Wie können Ressourcenbeschränkungen eines Dialogparters erkannt und berücksichtigt werden?

This paper reports on research on the question of how a dialog system can recognize and adapt to the resource limitations of its user: specifically, limitations of time and working memory. The results of an exploratory study, together with other empirical research, yield a number of probabilistic causal relationships among relevant variables. It is shown how these relationships can be represented in dynamic Bayesian networks and used as a basis for inferences and decisions of a dialog system.     

Wie können wir in das psychodynamische Erstinterview einführen?

We reflect on which traditional texts are suitable for the introduction into psychodynamic thinking for bachelor students in the faculty of psychology. We come to the conclusion that the use of works known and individually valued by the students from the world and/or trivial literature are suitable to allow students to carry out fictive preliminary conversations with their heroes from novels or films.     

„Ich möchte an Sie glauben können!“

During daily psychoanalytic treatment something happens that can be described with a term from the Old Testament: “to know”, giving psychoanalytic praxis a religious dimension. The author illustrates this thesis with a case report. First he tries to show how an interpretation of the casuistic material appears in the scope of the well-known concept of religion as an expression of dissoluble narcissistic conflicts. Then he applies Winnicott’s idea of “potential space” as a new scope for interpretation of the case. The conception of the “destruction of the object” according to Winnicott will be related exemplarily to the history of Jesus’ death on the cross and the miracle of his survival. By heeding the world of ideas of Klein and Bion, the author comes to the conclusion that religiosity is an anthropological constant, which cannot be reduced to a pathologic narcissistic event.     

Wie arbeite ich wirklich mit einem Traum?

According to Jung major impulses for psychic development and therefore for dealing with conflicts accrue from the unconscious in the form of dreams. In this article it will be shown as clearly as possible how a dream was dealt with in the therapeutic relationship.     

Brauchen wir Richtlinien oder Leitlinien für psychotherapeutische Behandlungen?

In many countries, psychotherapy is increasingly influenced by standards of scientifically evaluated methods and disorder-specific approaches. Referring to the definitions of the Scientific Council for Psychotherapy in Germany (WBP) concerning the differentiation of modalities, methods and techniques, this article points out that clear distinctions between modalities and methods are increasingly vanishing; instead, the tendency, especially within behavior therapy, to integrate all scientifically based methods and techniques is prevailing. This trend runs parallel with a development away from ?disorder-specific“ to a ?disorder-oriented“ approach. Facing the fact that technical aspects explain a relatively small proportion of outcome variance in psychotherapy, research related to the quality of psychotherapists is recommended. In addition, ?empirically validated psychotherapists“ should receive guidelines instead of rules of action.     

Wie Natürlich ist das System der Natürlichen Deduktion?

How natural is natural deduction?– Gentzen's system of natural deduction intends to fit logical rules to the effective mathematical reasoning in order to overcome the artificiality of deductions in axiomatic systems (¶ 2). In spite of this reform some of Gentzen's rules for natural deduction are criticised by psychologists and natural language philosophers for remaining unnatural. The criticism focuses on the principle of extensionality and on formalism of logic (¶ 3). After sketching the criticism relatively to the main rules, I argue that the criteria of economy, simplicity, pertinence etc., on which the objections are based, transcend the strict domain of logic and apply to arguments in general (¶ 4). (¶ 5) deals with Frege's critique of the concept of naturalness as regards logic. It is shown that this concept means a regression into psychologism and is exposed to the same difficulties as are: relativity, lack of precision, the error of arguing from `is' to `ought' (the naturalistic fallacy). Despite of these, the concept of naturalness plays the role of a diffuse ideal which favours the construction of alternative deductive systems in contrast to the platonic conception of logic (¶ 6).     

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.     

Wie wirksam sind psychoanalytisch orientierte Therapie und Verhaltenstherapie bei Persönlichkeitsstörungen?

This meta-analysis adresses the effectiveness of psychodynamic therapy and cognitive-behavioral therapy in personality disorders. Included were 14 studies of psychodynamic therapy and 11 studies of cognitive-behavioral therapy from 1974 to 2001. There is evidence that both psychodynamic therapy and cognitive-behavioral therapy are effective treatments of personality disorders. As the number of studies that could be included in this meta-analysis was limited, the conclusions that can be drawn are only preliminary. Further studies which examine specific forms of psychotherapy in specific types of personality disorders using criteria of core psychopathology are necessary. Both longer periods of treatment and follow-up studies should be included.     

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.     

Konzeption zum Umgang mit rückfallgef?hrdeten Sexualstraft?tern (KURS NRW)

The concept of the management of sexual offenders at risk for recidivism in Northrhine-Wesfalia (Konzeption zumUmgang mitrückfallgef?hrdetenSexualstraft?tern in Nordrhein-Westfalen, KURS NRW) came into effect on February 1, 2010 with a joint circular of the Ministries of Justice, Health and the Interior. Thereby Northrhine-Westfalia has created a systematic for monitoring sexual offenders at risk for recidivism, comparable to those already or in the meantime developed in other federal states in Germany. This article initially describes the procedural nature underlying the KURS concept, regarding mutual information routing and collaboration between the parties involved, i.e. justice, hospital order treatment, police and if necessary others as well. In addition, the framework in which KURS is ingrained, will be shown. Based on case reports this article will finally explain how actions and reactions will be specified in case conferences. Within the systematic KURS it is important that all participants reach all relevant information expeditiously, thus being able to react within their own jurisdiction. When planning actions it is essential to carefully consider the individual case parameters. Within the case conferences it remains a strength of the KURS concept that different perspectives of the case and the offender are bundled together. Ideally this and the case-specific actions will help to avoid similar offences to those committed previously.     

Die Behandlung paraphiler Störungen mit GnRH-Agonisten unter besonderer Berücksichtigung ethischer und rechtlicher Aspekte

Current guidelines recommend the use of antiandrogenic medication in addition to psychotherapeutic procedures in the treatment of patients and sexual offenders with severe paraphilic disorders and a high to very high risk of committing severe sexual offences. This article provides an overview about the current state of research concerning the effectiveness and possible side effects of antiandrogens and discusses the legal and ethical basis of using antiandrogens in the therapy of paraphilic disorders with a focus on gonadotropin-releasing hormone (GnRH) agonists. Meanwhile, a great deal of empirical evidence exists with respect to the effectiveness of GnRH agonists for lowering paraphilic sexual fantasies and behaviors; however, GnRH agonist treatment also still has a risk of mild to severe undesired side effects, e.?g. hypertension, hyperlipidemia, liver damage, bone demineralization and depression. Nevertheless, in German forensic psychiatric institutions a not insignificant proportion of patients are treated with antiandrogens and furthermore, in the last few years treatment with GnRH agonists has become more important. In Germany, GnRH agonists can only be used on a voluntary basis; however, in some European countries and North American states legal statutes for compulsory treatment also exist. This is clearly contrary to the recommendations of current international guidelines. In light of the fact that GnRH agonist treatment could violate basic human rights, the need for an ethically sound approach is even more important in the decision for therapy with GnRH agonists. This article provides some proposals for a treatment approach that is in line with current ethical and legal requirements.     

Vitamin D und die diabetische Neuropathie: (k)ein Alleskönner?

psychopraxis. neuropraxis - Zahlreiche Studien zeigen eine Korrelation zwischen niedrigen Vitamin-D-Werten und diversen Krankheiten. Diese Assoziation konnte in einer großen epidemiologischen...     

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.     

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.