Aspects of process diagnosis in the psychotherapy of psychosomatic diseases

15 patients with psychosomatic diseases and the phenomenon of alexithymia, together with neurotic patients are treated psychotherapeutically in half-open groups. Contrary to the neurotics the patients show some special features regarding the process diagnostics. In assessing the wished and really experienced nearness to the group members there is a deficient ability to differentiate. During the therapeutic process the intrapsychic tension (EMI - Inventory of Emotionalities) is subject to great fluctuations or doesn't change. The occurrence of fluctuations in the EMI and of greater differentiations in the N-D-Test (Nearness-Distance-Test) suggest a good prognosis. A therapy of psychosomatic patients together with neurotic patients seems to be more effective than the treatment in homogeneous groups.     

Differential indications for desipramine--results of a controlled multiclinical study]

The antidepressants desipramine and imipramine were compared within the framework of a multiclinical study performed under the conditions of a controlled clinical experiment. There has been found a time-different remission of affective symptoms, which was not detectable for the inhibition of drive. The tachythymoleptic action of desipramine is discussed with reference to these results. Evaluation of the possibility of controlling affects shows different ranges of activity of desipramine and imipramine, with desipramine influencing especially negative psychoenergetic symptoms in the area of drives and emotions and imipramine, restrictive symptoms in addition to differential phenomena of the psychomotor expression.     

Differential indication of trimipramine - results of a controlled multiclinical study]

The antidepressants trimipramine and imipramine were compared within the framework of a multiclinical study performed under the conditions of a controlled clinical experiment. There has been found a time-different remission of affective und psychomotoric symptoms. The panthymoleptic action of trimipramine and other antidepressants is discussed with reference to these results. Trimipramine influences psychotic states, especially if in depression anxiety is combined with agitation, also in hypochondriac forms of depression.     

Neural correlates of a default response in a delayed go/no-go task

Working memory, the ability to temporarily retain task-relevant information across a delay, is frequently investigated using delayed matching-to-sample (DMTS) or delayed Go/No-Go tasks (DGNG). In DMTS tasks, sample cues instruct the animal which type of response has to be executed at the end of a delay. Typically, performance decreases with increasing delay duration, indicating that working memory fades across a delay. However, no such performance decrease has been found when the sample cues exist of present vs. absent stimuli, suggesting that pigeons do not rely on working memory, but seem to respond by default in those trials. We trained 3 pigeons in a DGNG task and found a similar default response pattern: The diverging slopes of the retention functions on correct Go and No-Go trials suggested that pigeons by default omitted their response following No-Go stimuli, but actively retained task-relevant information across the delay for successful responses on Go trials. We conducted single-cell recordings in the avian nidopallium caudolaterale, a structure comparable to the mammalian prefrontal cortex. On Go trials, many neurons displayed sustained elevated activity during the delay preceding the response, replicating previous findings and suggesting that task-relevant information was neurally represented and maintained across the delay. However, the same units did not show enhanced delay activity preceding correct response suppressions in No-Go trials. This activation-inactivation pattern presumably constitutes a neural correlate of the default response strategy observed in the DGNG task.     

Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

Discussing Adolescent Sexual Health in African-American Churches

This study describes the ways in which two African-American churches discuss adolescent sexual health topics. Six focus groups were conducted in two churches in Flint, Michigan, that reported no formal sexual health programming for their congregants. Three themes emerged to highlight the different perspectives about the role of churches in adolescent sexual decision-making and sexual health education: (1) churches as sources of sexual information, (2) churches as complex communities, and (3) recommendations for sexual education in churches. Participant responses suggest that churches can and should serve a resource for sexual health information. Implications for practice and research are discussed.     

Ethnically based rejection sensitivity and academic achievement: The danger of retracting into one's heritage culture

This study examined the relation between ethnically based rejection sensitivity and academic achievement in a sample of 936 immigrant students in Germany and Switzerland. The theory of race‐based rejection sensitivity that originated in North America was extended to immigrant students in Europe. The rough political climate against immigrants in Europe makes it probable that immigrant youth face particular difficulties and are affected by ethnically based rejection sensitivity, at least as much as—or even more than—minority youth in the United States. Using a standardized literacy performance test and multilevel analyses, we found that ethnically based rejection sensitivity was negatively related to academic achievement for immigrant students. This relation was partially mediated by a strong contingency of the students' self‐worth on the heritage culture, as well as by a low number of native German or Swiss majority‐group friends. We interpret these processes as immigrant students' efforts to cope with ethnically based rejection sensitivity by retracting into their heritage culture and avoiding majority‐group contact, which unfortunately, however, at the same time also results in lower academic achievement. Copyright © 2014 John Wiley & Sons, Ltd.     

