Die sexuelle Entwicklung Jugendlicher und Heranwachsender im Kontext von Sexualstraftaten und Körperverletzungsdelikten

To find out possible differences concerning the sexual development of juveniles who had committed either sexual or assaultive offenses. In order to reduce confounding variables a defined group of perpetrators was studied during ongoing criminal proceedings: 107 German single perpetrators, of average intelligence, between 14 and 21 years old, committing hands-on offenses, were investigated in respect to their physical-sexual development (i.e. maldescensus testis, orchitis and others), their socio-sexual development (i.e. attitude to masturbation, to sexuality within the family and others), and their psycho-sexual development (i.e. homo- or heterosexual experiences by mutual agreement like petting or sexual intercourse). 38 subjects had sexually forced female juveniles or women, 36 subjects had sexually abused children of both sexes, 33 subjects had committed assaultive offences towards male juveniles or men (control group). No differences were found between the groups concerning their physical-sexual development. The socio-sexual development distinguished between the sexual offender groups and the control group. The outcome concerning the psycho-sexual development was specific for every single offender group. Many of the juveniles who had committed sexual offences were acting like this already before the age of 14 (limit of criminal responsibility in Germany). This was so as well for some few subjects of the control group. After the age of 14 juveniles of the sex offender groups - in contrast to the control group - committed sexual offences which were not reported. Considering further characteristics of the biography and the results of psychometric instruments of the 107 subjects investigated, this study describes early markers of the development of deviant sexual fantasies in juvenile sex offenders.     

Alkoholabhängigkeit in der psychiatrischen Klinik

In Germany 2.4?% of the population suffer from alcohol dependency and 3.8?% of adults from alcohol abuse. Despite an extensive number of options available for addiction therapy only a minority of affected persons receive addiction-specific therapy. This results in a chronification of the disease and a reduction of approximately 15 years in life expectancy. Background knowledge of the foundations of alcohol addiction leads to a new understanding of the processual course of the disease as well as to new therapy interventions. Individualized treatment includes a combination of outpatient, partial inpatient or inpatient therapeutic measures and range from medical advice for reduction of alcohol consumption, to qualified withdrawal treatment up to pharmacological relapse prophylaxis and long-term weaning treatment. Under current therapeutic conditions abstinence quotas of 50-70?% over 1 year can be achieved. Treating physicians must have sufficient diagnostic certainty and furthermore must be in command of motivating discourse techniques, knowledge on the therapeutic options of outpatient and inpatient withdrawal treatment, pharmaceutical relapse prophylaxis and mediation in rehabilitation measures.     

Die Religionsfreiheit im Spiegel des Staat-Kirche-Verhältnisses in Finnland

Die Beziehung von Kirche und Staat hemmt seit langem nicht mehr die vollständige Verwirklichung der Religionsfreiheit in Finnland. Für das finnische Modelle ist es Ende des 20. Jahrhunderts kennzeichnend, dass die lutherische Kirche selbst ohne äußeren Druck das Verhältnis zum Staat geklärt hat. Heutzutage gehört Finnland zu den westeuropäischen Ländern, in denen sich der Staat neutral zu den mit der Religion ihrer einzelnen Bürger verknüpften Entscheidungen hält. Dabei gehört zur Religionsfreiheit sowohl das Recht, sich zu einer bestimmten Religion zu bekennen und sie zu praktizieren, als auch ein Recht darauf, sich zu keiner Religion zu bekennen. Die Verwirklichung der Religionsfreiheit des Einzelnen setzt keine einheitliche Verhaltensweise des Staates mit allen in seinem Bereich tätigen Kirchen und religiösen Gemeinschaften voraus. Man geht aber davon aus, dass die Ungleichheit zwischen den religiösen Gemeinschaften nicht die Verwirklichung der Religionsfreiheit aller Bürger aufs Spiel setzen darf. Weil die Entwicklung in Finnland auch in Richtung einer mehr gleichgestellten Stellung religiöser Gemeinschaften führt, so stärkt dies gleichzeitig auch die gesellschaftlichen Voraussetzungen für die Realisierung der Religionsfreiheit des Einzelnen.     

