Ersch?pfung und Depression in der Schwangerschaft

For women pregnancy represents a condition of intense physical and psychological changes which subject the pregnant women to a number of potentially stressful situations. Hormonal changes during pregnancy predispose to exhaustion and therefore to an increased vulnerability to affective disorders. Depression is one of the most commonly diagnosed psychiatric disorders in the female population with an increased incidence during the reproductive years. Recent studies showed that approximately 10?C13% of patients suffer from a depressive episode in the perinatal period requiring specialized treatment including psychotherapy and/or pharmacotherapy. Underestimation of this condition and a lack of proper management can hinder normal mother-child bonding leading to impaired cognitive and emotional long-term development of the child. In this article the medical literature related to the prevalence and clinical presentation of depression during the perinatal period and its association to maternal exhaustion is reviewed. The clinical implications and therapeutic options are discussed.     

Qualifizierung und Qualit?tskontrolle in der forensischen Psychiatrie

At the end of the last decade severely violent and sexual crimes by previously convicted persistent offenders initiated a discussion about the necessity of quality control in the forensic psychiatric practice in Switzerland. Subsequently, measures similar to those in Germany were adopted, e.g. the implementation of a specialisation in forensic psychiatry. In addition, they included the creation of commissions with the duty of evaluating the dangerousness of serious offenders, the implementation of a standardized and certificated postgraduate training in forensic psychiatry and guidelines for the qualification of forensic assessment experts and the quality of reports. The following article presents the implemented measures and discusses their possible consequences for the quality of forensic psychiatric work.     

Einprägen und Aktivierung bei gleichzeitiger Variation der Absichtlichkeit des Lernens und der Ich-Bezogenheit des Lernstoffs

Zusammenfassung Eine Gruppe von Wörtern mit höherer Ich-Bezogenheit und eine von Wörtern mit niedrigerer Ich-Bezogenheit war einmal absichtlich, einmal beiläufig einzuprägen. Als abhängige Variablen dienten die Zahl der behaltenen Glieder und — zur Bestimmung des Aktiviertheitsgrades während des Einprägens — die Höhe des elektrischen Hautwiderstands. Sowohl einzeln als auch in Wechselwirkung verursachten die genannten unabhängigen Variablen bedeutsame Unterschiede hinsichtlich des Behaltens und der Aktivisierung. Der Deutung der Ergebnisse wurde die Annahme zugrunde gelegt, daß Aktivierungsvorgänge zu den Geschehnissen gehören, die für das Behalten von Bedeutung sind.

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Summary Two series of nouns with high and low emotional tone had to be memorized both intentionally and incidentally. During learning the amount of electrodermal skin resistance was registered as a measure of organismic activation, thereafter the Ss had to recall the words presented previously. The independent variables mentioned led to significant main and interaction effects in regard to both retention and activation data. The interpretation of the results is based on the assumption that retention is affected by activational processes.

     

Das „Problem“ der Habituskonstitution und die Spätlehre des Ich in der genetischen Phänomenologie E. Husserls

Der vorliegende Aufsatz behandelt zwei Bereiche, deren Zusammenhang in der aktuellen Husserlforschung zu Unrecht in Vergessenheit geraten zu sein scheint: Zum einen konturiere ich den Habitusbegriff und das damit verbundene Problem der Habituskonstitution im Spätwerk E. Husserls. Zum anderen dient das Ergebnis dieser ersten Untersuchung dann als Grundlage für die Frage nach dem Wesen des Ich in der genetischen Phänomenologie. Die Untersuchung besteht (nach einer kurzen Einleitung) aus drei Teilen: Zuerst stelle ich, um die Bedeutung des Begriffs ?Habitus“ zu klären, Ingardens Interpretationsalternativen der Habituskonstitution vor. Im Anschluss daran werde ich mich mit dem sogenannten ?transzendentalen Okkasionalismus“ befassen, der eine der zuvor vorgestellten Alternativen Ingardens aufgreift und weiterführt. Der ?transzendentale Okkasionalismus“ vertritt die These, dass die habituellen Eigenschaften des Ich durch den einfachen Vollzug der Akte entstünden. Weil diese These als Interpretation des Habitusbegriffs bei Husserl weit verbreitet ist, muss sie als Lösungsansatz in Erwägung gezogen werden. Jedoch zeigt eine genaue Lektüre der Forschungsmanuskripte Husserls, dass dieser scheinbare Lösungsansatz einen dort wichtigen Begriff außer Acht lässt: die ?Geschichte des Ich“. Diese wird im dritten und letzten Teil dieses Aufsatzes näher betrachtet und erläutert. Husserl selbst hob nämlich einen wesenhaften Zusammenhang zwischen den mannigfaltigen Erfahrungen des Ich hervor, durch den die Bezeichnung der Habituskonstitution als ?Okkasionalismus“ nicht zutreffend sein kann. Aus diesem Grund geht dieser Beitrag über die reine Wiedergabe der Habitusproblematik in Husserls Phänomenologie hinaus und beschreibt eine Auffassung der transzendentalen Subjektivität, die aus dem Spätwerk Husserls stammt.     

