Jugenddelinquenz - Aktuelle Präventions - und Interventionskonzepte

This article presents an overview on the concepts and the outcomes of current prevention and intervention measures for juvenile delinquency and offender rehabilitation. The main focus is on a discussion of recent evaluation results. Social skills training, parent training programs, family-oriented early intervention, and multimodal school-based programs are discussed as prevention measures. Cognitive-behavioral and family therapy as well as diverse concepts of offender rehabilitation (e.g., boot camps) are delineated as intervention measures. The article concludes with an integrated evaluation of these results and a discussion of general theoretical and strategic issues.     

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.     

Differenzielle Effekte klassischer Prädiktoren von Jugendgewalt

Previous studies were able to identify numerous predictors of aggressive and violent behavior in youth. Although it is to be expected that these predictors may behave differently with varying personal and situation-specific characteristics, no study has yet empirically examined whether predictors of youth violence really exhibit differential effects. The current study will fill this gap in the literature by asking how do some predictors of youth violence differ between slightly and highly criminal individuals? To answer this question a representative sample of German students of the ninth class from 2007 and 2008 was used (N?=?44,610). Using the technique of quantile regression the effects of the predictors sex, origin, risk seeking, number of delinquent friends, alcohol consumption, parental violence, interparental violence and violent victimization on the number of violent incidents were analyzed. The results showed that all predictors significantly influenced the number of violent incidents; however, the effects of all predictors also varied significantly with the intensity of criminal activity of offenders. Whereas all predictors were valid for highly criminal individuals, only some predictors also influenced the amount of violent crime in occasionally violent youth. These results have important implications regarding the identification of new predictors, theory building and practice. Additionally, the present approach of studying differential effects might prove useful to psychology and law in general. The more empirical research is individualized, the better this research can also be applied in practice.     

Qualitätssicherung von Gerichtsgutachten im Familienrecht

In recent years many controversial verdicts and studies have brought discussions about the quality of expert opinions in family law into the focus of the media, political and expert public spheres. With the coalition contract, the ruling parties agreed on improving the quality of expert opinions, especially in the sector of family law, in collaboration with professional institutions. Representatives of the legal, psychological and medical associations, the Federal Bar Association and the Federal Chamber of Psychotherapists worked out guidelines for expert opinions in family law in cooperation with the Federal Ministry of Justice and Consumer Protection. The three main quality assurance aspects are scientifically founded procedures, transparency and traceability. These requirements are concretely illustrated in this article with recommendations concerning the procedure and composition of expert opinions.     

Zur Häufigkeit der Schuldfähigkeitsbegutachtung von Sexualstraftätern im Erkenntnisverfahren

This study investigated how often and depending on which factors sexual offenders are examined by mental health experts regarding their criminal responsibility. Out of a total of 306 legal charges against sex offenders accused of child sexual abuse (CSA: n?=?145), rape or sexual assault (n?=?89), exhibitionism (n?=?39), sexual abuse of adolescents, mentally defective, physically helpless or warded persons (n?=?18) that were admitted by a criminal court in 2001 in the German federal state of Schleswig-Holstein, 209 (95.6 %) were analyzed regarding the following questions: how often was the accused examined by a mental health professional regarding mental responsibility? Was the chance of being examined systematically related to certain factors (e.g., personality of the accused)? Expert advice regarding the mental responsibility of the accused was obtained by the court in only 34 cases (11.7 %). No systematic relationships of personal variables as well as the modus operandi and the chance of commissioning a mental health expert were found. The main reason for assigning a forensic expert opinion was the vague impression of a psychic disorder. Re-offending increased the rate of a mental health examination only in CSA (34.6 % of re-offenders were examined compared to 9.2 % of first-time offenders), but not in rape or sexual assault. Also age does not predict the commissioning of an expert opinion. Only one fifth of all accused below the age of 21 were investigated by a mental health professional. Results are discussed in terms of legal background, consequences for risk assessment and relapse prevention.     

