Werden Psychotherapeuten,Psychiater oder die Psychotherapie stigmatisiert?

Background

In the last decades much has been found out about the stigmatization of persons with mental illnesses. Recently, a potential stigmatization of psychologists, psychiatrists and psychotherapy has been debated.

Aim

The question should be answered whether there is any scientific evidence for stigmatization of psychologists, psychiatrists and psychotherapy by using the conceptualization of stigma as brought forward by Link and Phelan (Ann Rev Sociol 2001; 27:363–385).

Material and methods

For the systematic literature search in 2013 a databank search was carried out in Web of Science using the search terms stigma or discrimination or stereotypes or prejudice AND psychiatrist or psychotherapist or psychotherapy or mental health professional. A total of 2013 publications were identified which were systematically arranged according to the title and abstract with respect to the relevance for the question whether psychotherapy or associated professional groups are stigmatized. Only four of the articles were considered to be relevant. After advice from experts six further relevant articles could be found which did not appear in the databank search.

Results

The review found evidence for both positive and negative stereotypes but not for other components of the stigmatization process.

Conclusion

At present there is no evidence for a stigma related to psychotherapy or to the professions of psychotherapists and psychiatrists.     

Nichtspezifische,funktionelle und somatoforme Körperbeschwerden

In the S3 guidelines on non-specific, functional and somatoform bodily complaints, a broad group of medical and psychological societies as well as patient representatives have for the first time achieved an evidence-based consensus on terminology and care of these patients. This paper summarizes the main background information and recommendations for psychotherapists. For mild courses treatment by the general practitioner with establishment of a biopsychosocial explanatory model and physical as well as social activation is usually sufficient. More severe courses call for cooperative, coordinated management, including regular appointments with the general practitioner, graded activation and psychotherapy, especially cognitive behavioral, in addition to psychodynamic interpersonal or hypnotherapeutic imaginative psychotherapy. In particularly severe courses multimodal and if necessary day clinic or inpatient treatment is needed. Additionally the patient guidelines for affected people and their relatives are presented.     

Saying and Doing: Speech Actions,Speech Acts and Related Events

The question which this paper examines is that of the correct scope of the claim that extra‐linguistic factors (such as gender and social status) can block the proper workings of natural language. The claim that this is possible has been put forward under the apt label of silencing in the context of Austinian speech act theory. The ‘silencing’ label is apt insofar as when one's ability to exploit the inherent dynamic of language is ‘blocked’ by one's gender or social status then one might justly be said to be silenced. The notion that factors independent of any person's linguistic competence might block her ability to exploit the inherent dynamic of language is of considerable social as well as theoretical significance. I shall defend the claim that factors independent of a person's linguistic competence can indeed block her ability to do things with words but I will show that the cases that have been previously considered to be cases of illocutionary failure are instances of rhetic or locutionary act failure instead. I shall refine the silencing claim as previously advanced in the debate in at least one fundamental respect. I also show that considering the metaphysics of speech acts clarifies many of the issues previously appearing as thorny bones of contention between those who hold that the only notion of silencing that is coherent is that of physically preventing someone from speaking or writing and those who hold the opposite sort of claim sketched above.     

Human melody singing by bullfinches (Pyrrhula pyrrula) gives hints about a cognitive note sequence processing

We studied human melody perception and production in a songbird in the light of current concepts from the cognitive neuroscience of music. Bullfinches are the species best known for learning melodies from human teachers. The study is based on the historical data of 15 bullfinches, raised by 3 different human tutors and studied later by Jürgen Nicolai (JN) in the period 1967–1975. These hand-raised bullfinches learned human folk melodies (sequences of 20–50 notes) accurately. The tutoring was interactive and variable, starting before fledging and JN continued it later throughout the birds’ lives. All 15 bullfinches learned to sing alternately melody modules with JN (alternate singing). We focus on the aspects of note sequencing and timing studying song variability when singing the learned melody alone and the accuracy of listening-singing interactions during alternatively singing with JN by analyzing song recordings of 5 different males. The following results were obtained as follows: (1) Sequencing: The note sequence variability when singing alone suggests that the bullfinches retrieve the note sequence from the memory as different sets of note groups (=modules), as chunks (sensu Miller in Psychol Rev 63:81–87, 1956). (2) Auditory–motor interactions, the coupling of listening and singing the human melody: Alternate singing provides insights into the bird’s brain melody processing from listening to the actually whistled part of the human melody by JN to the bird’s own accurately singing the consecutive parts. We document how variable and correctly bullfinches and JN alternated in their singing the note sequences. Alternate singing demonstrates that melody-singing bullfinches did not only follow attentively the just whistled note contribution of the human by auditory feedback, but also could synchronously anticipate singing the consecutive part of the learned melody. These data suggest that both listening and singing may depend on a single learned human melody representation (=coupling between perception and production).     

