Vom Verhältnis zwischen Psychosomatik und Verhaltensmedizin

Ohne Zusammenfassung     

Zum Verhältnis zwischen Experiment und Gedankenexperiment in den Naturwissenschaften

On the relation between experiment and thought experiment in the natural sciences. To understand the reciprocal autonomy and complementarity of thought and real experiment, it is necessary to distinguish between a ‘positive’ (empirical or formal) and a transcendental perspective. Empirically and formally, real and thought experiments are indistinguishable. However, from a reflexive-transcendental viewpoint thought experiment is at the same time irreducible and complementary to real experiment. This is due to the fact that the hypothetical-anticipatory moment is in principle irreducible to physical reality—even though it refers to physical reality and is bound with the empirical use of our understanding. The presence of counterfactuals is the condition of the possibility for thought experiments to become in principle real ones, by means of a series of technical realisations that gradually approximate the idealisations that they contain.     

Untersuchungen über Zusammenhänge zwischen drei Leistungsfaktoren und Antworten auf Fragebogenitems

Zusammenfassung 90 Oberschüler beantworteten 214 Fragebogenitems und bearbeiteten 41 Leistungsaufgaben, die zusammen drei in einer faktorenanalytischen Untersuchung von Jäger gefundene Faktoren repräsentieren. Die Zusammenhänge zwischen Fragen- und Aufgabengruppen wurden korrelations- und faktorenanalytisch untersucht. Die Leistungen in den den Faktor Anschauungsgebundenes Denken repräsentierenden Aufgaben korrelierten positiv mit durch Fragebogenitems definierten Verhaltensdimensionen Hinwendung zum Konkreten und Wohlbefinden-Emotionale Stabilität-Leistungszuversicht. Die Leistungen in Einfallsreichtum und Produktivität korrelierten positiv mit Überlegenheitsgefühl-Leistungszuversicht-Emotionale Stabilität-Wohlbefinden, sowie mit Spontaneität, Selbständigkeit und Flexibilität. Die Leistungen in einem dritten Faktor, der Tempo-Motivation bei einfach strukturierten Aufgaben benannt werden könnte, korrelierten positiv mit Soziale Zuwendung-Extraversion und scheint darüberhinaus mit einem Merkmal kompensatorischer Leistungsehrgeiz in Beziehung zu stehen. Die Ergebnisse werden diskutiert und Hypothesen zur Überprüfung und Ausweitung der Befunde formuliert.

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Summary 90 subjects answered 214 questionnaire and 41 ability test items, tbe latter representing three factors found by Jäger in an extensive factor analytic investigation. The relations between all the variables were analyzed by correlational and factor analytic methods. It was found that the ability called vision-related thinking is positively correlated with questionnaire-defined behavioral dimensions called reality orientation and well-being-emotional stability-achievement confidence. The ability fluency and productivity is positively correlated with superiority feeling-achievement confidence-emotional stability-well-being, with spontaneity, independence, and flexibility. Speed-motivation in simple tasks is positively correlated with social participation-extraversion and seems to be related to a trait called compensatory achievement orientation. The findings are discussed and hypotheses for subsequent test and extension formulated.

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Wir danken Herrn Dr. A. O. Jäger für die freundliche Erlaubnis, Aufgaben und Ergebnisse aus seiner Forschungsarbeit vor deren Veröffentlichung zu verwerten. Herrn Dipl.-Math. P. Schnell vom Deutschen Rechenzentrum in Darmstadt für die Durchführung der Berechnungen, unseren Kollegen, den Dipl.-Psychologen K. Althoff, Ch. Balzert, K. D. Stoll und P. Wolff für freundliche Mithilfe, nicht zuletzt unseren Vpn für ihren Einsatz und den Herrn Oberstudiendirektoren Jung, Hadamar, Dr. Keller, Montabaur, und Sauer, Limburg, für die Erlaubnis zur Durchführung der Untersuchungen an ihren Schulen.     