Das Konstrukt „sexuelle Sucht“ im Zusammenhang mit forensisch psychiatrischen Fragestellungen

The construct of sexual addiction is still of great importance for forensic psychiatry in German-speaking countries. The aim of this article is to examine the concept in relation to the forensic psychiatric topic in more detail. Given the different historical developments in German and Anglo-American countries, definitions of hypersexuality as opposed to diagnostic categories and etiological considerations are presented. A central topic for forensic psychiatry is in the context of the assessment of self-control and criminal responsibility as well as a dynamic risk factor and thus also as a target for therapy. Finally, problem areas of the construct are discussed.     

Die Durchführung antiandrogener Behandlung von Sexualstraftätern im Berliner Maßregelvollzug

In 2002, the Forensic Psychiatric Hospital in Berlin started a pilot project for combined treatment of sex-offenders with anti-androgenic LH-RH agonists and psychotherapy. On the basis of experience-based knowledge transfer and with almost six years of practical experience, this article reports results of this new approach of combined psychotherapy and drug treatment from medical and psychological viewpoints. First, a short history and general information about the combined treatment are provided. Secondly, its effects on patients’ sexual self-perception, personality disorders and aspects of prognosis are explored. Thirdly, a medical therapy scheme, possible side effects, as well as issues of patients’ rights and approvals are discussed.     

Die Kategorie “Freiheit” im marxschen Denken

Ohne Zusammenfassung     

Die Rehabilitation von Straftätern

The rehabilitation of offenders in English-speaking countries is primarily guided by a risk management framework (the risk-need-responsivity principles: RNR model), which aims at reducing the possibility of harm to the community rather than improving offenders’ quality of life. In the last decade Tony Ward and his colleagues have developed the good lives model of offender rehabilitation (GLM) as an alternative to the RNR model. The GLM incorporates the RNR principles of risk, need and responsivity into its theoretical structure while aiming to provide a more constructive and comprehensive approach to correctional practice. More specifically, it aims to both reduce risk while enhancing the quality of offenders’ lives. The present article aims at outlining the general, etiological assumptions and practice implications of the GLM. In addition, its strengths and limitations and evidence base are reported. These illustrations highlight the usefulness of the GLM for the treatment of offenders and sex offenders in particular.     

Die ästhetische Erscheinungsweise der Farben

Ohne Zusammenfassung     

Die Effektivität der Hypnose

From 193 studies published until 1998 that investigated the efficacy of hypnosis 43 randomized clinical studies were selected that compared a patient group treated exclusively by hypnosis with an untreated control group (or with a group of patients treated by conventional medical procedures). The 43 studies were integrated into a meta-analysis that yielded a weighted average post-treatment effect size of d=.60 (medium effect size) for hypnotic treatment of ICD-10 coded disorders (24 studies; average treatment period: 5.1 weeks) and d=.38 (small effect) for hypnosis as an adjunct for supporting medical procedures (19 studies). These estimates are conservative since all variables of a given study were used. Most of the studies employed methods of the classical approach to hypnosis. In order to obtain an estimate to which extent non-clinical factors (design-quality, way of comparison of dependent variables) have an influence on the effect sizes, effect sizes were computed for all studies of the original 193 studies that reported the necessary statistical information (N=89). For those studies with an average effect size of d=.80 a massive influence of non-clinical factors was demonstrated with a range from d=.51 for randomized studies with group comparisons to d=2.0 for non-randomized studies using pre-post-comparisons.     

Patientenpfade im psychiatrischen Ma?regelvollzug �C Intensivere Behandlung, k��rzerer Freiheitsentzug?

This article reports on the results of two workshops which attempted to register and characterize clinical pathways in special hospitals for schizophrenic offenders. The starting point for both workshops was the analysis of the stages and elements which naturally constitute long-term therapy in schizophrenic patients. Based on this analysis it was aimed to develop standardized operating procedures: which mode of action is most sensible in which phase of treatment? How to respond to the different problems arising during therapy? How to prevent therapeutic stagnation? How to retain up-to-date knowledge on the patient? How to manage a faster and more effective transfer into outpatient care? This article focuses particularly on the course of patientsduring the process of in-patient care in special hospitals for schizophrenic offenders.     

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.     

Bulimiebehandlung im stationären und teilstationären Setting

While treatment guidelines for outpatient psychotherapy for bulimia nervosa are known, it is hard to find published concepts for inpatient or day clinic settings. We will describe a treatment program developed in Freiburg/Germany, which integrates symptomoriented, cognitive-behavioral elements into a psychodynamic concept. The program presented can be seen as an example. For implementation at other clinics, it should be adapted to their special context and structure.