Zum Unterstützungsbedarf von Partnern schizophrener Patienten

The aim of this paper is to define concepts regarding the psychological assistance for partners of schizophrenic patients. A total of 28 in-depth interviews were analysed focussing on burdens and needs specific to partners of schizophrenic patients. Additionally, a focal group discussion was carried out. Partners often feel disappointed and dissatisfied with the information and the cooperation provided by psychiatric services. Criticism is directed towards inadequate information and insufficient counselling by physicians, the lack of integration of partners into long-term treatment and neglecting the specific needs of partners by professionals. Partners wish, in contrast, comprehensive information on an individual basis as well as the possibility of an exchange with other partners confronted with similar or identical problems. Generally, psychological assistance and cooperation should be made available as soon as possible after the diagnosis of the disorder. In addition to detailed individual conversations with the treating physician, regular meetings between partners, patient and treatment staff are recommended. Furthermore, specific workshops for partners of schizophrenic patients should be offered, with topics centered on possible changes within the relationship, such as problems with family and household organisation, questions of child education and sexual impairments.     

Leitlinie für die Begutachtung von Schmerzen

The present guidelines for expert testimony have been elaborated for the first time in 2004 by medico-legal representatives from several German professional academic societies (neurology, orthopedic surgery, psychiatry, psychosomatic medicine, psychotherapy). Their aim is to standardize the course and the content of expert testimony in subjects, who complain about chronic pain as the leading symptom for seeking pension or other compensation. In 2006, the guidelines have been revised and completed by adding detailed data about classification and prognosis of chronic pain, about causality questions, and about estimation of functional impairment in different legal areas.     

Ambulante Gruppenpsychotherapie von Müttern mit psychosomatischen Erkrankungen

Zusammenfassung Nach einem Überblick über die Literatur zu den unterschiedlichen Faktoren, die die mütterliche Gesundheit beeinflussen können, werden die psychotherapeutischen Behandlungskonzepte sowie die phasenspezifischen Besonderheiten der ambulanten gruppenpsychotherapeutischen Behandlung von Müttern dargestellt. Eine Zusammenfassung der Wirksamkeitsnachweise und eine kritische Diskussion der Grenzen ambulanter Gruppentherapie beschließen die Arbeit.     

Unerwünschte und schädliche Wirkungen von Psychotherapie

Unwanted effects or even damage due to psychotherapy are largely neglected issues within psychotherapy research as compared to other fields. On the other hand, it is reasonable to assume that unwanted effects of a treatment which intends to influence patients into a positive direction are very likely. The rate of negative effects of psychotherapy (the deterioration effect according to Bergin) is consistently estimated to be 10% of all cases and shows this same rate in a variety of studies. This review highlights side effects of psychotherapy both on the part of the patients and of the therapists. It reports unwanted effects related to different psychotherapeutic methods, i.e. psychoanalysis, cognitive behaviour therapy, client-centered psychotherapy and – beyond these basic orientations – group psychotherapy. The paper also reports on negative effects of psychotherapy on an untreated partner. Finally, some proposals are given on how negative effects of psychotherapy could be diminished. The authors especially highlight the possibilities of changing the therapist, the treatment technique, or the theoretical treatment approach as a way to reduce negative effects.     

Max Webers Wertfreiheitspostulat und die naturalistische Begründung von Normen

Max Weber's postulate of value-neutrality and the naturalistic justification of norms. The relationship between facts and values is an essential problem in philosophy, political science and sociology. Usually it is held that there is a wide gap between what is and what ought to be, the nature of which, however, is far from clear. My purpose is to elucidate this relationship by analyzing some well-known articles of Max Weber. I first present Weber's postulate of ‘value-neutrality’ and outline the reasons he gave for it. Then I proceed by examining Weber's scientific methodology, arguing that its presuppositions contradict the existence of a hiatus irrationalis between facts and values. This conclusion is supported by some historical examples which show that facts are constituted by values and values by facts. I propose that Weber's epistemological justification of value-neutrality be discarded in favor of a pragmatic one that can also be derived from his arguments. I conclude by sketching the outline of a naturalistic approach in philosophy and related disciplines. This approach admits the continuity of facts and values and provides a realistic view of every-day normative disputes. This revised version was published online in August 2006 with corrections to the Cover Date.     

Updating von Uexküll: new directions in communication research

The study of communication in all its forms has come a long way conceptually and methodologically in the last decade, and this is more true of auditory communication than of the other sensory modalities. In considering the issues involved in communication, it is clear that simple dyadic considerations leave out too many important issues. Background noise, eavesdropping, and deception represent important neglected factors driving the evolution of the mechanisms, development, and ecological adaptiveness of communicatory processes in natural environments.     