Phänomenologie und Realismus. Die Frage nach der Wirklichkeit im Streit zwischen Husserl und Ingarden

I deal with the relation between phenomenology and realism while examining Ingarden’s critique towards Husserl. I exhibit the empiricist nucleus of Husserl’s phenomenology, according to which the real is what can be sensuously experienced. On this basis, I argue that Husserl’s phenomenology is not idealistic, in opposition to the realistic phenomenology, according to which reality consists in entities which cannot be sensuously experienced and are thus ideal. Finally I attempt to show that the idealistic elements of Husserl’s thinking do not originate from the transcendental turn, but from a remainder of psychologism that contradicts his empiricism.     

Zum Zusammenhang zwischen Vollzugslockerungen, Unterbringung im offenen Vollzug und Legalbewährung bei Sexualstraftätern

Early release, temporary absence, and minimum security confinement have been permitted less often in German prisons in recent years. There are several reasons and indications that sexual offenders are particularly affected by these developments. Prison files and recidivism data of 115 adult sexual offenders who had been in a Lower Saxony prison in the mid-1990s were analyzed for the current study to find out whether this group posed a specific risk when permitted temporary absence or minimum security confinement. It was also considered whether temporary absence and minimum security confinement were related to reduced recidivism after release. The average follow-up interval was 8.5 years. The following findings emerged: First, 50.9% were reconvicted for any offence, 21.3% with an aggressive offence, and only 7.4% were reconvicted with a sexual offence. Every fifth (19.4%) was sentenced to another prison term or had another probation term revoked. Second, rule-breaking and criminal activity by sex offenders during minimum confinement or temporary absence were very rare and of low severity. Third, sexual offenders in minimum security confinement were less likely to recidivate than others on all measures of reoffending. With Cox regression analyses that controlled for important risk factors for recidivism it was found that minimum security confinement contributed to reduced general, but not to reduced sexual or aggressive reoffending. No relationship was found between level of temporary absence status (unaccompanied vs. accompanied) and recidivism. It is concluded that, contrary to public opinion and judicial practice, sexual offenders can be granted minimum security confinement and temporary absence if an adequate selection process is implemented.     

Forensisch-psychiatrische Versorgungsstrukturen in Deutschland: Ein Vergleich zwischen Alten und Neuen Bundesländern

Differences and similarities of the forensic mental health hospitals in the New Federal States (NFS) (former East Germany) and the Old Federal States (OFS) (former West Germany) were assessed. The focus of the study was set on institutional features of these hospitals as well as on characteristics of the detained patients. Data were based on a survey conducted in 2006. Specifically designed questionnaires were sent to the mental health departments of the State Ministries, and to all forensic mental health hospitals (response rates 100% and 62%). The general finding is that structures of forensic mental health services in NFS and OFS, e.g. the number of beds per million inhabitants and institutional features, have become similar since the German reunification. The health staff-patient relation is equal for some professions, whereas for other professions this relation is even better in NFS. Differences exist regarding the forensic mental health law of the Federal States. Moreover, the proportions of some delicts and diagnoses in the detained clientele differ. In NFS, the need for forensic aftercare facilities is even more urgent than in OFS. In both parts of the country there is a need for the development of some aspects of quality assurance for both forensic mental health hospitals as well as governmental institutions. Generally, the evaluation of quality of structures, processes and results is yet impossible for many fields of forensic mental health care, because there is no sufficient data base.     

