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Pathologische Sorgen sind ungenau definiert. Für die Behandlungsplanung bleiben wichtige Fragen offen: Welche Merkmale sind für die Unterscheidung zwischen behandlungsbedürftigen und nicht behandlungsbedürftigen Sorgen relevant? Welche Art von Sorgen muss wie behandelt werden? Und: Welche Art von Sorgen gilt es eher zu akzeptieren? Wir machen praxisnahe Vorschläge dafür, wie Sorgen mittels einer einfachen Heuristik auch vom Patienten selbst als «pathologisch» identifiziert werden können. Im Sinne eines therapeutischen Arbeitsmodells ergeben sich differentielle Bearbeitungsstrategien, je nachdem, ob es sich um wichtige oder weniger wichtige, auf lösbare oder unlösbare Probleme bezogene sowie angemessene oder überzogene Sorgen handelt. Das vorgestellte Arbeitsblatt zu den Sorgen soll vor allem die wahrgenommene Kontrolle des Patienten stärken und die Psychoedukation zur Generalisierten Angststörung erleichtern. / Pathological worries have not yet been clearly defined. As a consequence, practically relevant questions remain open: Which characteristics distinguish worries relevant for treatment from those which are not? What kind of worries has to be treated in which way? And: What kind of worries is rather to be accepted? We propose a simple rationale which helps the therapist and the patient to identify pathological worries. According to this working model, different treatment strategies result depending on whether worries are central or not, whether they relate to a problem which can be solved or not, and whether they seem proportionate or exaggerated. The presented worksheet is meant to strengthen the perceived control of the patient and to help facilitate psychoeducation for generalised anxiety disorder. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

本研究旨在探索自我傷害行為的動機、相關現象與情緒調節功能，並以此為基礎釐清該行為的情緒內涵，包括正向情緒強度特質、負向情緒強度特質、平靜滿足、經驗迴避程度及情緒調節能力。此外，本研究以因素分析探索自傷動機的分類，並以此分類結果為基礎，探討不同自傷動機所引發的情緒種類、情緒強度是否有所不同，在自傷行為的進行方式、次數上是否有顯著差異，並瞭解其無法適當應用的情緒調節能力為何。研究採用問卷調查的方式，研究對象為839位私立高中職生，包括日間部與夜間部，調查所得資料以描述統計分析、卡方檢定、相關分析、獨立樣本t檢定、相依樣本t檢定、因素分析、邏輯迴歸分析和階層迴歸分析進行處理。 本研究主要結果如下：首先支持自傷行為具有負向情緒調節的功能，而經驗迴避對於自傷行為的影響有限。其次，將自傷動機進行因素分析的結果發現可以將其分為四類：人際影響、負向感受的因應、避免失控和負向自我評價。在區分是否有自傷行為部分，情緒調節困難的不接納與無助能夠有效解釋自傷行為的有無；在影響自傷行為的頻率部分，自傷動機的強度與情緒調節困難的衝動失控能夠有效解釋自傷頻率的多寡。此外，本研究發現不同的自傷方式與不同的動機、所處的自傷前情緒有關，且不同的自我傷害動機在情緒強度特質、情緒調節困難、負向情緒和自傷方式上會呈現出不同的樣貌。 / The purpose of this study was to explore the motivations, the phenomenon, and the function of deliberate self-harm behaviors(DSH), and based on these, to clarify emotional contents behind DSH, including positive affect intensity, negative affect intensity, serenity, experiential avoidance and the emotional regulation ability. Besides, the study investigated the classification of the motivations of DSH by exploratory factor analysis, and accordingly discussed whether the affect categories and the affect intensity resulted from the motivations of DSH were different, and whether the motivations of DSH resulted in significantly different using of methods and frequencies, moreover, the emotional dysregulation. The study was based on questionnaires, and the participants were 839 students from a private senior high school , including vocational schools. Data obtained were analyzed by descriptive statistics, correlation analysis, t-test, factor analysis (FA), logistic regression, and hierarchical regression analysis. The main results were as follows: First, the results supported that DSH has regulative function on negative affect, and experiential avoidance influenced DSH limitedly. Second, according to factor analysis, the motivations of DSH were classified into four categories: interpersonal influence, negative affect modulation, control, and negative self-evaluation. Moreover, nonacceptance of the emotion dysregulation could successfully distinguish students with DSH from students with no history of DSH in the past 1 year. Both intensity of motivations and impulse of the emotion dysregulation could reliably predict DSH’s frequency. Finally, different methods of DSH correlated to different motivations and different emotions before DSH, and there were various representations of affect intensity, emotion dysregulation, and methods depends on different motivations.