TY - THES A1 - Heinze, Peter Eric T1 - An exploration of activity and therapist preferences and their predictors in German-speaking samples T1 - Exploration von Aktivitäts- und Therapeut:innenpräferenzen und deren Prädiktoren in deutschsprachigen Stichproben N2 - According to current definitions of evidence-based practice, patients’ preferences play an important role for the psychotherapeutic process and outcomes. However, whereas a significant body of research investigated preferences regarding specific treatments, research on preferred activities or therapist characteristics is rare, investigated heterogeneous aspects with inconclusive results, lacked validated assessment tools, and neglected relevant preferences, their predictors as well as the perspective of mental health professionals. Therefore, the three studies of this dissertation aimed to address the most fundamental drawbacks in current preference research by providing a validated questionnaire, focus efforts on activity and therapist preferences and add preferences of psychotherapy trainees. To this end, Paper I reports the translation and validation of the 18-item Cooper-Norcross Inventory of Preference (C-NIP) in a broad, heterogeneous sample of N = 969 laypeople, resulting in good to acceptable reliabilities and first evidence of validity. However, the original factor structure was not replicated. Paper II assesses activity preferences of psychotherapists in training using the C-NIP and compares them with the initial laypeople sample. There were significant differences between both samples, with trainees preferring a more patient-directed, emotionally intense and confrontational approach than laypeople. CBT trainees preferred a more therapist-directed, present-focused, challenging and less emotional intense approach than psychodynamic or -analytic trainees. Paper III explores therapist preferences and tests predictors for specific preference choices. For most characteristics, more than half of the participants did not have specific preferences. Results pointed towards congruency effects (i.e., preference for similar characteristics), especially for members of marginalized groups. The dissertation provides both researchers and practitioners with a validated questionnaire, shows potentially obstructive differences between patients and therapists and underlines the importance of therapist characteristics for marginalized groups, thereby laying the foundation for future applications and implementations in research and practice. N2 - Aktuelle Definitionen von evidenzbasierter Psychotherapie betonen neben Faktoren wie Therapiearten, Interventionen, Therapeut:inneneffekte, Beziehungseffekte und Patient:innenfaktoren die Relevanz von Präferenzen für den Therapieprozess und -erfolg. Während Behandlungspräferenzen bereits in vielen Studien untersucht wurden, gibt es nur wenige heterogene Ergebnisse zu Präferenzen bezüglich des psychotherapeutischen Vorgehens sowie gewünschter Eigenschaften von Psychotherapeut:innen. Zudem fehlen ein validierter Fragebogen, wichtige Präferenzen und deren Prädiktoren sowie die Perspektive der Behandler:innen. Die Dissertation greift daher die größten Lücken der Präferenzforschung im Rahmen von drei Studien zu Aktivitäts- und Therapeut:innenpräferenzen auf. Paper I stellt die Übersetzung und Validierung des Cooper-Norcross Inventory of Preferences in einer breiten Bevölkerungsstichprobe (N = 969) dar. Obwohl die Originalfaktorstruktur nicht repliziert werden konnte, erfasst die Skala vier Faktoren der Aktivitätspräferenz reliabel und valide. Paper II ergänzt eine Stichprobe von N = 466 Psychotherapeut:innen in Ausbildung (PiA) und vergleicht diese mit der ursprünglichen Bevölkerungsstichprobe. PiAs präferierten dabei einen signifikant stärkeren patientengeleiteten, emotional fordernden und konfrontativen Ansatz. PiAs der KVT präferierten im Vergleich zu PiAs der Psychoanalyse oder -dynamik einen therapeutengeleiteten, gegenwärtigen, konfrontativen und weniger emotional fordernden Ansatz. Paper III untersuchte Präferenzen hinsichtlich mehrerer Therapeut:inneneigenschaften und deren Prädiktoren. Für die meisten Eigenschaften gaben mehr als die Hälfte der Proband:innen an, keine spezifischen Präferenzen zu haben. Es zeigten sich jedoch