How Emotional Media Reports Influence Attitude Formation and Change: The Interplay of Attitude Base,Attitude Certainty,and Persuasion

This study examined the influence of an emotionally arousing writing style on attitude formation and change. It has been proposed that different writing styles induce attitudes based on either affect or cognition and with either high or low certainty. Previous work indicates that the interplay of these attitude characteristics determines the persuasiveness of emotional and rational media appeals. To test the hypotheses, participants in an experimental study read articles from a magazine about a fictitious attitude object. In the first step, 4 different types of attitudes varying in base and level of certainty were induced through a respectively manipulated article. In the second step, these attitudes were challenged by an additional article, which presented either an emotional or rational persuasive appeal. The results supported hypotheses on attitude induction through media stimuli and 3 of 4 hypotheses regarding the persuasiveness of emotionally and rationally written articles.     

Analogue Mental Transformations in 3‐Year‐Olds: Introducing a New Mental Rotation Paradigm Suitable for Young Children

Until now, a successful application of the mental rotation paradigm was restricted to children 5 years or older. By contrast, recent findings suggest that even infants can perform mental rotation. Unlike the methods used in infant studies (looking time), our new research paradigm allows for the measurement and interpretation of reaction times. Kindergartners (aged 3–6 years) were presented with a stimulus configuration on a touchscreen and asked to bring a rotated stimulus into an upright position using the shortest path. Mean reaction time (RT) increased linearly with angular disparity. The ensuing linear trend was significant not only for the entire sample but also for the youngest age group analysed separately. To exclude the possibility that linearity was due to movement planning, 3‐year‐olds had to manually rotate a stimulus about the same trajectory without the need for a corresponding mental transformation in a second experiment. Here, no linear trend was observed. These results are interpreted as evidence for an analogue mental transformation in 3‐year‐olds, equal to the transformation processes in older children's and adults' mental rotation. Copyright © 2013 John Wiley & Sons, Ltd.     

Trauma exposure is associated with increased context-dependent adjustments of cognitive control in patients with posttraumatic stress disorder and healthy controls

Recent evidence has suggested that posttraumatic stress disorder (PTSD) is associated with alterations in prefrontal-cortex-dependent cognitive processes (e.g., working memory, cognitive control). However, it remains unclear whether these cognitive dysfunctions are related to PTSD symptomatology or trauma exposure. Furthermore, regarding cognitive control, research has only focused on the integrity of selected control functions, but not their dynamic regulation in response to changing environmental demands. Therefore, the present study investigated dynamic variations in interference control, in addition to overall interference susceptibility and working memory (WM) performance in matched groups of 24 PTSD patients and 26 traumatized and 30 nontraumatized healthy controls. The Simon task was used to measure overall interference susceptibility and the flexible adjustment of cognitive control, on the basis of the occurrence of response conflicts (conflict adaptation effect). WM performance was assessed with the forward and backward digit span tasks. Since we have previously shown that trauma exposure per se is associated with reduced hair cortisol concentrations (HCC), we further explored whether PTSD/trauma-related cognitive alterations are related to HCC in proximal 3-cm hair segments. The results revealed that PTSD patients and traumatized controls showed significantly more pronounced conflict adaptation effects than nontraumatized controls. Moreover, the conflict adaptation effect was positively related to the number of lifetime traumatic events and the frequency of traumatization. The groups did not differ in overall interference susceptibility or WM performance. Exploratory analyses revealed no association between HCC and the observed cognitive differences. These results suggest that context-driven control adjustments constitute a sensitive correlate of trauma exposure, irrespective of PTSD.     

Examining gender differences in received,provided, and invisible social control: an application of the dual-effects model

The dual-effects model of social control not only assumes that social control leads to better health practices but also arouses psychological distress. However, findings are inconsistent. The present study advances the current literature by examining social control from a dyadic perspective in the context of smoking. In addition, the study examines whether control, continuous smoking abstinence, and affect are differentially related for men and women. Before and three weeks after a self-set quit attempt, we examined 106 smokers (77 men, mean age: 40.67, average number of cigarettes smoked per day: 16.59 [SD = 8.52, range = 1–40] at baseline and 5.27 [SD = 6.97, range = 0–40] at follow-up) and their nonsmoking heterosexual partners, assessing received and provided control, continuous abstinence, and affect. With regard to smoker's affective reactions, partner's provided control was related to an increase in positive and to a decrease in negative affect, but only for female smokers. Moreover, the greater the discrepancy between smoker received and partner's provided control was the more positive affect increased and the more negative affect decreased, but again only for female smokers. These findings demonstrate that female smokers' well-being was raised over time if they were not aware of the control attempts of their nonsmoking partners, indicating positive effects of invisible social control. This study's results emphasize the importance of applying a dyadic perspective and taking gender differences in the dual-effects model of social control into account.