Verläufe bei sexuellen Tötungen

This article summarizes main results of studies on forensic psychiatric court reports on 166 men who had been persecuted between 1963 and 1991 for a sexual offence leading to the death of the victim. Comparing perpetrators with a single victim and those with multiple victims we found similar results as in two previous studies with smaller samples: Multiple sexual homicide perpetrators showed more often sexual sadism and other paraphilias, as well as antisocial, schizoid and sadistic personality disorders. Follow-up data from the federal criminal records could be obtained for 139 offenders. Ninety perpetrators had been released after a mean detention of 12.2 years, whereas the 49 offenders who were still in prison or forensic psychiatric hospitals had been detained for a mean period of 20.6 years. The non-released offenders showed more often paraphilias as well as antisocial and sadistic personality disorders than the released perpetrators. Paraphilias and antisocial personality traits are empirically well proven risk factors for criminal recidivism with sexual reoffences. In addition, the non-released sexual homicide perpetrators had higher scores in all applied risk assessment instruments (PCL-R, HCR-20, SVR-20, Static-99). Among the released offenders only 1.1% (n=1) reoffended with a completed homicide and 2.2% (n=2) with attempted homicide. The recidivism rates with sexual and other violent reoffences in this sample of sexual homicide perpetrators were similar to those in a large meta-analysis on recidivism in sexual offenders by Hanson and Morton-Bourgon (4). Since well established risk factors had apparently been “used-up” for the decisions about release or non-release, in the follow-up data about the released offenders only age at the sexual homicide and age at the time of release were found as risk factors for recidivism with any violent (sexual or non-sexual) reoffence, i.e. the younger the offender at the time of the homicide and the younger at the time of release, the more likely is the risk of violent reoffending.     

Eine Therapiestunde mit einem Mörder

Although psychodynamic concepts may be helpful in identifying the complex interpersonal and manipulative processes that occur between inmates and therapists and to transform them into the therapeutic process they are hardly ever applied in a correctional setting. The author provides an insight into the psychotherapeutic work conducted in prison. The first part of the paper outlines the special conditions in which psychodynamic psychotherapy occurs in a social therapeutic intervention institution within the German prison service. Characteristic transference and countertransference constellations are described. Based on a verbatim report an account is provided of a therapy session with a serious violent offender. In his reflections on the session the author focuses on the effects on the transference process of, in the offender’s eyes, being both therapist and assessor at the same time.     

Therapieverläufe von Sexualstraftätern

Throughout the past decades evaluation studies on sexual offender treatment have led to controversies. While numerous studies examined the effectiveness of different interventions, the possible underlying mediating mechanisms have largely been neglected. This study took a multimethod approach to investigate the measurability of change processes in sexual offenders serving a sentence in the social therapeutic institution (SothA) of the detention center in Tegel, Germany (n?=?105). A longitudinal design with three groups (i.e. waiting group, treatment group and day release group) from four perspectives on change processes (i.e. external criminal prognostic assessment, therapists’ view, staff observation and clients’ perspective) was employed. Most criminal prognostic risk and protective factors improved over the course of treatment and this effect was smallest in the waiting group. While therapists reported increased therapeutic constraints in the course of treatment, they were more favorable in the criminal prognosis and detected more differentiated patterns of needs and resources of clients as conceptualized by the primary and secondary assets of the good lives model (GLM). In contrast, during the course of treatment the sexual offenders showed an increased awareness of the criminogenically relevant problems in the sexual domain. Nonetheless, the overall number of problems they identified as criminogenically relevant decreased. The internal problem attribution in the sense of internal causes (“It is my fault”) and capability of change (“Only I can solve the problem”) was increased. The stronger the clients’ perception of own problems in the sexual context increased over the course of treatment, the more positive the change in the staff’s view of their behavior became and the more their dynamic risk factors improved. Overall, this study found strong evidence that change processes in SothA might already be detectable during ongoing social treatment. It is currently uncertain whether these changes influence future recidivism. A comparison with recidivism data is necessary and in planning.     

Tötungsdelinquenten im Normalvollzug unter besonderer Berücksichtigung psychiatrisch unauffälliger Mörder

We collected data on 121 cases of homicide and manslaughter in the normal penitentiary system and counted the cases of perpetrators with, and without, psychiatric diagnosis. About 30% of the sample consisted in perpetrators without any psychiatric diagnosis; in contrast, about 40% were diagnosed as personality disorder; some few cases (7%) were classified as alcoholism or polytoxicomania, respectively; and the rest (23%) were cases of both personality disorder and alcoholism/polytoxicomania. Perpetrators without psychiatric diagnosis differed in systematic ways from perpetrators with psychiatric diagnosis. The former committed their offenses more on victims in partnership and family, while perpetrators with psychiatric diagnosis frequently offended strangers. Perpetrators lacking a diagnosis used poison, and striking to dead, relatively more frequently while homicide and manslaughter by stabbing, shooting, or some combination thereof were committed mainly by perpetrators with psychiatric diagnosis. Diagnosed perpetrators had more frequently been previously convicted (nearly 70%). In sum we found a considerable percentage of perpetrators who lacked a psychiatric diagnosis. We argue that this group can properly be distinguished from perpetrators who have some psychiatric diagnosis.     

