Forensische Psychiatrie zwischen Therapie und Sicherung

The therapeutic tasks of forensic psychiatry range between the field of tension of “improvement” and “security” of entrusted persons. With respect to these aspects a paradoxical position of politics and society can be seen: whereas, regulatory security aspects are emphasized and detention measures are required with respect to the treatment measures according to §63 and §64 of the penal code (StGB) and any relaxation of rules is critically viewed, under pressure from the European jurisprudence preventive detention has been declared as a therapeutic measure. The superordinate priority of these measures is to prevent recidivism. This article firstly summarizes the empirical evidence concerning the efficacy of forensic psychiatric treatment of relevant disorders. From this it becomes obvious that the data are unreliable due to relevant risk aspects; therefore, the comparison of safety and therapeutic interests remains a challenging undertaking. A working approach that can successfully encompass both aspects is long-term case management, which is in a position to do justice to both the inpatient interaction and dynamic aspects of the treatment process beyond detention. Because the effectiveness of aftercare has been confirmed, we propose the implementation of forensic outpatient treatment as an alternative to forensic inpatient treatment.     

Das DGPPN-Zertifikat Forensische Psychiatrie

The introduction of the German Society for Psychiatry Psychotherapy and Mental Health (DGPPN) certificate for forensic psychiatry significantly contributed to improving the quality of forensic psychiatric expertises. The corresponding designations of state medical boards were created in 2004 and have now become established. Currently two methods of certification of forensic psychiatric training are possible which opens up the opportunity to further develop the certificate and to set standards for quality assurance. This article discusses in particular quality control measures, ways to respond to serious quality issues and the development process in terms of a continuing medical education. By establishing and enforcing such standards the DGPPN will achieve a key position.     

Diagnostischer Prozess und Voreingenommenheit in der forensischen Psychiatrie

This article analyses the problem of bias and confirmatory bias in the diagnostic process. The analysis is situated mainly within the context of the legal system in the United States but also with consideration of the situation in Germany. Special attention is given to the conceptual history and the development of modern operational classifications, particularly the Diagnostic and Statistical Manual of Mental Disorders (DSM) system.     

Virtuelle Objekte und ihre Verwendung

Zusammenfassung. Wir leben in einer Epoche, die man als Post-Gutenberg-Epoche bezeichnen kann. Das dominierende Zeichensystem ist nicht mehr die Schrift, sondern das elektronische Zeichen. Ungef?hr das Jahr 1950 wird als Wendepunkt zwischen diesen beiden Epochen angesehen, und zwar deshalb, weil in den Jahren nach dem 2. Weltkrieg die amerikanischen Haushalte mit Fernsehger?ten ges?ttigt waren und sich somit dieses neue Zeichensystem durchgesetzt hatte. Thema dieses Aufsatzes ist die Ver?nderung unserer Zeichensysteme und damit unserer Symbolwelten, der Wandel von der Welt des Schriftzeichens zur Welt des elektronischen Zeichens, die dadurch entstandene M?glichkeit, elektronische Objekte zu schaffen, die ich virtuelle Objekte nennen m?chte, die Manipulation von Objektwahl und Objektbeziehung, die damit einhergeht und die Rolle, die uns Analytikern in einer solchen Welt zukommt. Diese elektronischen Zeichen haben mit gro?em Tempo ein Eigenleben entwickelt, es ist eine ganze Klasse neuer Objekte entstanden, die Klassen der virtuellen Objekte. Dies sind elektronisch ver?nderte, erg?nzte oder rein elektronisch produzierte Objekte. Damit verbunden ist eine Industrialisierung von Objektwahl und Objektbeziehung. Es entsteht die manipulierte Objektwahl und Objektbeziehung und die Verdr?ngung natürlicher Objekte durch virtuelle. Dieser Vorgang ist auch mit einem Wechsel des Sozial- und Kulturverst?ndnisses verbunden. Es entstehen neue Muster des Sozial- und Kulturverst?ndnisses, die man als Industriefeudalismus bezeichnen k?nnte. Ziel des Beitrags ist es, über die Ver?nderung unserer Zeichenwelt und die damit verbundene Industrialisierung von Objektbeziehung zu reflektieren und sie, soweit schon m?glich, zu deuten.