Psychotherapie zwischen Narrativ und Qualit?tssicherung

Two important books and a psychotherapeutic quality study published in 2011 serve as background for the examination of the polar conditions that determine psychotherapeutic work: the laws of the narrative, i.e. of relating, which provides the contents of the psychotherapeutic work and quality assurance as the canon of the scientific, politically correct and governmental controls of psychotherapeutic practice. The narrative is a composition formally characterized by a course scheme and in terms of contents as an enactment of the first person narrator and a narrated first person. Different from daydreams it seeks public attention and the listener in order to evoke concern and identification. It transports wishes, anxiety, fulfillment and catastrophes. The narrative is the phenomenology of speech logic and interpersonal coherence and can be linked to different theories, above all psychoanalytical ones. For psychotherapy it opens the world of the ??I??, with its conflicts, assessments and stabilizing efforts in the interpersonal context. Quality control is also a scientifically based steering of practical work which is increasingly being manifested in psychotherapy as well as in medicine and other areas of life. A study of the Techniker Krankenkasse (Technical Health Insurance) concluded in May 2011, confirms the uselessness of time-consuming and costly control procedures in psychotherapy and emphasizes the importance of good training and further education, for which the study has attested a high quality for Germany.     

Träume werden zwischen den Menschen geträumt

Because we humans have a multitude of relationships, which first allow us to live, dreams as a natural phenomenon can express this basic feature of humans but they can also be understood specially for various relationships: they depict multiple relationships in which we are involved, illuminate relationships, give another new component to conscious knowledge and in this way alter relationships. We tell each other about dreams and exchange them amongst ourselves in a special narrative sphere.When working with dreams in the therapeutic process, the messages of dreams on the analytical relationship are important information and experiences from an unaccustomed perspective. That both the analysand and the analyst share an understanding of the dreams, is shown in particular by the initial dream. It can conclusively be shown in dream series how relationship conflicts change through the work with dreams.     

Psychodynamische Zusammenh?nge zwischen Psychose und Lebensgeschichte

Using two cases as examples it is shown how psychotic experiences and behaviour are psychodynamically associated with the biography of affected patients and can be beneficially used in therapy. Based on the historic pioneer work of Sigmund Freud who, with his psychoanalytical interpretation of Daniel Paul Schreber??s autobiography Memoirs of my nervous illness (Denkwürdigkeiten eines Nervenkranken) from 1903 shortly after his death 100 years ago, was the first to attempt to construct an association between Schreber??s delusional symptoms and his past history, this approach will be extensively discussed for patients with schizophrenia and similar psychoses. Particular attention is paid to trigger situations for the occurrence of psychotic conditions and the interpretation of certain delusional symptoms with respect to conflictual subjects from the past. In patients suffering from monopolar or bipolar affective disorders or psychoses, the symptoms are generally less exaggerated and extravagant than in schizophrenic psychoses. However, in such cases it can also be beneficial for the therapy in depressive or manic episodes to follow up the long-lasting conflicts which existed prior to the psychosis, where they either experience an escalation or describe an attempt to free themselves from previous pathogenic settings.     

Homosexualität und Prägung

Ohne ZusammenfassungMit Unterstützung der Deutschen Forschungsgemeinschaft.     

Zur Beziehung zwischen Schizophrenie und gewaltt?tigem Verhalten

The relationship between schizophrenia and violence with its substantial implications for the care of the severely mentally ill is one major reason for the special position of psychiatry. Due to the unique complexity of the human brain psychiatry was able to catch up with all other medical disciplines as late as the second half of the twentieth century only by means of the progress in biological brain research and psychopharmacology. At the same time the position of psychopathology has substantially changed. Being one of the core research issues until the introduction of antipsychotic drugs, it is nowadays primarily understood as a mere auxiliary tool for communication, for the collection of administrative data and for the recruitment of patients for various research projects. After a short overview of the current knowledge concerning the association between schizophrenia and violence the authors demonstrate by means of two psychopathological models, the differentiated classification according to Leonhard and the concept of structural dynamics by Janzarik, that many of the findings of current brain research are compatible with these models, exclusively based on detailed psychopathological observations. Differentiated psychopathology plays an indispensable mediator role between biological brain research methods and the complex reality of human behaviour, which is of major importance especially in forensic psychiatric issues. By neglecting this fact psychiatry is in danger of abandoning the possibility to generate relevant questions and hypotheses for future research.     

