Antidepressive Behandlung und Suizidalität

Die Diagnostik und Behandlung depressiver St?rungen ist eines der wichtigsten Ziele der Suizid-Pr?vention. In letzter Zeit wurde in der Kontroverse um die Verabreichung von Serotonin-Wiederaufnahme-Hemmern an Kinder und Jugendliche eine gewisse Skepsis gegenüber antidepressiver Medikation im Zusammenhang mit Suizidalit?t geweckt, die suizidpr?ventiven Bemühungen entgegensteht. Bei genauer Betrachtung zeigt sich, dass SSRI’s nach wie vor bei Erwachsenen unumstritten sind. Die suizidprotektive Wirkung antidepressiver Medikation und psychotherapeutischer Behandlung bei Erwachsenen wird durch die Verbesserung einiger psychosozialer Versorgungsfaktoren in ?sterreich unterstrichen.     

Indeterminiertheit,Iterabilität und Intentionalität

In his recent paper Indeterminacy, empiricism, and the first person John R. Searle tries to refute Willard V. O. Quine's famous indeterminacy of translation thesis by arguing that this thesis is in fact areductio ad absurdum of Quine's own linguistic behaviorism. Searle accuses Quine of being (irrationally) antimentalistic and suggests that the absurdity of Quine's thesis might be avoided if a full-fledged intentionality were tolerated in the debate on meaning. — This anti-Quinean approach in some respects reminds of the improbable debate between Searle and Jacques Derrida ten years ago, when Derrida had split and deferred intentionality by showing that the essential iterability of signs inevitably infects every intentional act with an unremovable non-presence.In this paper it is argued that Searle's attacks on Quine and Derrida have both failed — and that there are structural similarities between these two failures which reveal some interesting parallels between Quine's and Derrida's philosophy.     

Erfolg,Ausdauer und Aktivität beim Säugling und Kleinkind

Psychological Research -     

Über Summativität und Nichtsummativität

Ohne Zusammenfassung Dissertation der Naturwissenschaftlichen Fakult?t der Universit?t Frankfurt a. M.     

Interdisziplinarität und Wissensentwicklung

Interdisciplinarity and the Development of Knowledge. The author is engaged in the question how to explain the development of scientific meanings of facts which does not coincide with producing them rather with processes of the scientists' public communication. So long as the facts are adjustable to the conventional theories of those discipline which the researcher belongs to this connection does not reveal perfectly clear. More instructive is a consideration of so-called anomalies. The author demonstrates with an example of the history of science that researchers in case of new phenomena use to borrow concepts from other disciplines for resolving the interpretative problems. It emerges a loose net-work of concepts. In this way the researchers are producing a disciplinary mixed public at the same time. This process is seen as an important phase of the development of new theories and, complementary, new disciplines.     

Ichqualität und Impulserlebnis

Ohne Zusammenfassung     

Familienfunktionalität und Therapieerfolg

Background

Even though it is a treatment standard of child psychotherapy to involve the parents, hardly any research has been carried out about the impact of family functioning on treatment outcome. Aims of the present study were to investigate the change in and the prognostic power of family functioning on treatment outcome of short-term psychodynamic psychotherapy in children and adolescents.

Patients and methods

The sample consisted of 54 children and adolescents undergoing outpatient short-term psychodynamic psychotherapy. To assess family functioning, their parents were asked to complete the Family Assessment Measure (FAM).

Results

Patients from families with high levels of functioning in task accomplishment, communication and affective expression were more often treated successfully. Improvement in levels of functioning in role performance, emotionality and control were only found in the group of successfully treated patients.

Conclusion

Family functioning is a decisive factor in the differential indication of psychotherapeutic treatment in children and adolescents.     

Sexualität und Gewalt

Sexual assault as defined by law, psychiatry and sociological research is contrasted to the everyday definition of rape. Official figures on the frequency of sexual assaults as communicated in annual reports by the police differ greatly from figures found by research on sexual victimization or representative studies using different definitions of violence and abuse in sexual relations. Overpowering and violence is not a rare phenomenon in sexual relations – nearly every second woman and 10% of men are familiar with such situations. There are not only biological conditions (individual variance in neurophysiological parameters) but also psychological conditions favoring the use of power and threat instead of courting in sexual partnerships. External conditions are certain popular opinions in parts of society and certain subcultures which may also be more or less in favor of male superiority, thus helping the perpetrator to justify his assault or on the contrary helping the victim to find support in court procedures and therapy if necessary. Prevention therefore has two targets: a general one by changing popular opinions which are in favor of the use of power in sexual relations and informing persons in danger of becoming victims about the risks and the possibilities to protect themselves and an individual one by treating victims to overcome their psychological injuries and to treat perpetrators inside and outside the judicial system. The current discussion on increased availability of pornography in the internet shows both aspects: a general target to reduce negative influences of pornography which produces devaluating views on sexuality and women and the more individual task of tackling new forms of pathology created by the media at least for some of the consumers.     