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Virtual objects and their application: about the industrial production of object relationships

Summary. We live in an epoch that could be designated as the post-Gutenberg-era. Writing is no longer the dominant sign system. It is replaced by electronic signs. We consider approximately the year 1950 as the turning-point between these two epochs, because by then, in the years after the 2nd World War the American households were saturated with televisions. Thereby, the new sign system asserted itself. The topic of this article is the transformation of our sign system and thereby of our worlds of symbols, the leap from the world of written signs into the world of electronic signs, and the possibility born out of it to create electronic objects, which I prefer to call virtual objects. The manipulation of object-choice and object-relationships accompanying this change and the role assigned to analysts in this new world will be considered as well. These electronic signs developed quickly a life of their own. A totally new class of objects came into being, the class of virtual objects. These are electronically transformed, completed or wholly electronically produced objects. This procedure is accompanied by an industrialization of object-choice and object-relationships. The manipulated object-choice and object-relationship is born and, moreover, a displacement of natural objects through virtual ones. A change of the socio-cultural understanding is also a consequence of this process. New patterns of socio-cultural understanding develop, that could be described as industrial feudalism. The goal of this article is to describe the transformation of our world of signs and the connected industrialization of object relationships, and to interprete them according to our present possibilities.

     

Psychotherapeuten und ihre psychischen Probleme

A cliché about psychotherapists, psychologists and psychiatrists is that they themselves apparently all have mental problems. This review article analyzes the state of research on the topic based on a databank search in PubMed using the terms “(mental disorders OR suicide) AND (psychologists OR psychiatrists OR therapists OR psychoanalysts)” and an analysis of relevant review articles. In the databank search only ten publications were identified which related to any mental problems of therapists. These partially confirmed an increased risk of suicide, increased mental problems, such as depression, increased burnout risk and increased problems in childhood (e.g. sexual abuse and parentification) and showed that research deficits clearly exist. With respect to coping with such risks, the topics training therapy, personal therapy, self-care, and additional opportunities are discussed. In conclusion the implications for research and practice are discussed.     

Kategorien der Personwahrnehmung und ihre kulturelle Bedingtheit

Summary This research was undertaken in order to find out (1) whether the socio-cultural background of S has any influence on how he perceives and judges other people, (2) whether the thematic emphasis of his judgments mirrors the culturally determined aspects of his personality. Specifically, it was intended, by analyzing the social judgments of a group of Thai Ss, to gain information on the nearly unexplored characteristics of their personality as compared with a German group of Ss which served as a match.40 students of the College of Education in Bangkok were presented a list of 32 pairs of words (a noun and an adjective). Ss were instructed to take these word-pairs as metaphors serving to characterize people and to reinterpret them in concrete, non-metaphorical terms of personality characteristics. The same procedure was administered with a comparable group of 42 German students.The responses of the Ss were classified and the frequency of occurence of each category of response determined for each S. A comparison of the frequency of occurence of the responses between the Thai and German group yielded significant differences in a great number of response categories. The first hypothesis was thus confirmed.The categories of responses in which significant differences were obtained were grouped into clusters in order to reduce the multiplicity of differences to a limited number of underlying trends. These trends were found to reflect basic differences of the cultural values between the Thai and German, and, more generally, between the Asian and Western people.     

Zertifizierung, Rezertifizierung und Aufrechterhaltung der Zertifizierung in forensischer Psychiatrie in den USA

Certification in forensic psychiatry in the United States has previously included testing for the appropriate fund of knowledge and in various ways and degrees the skills needed to practice this subspecialty competently. Today explicit attention is increasingly being given to supporting methods for forensic psychiatrists to systematically identify and then fortify areas of weakness in forensic knowledge and skill sets. The development of certification in forensic psychiatry can be traced through four phases: (1) certification in general psychiatry by the American Board of Psychiatry and Neurology (ABPN) a prerequisite for certification in forensic psychiatry in each of the three certification phases to follow, (2) certification in forensic psychiatry by the American Board of Forensic Psychiatry (ABFP), (3) certification and recertification in forensic psychiatry by the ABPN and (4) certification, recertification and maintenance of certification by the ABPN. The level of actual competence has always been a challenge to assess adequately and today is both supported and further challenged by measures designed to encourage a lifetime of learning and focused self-improvement required through the ABPN??s maintenance of certification program.