Primär- und Sekundärprozess bei Angst und Depressivität im psychoanalytischen Erstinterview

Zusammenfassung Vorgestellt wird eine quantitative inhaltsanalytische Untersuchung an 46 psychoanalytischen Erstinterviews, die mit Angstpatienten und depressiven Patienten in Düsseldorf und Magdeburg geführt wurden. Im Mittelpunkt der Methodik steht das Regressive Imagery Dictionary (RID), ein computergestütztes Verfahren mit 43 Einzelkategorien, die zu den drei Indikatoren primärprozesshafter Inhalt, sekundärprozesshafter Inhalt und Emotionalität zusammengefasst werden. Die durchgeführten Subgruppenvergleiche beziehen sich auf Unterschiede zwischen Angstpatienten und depressiven Patienten sowie ostdeutschen (Magdeburg) und westdeutschen (Düsseldorf) Patienten. Die Ergebnisse zeigen in den Texten der ostdeutschen Patienten ein höheres Maß an primärprozesshaften Inhalten, insbesondere in den Kategorien Passivität und regressive Kognition. Bezüglich der Diagnosegruppen zeigen die Angstpatienten gegenüber den depressiven Patienten ein höheres Maß an primärprozesshaften Inhalten in der Subkategorie Oralität. Es zeigt sich, dass in psychoanalytischen Interviews nicht nur diagnosespezifische Inhalte thematisiert werden, sondern auch kultureller Hintergrund, Geschlecht und Bildung von Bedeutung sind. Die Studie leistet einen Beitrag zur Identifizierung automatisch erfassbarer Textmerkmale, die charakteristisch für die in einer qualitativen Studie gefundenen idealtypischen nosologischen Konstrukte der neurotischen Depression und der phobisch-angstneurotischen Erkrankung sind. Hierbei ist der depressive Idealtypus durch eine Überidentifikation mit Werten, durch das Gefühl der Abhängigkeit von einer schädigenden Person, durch Selbstwertprobleme, Hemmung und den unerfüllten Wunsch, geliebt zu werden, gekennzeichnet. Der Angsttypus zeichnet sich durch ein klischeehaft positives Bild der eigenen Persönlichkeit aus sowie durch die Gefühle, falsch verstanden, ausgenutzt, nicht ernst genommen und zum Außenseiter gemacht zu werden, sodass er bei nachlassenden Kräften im Kampf um Leistung nicht mehr mithalten kann.

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Primary and secondary processes in psychoanalytic first interviews with patients suffering from anxiety and depressionA regressive imagery dictionary content analysis study in West and East German patients

The present paper describes a study on the intake interview narratives of psychotherapy patients with computer assisted content analysis methods. 46 psychoanalytic first interviews of patients suffering from depression or anxiety disorders were analysed with the Regressive Imagery Dictionary (RID), a computer assisted content analysis method with 43 subcategories, which were sumed up to three main categories: Primary Process, Secondary Process, and Emotion. Comparisons between different subgroups of this sample were made: Anxiety vs. depressive patients, and East Germans (Magdeburg) vs. West Germans (Düsseldorf). Significant correlations were found between the Primary Process subcategories Passivity and Regressive Cognition, and East German patients, as well as correlations between the Primary Process subcategory Orality, and anxiety patients. The results confirm our hypothesis, that the psychotherapist-patient-interaction sequences, which are the basis of diagnostic categorization, enclose as well elements which are specific for the disorders under study as elements which are specific for sex and culture (east vs. west). The study contributes to the identification of specific text markers, which can be found in the narratives of patients suffering from neurotic depression vs. patients with phobia and panic disorders. The results of the study are compared with a previous qualitative study. Using the ideal-type concept, our qualitative content analysis study showed as characteristic features of depressed patients overidentification with social roles and norms, feeling of being dependent and injured by another person, problems of self-esteem, shyness, and unfulfilled wishes to be loved and accepted. In contrast, phobic patients characterized the own personality as normal and without any problems in a stereotype way, at the same time feeling misunderstood and exploited by other persons, feeling as an outsider and left alone, and being no more able to compete with others.