Kongruenzeffekte, insbesondere für Personen aus marginalisierten Gruppen. Die Dissertation legt den Grundstein für künftige Anwendungen von Präferenzen für Forschende und Behandelnde, indem ein validierter Fragebogen vorgestellt, potentiell hinderliche Unterschiede zwischen Patient:innen und Therapeut:innen beschrieben und die Relevanz von Therapeut:inneneigenschaften für marginalisierte Gruppen dargestellt wird. KW - psychotherapy KW - preferences KW - preference assessment KW - psychotherapy training KW - respondent pool KW - Psychotherapie KW - Präferenzen KW - Präferenzmessung KW - Psychotherapieausbildung KW - Panelstichprobe Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-607534 ER - TY - GEN A1 - Heinze, Peter Eric A1 - Weck, Florian A1 - Kühne, Franziska T1 - Assessing Patient Preferences BT - Examination of the German Cooper-Norcross Inventory of Preferences T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Despite the positive effects of including patients’ preferences into therapy on psychotherapy outcomes, there are still few thoroughly validated assessment tools at hand. We translated the 18-item Cooper-Norcross Inventory of Preferences (C-NIP) into German and aimed at replicating its factor structure. Further, we investigated the reliability of the questionnaire and its convergence with trait measures. A heterogeneous sample of N = 969 participants took part in our online survey. Performing ESEM models, we found acceptable model fit for a four-factor structure similar to the original factor structure. Furthermore, we propose an alternative model following the adjustment of single items. The German C-NIP showed acceptable to good reliability, as well as small correlations with Big-Five personality traits, trait and attachment anxiety, locus of control, and temporal focus. However, we recommend further replication of the factor structure and further validation of the C-NIP. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 753 KW - psychotherapy KW - preference KW - activity preference KW - preference assessment KW - validation study Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-544140 SN - 1866-8364 ER - TY - JOUR A1 - Heinze, Peter Eric A1 - Weck, Florian A1 - Kühne, Franziska T1 - Assessing patient preferences BT - examination of the german cooper-norcross inventory of preferences JF - Frontiers in psychology N2 - Despite the positive effects of including patients' preferences into therapy on psychotherapy outcomes, there are still few thoroughly validated assessment tools at hand. We translated the 18-item Cooper-Norcross Inventory of Preferences (C-NIP) into German and aimed at replicating its factor structure. Further, we investigated the reliability of the questionnaire and its convergence with trait measures. A heterogeneous sample of N = 969 participants took part in our online survey. Performing ESEM models, we found acceptable model fit for a four-factor structure similar to the original factor structure. Furthermore, we propose an alternative model following the adjustment of single items. The German C-NIP showed acceptable to good reliability, as well as small correlations with Big-Five personality traits, trait and attachment anxiety, locus of control, and temporal focus. However, we recommend further replication of the factor structure and further validation of the C-NIP. KW - psychotherapy KW - preference KW - activity preference KW - preference assessment KW - validation study Y1 - 2022 U6 - https://doi.org/10.3389/fpsyg.2021.795776 SN - 1664-1078 VL - 12 PB - Frontiers Media CY - Lausanne ER - TY - JOUR A1 - Heinze, Peter Eric A1 - Weck, Florian A1 - Kühne, Franziska T1 - Assessing Patient Preferences BT - Examination of the German Cooper-Norcross Inventory of Preferences JF - Frontiers in Psychology N2 - Despite the positive effects of including patients’ preferences into therapy on psychotherapy outcomes, there are still few thoroughly validated assessment tools at hand. We translated the 18-item Cooper-Norcross Inventory of Preferences (C-NIP) into German and aimed at replicating its factor structure. Further, we investigated the reliability of the questionnaire and its convergence with trait measures. A heterogeneous sample of N = 969 participants took part in