Partizipationsverhalten schizophren erkrankter Patienten in Psychoedukationsgruppen

Background

The effectiveness of psychoeducation groups for people with schizophrenia is well documented; however, there are no studies which examined patient participation behavior although this behavior might be critical for accomplishment of the therapeutic goals. This article presents newly developed 4-point Likert scale, the participation quality rating scale (PQRS), together with initial results on practicability, validity, change sensitivity, sociodemographic and clinical correlates and on the question whether participation quality might be a significant predictor of the short and long-term outcome of psychoeducation.

Patient and methods

Within the framework of the Munich Study “Cognitive Determinants of Psychoeducation and Information in Schizophrenic Psychoses” (COGPIP) the individual participation behavior of 97 patients with schizophrenia was examined after each psychoeducational group session (4 weeks). Individual mean PQRS scores were correlated with sociodemographic, anamnestic and clinical variables. In addition to change sensitivity the ability of the scale to predict the acquisition of illness knowledge during psychoeducation was examined as well as readmission during a 9-month follow-up period and the psychopathological endpoint (positive and negative syndrome scale, PANSS).

Results

Practicability and change sensitivity of the PQRS were found to be sufficient. Significant correlations with independently rated illness insight and medication compliance indicated a construct validity of the scale. Higher age, female sex and less pronounced psychopathological symptoms (PANSS) were associated with better participation behavior. Even patients with clearly impaired participation behavior profited from psychoeducation in that they were able to catch up with the delay with regard to illness knowledge. However, the PQRS was not a predictor of readmission during the 9-month follow-up period or of psychopathological endpoints.

Conclusions

The PQRS is qualified as a new tool for the standardized assessment of participation behavior in people with schizophrenia attending psychoeducation groups. The scale can be applied in research as well as clinical contexts in order to further improve understanding of how psychoeducation works and how this kind of supplementary therapy could become even more effective.     

Neurobiologische Grundlagen psychotherapeutischer Verfahren

In the last few years the investigation of the neurobiological basis of psychotherapeutic treatments has gained importance. Therapy-associated functional changes have been studied in a number of different psychiatric diseases. It has been shown that diseases with a central role of emotions (e.g. depression, anxiety disorders, borderline personality disorder) often demonstrate dysfunctions in brain areas that are linked to emotional regulation. Psychotherapeutic interventions can lead to a kind of normalization of brain responses in these areas (e.g. amygdala, ventromedial prefrontal cortex, anterior cingulate cortex, orbitofrontal cortex). In addition, therapy-associated transformations were also demonstrated in areas which are related to attention processes and visual perception. Other studies have aimed at finding neurobiological parameters that can be used to predict a therapeutic outcome or to choose between various therapeutic strategies. For instance, in depression, the amygdala and the anterior cingulate cortex are assumed to play a major role. Altogether, knowledge on the neurobiological basis of psychotherapeutic procedures is limited. A comparatively small number of studies and several methodological problems (e.g. small sample sizes, insufficient control groups, variability of methods used) make it difficult to propose reliable statements.     

Is the map in our head oriented north?

We examined how a highly familiar environmental space--one's city of residence--is represented in memory. Twenty-six participants faced a photo-realistic virtual model of their hometown and completed a task in which they pointed to familiar target locations from various orientations. Each participant's performance was most accurate when he or she was facing north, and errors increased as participants' deviation from a north-facing orientation increased. Pointing errors and latencies were not related to the distance between participants' initial locations and the target locations. Our results are inconsistent with accounts of orientation-free memory and with theories assuming that the storage of spatial knowledge depends on local reference frames. Although participants recognized familiar local views in their initial locations, their strategy for pointing relied on a single, north-oriented reference frame that was likely acquired from maps rather than experience from daily exploration. Even though participants had spent significantly more time navigating the city than looking at maps, their pointing behavior seemed to rely on a north-oriented mental map.     

Adorno on Kant,Freedom and Determinism

Abstract: In this paper I argue that Adorno's metacritique of freedom in Negative Dialectics and related texts remains fruitful today. I begin with some background on Adorno's conception of ‘metacritique’ and on Kant's conception of freedom, as I understand it. Next, I discuss Adorno's analysis of the experiential content of Kantian freedom, according to which Kant has reified the particular social experience of the early modern bourgeoisie in his conception of unconditioned freedom. Adorno argues against this conception of freedom and suggests that freedom is always conditioned by our embodiment and by our social and historical situation. Finally, I turn to Adorno's criticism of Kant's discussion of freedom and determinism in the Critique of Pure Reason and argue that while his philosophical argument against Kant fails, his metacritical argument remains suggestive. Scepticism about freedom arises when the standpoint of theoretical reason encroaches upon the standpoint of practical reason and assimilates persons to things.     