Gibt es einen Goldstandard für die Diagnose von Demenzen?

Als Demenz bezeichnet man St?rungen in mehreren kognitiven Dom?nen, die durch Neurodegeneration und andere Erkrankungen bedingt sein k?nnen. Ihre klinische und neuropathologische Diagnose erfolgt nach spezifischen Konsensuskriterien. Die klinische Treffsicherheit bei Verwendung revidierter Forschungskriterien und moderner Biomarker (MRI, PET, Liquoranalyse, genetische Marker) liegt für die Alzheimer-Krankheit (AK) als h?ufigste Demenzform bei 65–96 Prozent mit einer Spezifit?t gegenüber anderen Demenzen von 23–88 Prozent. Die Neuropathologie mit moderner Immunhistochemie, Molekularbiologie und -genetik gestattet bei homogenen Definitionen, harmonisierten Labormethoden und Standards für die Erfassung morphologischer L?sionen eine Diagnose/Klassifikation in bis zu 99 Prozent, ohne jedoch bisher die Ursache/?tiologie der meisten dementiven Erkrankungen aufgekl?rt zu haben. Dies liegt an der enormen Komplexit?t der Hirnver?nderungen, oft fehlender übereinstimmung zwischen klinischem Verlauf und morphologischem Befund, der Komorbidit?t im hohen Alter mit Zusammentreffen verschiedener Pathologien sowie erheblichen Unterschieden zwischen jungen und hochbetagten dementen Patienten, wobei letztere h?ufig „Demenzen ungekl?rter ?tiologie“ beziehungsweise Nicht-AK-Pathologie darstellen. Datenfusion und einheitliche, in prospektiven klinisch-pathologischen Studien validierte Kriterien sollen „Goldstandards“ für die Diagnose kognitiver St?rungen erarbeiten und ihre Abgrenzung vom „gesunden“ Hirnaltern erm?glichen, um künftige Grundlagen für Früherkennung, Prophylaxe und neu wirksame Behandlungsmethoden zu schaffen.     

Medikamentöse Behandlung von Adoleszenten mit paraphiler Symptomatik und einem Risiko für die Begehung von Sexualstraftaten

The diagnostics and treatment of adolescents who show paraphilic symptoms should be approached with extreme caution. The aim of this paper is to present and discuss the recently published World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the treatment of adolescents with paraphilic disorders and a risk for committing sexual offences. The basis of therapy is always a thorough diagnostic procedure and an estimation of the risk of behavior harmful to others. The basis of treatment is formed by psychosocial interventions. The indications for pharmacological therapy, in particular for antiandrogens and gonadotropin-releasing hormone (GnRH) agonists are closely controlled (e.g. only one adolescent treated with GnRH agonists was found in a study of German forensic psychiatry hospitals). The indications are guided by a high risk of substantial danger to others and with respect to the stage of puberty reached by the adolescent person. The therapy should only be carried out in collaboration with specialized pediatric endocrinologists. Administration of therapy should be regularly checked at short intervals with a strict control of the risk/benefit ratio. The guidelines also illustrate the contraindications to pharmacological treatment of adolescents with paraphilic symptoms.     

Zur Interpretation der strukturalistischen Auffassung über die Prüfbarkeit von Theorien

Struve has tried to refute my critic of the structuralist thesis that testing theories leads in an epistemological circle. But he misunderstands the thesis he wants to defend.     

