...
Article
Auch 30 Jahre nach der friedlichen Revolution im Osten Deutschlands gibt es gute Gründe, an die Opfer der dortigen politisch motivierten Repression und Verfolgung zu erinnern. Die Staatssicherheit der DDR setzte als Arbeitsmethode die »Zersetzung« ein, die auf Konzepten der »Operativen Psychologie« beruhte, wie sie am Psychologischen Institut der S...
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Zusammenfassung Der Artikel begründet die Notwendigkeit eines genuin psychoanalytischen und gleichsam in der empirischen Psychotherapieforschung anschlussfähigen Beitrags zum Verständnis psychotischer Erkrankungen. Die sequenziell erklärende Mixed-Methods-Studie „Therapie und Psychodynamik von Patient*innen mit psychotischen Symptomen“ (T3PS-Studie...
Article
Importance Identifying psychosis subgroups could improve clinical and research precision. Research has focused on symptom subgroups, but there is a need to consider a broader clinical spectrum, disentangle illness trajectories, and investigate genetic associations. Objective To detect psychosis subgroups using data-driven methods and examine their...
Article
Background: Aggressiveness resulting from inappropriately intense anger plays a major role in borderline personality disorder (BPD) and research using self-report measures has consistently found elevated levels of aggression in this condition. However, while self-report assesses explicit dimensions of the self-concept, it cannot elucidate implicit...
Article
Objective: Low levels of vitamin D were found to be associated with different mental disorders. However, the role of vitamin D in the pathogenesis of PTSD is unclear. In this study, we aimed at investigating whether PTSD is linked to reduced vitamin D levels and vitamin D deficiency. Moreover, we sought to investigate the role of the vitamin D-bin...
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Cognitive deficits are a core feature of psychiatric disorders like schizophrenia and bipolar disorder. Evidence supports a genome-wide polygenic score (GPS) for educational attainment (GPSEDU) can be used to explain variability in cognitive performance. We aimed to identify different cognitive domains associated with GPSEDU in a transdiagnostic cl...
Article
Background: Religious delusions are a common symptom in patients experiencing psychosis, with varying prevalence rates of religious delusions across cultures and societies. To enhance our knowledge of this distinct psychotic feature, we investigated the mutually-adjusted association of genetic and environmental factors with occurrence of religious...
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Impaired cognitive functioning constitutes an important symptom of major depressive disorder (MDD), potentially associated with elevated cortisol levels. Adverse childhood experiences (ACE) enhance the risk for MDD and can contribute to disturbances in the stress systems, including cortisol and cognitive functions. In healthy participants, cortisol...
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Why the concept of distinct psychotherapeutic approaches is indispensable - and why the tool box concept of psychotherapy cannot workBackground: In Germany, the official psychotherapy guidelines are oriented towards the model of distinct psychotherapeutic approaches. Within the German health care system this also applies to the training in psychoth...
Article
Objective: Patients with mental disorders do not only show specific symptoms but also impairments in personality functioning, especially those with personality disorders. Recent developments in DSM-5 and ICD-11 suggest a dimensional approach to personality disorders. Few studies, however, have examined changes in personality functioning. Methods:...
Article
Kindheitstraumatisierungen sind Risikofaktoren für psychische Erkrankungen, steigern die Symptombelastung, verschlechtern den Krankheitsverlauf und beeinflussen das therapeutische Ansprechen. Die differenzielle Bedeutung einzelner Traumatisierungstypen in Kindheit und Jugend hinsichtlich der psychopathologischen Beeinträchtigung und des Therapieerg...
Article
Dialectical behavior therapy (DBT) is the best empirically validated disorder-specific psychotherapy for patients with borderline personality disorder (BPD). The efficacy and effectiveness of the inpatient application has been demonstrated in controlled and naturalistic studies; however, the majority of studies included exclusively women, so that i...
Article
Full-text available
Both theories and cutting-edge research highlight the dynamic nature of personality and personality pathology, thereby posing significant challenges for an exclusively between-person, trait-based approach to personality assessment. In a series of three studies, we explored the viability of integrating within-person, dynamic aspects into clinical pe...