Theory use in social predictions

In a commentary to our article on the role of theory and simulation in social predictions, Krueger (2012) argues that the role of theory is neglected in social psychology for a good reason. He considers evidence indicating that people readily generalize from themselves to others. In response, we stress the role of theoretical knowledge in predicting other people’s behavior. Importantly, prediction by simulation and prediction by theory can lead to high as well as to low correlations between own and predicted behavior. This renders correlations largely useless for identifying the prediction strategy. We argue that prediction by theory is a serious alternative to prediction by simulation, and that reliance on correlation has led to a bias toward simulation.     

Wistar rats subjected to chronic restraint stress display increased hippocampal spine density paralleled by increased expression levels of synaptic scaffolding proteins

The aim of this study was to investigate whether the previously reported effect of chronic restraint stress (CRS) on hippocampal neuron morphology and spine density is paralleled by a similar change in the expression levels of synaptic scaffolding proteins. Adult male Wistar rats were subjected either to CRS (6 h/day) for 21 days or to control conditions. The resulting brains were divided and one hemisphere was impregnated with Golgi-Cox before coronal sectioning and autometallographic development. Neurons from CA1, CA3b, CA3c, and dentate gyrus (DG) area were reconstructed and subjected to Sholl analysis and spine density estimation. The contralateral hippocampus was used for quantitative real-time polymerase chain reaction and protein analysis of genes associated with spine density and morphology (the synaptic scaffolding proteins: Spinophilin, Homer1-3, and Shank1-3). In the CA3c area, CRS decreased the number of apical dendrites and their total length, whereas CA1 and DG spine density were significantly increased. Analysis of the contralateral hippocampal homogenate displayed an increased gene expression of Spinophilin, Homer1, Shank1, and Shank2 and increased protein expression of Spinophilin and Homer1 in the CRS animals. In conclusion, CRS influences hippocampal neuroplasticity by modulation of dendrite branching pattern and spine density paralleled by increased expression levels of synaptic scaffolding proteins.     

Navigation assistance: a trade-off between wayfinding support and configural learning support

Current GPS-based mobile navigation assistance systems support wayfinding, but they do not support learning about the spatial configuration of an environment. The present study examined effects of visual presentation modes for navigation assistance on wayfinding accuracy, route learning, and configural learning. Participants (high-school students) visited a university campus for the first time and took a predefined assisted tour. In Experiment 1 (n = 84, 42 females), a presentation mode showing wayfinding information from eye-level was contrasted with presentation modes showing wayfinding information included in views that provided comprehensive configural information. In Experiment 2 (n = 48, 24 females), wayfinding information was included in map fragments. A presentation mode which always showed north on top of the device was compared with a mode which rotated according to the orientation of the user. Wayfinding accuracy (deviations from the route), route learning, and configural learning (direction estimates, sketch maps) were assessed. Results indicated a trade-off between wayfinding and configural learning: Presentation modes providing comprehensive configural information supported the acquisition of configural knowledge at the cost of accurate wayfinding. The route presentation mode supported wayfinding at the cost of configural knowledge acquisition. Both presentation modes based on map fragments supported wayfinding. Individual differences in visual-spatial working memory capacity explained a considerable portion of the variance in wayfinding accuracy, route learning, and configural learning. It is concluded that learning about an unknown environment during assisted navigation is based on the integration of spatial information from multiple sources and can be supported by appropriate visualization.     

Challenge me! Communicating in multicultural classrooms

The current study investigated the value of Socratic classroom communication (e.g., critical debate and challenging each other on content matters) among students from various cultures (clustered into Western Europeans, Eastern Europeans and Non-Europeans) and from members of faculty at an international university in Germany. Students from Western cultures where Socratic communication had been valued in the school systems reported a greater ease of engaging in the respective communication style than did Eastern European and Non-European students. Furthermore, we assessed how strongly the faculty valued the respective kinds of behavior. The results show that overall students underestimated the extent to which Socratic communication behavior was esteemed by members of faculty. In addition, faculty members perceived themselves to be more explicit about their pedagogical principles than they were perceived by students. Finally, the easier it was for students to show Socratic classroom communication, the more academically satisfied they were and the better their grades. The results are discussed with regard to practical implications and the internationalization of universities.     

Brain oscillatory activity associated with task switching and feedback processing

In this study, we sought to dissociate event-related potentials (ERPs) and the oscillatory activity associated with signals indicating feedback about performance (outcome-based behavioral adjustment) and the signals indicating the need to change or maintain a task set (rule-based behavioral adjustment). With this purpose in mind, we noninvasively recorded electroencephalographic signals, using a modified version of the Wisconsin card sorting task, in which feedback processing and task switching could be studied separately. A similar late positive component was observed for the switch and correct feedback signals on the first trials of a series, but feedback-related negativity was observed only for incorrect feedback. Moreover, whereas theta power showed a significant increase after a switch cue and after the first positive feedback of a new series, a selective frontal beta–gamma increase was observed exclusively in the first positive feedback (i.e., after the selection of the new rule). Importantly, for the switch cue, beta–alpha activity was suppressed rather than increased. This clear dissociation between the cue and feedback stimuli in task switching emphasizes the need to accurately study brain oscillatory activity to disentangle the role of different cognitive control processes.