Homosexualität und Prägung

Ohne ZusammenfassungMit Unterstützung der Deutschen Forschungsgemeinschaft.     

Intensität und Qualität in der Geruchswahrnehmung

Zusammenfassung Vier unterschiedliche Geruchsstoffe in je 4 Konzentrationen wurden von 23 Versuchspersonen nach Intensität beurteilt und paarweise auf ihre relative Ähnlichkeit hin verglichen. Eine Systematik der Versuchspersonenvarianz konnte weder in den Intensitäts- noch in den Ähnlichkeitsurteilen mit dem Tucker-Messick-Verfahren nachgewiesen werden. Mit den Medianwerten der Ähnlichkeitsurteile wurde das Skalierungsverfahren von Kruskal durchgeführt. Unter 25 Lösungen wurde diejenige mit einem Exponenten (Minkowski-Metrik) von r=2,5 und 5 Dimensionen als optimal ausgewählt und zur Grundlage der Interpretation genommen. Als wichtigstes Ergebnis erhielten wir eine unabhängige Intensitätsdimension mit Ursprung außerhalb der Reizkonfiguration, die eine hohe Übereinstimmung zur Intensitätsskalierung aufwies. Weiter konnte ein Qualitätswechsel jeweils innerhalb eines Stoffes zwischen den Konzentrationen festgestellt werden. Dieser Qualitätswechsel ist bei den einzelnen Stoffen unterschiedlich stark ausgeprägt.

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Quality and intensity in olfactory perception

Summary In an experiment on olfaction 23 subjects judged 16 odors (four chemicals each in four concentrations) with respect to intensity and with respect to similarity for each pair of stimuli. Systematic interindividual variation can he found neither in the intensity nor in the similarity data. Multidimensional scaling according to Kruskal's procedure reveals a configuration in 5 dimensions, the exponent of the optimal Minkowski-metric (out of 25 alternative solutions) is r=2.5. This scaling is based on the medians of similarity judgments. One of the dimensions corresponds to a subjective scale of intensity, with a zero-point lying outside of the configuration. The quality of the stimuli depends on their concentrations. The perceived quality-changes differ in amount and directions for each of the chemicals.

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Von der Philosophischen Fakultät der Universität des Saarlandes auf Antrag von Prof. Dr. K. Eyferth angenommene Dissertation.     

Religiosität und Spiritualität in der Psychotherapie

For many years religious and spiritual issues have been avoided in psychotherapy. In the face of social changes a more culturally sensitive psychotherapy is needed to professionally deal with religious backgrounds, spiritual needs and spiritual resources. A remarkable spiritual turn has recently been observed particularly in psychoanalysis, which was originally very antireligious. Health research studies are exploring the healing craft of religious virtues and values. It is important to discern between an empirically proven healing method and an ideologically founded promise of salvation. It is the task of the therapist to find out whether the patient's religiosity or spirituality is part of the problem or part of the solution.     

Über Einsamkeit, Narzissmus und Intimität

Zusammenfassung Die komplexe Wechselwirkung zwischen narzisstischer Verwundbarkeit, adoleszenter Entwicklung und der F?higkeit zu intimer Beziehung wird aus der Perspektive der unterschiedlichen, jedoch aufeinander bezogenen Erlebnismodalit?ten von Sein und Tun dargestellt. Die hier entwickelte Sicht auf die Einsamkeit beginnt mit einer kritischen Neubewertung des Konzepts der Selbstbezogenheit in Verbindung mit den Schwierigkeiten, Intimit?t herzustellen. Die Schwierigkeiten entstehen im Misslingen der in der Entwicklung vorgezeichneten Integration der beiden Erlebnismodalit?ten in der Zeit der sp?ten Adoleszenz und des jungen Erwachsenenalters. Die Einsamkeit im Leben der Erwachsenen, ihre besondere Auspr?gung und subjektiv erlebte Natur sind determiniert durch die spezifische Modalit?t ihrer prim?ren Organisation. Zur Illustration der Bedeutung der Einsamkeit in der Anwesenheit des Objekts und der paradoxen Unf?higkeit, mit dem Objekt und ohne es zu sein, wird klinisches Material pr?sentiert.