Article
Zusammenfassung Es gibt kaum systematisches Wissen über Patienten, die sich in symptombezogenen Selbstbeurteilungsskalen nicht von der Allgemeinbevölkerung unterscheiden und daher als „pseudogesund“ bezeichnet werden. 4088 stationäre Psychotherapiepatienten wurden explorativ darauf untersucht, wie groß der Anteil dieser Gruppe an der Gesamtstichpro...
Article
The cover image is based on the Research Article A longitudinal approach to biological psychiatric research: The PsyCourse study by Monika Budde et al., DOI: 10.1002/ajmg.b.32639.
Chapter
The introduction of the dissociative disorders in the DSM‐III renewed the clinical and scientific interest in the concept of dissociation and brought about a different perspective with respect to dissociative phenomena in psychotic patients. Despite the high rate of trauma in patients with psychotic disorders, relatively few studies have focused on...
Article
Atrial natriuretic peptide (ANP) exerts anxiolytic effects in animals and humans. Patients with anxiety, trauma-associated and depressive disorders exhibit lower ANP plasma levels compared to healthy individuals. However, the role of ANP in patients with major depressive disorder (MDD) with and without concomitant adverse childhood experiences (ACE...
Article
Alterations of the hypothalamic-pituitary-adrenal (HPA) axis such as altered glucocorticoid receptor sensitivity and increased immune reactivity might contribute to the pathogenesis of major depressive disorder (MDD). Exposure to adverse childhood experiences (ACE) precipitates vulnerability to MDD and might be associated with endocrine and immune...
Article
Der Erfolg einer Psychotherapie hängt von der Verzahnung der Diagnostik mit der Therapie ab, um z. B. den Therapieverlauf und -erfolg zu bewerten und bei Bedarf das therapeutische Vorgehen zu verändern. Eine Therapie-begleitende Diagnostik bietet hier ein hilfreiches Rahmenmodell und konkrete Vorschläge sowie Kriterien zur Realisierung dieser Verza...
Article
Es gibt kaum systematisches Wissen über Psychotherapiepatienten, die sich in symptombezogenen Selbstbeurteilungsskalen nicht von der Allgemeinbevölkerung unterscheiden und daher als „pseudogesund“ bezeichnet werden. In einer explorativen Studie mit 6585 stationären Psychotherapiepatienten wurde untersucht, wie groß ihr Anteil an der Gesamtstichprob...
Article
Full-text available
In current diagnostic systems, schizophrenia and bipolar disorder are still conceptualized as distinct categorical entities. Recently, both clinical and genomic evidence have challenged this Kraepelinian dichotomy. There are only few longitudinal studies addressing potential overlaps between these conditions. Here, we present design and first resul...
Article
Full-text available
Objectives Bipolar disorder (BD) with early disease onset is associated with an unfavorable clinical outcome and constitutes a clinically and biologically homogenous subgroup within the heterogeneous BD spectrum. Previous studies have found an accumulation of early age at onset (AAO) in BD families and have therefore hypothesized that there is a la...
Preprint
Both theories and cutting-edge research highlight the dynamic nature of personality and personality pathology, thereby posing significant challenges for an exclusively between-person, trait-based approach to personality assessment. In a series of three studies, we explored the viability of integrating within-person, dynamic aspects into clinical pe...
Article
Given the epidemiological relevance and the growing insights into biopsychosocial mechanisms and etiological pathways, this paper describes the current practice in psychotherapy as treatment of choice for patients with personality disorders. The main focus is on borderline, antisocial, narcissistic and avoidant personality disorders. Borderline per...
Chapter
Gruppen und Gruppenpsychotherapie auf verschiedensten Ebenen gehören heute in der Mehrzahl der psychiatrischen Kliniken zur Behandlungsrealität. Historisch fußen viele Konzepte auf dem Konstrukt der „therapeutischen Gemeinschaft“. Speziell für die sozialpsychiatrische Versorgungslandschaft außerhalb der Klinik ist eine ausgesprochene Gruppenorienti...