Psychotherapeut

, Volume 63, Issue 3, pp 188–193 | Cite as

Optimierung von Expositionstherapie bei pathologischen Krankheitsängsten

Theoretische Grundlagen und praktische Implikationen
  • Maria Gropalis
  • Josef Bailer
  • Florian Weck
  • Michael Witthöft
Schwerpunkt: Angst – Übersichten
  • 55 Downloads

Zusammenfassung

Pathologische Krankheitsängste wurden bislang nach ICD und DSM primär als somatoforme Störung bzw. als somatische Belastungsstörung klassifiziert. Theoretische Erwägungen und empirische Befunde legen jedoch nahe, dass es sich bei pathologischen Krankheitsängsten eigentlich um eine Angststörung handelt. Innerhalb des vorliegenden Beitrags wird dafür argumentiert, dass Defizite in der aktuellen Behandlungspraxis und in der Wahrnehmung von Patienten mit Hypochondrie als „schwierige Patienten“ teilweise auf Unklarheit in der Nosologie sowie bezüglich der entscheidenden Mechanismen der Entstehung und Aufrechterhaltung zurückzuführen sind. Ausgehend von innovativen theoretischen Ansätzen zur Erklärung pathologischer Krankheitsängste werden Vorschläge für eine verbesserte therapeutische Praxis skizziert. Der Fokus liegt hierbei auf einem verstärken Einsatz expositionsbasierter Behandlungselemente, die sich am „Inhibitory-learning“-Ansatz orientieren und sich bei anderen Angststörungen bereits bewährt haben.

Schlüsselwörter

Hypochondrie Angststörungen Inhibition Lernen Kognitive Verhaltenstherapie 

Optimization of exposure therapy for pathological health anxiety

Theoretical principles and practical implications

Abstract

Up to now pathological health anxiety has been classified primarily as a somatoform disorder or a somatic symptom disorder in ICD and DSM. Theoretical and empirical evidence, however, suggest that pathological health anxiety basically represents an anxiety disorder. In this paper, it is argued that deficits in the treatment and perception of patients with pathological health anxiety as “difficult patients” are partly attributable to a lack of clarity in terms of nosology and with respect to central mechanisms of etiology and pathogenesis. Based on novel theoretical approaches for the explanation of pathological health anxiety, suggestions for an improved therapeutic practice are outlined. This approach focuses on a more intensive use of exposure-based treatment elements that are oriented to the inhibitory learning approach, which has already proven its effectiveness for other anxiety disorders.

Keywords

Hypochondriasis Anxiety disorders Inhibition Learning Cognitive behavior therapy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Gropalis, J. Bailer, F. Weck und M. Witthöft geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Maria Gropalis
    • 1
  • Josef Bailer
    • 2
  • Florian Weck
    • 3
  • Michael Witthöft
    • 1
  1. 1.Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle PsychopathologieJohannes Gutenberg-UniversitätMainzDeutschland
  2. 2.Abteilung für Klinische Psychologie, Zentralinstitut für Seelische GesundheitMedizinische Fakultät Mannheim, Universität Heidelberg, J5MannheimDeutschland
  3. 3.Abteilung für Klinische Psychologie und PsychotherapieUniversität PotsdamPotsdamDeutschland

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