our online survey. Performing ESEM models, we found acceptable model fit for a four-factor structure similar to the original factor structure. Furthermore, we propose an alternative model following the adjustment of single items. The German C-NIP showed acceptable to good reliability, as well as small correlations with Big-Five personality traits, trait and attachment anxiety, locus of control, and temporal focus. However, we recommend further replication of the factor structure and further validation of the C-NIP. KW - psychotherapy KW - preference KW - activity preference KW - preference assessment KW - validation study Y1 - 2021 U6 - https://doi.org/10.3389/fpsyg.2021.795776 SN - 1664-1078 VL - 12 PB - Frontiers Research Foundation CY - Lausanne ER - TY - THES A1 - Perlich, Anja T1 - Digital collaborative documentation in mental healthcare T1 - Digitale Mittel zur kooperativen Dokumentation im Bereich der psychischen Gesundheit N2 - With the growth of information technology, patient attitudes are shifting – away from passively receiving care towards actively taking responsibility for their well- being. Handling doctor-patient relationships collaboratively and providing patients access to their health information are crucial steps in empowering patients. In mental healthcare, the implicit consensus amongst practitioners has been that sharing medical records with patients may have an unpredictable, harmful impact on clinical practice. In order to involve patients more actively in mental healthcare processes, Tele-Board MED (TBM) allows for digital collaborative documentation in therapist-patient sessions. The TBM software system offers a whiteboard-inspired graphical user interface that allows therapist and patient to jointly take notes during the treatment session. Furthermore, it provides features to automatically reuse the digital treatment session notes for the creation of treatment session summaries and clinical case reports. This thesis presents the development of the TBM system and evaluates its effects on 1) the fulfillment of the therapist’s duties of clinical case documentation, 2) patient engagement in care processes, and 3) the therapist-patient relationship. Following the design research methodology, TBM was developed and tested in multiple evaluation studies in the domains of cognitive behavioral psychotherapy and addiction care. The results show that therapists are likely to use TBM with patients if they have a technology-friendly attitude and when its use suits the treatment context. Support in carrying out documentation duties as well as fulfilling legal requirements contributes to therapist acceptance. Furthermore, therapists value TBM as a tool to provide a discussion framework and quick access to worksheets during treatment sessions. Therapists express skepticism, however, regarding technology use in patient sessions and towards complete record transparency in general. Patients expect TBM to improve the communication with their therapist and to offer a better recall of discussed topics when taking a copy of their notes home after the session. Patients are doubtful regarding a possible distraction of the therapist and usage in situations when relationship-building is crucial. When applied in a clinical environment, collaborative note-taking with TBM encourages patient engagement and a team feeling between therapist and patient. Furthermore, it increases the patient’s acceptance of their diagnosis, which in turn is an important predictor for therapy success. In summary, TBM has a high potential to deliver more than documentation support and record transparency for patients, but also to contribute to a collaborative doctor-patient relationship. This thesis provides design implications for the development of digital collaborative documentation systems in (mental) healthcare as well as recommendations for a successful implementation in clinical practice. N2 - Die Verbreitung von Informationstechnologie kann die Rolle von Patienten verändern: weg vom passiven Erhalt ärztlicher Zuwendung hin zur eigenverantwortlichen Mitwirkung an ihrer Genesung. Wesentliche Schritte zur Ermündigung von Patienten sind eine gute Zusammenarbeit mit dem behandelnden Arzt und der Zugang zu den eigenen Akten. Unter