Primär- und Sekundärprozess bei Angst und Depressivität im psychoanalytischen Erstinterview

Zusammenfassung Vorgestellt wird eine quantitative inhaltsanalytische Untersuchung an 46 psychoanalytischen Erstinterviews, die mit Angstpatienten und depressiven Patienten in Düsseldorf und Magdeburg geführt wurden. Im Mittelpunkt der Methodik steht das Regressive Imagery Dictionary (RID), ein computergestütztes Verfahren mit 43 Einzelkategorien, die zu den drei Indikatoren primärprozesshafter Inhalt, sekundärprozesshafter Inhalt und Emotionalität zusammengefasst werden. Die durchgeführten Subgruppenvergleiche beziehen sich auf Unterschiede zwischen Angstpatienten und depressiven Patienten sowie ostdeutschen (Magdeburg) und westdeutschen (Düsseldorf) Patienten. Die Ergebnisse zeigen in den Texten der ostdeutschen Patienten ein höheres Maß an primärprozesshaften Inhalten, insbesondere in den Kategorien Passivität und regressive Kognition. Bezüglich der Diagnosegruppen zeigen die Angstpatienten gegenüber den depressiven Patienten ein höheres Maß an primärprozesshaften Inhalten in der Subkategorie Oralität. Es zeigt sich, dass in psychoanalytischen Interviews nicht nur diagnosespezifische Inhalte thematisiert werden, sondern auch kultureller Hintergrund, Geschlecht und Bildung von Bedeutung sind. Die Studie leistet einen Beitrag zur Identifizierung automatisch erfassbarer Textmerkmale, die charakteristisch für die in einer qualitativen Studie gefundenen idealtypischen nosologischen Konstrukte der neurotischen Depression und der phobisch-angstneurotischen Erkrankung sind. Hierbei ist der depressive Idealtypus durch eine Überidentifikation mit Werten, durch das Gefühl der Abhängigkeit von einer schädigenden Person, durch Selbstwertprobleme, Hemmung und den unerfüllten Wunsch, geliebt zu werden, gekennzeichnet. Der Angsttypus zeichnet sich durch ein klischeehaft positives Bild der eigenen Persönlichkeit aus sowie durch die Gefühle, falsch verstanden, ausgenutzt, nicht ernst genommen und zum Außenseiter gemacht zu werden, sodass er bei nachlassenden Kräften im Kampf um Leistung nicht mehr mithalten kann.

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Primary and secondary processes in psychoanalytic first interviews with patients suffering from anxiety and depressionA regressive imagery dictionary content analysis study in West and East German patients

The present paper describes a study on the intake interview narratives of psychotherapy patients with computer assisted content analysis methods. 46 psychoanalytic first interviews of patients suffering from depression or anxiety disorders were analysed with the Regressive Imagery Dictionary (RID), a computer assisted content analysis method with 43 subcategories, which were sumed up to three main categories: Primary Process, Secondary Process, and Emotion. Comparisons between different subgroups of this sample were made: Anxiety vs. depressive patients, and East Germans (Magdeburg) vs. West Germans (Düsseldorf). Significant correlations were found between the Primary Process subcategories Passivity and Regressive Cognition, and East German patients, as well as correlations between the Primary Process subcategory Orality, and anxiety patients. The results confirm our hypothesis, that the psychotherapist-patient-interaction sequences, which are the basis of diagnostic categorization, enclose as well elements which are specific for the disorders under study as elements which are specific for sex and culture (east vs. west). The study contributes to the identification of specific text markers, which can be found in the narratives of patients suffering from neurotic depression vs. patients with phobia and panic disorders. The results of the study are compared with a previous qualitative study. Using the ideal-type concept, our qualitative content analysis study showed as characteristic features of depressed patients overidentification with social roles and norms, feeling of being dependent and injured by another person, problems of self-esteem, shyness, and unfulfilled wishes to be loved and accepted. In contrast, phobic patients characterized the own personality as normal and without any problems in a stereotype way, at the same time feeling misunderstood and exploited by other persons, feeling as an outsider and left alone, and being no more able to compete with others.

