Modeling Martin-Löf type theory in categories

We present a model of Martin-Löf type theory that includes both dependent products and the identity type. It is based on the category of small categories, with cloven Grothendieck bifibrations used to model dependent types. The identity type is modeled by a path functor that seems to have independent interest from the point of view of homotopy theory. We briefly describe this modelʼs strengths and limitations.     

Therapiekonzeption für traumatisierte Patienten mit schweren Persönlichkeitsstörungen

Comorbidity between severe personality disorder and posttraumatic stress disorder is a frequent clinical problem. Severe personality disorders are characterized by an impaired regulation of emotions, a low mentalization capacity and deficits in personality integration. For severe personality disorders and posttraumatic stress disorder, a variety of evidence-based treatment approaches of psychodynamic and cognitive-behavioral origin are available. However, a closer inspection of these treatment concepts shows that they do not sufficiently take the respective comorbid condition into account. No single concept is able to cover all problem areas presented by patients with this comorbidity. Therefore, an attempt is made to present an integrative psychodynamically oriented therapy concept for traumatized patients with personality disorders which contains elements from psychodynamic, cognitive-behavioral and other concepts. The phase structure of the concept clarifies the sequence hierarchy of the therapeutic interventions. The content of the five phases are: (1) safety, holding and strengthening of coping capacities, (2) emotion regulation and self-care, (3) mentalization and development of stable representations, (4) gentle trauma processing and (5) conflict-oriented psychotherapy and treatment of maladaptive relationship patterns.     

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.     

Dialektisk beteendeterapi för suicidala borderline-kvinnor: En presentation

Abstract

Patients showing the features of Borderline Personality Disorder as defined in DSM-IV are notoriously difficult to treat. They are difficult to keep in therapy, frequently fail to respond to therapeutic efforts, and make considerable demands on the emotional resources of the therapist, particularly when suicidal and parasuicidal behaviors are prominent. Dialectical Behaviour Therapy, (DBT) devised by Marsha Linehan at the University of Washington in Seattle, is an innovative method of treatment that has been developed specifically for this difficult group of patients. In the present paper, the theoretical grounds for DBT are summarized, as well as the treatment format and different treatment techniques. The empirical evidence for the effectiveness of the method, which has so far been demonstrated in a few controlled studies, is also summarized. Finally, there is a presentation of a research project led by Professor Marie Åsberg at the Karolinska Hospital in Stockholm, where a group of female patients at high risk of suicide will be scientifically investigated and described. Besides this careful investigation, Otto Kernberg's treatment model (PDT), Marsha Linehan's treatment model (DBT) and treatment as usual (TAU) will be to be implemented and compared in a controlled treatment study for this group of patients.     

Categorical and algebraic aspects of Martin-Löf Type Theory

In the paper there are introduced and discussed the concepts of an indexed category with quantifications and a higher level indexed category to present an algebraic characterization of some version of Martin-Löf Type Theory. This characterization is given by specifying an additional equational structure of those indexed categories which are models of Martin-Löf Type Theory. One can consider the presented characterization as an essentially algebraic theory of categorical models of Martin-Löf Type Theory. The paper contains a construction of an indexed category with quantifications from terms and types of the language of Martin-Löf Type Theory given in the manner of Troelstra [11]. The paper contains also an inductive definition of a valuation of these terms and types in an indexed category with quantifications.     

En experimentell prövning av aktivt lyssnande som tröst för sm[acaron] barn som gr[acaron]ter

The procedural validity of the Composite International Diagnostic Interview - short form (CIDISF) administered via an Internet web-page was examined and compared with an in-person interview (Structured Clinical Interview for DSM-IV Axis I Disorders, research version; SCID) for 7 DSM-IV mental disorders: major depression, generalized anxiety, specific phobia, social phobia, agoraphobia, panic attack and obsessive-compulsive disorder. The 53 participants completed a computerized interview (CIDI-SF) via a web page 2 days before the scheduled in-person interview (SCID). The agreement between CIDI-SF and SCID was generally low (Cohens Kappa <0.40). However, if the panic disorder module from the long version of CIDI is used instead, the Kappa is fair (K = 0.48) with an agreement of 75%. Practical applications and future directions are discussed.     

Die postpartale Bindungsstörung: Eine Risikokonstellation für den Infantizid ?

Background

The effectiveness of preventive approaches in the field of child protection depends, amongst other things, upon identifying typical risk constellations of infanticide. Postpartum bonding disorder, a disorder affecting a mother’s emotional relationship with her child, is one of those risk constellations alongside other negative consequences to child development. It frequently accompanies postpartum depression, which is determined by other emotional qualities. The therapeutic response is a determinant factor for the success of preventive measures.

Method

42 mothers with postpartum disorders (25 depressive, 17 schizophrenic) undergoing treatment at a mother-baby-unit were examined for bonding disorders and the therapeutic response, primarily regarding the mother-child relationship. Perception of bonding, maternal self-efficacy and objectively measured parameters of mother-child interaction were the most important parameters assessed. Results. Nearly 60% of the mothers suffered from a bonding disorder. Overall, the results indicated a clear improvement in psychiatric disorder as well as in the assessed parameters for the mother-child relationship and the experience of motherhood.