Psychotherapeuten gibt es jedoch einen impliziten Konsens darüber, dass die Einsicht in psychiatrische Akten unvorhersehbare, nachteilige Effekte auf die klinische Praxis hervorrufen könnte. Um auch Patienten aktiver an der Erhaltung und Wiederherstellung ihrer mentalen Gesundheit zu beteiligen, ermöglicht Tele-Board MED (TBM) das gemeinschaftliche Erstellen von digitalen Notizen. Diese Dissertation beschreibt die Entwicklung des TBM Software-Systems, das es Therapeut und Patient ermöglicht, gemeinsam während der Sitzung wie auf einem Whiteboard Notizen zu machen. Außerdem bietet TBM Funktionen, um auf Grundlage der digitalen Gesprächsnotizen automatisch Sitzungsprotokolle und klinische Fallberichte zu erstellen. Methodologisch basiert die Entwicklung und Evaluierung von TBM auf dem Paradigma für Design Research. Es wurden vielfältige Studien in den Bereichen der Verhaltens- und Suchttherapie durchgeführt, um die Auswirkungen auf folgende Aspekte zu evaluieren: 1) die Erfüllung der Dokumentationspflichten von Therapeuten, 2) das Engagement von Patienten in Behandlungsprozessen und 3) die Beziehung zwischen Patient und Therapeut. Die Studien haben gezeigt, dass Therapeuten dazu geneigt sind, TBM mit ihren Patienten zu nutzen, wenn sie technologie-freundlich eingestellt sind und wenn es zum Behandlungskontext passt. Zur Akzeptanz tragen auch die schnelle Erstellung von klinischen Dokumenten sowie die Erfüllung der gesetzlichen Forderung nach Aktentransparenz bei. Weiterhin schätzen Therapeuten TBM als Werkzeug, um Therapiegespräche zu strukturieren und während der Sitzung schnell auf Arbeitsblätter zuzugreifen. Therapeuten äußerten hingegen auch Skepsis gegenüber der Technologienutzung im Patientengespräch und vollständiger Aktentransparenz. Patienten erhoffen sich von TBM eine verbesserte Kommunikation mit ihrem Therapeuten und denken, dass sie sich besser an die Gesprächsinhalte erinnern können, wenn sie eine Kopie ihrer Akte erhalten. Patienten brachten Bedenken zum Ausdruck, TBM in Situationen zu nutzen, in denen der Beziehungsaufbau im Vordergrund steht, und darüber, dass Therapeuten sich abgelenkt fühlen könnten. Als TBM im klinischen Umfeld eingesetzt wurde, wurde ein erhöhtes Patientenengagement und ein gesteigertes Teamgefühl beobachtet. Außerdem stieg bei Patienten die Akzeptanz ihrer Diagnosen, welche wiederum ein wichtiger Prädiktor für Therapieerfolg ist. Zusammenfassend lässt sich festhalten, dass TBM großes Potential hat: Über die damit mögliche Dokumentationsunterstützung und Aktentransparenz hinaus wird auch die Zusammenarbeit von Therapeut und Patient unterstützt. Diese Dissertation fasst Kriterien zur Entwicklung von gemeinschaftlichen Dokumentationssystemen in der (psychischen) Gesundheitsfürsorge sowie Empfehlungen für eine erfolgreiche Implementierung in der klinischen Praxis zusammen. KW - medical documentation KW - psychotherapy KW - addiction care KW - computer-mediated therapy KW - digital whiteboard KW - patient empowerment KW - doctor-patient relationship KW - design research KW - user experience KW - evaluation KW - medizinische Dokumentation KW - Psychotherapie KW - Suchtberatung und -therapie KW - computervermittelte Therapie KW - digitales Whiteboard KW - Patientenermündigung KW - Arzt-Patient-Beziehung KW - Design-Forschung KW - User Experience KW - Evaluation Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-440292 ER - TY - GEN A1 - Kühne, Franziska A1 - Lesser, Hannah A1 - Petri, Franziska A1 - Weck, Florian T1 - Do mental health patients learn what their cognitive-behaviour therapists think they do? BT - a short report on qualitative interviews comparing perspectives T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Purpose: The acquisition of skills is essential to the conceptualization of cognitive-behavioural therapy. Yet, what experiences are encountered and what skills actually learned during therapy, and whether patients and therapists have concurrent views hereof, remains poorly understood. Method: An explorative pilot study with semi-structured, corresponding interview guides was conducted. Pilot data from our outpatient unit were transcribed and content-analyzed following current guidelines. Results: The responses of 18 participants (patients and their psychotherapists) were assigned to six main categories. Educational and cognitive aspects were mentioned most frequently and consistently by both groups. Having learned Behavioural alternatives attained the second highest agreement between perspectives. Conclusions: Patients and therapists valued CBT as an opportunity to learn new skills, which is an important prerequisite also for the maintenance of therapeutic change. We discuss limitations to generalizability but also theoretical and therapy implications. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 490 KW - cognitive-behavioural therapy (CBT) KW - psychotherapy KW - interview study KW - learning KW - skills Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-420607 SN - 1866-8364 IS - 490 ER - TY - JOUR A1 - Kühne, Franziska A1 - Lesser, Hannah A1 - Petri, Franziska A1 - Weck, Florian T1 - Do mental health patients learn what their cognitive-behaviour therapists think they do? BT - A short report on qualitative interviews comparing perspectives JF - International Journal of Qualitative Studies on Health and Well-being N2 - Purpose: The acquisition of skills is essential to the conceptualization of cognitive-behavioural therapy. Yet, what experiences are encountered and what skills actually learned during therapy, and whether patients and therapists have concurrent views hereof, remains poorly understood. Method: An explorative pilot study with semi-structured, corresponding interview guides was conducted. Pilot data from our outpatient unit were transcribed and content-analyzed following current guidelines. Results: The responses of 18 participants (patients and their psychotherapists) were assigned to six main categories. Educational and cognitive aspects were mentioned most frequently and consistently by both groups. Having learned Behavioural alternatives attained the second highest agreement between perspectives. Conclusions: Patients and therapists valued CBT as an opportunity to learn new skills, which is an important prerequisite also for the maintenance of therapeutic change. We discuss limitations to generalizability but also theoretical and therapy implications. KW - cognitive-behavioural therapy (CBT) KW - psychotherapy KW - interview study KW - learning KW - skills Y1 - 2018 U6 - https://doi.org/10.1080/17482631.2018.1527598 SN - 1748-2631 SN - 1748-2623 VL - 13 IS - 1 PB - Taylor & Francis Group CY - London ER - TY - JOUR A1 - Philipp, Rebecca A1 - Kriston, Levente A1 - Lanio, Jana A1 - Kühne, Franziska A1 - Härter, Martin A1 - Moritz, Steffen A1 - Meister, Ramona T1 - Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG) JF - Clinical psychology & psychotherapy N2 - We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random-effects meta-analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = -0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = -0.31). MCTrain was more effective than standard treatment in patients with obsessive-compulsive disorder (SMD = -0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = -2.80), posttraumatic stress disorder (SMD = -2.36), and psychological treatments (cognitive-behavioural) in patients with anxiety (SMD = -0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive-behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add-on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy. KW - mental disorders KW - meta-analysis KW - metacognition KW - psychotherapy KW - systematic review Y1 - 2018 U6 - https://doi.org/10.1002/cpp.2345 SN - 1063-3995 SN - 1099-0879 VL - 26 IS - 2 SP - 227 EP - 240 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Esser, Günter A1 - Blank, Sarah T1 - Efficacy of psychotherapy with children and adolescents JF - Praxis der Kinderpsychologie und Kinderpsychiatrie : Ergebnisse aus Psychotherapie, Beratung und Psychiatrie N2 - Efficacy of Psychotherapy with Children and Adolescents Psychotherapeutic interventions require empirical as well as scientific assessment. Specifically, the proven efficacy of psychotherapy for children and adolescents is essential. Thus, studies examining treatment efficacy and meta-analyses are necessary to compare effect sizes of individual therapeutic interventions between treatment groups and waiting control groups. Assessment of 138 primary studies from 1993-2009 