Zur Bedeutung von kurzzeitigen Gedächtnisleistungen für das langzeitige Behalten

Zusammenfassung Die vorliegende Arbeit ist auf die Untersuchung funktionaler Beziehungen zwischen kurz- und langzeitigen Gedächtnisleistungen gerichtet. Ausgehend von der allen zur Zeit diskutierten gedächtnistheoretischen Ansätzen gemeinsamen Annahme, daß jeder permanenten Veränderung im zentralnervösen Bereich (als neuronales Substrat dauerhafter Gedächtniseindrücke) ein dynamisches Erregungsgeschehen vorangeht, welches die Grundlage für kurzzeitige Gedächtnisleistungen bildet, wurde die Bedeutung kurzzeitiger Gedächtnisleistungen für das langzeitige Behalten zu ermitteln versucht.Nach einmaliger Präsentation einer Anzahl von Konsonanten-Trigrammen wurde sowohl die unmittelbare Behaltensleistung 0, 6 bzw. 12 sec nach Darbietung derselben als auch — im Anschluß an eine 5 min dauernde Konzentrationsaufgabe — die Leistung im freien Reproduzieren bzw. Wiedererkennen festgestellt, wobei ein aktives Memorieren der Trigramme während der Einprägungsphase nicht möglich war. Ein Vergleich der mittleren Langzeitleistungen je nach Leistung im unmittelbaren Behalten (KZ-Gedächtnisleistung) ließ keine entsprechenden Unterschiede derselben in Abhängigkeit von den verschiedenen Behaltensintervallen (0, 6, 12 sec) erkennen. Dies wird als ein Beleg dafür aufgefaßt, daß die Übertragung von Information in einen Langzeitspeicher nicht ausschließlich über den Kurzzeitspeicher erfolgt. Ein Modell wird vorgeschlagen, das die verschiedenen theoretischen Ansätze integriert und neue Möglichkeiten der Interpretation von Ergebnissen der experimentellen und klinischen Gedächtnisforschung, die mit den zur Zeit diskutierten Theorien nicht vereinbar sind, eröffnet.

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The effect of short-term memory performance on long-term memory

Summary A functional aspect of the relation between short- and long-term storage systems in human memory was investigated, i.e. the assumption that transfer of information to a long-term store depends on the processing of information by means of a short-term storage system. The testing of this hypothesis involves a within-Ss comparison of long-term recognition performance as a function of short-term recall in a modified Peterson paradigm. In spite of different scores in short-term recall as a consequence of various short-term retention intervals (0, 6 and 12 sec) during which rehearsal was prevented by making the Ss count backwards, there were no differences in long-term performance. This was interpreted as evidence against the common assumption that information is transferred into the long-term store through the short-term store.An alternative model is proposed which integrates different theoretical positions on the flow of information within the human organism. This model seems to allow the interpretation of some experimental and clinical data that are incompatible with existing theories.

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Erste Ergebnisse dieser Untersuchung wurden auf der XV. Tagung experimentell arbeitender Psychologen im April 1973 in Erlangen referiert.Der Verfasser dankt Frl. G. Gletthofer und Fr. I. Hausmann für die Mitarbeit bei der Abfassung des Manuskriptes sowie Herrn J. Egger für die überaus sorgfältige Durchführung der Versuche.     

Entwicklung und Evaluation eines interaktiven Films für Jugendliche zur Vermittlung von Gerichtswissen

An interactive movie for juvenile witnesses produced by the author was evaluated in terms of its effectiveness to convey court relevant knowledge to 16-year-old and 17-year-old students. A control group design was used. Controls received a brochure containing information comparable to the movie which was also developed by the author. The aim of the study was to empirically evaluate the movie in order to make it available to juvenile witnesses as an instrument for court preparation in the future. A total of 52 students aged 16 and 17 years at a training college were investigated and court knowledge was measured prior to testing. Participants in the treatment group then viewed the movie, which was produced by the author. The control group received a brochure containing information very similar to the contents of the movie. Approximately 2 weeks later, court relevant knowledge was again assessed and both treatment and control groups showed a strong and significant increase in court relevant knowledge. Comparing the groups showed that the effects tended to be stronger for the treatment group than for the control group. It was also investigated if legal misconceptions could be reduced by the interventions. Analyses indicated that effects were not significant and there was no significant difference between the groups. A significant increase of court relevant knowledge could be found for both treatment conditions. The weak effects concerning the reduction of legal misconceptions could be due to the fact that they were not explicitly presented in the movie but were treated more indirectly by presenting correct knowledge only.     

Onlineberatung für Betroffene von Essstörungen und deren Angehörige

An independent online consulting service for persons with eating disorders and their relatives (www.ab-server.de) exists in Germany since 1998, which was developed by physicians and psychologists. This study aims to comprehend the individual use of the online consulting for affected persons and their relatives. In order to do this, two online questionnaires were developed for these two groups. The questionnaires were sent digitally in two phases to those people who had posted an e-mail to the online consulting service from January 1999 to November 2003 and from January 2004 to July 2006 (phase 1: n=2,760; phase 2: n=1,419). A total of 493 data sets of affected persons and 127 of relatives were included in the analysis. The online consulting service is of great importance especially to establish the user’s first contact with professional help. The main reported effects were an improved understanding of the disease and the motivation to seek further professional help. This specific setting of internet-based intervention fulfils the function of a signpost within the German supply system.     

Der Einfluß von Zeitdruck auf die Leistung und das Denkverhalten bei Volksschülern

Ohne Zusammenfassung