     

Zur Entwicklung von Konzepten und Methoden der Prävention

Zusammenfassung  Die Verstärkung von Primärprävention als Senkung der Eintrittswahrscheinlichkeit von Krankheiten ist angesichts der Dominanz chronisch-degenerativer Erkrankungen und der wachsenden Ungleichheit von Gesundheitschancen in reichen Industrieländern eine zentrale Herausforderung zeitgemäßer Gesundheitspolitik. Die heute dabei verwendeten Konzepte und Methoden haben historische Wurzeln, deren Kenntnis Anregungen für ihre Verbesserung und weitere Entwicklung liefern kann. Moderne Primärprävention senkt Gesundheitsbelastungen und fördert gesundheitsdienliche Ressourcen, sie arbeitet mit spezifischen und unspezifischen Interventionen, gibt der Veränderung der Kontexte von Krankheitsentstehung und belastendem Verhalten Priorität und ist partizipativ angelegt. Das gilt für Interventionen auf der Ebene des Individuums ebenso wie für solche in settings/Lebenswelten und für bevölkerungsweite bzw. zielgruppenspezifische Kampagnen. Eine Verbesserung der Qualitätssicherung ist notwendig. Das im Jahr 2005 gescheiterte Präventionsgesetz sollte zwar lediglich den Beitrag der Sozialversicherungsträger zu dieser anspruchsvollen, gesamtgesellschaftlichen Strategie regeln, enthielt aber Festlegungen im Hinblick auf Ziele, Instrumente, Zuständigkeiten und Ressourcen, die auch für den nächsten Anlauf der Gesetzgebung richtungweisend sein sollten.

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.     

“Im Anfang liegt alles beschlossen”: Hannah Arendts politisches Denken im Schatten eines Heideggerschen Problems

The article seeks to understand Hannah Arendt's political thinking by relating it to an issue which is crucial to the thinking of the later Heidegger, i.e., the problem of originality ( Anfänglichkeit) and history. In opposition to Hegel's thesis of the “end of art,” Heidegger envisages in “great art” such as Hölderlin's poetry a new origin of thinking and history. The end of art, which Hegel holds to be necessary, is in Heidegger's view to be overcome precisely because art, for him, entails an origin which is not a “Not yet” of a teleological perfection in Hegel's sense, but a “Not yet” of a future history. However, Heidegger's orientation towards a “pure” origin qua future leads him to poietically escape the realm of the Political and the questions of praxis and practical rationality. Like Heidegger, Arendt is taken with the problem of origin; but in contrast to her former teacher, she tries to regain what Heidegger thought he could leave, viz., the dimension of the genuine Political and of acting. The original sense of acting (for Arendt, the capability of human beings to make a new beginning) can be observed in the Greek polis as well as in the American Revolution in modern times: The revolutionary act of a total new beginning elucidates, according to Arendt, what “acting” means in the full and truly political sense. However, Arendt's notion of an epochal beginning seems one-sided, and her abstract concept of acting seems to foster a mere actionism and anarchy. Therefore, contrary to Arendt's claims, the concept of the Political which she shapes in accordance with the extraordinary experiences of an epochal acting has apolitical consequences. The task of thinking after Heidegger and Arendt thus remains one of determining the political character of action in a convincing manner. In this respect, the paper pleads for a rethinking of Hegel's concept of ethical life ( Sittlichkeit).     

Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Jugendalter

Attention deficit–hyperactivity disorder (ADHD) in children and adolescents is a common and severe psychiatric disorder with a prevalence between 2 and 6%. In a high percentage of cases, there is a positive family history. In almost all sufferers, persistent functional limitations that impact everyday life are observed. The prognosis for untreated ADHD is very poor, being associated with social decline, drug addiction, and delinquency. Diagnosis is complex. Typical symptoms are often “hidden”. They are age specific and are mainly associated with inattention, impulsiveness associated with aggression and delinquency, and dangerous risk-taking behavior. More than half of patients also have additional comorbid disorders. The treatment concept always includes nonpharmacological interventions, which are often supplemented with drugs.     

Kasuistik eines Patienten mit Morbus Parkinson,der häufig wegen Schwindels stürzt

Reported is a case of a 73-year-old patient suffering from Parkinson’s disease, coronary artery disease with stable angina pectoris, polyneuoropathie NNB and untreated diabetes mellitus. For over a year, the patient reports experiencing dizziness which leads to falls. Presented is a case report in which the typical neurological cardinal symptoms have nothing to do with the neurological underlying illness. Without interdisciplinary cooperation no success can be achieved in these multimorbid patients.