Einfluss des Behandlungssettings auf den Gesundungsverlauf

Even though managed care systems research emerged as an important field in psychotherapy research in the last years, studies examining the effects of its psychotherapeutic measures on outcome are still rare, especially in Germany. Little is known about the effectiveness of psychotherapy in different treatment settings, i. e. whether and how patients in outpatient psychotherapy differ from inpatients in respect to initial impairment status and pace of improvement. Two longitudinal data sets—inpatient (N=759) and outpatient (N=521)—were used to scrutinize these questions. Results yielded no differences between treatment settings as to patients’ initial impairment. A linear model adequately represented the mean course of improvement in inpatient psychotherapy. For outpatient psychotherapy, a bipartite linear model for treatment and for the follow-up period proved more appropriate. During 1 year, patients in both settings attained a similar amount of improvement. However, pace of in-treatment improvement was 10 times faster in the inpatient setting. Initial impairment substantially predicted the course of psychological improvement in both treatment settings.     

Severity of childhood attention-deficit hyperactivity disorder--a risk factor for personality disorders in adult life?

Some evidence points to an increased rate of cluster B and C personality disorders (PDs) in adult ADHD patients. In order to assess axis II disorders comprehensively we used the diagnostic instrument of the WHO. In sixty adult out-patients with ADHD according to DSM-IV criteria PDs were assessed with the International PD Examination (IPDE) and severity of childhood ADHD with the Wender-Utah-Rating Scale (WURS). We found at least one PD in 25% of cases. Cluster C PDs were most common (36.6%) followed by Cluster B (23.3%) and A (8.3%). Avoidant (21.7%) and borderline (18.3%) were the most frequent single PD entities. ADHD patients with PD suffered from significantly more severe childhood ADHD compared to those without co-occurring PD. Applying the IPDE we confirmed a high number of PDs among adult ADHD patients. Our findings point to a higher vulnerability for the development of PDs in patients with severe childhood ADHD.     

Towards a New Epistemology of Mathematics

In this introduction we discuss the motivation behind the workshop “Towards a New Epistemology of Mathematics” of which this special issue constitutes the proceedings. We elaborate on historical and empirical aspects of the desired new epistemology, connect it to the public image of mathematics, and give a summary and an introduction to the contributions to this issue.

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Inanspruchnahme, Verlauf und Ergebnis ambulanter Psychotherapie

This paper summarizes the major results of the study ?Optimizing psychotherapy service provision via transparency and outcome orientation: evaluating outpatient psychotherapy“ (TRANS-OP). Between September 1998 and February 2000, all insured persons of a major German health insurance company (?Deutsche Krankenversicherung“) who requested reimbursement of outpatient psychotherapy were asked to participate in the study. Comprehensive data concerning structural, process and outcome criteria of outpatient psychotherapy were collected from 714 participants and from the majority of their psychotherapists during a 2-year observation period. Participants applied for the following treatments eligible for reimbursement in the German health insurance system: psychodynamically oriented psychotherapy (52%), cognitive behavioral therapy (31%), and psychoanalytic psychotherapy (17%). The amounts of sessions claimed for reimbursement were approved almost without exception. Participants in the three treatment modalities did not differ in socio-demographic characteristics, or in initial symptom severity as assessed by standardized measures. Even though courses of improvement of the symptoms varied, therapy outcome after 2 years was similar in the three forms of treatment. In addition, a cost offset was found, i.e. medical costs, especially for hospital days, substantially decreased during the course of psychotherapy. These findings support the effectiveness as well as the economic significance of outpatient psychotherapy across different treatment modalities in routine care. However, allocation of psychotherapeutic resources should be more considerate of individual patient needs and treatment outcome.     

German lexical personality factors: relations with the HEXACO model

We correlated the scales of the HEXACO Personality Inventory (HEXACO‐PI) with adjective scale markers of factors previously obtained in indigenous lexical studies of personality structure in the German language. Self‐ratings obtained from a sample of 323 German participants showed a pattern of strong convergent and weak discriminant correlations, supporting the content‐based interpretation of the German lexical factors in terms of the HEXACO dimensions. Notably, convergent correlations were strong for both the broader and the narrower variants of the Honesty‐Humility factor as observed in German lexical studies. Also, convergent correlations for HEXACO Openness to Experience were, as expected, stronger for German adjectives describing a creative and intellectual orientation than for German adjectives describing intellectual ability. Copyright © 2006 John Wiley & Sons, Ltd.     

Fibromyalgie und Leistungseinschränkung

Interdisciplinary guidelines allowed for new quality standards in pain appraisal. Simultaneously, the scientific notion of fibromyalgia changed from a subjectively overvalued malaise to a central disturbance of coping with stress, which is neurobiologically determined. Therefore, in this article a psychosomatics-based guide is given for the socio-medical appraisal of fibromyalgia with reference to the new International Classification for Functioning and Disability (ICF) of the World Health Organization (WHO). As illustration a case study is presented.     

Across the thin blue line: police officers and racial bias in the decision to shoot

Police officers were compared with community members in terms of the speed and accuracy with which they made simulated decisions to shoot (or not shoot) Black and White targets. Both samples exhibited robust racial bias in response speed. Officers outperformed community members on a number of measures, including overall speed and accuracy. Moreover, although community respondents set the decision criterion lower for Black targets than for White targets (indicating bias), police officers did not. The authors suggest that training may not affect the speed with which stereotype-incongruent targets are processed but that it does affect the ultimate decision (particularly the placement of the decision criterion). Findings from a study in which a college sample received training support this conclusion.     

Standardization and the competition on the market for ERP-systems

Although frameworks appear to be a promising means to provide the industry with business management software, one cannot observe that framework vendors begin to threat the market position of vendors of established standard software. We build a microeconomic model to analyze the competition of software development with or without frameworks in which we concentrate on the network effect and the effect of compatibility decisions. We can show how the introduction of a standard will help to establish framework technology on the software market and finally increase social welfare. Therefore we recommend the standardization organizations to support framework technology by establishing standards.