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On loneliness, narcissism and intimacy

Summary The complex interplay between narcissistic vulnerability, adolescent development, and the capacity for intimate relatedness is viewed here from the perspective of two distinct but interrelated experiential modes of Being and Doing. I offer a view of loneliness that begins with a critical reappraisal of the concept of narcissistic relatedness in association with difficulties in establishing intimacy. These difficulties are due to failures in the developmentally prescribed integration of the experiential modalities of Being and Doing during the course of late adolescence and young adulthood. The type of loneliness encountered in adult life, its particular cast and subjectively experienced nature, are determined by the specific modality around which it has become primarily organized. Clinical material is presented to illustrate the meaning of loneliness in the presence of the object, and the paradoxical inability to be both with the object and without it.

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Vortrag gehalten im Michael-Balint-Institut, Hamburg (Juni 2000). Frühere Versionen wurden vor der Israel Association for Psychotherapy (Februar 1989), der Israel Psycholanalytic Society (Dezember 1989), dem Sigmund Freud Institut, Frankfurt a. M. (M?rz 1990) und der Asian-Australian Psychoanalytic Conference (Januar 1995) gehalten. Aus dem Englischen übersetzt von Dr. Heinrich Vedder, Hamburg

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"Es ist nicht gut, dass der Mensch allein sei; ich will ihm eine Gehilfin machen" (Genesis 2:18).     

Somatische und psychische Komorbidität

Studies indicate that chronic somatic diseases are often associated with psychological burden and manifest mental disorders. The interaction may be a complex one rather than a mere reaction to severe somatic illness. Early recognition of psychosomatic comorbidities has important implications for adequate diagnostic classification, therapy, and the course of the whole disease pattern. The timely treatment of depression in somatic illnesses can for example not only alleviate depressive symptoms but also raise quality of life and reduce the consequences concerning the course of the somatic disease. However, many questions still need to be answered relating to the concrete influence of a therapy of the mental disorder on the somatic prognosis.     

Sexueller Sadismus und Sexualkriminalität

The categorization of sadism has turned out to be a versatile phenomenon, which covers a spectrum from harmless symbolic rituals to extremely violent acts where strong impulses or prolonged fantasies and rituals are involved. As the phenomenon is versatile its causes and appearances vary as well, although so-called BDSM (bondage & discipline & dominance & submission & sadism & masochism) practitioners and persons with severe sadism in a forensic context share only few common preferences. Based on own clinical experiences with sadism in forensic patients the authors support the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) especially the diagnostic disjuncture of sadism and masochism. Sexual sadism appears more frequently in forensic contexts in combination with sadistic, antisocial and borderline personality disorders but rarely with masochism. Masochism is otherwise reported to be more prevalent in patients of general psychiatry, however, combined with depression or dependent personality traits rather than with sadism. Moreover, the authors believe that if use of the diagnostic term sadism is perpetuated the establishment of the proposed new diagnosis “paraphilic coercive disorder” is unnecessary. The diagnostic term is also important for treatment and assessment. Despite the lack of reliable long-term studies with larger samples, it is reasonable to assume that medication, sometimes even anti-androgenic treatment, can be indicated in patients with severe sadism.     

Studienbezogene Belastungen, Lebensqualität und Beziehungserleben bei Medizinstudenten

In a cross-sectional study of medical students we examined educational strains, health feeling, and relationship patterns. Work stress was measured using the questionnaire by Jurkat et al., health-related quality of life was measured using the Short Form- (SF-)36 Health Survey, and relationship patterns to the partner as well as to a friend were mapped using“Beziehungsmusterfragebogen“ (BeMus). Study stress was assessed as being high by 60% of the students. Consequently, 39% had not enough time for their partners und 29% had no time for own interests. The mental health averaged significantly below the norm. A high workload and discontent correlated with aggressiveness, especially in the partnership, whereas loving care towards the partner or friend correlated with a high level of satisfaction and a lower strain level. Therefore, an improvement of psychosocial competence in medical students as well as a practice-oriented preparation for the profession is needed.