1.
Obese children, adults and senior citizens in the eyes of the general public: results of a representative study on stigma and causation of obesity.
Sikorski, C, Luppa, M, Brähler, E, König, HH, Riedel-Heller, SG
PloS one. 2012;7(10):e46924
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Obesity is a major health problem and associated with higher mortality and worse health outcomes. Obese individuals are commonly blamed for their excess weight which may lead to stigmatisation and discrimination which can further exacerbate unhealthy eating and activity behaviour, cause psychological problems, and prevent them from seeking help and health care. The aim of this telephone interview study of 3,003 persons was to investigate the prevalence of stigmatizing attitudes and determining the causal attribution of obesity by the German general public. Assessment of attitudes was through vignettes, i.e. presenting participants with a brief description of an obese or normal weight person, followed by vignette specific questions. The average Fat Phobia Score (FPS), which assesses stigmatising attitudes on a scale of 1 (positive attitude) to 5 (negative attitude), was 3.65 for obese vignettes compared to 2.38 for normal weight vignettes, indicating a negative attitude towards obesity, which was stronger towards obese children than towards obese adults or elderly. Causal attribution was significantly stronger for internal factors (lack of activity, eating too much, lack of willpower), whilst external and genetic factors were rated similar. For children genetic causes were agreed on less whilst external factors were seen as more important for a child’s obesity. Participants who favoured internal factors were also more likely to have a more negative view of obesity. Participants with a higher level of education or who were themselves overweight/obese or had an overweight/obese partner had a more positive attitude towards obesity.
Abstract
Obese individuals are blamed for their excess weight based on causal attribution to the individual. It is unclear whether obese individuals of different age groups and gender are faced with the same amount of stigmatization. This information is important in order to identify groups of individuals at risk for higher stigmatization and discrimination. A telephone interview was conducted in a representative sample of 3,003 participants. Experimental manipulation was realized by vignettes describing obese and normal-weight children, adults and senior citizens. Stigmatizing attitudes were measured by semantic differential. Causal attribution was assessed. Internal factors were rated with highest agreement rates as a cause for the vignette's obesity. Lack of activity behavior and eating too much are the most supported causes. Importance of causes differed for the different vignettes. For the child, external causes were considered more important. The overweight vignette was rated consistently more negatively. Higher educational attainment and personal obesity were associated with lower stigmatizing attitudes. The vignette of the obese child was rated more negatively compared to that of an adult or senior citizen. Obesity is seen as a controllable condition, but for children external factors are seen as well. Despite this finding, they are faced with higher stigmatizing attitudes in the general public, contradicting attribution theory assumptions. Internal and external attribution were found to be inter-correlated. Obese children are the population most at risk for being confronted with stigmatization, making them a target point in stigma-reduction campaigns.
2.
Lifetime traumatic experiences and posttraumatic stress disorder in the German population: results of a representative population survey.
Hauffa, R, Rief, W, Brähler, E, Martin, A, Mewes, R, Glaesmer, H
The Journal of nervous and mental disease. 2011;(12):934-9
Abstract
Only a few European population-based studies on the epidemiology of posttraumatic stress disorder (PTSD) are available to date. This study aims to broaden the epidemiological knowledge of traumatic experiences (TEs), PTSD, and comorbid mental conditions in a representative German sample (N = 2510). The Composite International Diagnostic Interview list of traumatic events, the Posttraumatic Diagnostic Scale, and Patient Health Questionnaire (PHQ)-9 as well as PHQ-15 were used in this survey. Main results were low frequencies of TEs (24%) and PTSD (2.9%). Older participants (>60 years) reported significantly more TEs and more posttraumatic symptoms, whereas there was no significant difference in PTSD prevalence. A third of the subjects diagnosed with PTSD were found positive for depressive syndromes, and 27% were found positive for somatization syndrome. The results show that TEs and posttraumatic symptoms are frequent in senior citizens and thus have to be considered when treating older patients with mental health conditions.
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A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study.
Wagenlehner, FM, Schneider, H, Ludwig, M, Schnitker, J, Brähler, E, Weidner, W
European urology. 2009;(3):544-51
Abstract
BACKGROUND National Institutes of Health (NIH) category III prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent condition for which no standardised treatment exists. OBJECTIVES To assess the safety and efficacy of a standardised pollen extract in men with inflammatory CP/CPPS. DESIGN, SETTING, AND PARTICIPANTS We conducted a multicentre, prospective, randomised, double-blind, placebo-controlled phase 3 study comparing the pollen extract (Cernilton) to placebo in men with CP/CPPS (NIH IIIA) attending urologic centres. INTERVENTION Participants were randomised to receive oral capsules of the pollen extract (two capsules q8h) or placebo for 12 wk. MEASUREMENTS The primary endpoint of the study was symptomatic improvement in the pain domain of the NIH Chronic Prostatitis Symptom Index (NIH-CPSI). Participants were evaluated using the NIH-CPSI individual domains and total score, the number of leukocytes in post-prostatic massage urine (VB3), the International Prostate Symptom Score (IPSS), and the sexuality domain of a life satisfaction questionnaire at baseline and after 6 and 12 wk. RESULTS AND LIMITATIONS In the intention-to-treat analysis, 139 men were randomly allocated to the pollen extract (n=70) or placebo (n=69). The individual domains pain (p=0.0086) and quality of life (QoL; p=0.0250) as well as the total NIH-CPSI score (p=0.0126) were significantly improved after 12 wk of treatment with pollen extract compared to placebo. Response, defined as a decrease of the NIH-CPSI total score by at least 25% or at least 6 points, was seen in the pollen extract versus placebo group in 70.6% and 50.0% (p=0.0141), respectively. Adverse events were minor in all patients studied. CONCLUSIONS Compared to placebo, the pollen extract significantly improved total symptoms, pain, and QoL in patients with inflammatory CP/CPPS without severe side-effects.