Conclusions.

Maternal bonding disorders are strongly associated with postpartum depression and low maternal self-efficacy, which can lead to a risk constellation for infanticide. The data confirm the therapeutic response, thus demonstrating that early diagnosis and treatment of postpartum depression can represent a timely and effective preventive approach in the field of child protection.     

Evaluation eines präventiven Beratungskonzeptes für Kinder körperlich kranker Eltern

Children of parents suffering from a serious disease (e.g. cancer, multiple sclerosis, Aids) are at increased risk for mental health problems. Empirically based interventions for these children are missing. At the University Medical Centre Hamburg-Eppendorf, a preventive short-term counselling service has been existing since July 2000. Results from a 6-month evaluation (n=50) are presented. The evaluation encompasses a retrospective interrogation in a multiperspective und multidimensional approach. Most families experienced the intervention as helpful and supportive in coping with the multiple stressors of the situation. Out of a previously defined list of 12 intervention goals, enhancing anticipatory grief in children, their active coping behaviour as well as parents’ sense of their own parenting competence were identified as the most important foci of the counselling interventions, as reported by parents, children and therapists.     

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.     

Persönlichkeitsfragebögen

The influence of defensivity, measured by validity scales of personality inventories (MMPI-K, FPI-R, GIESSEN-Test) on test results and psychotherapy outcome was studied in 309 patients treated with inpatient client-centered therapy. In general, psychotherapy patients exhibited low defensivity. 25% of patients, who denied psychopathology at admission, did so at discharge and to some extent at follow-up, demonstrating an ”especially good outcome” (means). Relative improvement (effect sizes), however, was significantly diminished in psychopathology scales and significantly enlarged in validity scales. – Results are discussed with regard to prior hypotheses about the influence of defensivity.     

Behandlungsleitlinie Persönlichkeitsstörungen

The S2 guidelines for the treatment of personality disorders (PD) are summarized. In the diagnostic assessment of personality disorders a clinical interview should be supplemented by (semi-) structured clinical interviews and self-report measures for the categorical and dimensional assessment of PDs. The results of the assessment process should be communicated to the patient based on a psycho-educational framework. The diagnosis should always be linked to the patient’s individual history. Psychotherapy is the treatment of choice for personality disorders. A detailed analysis of the patient’s problems as well as the definition of a hierarchy of treatment goals are part of the process of treatment planning. For three PDs empirical evidence for treatment approaches is available: (1) dialectical behavior therapy, mentalization-based therapy, schema focused therapy and transference focused therapy all proved beneficial in the treatment of borderline personality disorder. Cognitive-behavior therapy proved helpful in the treatment of (2) dissociative personality disorder and (3) avoidant personality disorder. There is limited evidence for interpersonal therapy and psychodynamic therapies in the treatment of avoidant personality disorder.     

Narzisstische Persönlichkeitsstörung

Narcissism is a multifaceted term which encompasses traits of normal personality as well as a specific personality disorder. While much research has been concerned with narcissism as a trait there are only few empirical studies on narcissistic personality disorder (NPS). The current diagnostic system of NPS according to DSM-5 (section II) focuses on grandiose narcissism whereas vulnerable narcissism, which is emphasized by clinicians and researchers, has not yet been recognized. While treating NPD patients an increased suicide risk has to be taken into consideration. Psychotherapy of narcissistic patients mainly focuses on processes during patient-therapist interactions, the analysis and processing of grandiose and vulnerable schemas, emotion regulation techniques and a correction of narcissistic behavior in favor of prosocial interactions.     

Die Bedeutung der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung für die Entstehung und Prognose von Störungen des Sozialverhaltens im Kindes- und Jugendalter

Attention Deficit/Hyperactivity Disorder (ADHD) and Conduct Disorder (CD) are two of the most common neurobehavioral disorders of childhood. Despite of their high comorbidity rate both disorders can be reliably differentiated. Especially the comorbid condition is associated with a poor outcome and some of the affected children develop an Antisocial Personality Disorder. This article summarizes diagnostic criteria and epidemiological data of both disorders and emphasises the role of ADHD in the aetiology and pathogenesis of antisocial behavior. ADHD seems to have a negative impact particular in children of the early-starter subtype of CD. Findings from genetic, psychophysiological and neuroimaging studies emphasise the relevance of biological risk factors in the etiological models and developmental pathways of antisocial behavior. We present so far unpublished data of children with ADHD and ADHD/disruptive behavior disorders which indicate group-specific neurocognitive impairments in the comorbid condition. ADHD and CD seem to constitute a synergistic and interactive relationship in that each disorder aggravates the other. Recent findings point to a “true hybrid” of ADHD/CD. Considering the negative outcome of the comorbid condition, several findings suggest that high-quality treatments may have considerable impact on restoring ADHD children to better functioning.