Development and Pilot Testing of a Decision Aid for Genomic Research Participants Notified of Clinically Actionable Research Findings for Cancer Risk

Germline genomic testing is increasingly used in research to identify genetic causes of disease, including cancer. However, there is evidence that individuals who are notified of clinically actionable research findings have difficulty making informed decisions regarding uptake of genetic counseling for these findings. This study aimed to produce and pilot test a decision aid to assist participants in genomic research studies who are notified of clinically actionable research findings to make informed choices regarding uptake of genetic counseling. Development was guided by published literature, the International Patient Decision Aid Standards, and the expertise of a steering committee of clinicians, researchers, and consumers. Decision aid acceptability was assessed by self-report questionnaire. All 19 participants stated that the decision aid was easy to read, clearly presented, increased their understanding of the implications of taking up research findings, and would be helpful in decision-making. While low to moderate levels of distress/worry were reported after reading the booklet, a majority of participants also reported feeling reassured. All participants would recommend the booklet to others considering uptake of clinically actionable research findings. Results indicate the decision aid is acceptable to the target audience, with potential as a useful decision support tool for genomic research participants.     

Effects of absolute luminance and luminance contrast on visual search in low mesopic environments

Diverse adaptive visual processing mechanisms allow us to complete visual search tasks in a wide visual photopic range (>0.6 cd/m²). Whether search strategies or mechanisms known from this range extend below, in the mesopic and scotopic luminance spectra (<0.6 cd/m²), has yet to be addressed. Based on a study that addressed simple target discrimination in luminance environments using contrast-dependent behavioral efficiency functions, we assessed visual search in more complex-feature and conjunction-search paradigms. The results verify the previously reported deficiency windows defined by an interaction of base luminance and luminance contrast for more complex visual-search tasks. Based on significant regression analyses, a more precise definition of the magnitude of contribution of different contrast parameters. Characterized feature search patterns had approximately a 2.5:1 ratio of contribution from the Michelson contrast property relative to Weber contrast, whereas the ratio was approximately 1:1 in a serial-search condition. The results implicate near-complete magnocellular isolation in a visual-search paradigm that has yet to be demonstrated. Our analyses provide a new method of characterizing visual search and the first insight in its underlying mechanisms in luminance environments in the low mesopic and scotopic spectra.

     

‘Put Your Money Where Your Mouth Is!’: Effects of Streaks on Confidence and Betting in a Binary Choice Task

Human choice under uncertainty is influenced by erroneous beliefs about randomness. In simple binary choice tasks, such as red/black predictions in roulette, long outcome runs (e.g. red, red, red) typically increase the tendency to predict the other outcome (i.e. black), an effect labeled the “gambler's fallacy.” In these settings, participants may also attend to streaks in their predictive performance. Winning and losing streaks are thought to affect decision confidence, although prior work indicates conflicting directions. Over three laboratory experiments involving red/black predictions in a sequential roulette task, we sought to identify the effects of outcome runs and winning/losing streaks upon color predictions, decision confidence and betting behavior. Experiments 1 (n = 40) and 3 (n = 40) obtained trial‐by‐trial confidence ratings, with a win/no win payoff and a no loss/loss payoff, respectively. Experiment 2 (n = 39) obtained a trial‐by‐trial bet amount on an equivalent scale. In each experiment, the gambler's fallacy was observed on choice behavior after color runs and, in experiment 2, on betting behavior after color runs. Feedback streaks exerted no reliable influence on confidence ratings, in either payoff condition. Betting behavior, on the other hand, increased as a function of losing streaks. The increase in betting on losing streaks is interpreted as a manifestation of loss chasing; these data help clarify the psychological mechanisms underlying loss chasing and caution against the use of betting measures (“post‐decision wagering”) as a straightforward index of decision confidence. © 2014 The Authors. Journal of Behavioral Decision Making published by John Wiley & Sons Ltd.