documented the efficacy of psychotherapy for children and adolescents. Furthermore, behavioural therapy outperformed non-behavioural interventions, as 90 % of behavioural interventions showed larger effect sizes compared to non-behavioural psychotherapy. Analysis of moderator variables demonstrated an improved treatment efficacy for individual therapy, inclusion of the family, treatment of internalised disorders, and in clinical samples. Stability of psychotherapeutic treatment effects over time was demonstrated. KW - psychotherapy KW - efficacy KW - child and adolescent psychotherapy KW - meta-analysis Y1 - 2011 SN - 0032-7034 VL - 60 IS - 8 SP - 626 EP - 638 PB - Vandenhoeck & Ruprecht CY - Göttingen ER - TY - JOUR A1 - Kühne, Franziska A1 - Maaß, Ulrike A1 - Weck, Florian T1 - Einsatz standardisierter Patienten im Psychologiestudium BT - von der Forschung in die Praxis JF - Verhaltenstherapie : Praxis, Forschung, Perspektiven N2 - Hintergrund: Im Rahmen des reformierten Psychotherapeutengesetzes wird eine starkere Praxisorientierung in der klinisch-psychologischen Lehre und in der Prufung psychotherapeutischer Kompetenzen verankert. Hierbei sollen Studierende durch die Interaktion mit standardisierten Patient*innen (SP) therapeutische Kompetenzen erwerben und demonstrieren. Fragestellung: Das Ziel des vorliegenden Beitrags ist es, eine evidenzbasierte Umsetzung dieser neuen Lehr- und Prufungsformate zu unterstutzen, indem bisherige Forschungsbefunde zum Einsatz von SP dargestellt und Bereiche, in denen weitere Forschung notwendig ist, aufgezeigt werden. Ergebnisse: Empirische Befunde zeigen, dass SP psychische Storungen authentisch darstellen konnen. Voraussetzung dafur sind beispielsweise die Auswahl geeigneter SP, detaillierte Rollenanleitungen, spezifisches Training, Feedback und Nachschulungen. Auch wenn einige Forschungsfragen, wie zur vergleichenden Wirksamkeit des Einsatzes von SP, noch unbeantwortet sind, lassen sich praktische Implikationen fur SP-Programme in Lehre, Prufung und Forschung ableiten, die in einem Ablaufschema dargestellt werden. Schlussfolgerungen: Der Einsatz von SP bietet gro ss es Potenzial fur die klinisch-psychologische Lehre und Ausbildungsforschung. Um den Einsatz von SP an anderen Standorten zu unterstutzen, werden Beispielmaterialien (z.B. Rollenanleitung) in den elektronischen Supplementen (siehe www.karger.com/doi/10.1159/000509249 fur alle Supplemente) zum Artikel zur Verfugung gestellt. N2 - Background: Within the pending reformation of the German law of psychotherapy training, education in clinical psychology and the examination of psychotherapeutic competencies are established as more practice oriented. Students will acquire and demonstrate therapeutic skills through interactions with standardized patients (SPs). The aim of the current paper is to enhance evidence-based implementation of these new methods of education and examination by presenting the current evidence regarding the use of SPs and by pointing out areas for further research. Results: Results of recent studies demonstrate that SPs are able to present mental disorders authentically. Prerequisites are, among others, the selection of suitable SPs, detailed role scripts, specific training, feedback, and corrective training. Although some research questions, including the comparative effectiveness of SPs, remain unanswered, practice implications for using SPs in education, examination, and research can be drawn. These implications are illustrated schematically. Conclusions: The use of SPs has large potential for education in clinical psychology and for research on psychotherapy training. With a view to encouraging the widespread use of SPs, we provide exemplary materials (e.g., role script) within the online supplements (see www.­karger.com/doi/10.1159/000509249 [Titel anhand dieser DOI in Citavi-Projekt übernehmen] for all online suppl. material). T2 - Standardized patients in clinical psychology: from research to practice KW - Training KW - Ausbildung KW - Psychotherapie KW - Evidenzbasierte Versorgung KW - training KW - education KW - psychotherapy KW - evidence-based care Y1 - 2021 U6 - https://doi.org/10.1159/000509249 SN - 1016-6262 SN - 1423-0402 VL - 31 IS - 2 SP - 152 EP - 160 PB - Karger CY - Basel ER -