Zeitlosigkeit und Verg?nglichkeit (in) der Psychoanalyse

The author shows that the accessible psychoanalytic unconscious is not timeless. Freud??s ??timeless unconscious??, which was ontologized by himself and his successors, proves to be fiction with negative consequences. Assuming ??timeless?? primary processes psychoanalysis as a therapy would bite the hand which feeds it. Instead of contrasting linear time to the cyclic personal experience of time, the author suggests to speak about the ??emergence of lived time?? and the ??new moments?? of encounter in the therapeutic situation, to emphasize the importance of the opportune moment for change in contrast to the cyclic repetition of transference. In order to understand and approach disorders of time perception knowledge of unconscious conflicts and defense processes remains crucial. Even dreams are not timeless. While our conscious mind works according to chronological patterns, the pictorial representation in the particular form of thinking asleep, dreaming, makes it possible to map different memory traces simultaneously. Freud??s speculations about the ??timeless unconscious?? and Nirvana may originate from a longing for redemption. In contrast the author??s final chapter deals with the potential life span and transience of some central psychoanalytic concepts. Not even those who prove to be very close to observation can be attributed with ??eternal life??.     

Anfänge und Entwicklung der Leistungsmotivation: (II.) in der Zielsetzung des Kleinkindes

Ohne ZusammenfassungDiese Arbeit ist Herrn Prof. Dr. Wolfgang Metzger zum 65. Geburtstag gewidmet.     

Der Phänomenologe in der Galerie. Husserl und die Malerei

Ohne Zusammenfassung     

Response und Non-Response in der station?ren Psychotherapie depressiver Patienten

Background

Poor outcome of psychotherapeutic treatment has not yet been sufficiently investigated. It is assumed that approximately 25–30% of patients are treatment non-responders and about 5–10% suffer deterioration.

Study design and methods

The therapeutic success of a total of 2,323 consecutively admitted inpatients with a depressive episode (F32.0-2, F33.0-2) was evaluated by using different strategies based on self ratings at admission and at discharge, i.e. the Beck depression inventory II (BDI-II) and the brief symptom inventory (BSI). In intention to treat (ITT) and completer analyses various measures of therapy success were compared (e.g. statistical significance, effect sizes and clinical significance).

Results

Effect sizes were 1.59 (BDI-II) and 0.86 (BSI) for the ITT sample and 1.64 and 0.89 for the completer sample. Analyses using criteria of clinical significance resulted in response rates of 75.5% (BDI-II) and of 68.7% (BSI) for completer analyses and remission rates of 62.2% (BDI-II) and of 40.8% (BSI). Non-Response rates, also including minor responders, varied between 23.4% (BDI-II) and 27.4% (BSI). Deterioration was observed in only 1% (BDI-II) and 3.9% (BSI) of the patients.

Discussion

The results demonstrate that about two thirds of depressive patients show clinically significant improvements within a multimodal, primarily psychotherapeutic inpatient setting, whereas the rates of deterioration are lower than expected. The aim for the future should be to identify poor or minor response as early as possible in order to optimize treatment.     

Idealistische Häresien in der Wissenschaftsphilosophie: Cassirer, Carnap und Kuhn

Idealist Heresies in Philosophy of Science: Cassirer, Carnap, and Kuhn. As common wisdom has it, philosophy of science in the analytic tradition and idealist philosophy are incompatible. Usually, not much effort is spent for explaining what is to be understood by idealism. Rather, it is taken for granted that idealism is an obsolete and unscientific philosophical account. In this paper it is argued that this thesis needs some qualification. Taking Carnap and Kuhn as paradigmatic examples of positivist and postpositivist philosophies of science it is shown that these accounts share important features with Cassirer's idealist philosophy of science developed in the first half of this century. As it turns out, often Cassirer is more modern than those classical philosophers of (post)posivitist philosophy of science. For instance, Quine's criticism against Carnap's empiricist philosophy of science launched in Two Dogmas of Empiricism is anticipated by Cassirer for several decades. This revised version was published online in August 2006 with corrections to the Cover Date.     

Stationäre Psychotherapie in der Kinder- und Jugendpsychiatrie: “Die Kunst des Unmöglichen?”

Inpatient psychotherapy of children and adolescents occurs in a tangle of reciprocal psychodynamic effects. It comprises the individual level of each patient, the dynamics within the group of the patients and within the staff on the ward and as well the influence of the institution and its structure. The psychopathology of the patients will be coloured by these interactions. They have to be cared for and analysed to prevent the repetition of patients' traumatic experiences and the failing of the goals of the treatment directed on autonomous functioning of the patients outside of the hospital. The statements are illustrated by case vignettes.     

Evaluation der polizeilichen Kriminalpr?vention bei Mehrfach- und Intensivt?tern in NRW

Recent years have seen the development of a range of concepts throughout Germany addressing how the police should deal with persistent offenders in order to reduce the amount of offending. The State Office of Criminal Investigations in North Rhine-Westphalia commissioned an evaluation of the concepts applied in four different district police authorities in the state. The offence records of almost 300 young persistent offenders from the year they entered until the year they left the program were compared with those of a matched control group with a similarly high rate of offending who were not included in the measures. The summative evaluation showed a higher reduction in crime in the treatment group compared to controls by a factor of 1.31 with an effect size ofd?=?0.26. Further analyses indicated the effect of the program was independent of the persistent offenders?? age, gender or migration status. The discussion on this positive outcome focuses on the methodological problems in the study and also on the very low intensity of the measures compared to other offender treatment programs.