Primärprävention bei Essstörungen

Zusammenfassung Essstörungen gelten als schwer therapierbar. Mit einer Mortalitätsrate von 5–16% ist Magersucht die schwerste psychosomatische Erkrankung bei Mädchen und jungen Frauen. In den letzten Jahren wurde daher verstärkt versucht, der Entstehung von Essstörungen durch präventive Maßnahmen entgegenzuwirken. Der Schwerpunkt liegt hierbei auf der Primärprävention im Rahmen von Schulprojekten. Hierfür liegen bereits ermutigende Wirkungs- und Qualitätsnachweise vor. Entsprechende Projekte stehen im Zentrum der vorliegenden Übersichtsarbeit. Diese stellt keinen Anspruch auf vollständige Darstellung, sondern ist ein Versuch der Systematisierung unterschiedlicher Herangehensweisen und soll durch die kurze Beschreibung möglichst prototypischer und evaluierter Beispiele einen Einblick in die derzeitige Praxis der Primärprävention von Essstörungen geben. Quellen der Übersicht sind die Datenbank der Bundeszentrale für gesundheitliche Aufklärung (BZgA), Veröffentlichungen in Fachzeitschriften sowie Internetauftritte. Da Art, Umfang und Umsetzung der Präventionsprogramme sehr von politischen Bedingungen und Voraussetzungen innerhalb des Gesundheits- und Bildungssystems abhängen, bleibt die Übersicht auf Programme aus dem deutschen Sprachraum beschränkt.     

Rökavvänjning genom självterapi

Sammanfallning : I artikeln presenteras kortfattat ett program för rökawanjning, vilket utvärderats på experimentell basis. Programmet, som består av olika självterapeutiska tekniker, föreligger i bokform och omfattar 5 veckor. Under derma period instruerades fpp att observera sig själva på olika sätt för att bli medvetna om sitt rökbe—teende. Därefter gavs de uppgifter som gradvis fick dem att minska sin cigarrettkonsumtion. Slutligen fick de lära sig nya beteendemönster som ersättning för den avlagda rökvanan. 150 personer del tog i försoket, indelade i 3 olika be—handlingsgrupper. Dessutom fanns en kontrollgrupp     

Die Kriminalprognose bei persönlichkeitsgestörten Straftätern

Many studies have shown that there is an elevated prevalence of personality disorders in criminal offenders in addition to the statistically higher probability of becoming repeat offenders. This article highlights in part I the method of Applied Criminology which explains how this method can help to detect the relevance of personality disorders when applied to an individual case. In this second part the personality disorders are examined and also how this method facilitates the risk assessment process.     

Die Kriminalprognose bei persönlichkeitsgestörten Straftätern

Many studies have shown that there is an elevated prevalence of personality disorders in criminal offenders in addition to the statistically higher probability of becoming repeat offenders. This article highlights the method of Applied Criminology which explains how this method can help to detect the relevance of personality disorders when applied to an individual case. In a second part of this article the personality disorders are examined and also how this method facilitates the risk assessment process by allowing case managers to highlight the aspects that are prevalent to predict future criminal behavior.     

Psychotherapie chronischer Erschöpfungszustände

Chronic fatigue is common. Since fatigue has little specificity, it can be the consequence of many different somatic diseases and psychiatric disorders. Therapy needs to be individually tailored with regard to the underlying or assumed causes. When objective and established causes cannot be identified or cannot adequately explain the symptoms experienced, the diagnosis of chronic fatigue syndrome (CFS) is possible. But what is CFS? Is it a valid diagnosis? How can the chronic fatigue patient be treated? Based on an integrative understanding, a psychobiological etiological and psychotherapeutical model of chronic fatigue will be developed and described.     

Über die phänomenale Höhe und Stärke von Teiltönen

Ohne Zusammenfassung Mit 1 Textabbildung.     

Zahnhartsubstanzschäden bei Essstörungen

Eating disorders such as anorexia nervosa and bulimia nervosa lead to several serious physical problems. One possible consequence is acid-related dental erosion. Dental erosion can be identified early and is caused by exogenic (selection of food) and / or endogenic (gastric acid) factors. That is why dentists play an important role in the early identification of eating disorders as well as in the prevention and therapy of dental erosion. They should be important collaborators of psychotherapists. We review characteristic damages to the teeth that are seen in eating disorders as well as preventive and therapeutic interventions. Psychotherapists should be informed about dental problems and preventive strategies to educate their patients.     

Entwicklung religiöser Glaubensfähigkeit

Faith in a broad sense is viewed as trustingly turning to a (personal) object located in the immanent as well as in the (relativ or absolute) transcendental field. The author describes on grounds of the object relational theory how the ability for faith is developing already in early childhood. In case of a beneficial development a firstly archaic faith is replaced later on by a faithful certainty (basic confidence) and, finally, by personal faith. Other forms of faith (faithful longing, magic or irrational faith culminating in fanatism) is viewed by the author as a consequence of unresolved archaic anxiety from the absolute evil. The development of the ability for religious faith is explained on the basis of the model of intersubjective narcissism.     

Angstzustände bei Patienten mit schweren Persönlichkeitsstörungen

States of anxiety are very common problems in patients with severe personality disorders. All phenomena of anxiety can be observed. In this connection a continuum of the severity of impairment of structural personality organisation can be postulated. In many cases proper anxiety disorders exist as comorbid disorders. Anxiety is esteemed to be the central affective problem of borderline patients. In spite of these relations, states of anxiety in patients with personality disorders are often underdiagnosed or misdiagnosed. For the treatment of neurotic anxiety disorders (for example panic disorders), there exist disorder-specific therapy manuals that proceed from behavioural as well as psychodynamic perspectives. Nevertheless, for the treatment of anxiety states in personality disordered patients, the techniques that focus heavily on symptomatology appear often contraindicated. In our opinion, treatment of these typically severe anxieties must be contained within a therapeutic framework, which essentially takes into account the personality organisation of this group of patients. Such treatment makes special demands on the therapist for working with transference and countertransference processes. From a disorder-specific psychodynamic perspective recommendations are given for psychotherapy.     

Flygrädsla i Sverige. En enkätundersökning av svenskars rädsla för trafikflyg som transportmedel

Abstract

Föreliggande arbete avser en enkätundersökning av svenskars flygrädsla. Tvätusen svenska med-borgare i äldrarna 18–75 är erhöll en enkät med 25 frägor angäende flygrädsla och hur denna päverkar viljan att utnyttja trafikflyget.

Christer L. Nordlund: A questionnaire of Swedes' fear of flying. During the spring and summer of 1982, 1 992 randomly selected individuals received a written questionnaire concerning fear of flying. 1 484 individuals returned the questionnaire and 169 of the remainders were interviewed by telephone and were included in the material. 76% of the individuals in the material had flown one or more times, while 6% reported that because of fear they had never flown. 17% reported that they could not consider flying, owing to fear, or for other reasons. 10% answered that they experienced relatively great or greater fear when flying, while 15% answered that they felt the same when thinking about flying. When asked about different parts of a flight, 25% revealed that they felt relatively great or greater fear during some part of it, and about 30% reported the same level of fear when clear air turbulence was encountered. The prevalence of flight fear depends upon the definition used. If “daring to fly” is used as a criterion, 10% of the Swedish population, i.e. 600 000 Swedes, can be considered to be afraid of flying. Given that flying is quite safe (from a statistical point of view), anyone experiencing discomfort during a flight could be regarded as demonstrating fear of flying. With this criterion, 50% of the interviewed individuals (= 3 000 000 Swedes) could be regarded as apprehensive about flying.     

Borderline-Persönlichkeitsstörung (BPS) und Dissoziative Identitätsstörung (DIS)

Patienten mit einer Vorgeschichte mit komplexen (Kindheits-) Traumatisierungen und daraus resultierenden posttraumatischen St?rungsbildern wie z.B. der komplexen posttraumatischen Belastungsst?rung, der Borderline-Pers?nlichkeitsst?rung (BPS) und/oder komplexen dissoziativen St?rungen (Dissoziative Identit?tsst?rung, DIS und DIS-?hnliche Formen der Nicht n?her bezeichneten dissoziativen St?rung, engl. dissociative disorder not otherwise specified, DDNOS) stellen in der klinischen Praxis h?ufig eine besondere Herausforderung für psychotherapeuten, ?rzten bzw. Stationsteams dar. Sowohl die klinische Erfahrung als auch empirische Forschungsergebnisse zeigen, dass betroffene Patienten h?ufig unter sehr komplexen St?rungsbildern mit oft vielen Komorbidit?ten leiden (Kessler, 1995), dass viele Patienten zu wiederholten Krisen und Dekompensationen neigen und dass es ohne eine traumaspezifische Psychotherapie h?ufig zu einem chronischen St?rungsverlauf mit oft intensivem psychiatrischem Behandlungsbedarf und entsprechend hohen Krankheitskosten kommt.     

Lästererfahrungen, Körperbild und Körpergewicht bei jungen Erwachsenen

Background

Negative comments (teasing) on weight and body image in adolescence might predict body dissatisfaction, overweight and eating disorders in adulthood. This study investigated 134 nursing students for a relationship between a history of teasing, body image and weight.

Materials and methods

Subjects with a body mass index (BMI)>?25 kg/m² reported more teasing compared with normal subjects whereas those with a BMI<?20 kg/m² showed lower values compared with normal or overweight subjects. Teasing questionnaire values correlated with aspects of negative body image. The BMI was predicted by factors age (p?=?0.001), sex (p?=?0.016) and teasing subscale weight (p?=?0.001).

Conclusions

It is remarkable that low teasing experience was associated with low weight, which might point to underweight as protective factor against teasing; however, the cross-sectional design of this study precludes direct causal inferences.     

Über Höhenänderungen bei Schwebungen

Ohne Zusammenfassung Mit 2 Textabbildungen.