Psychoedukation bei Personen mit erh?htem Psychoserisiko

Background

So far only few studies are available which have evaluated the effectiveness of psychoeducation for individuals at risk of psychosis in the early initial prodromal state (EIPS) whereas the benefit of psychoeducation in psychotic patients has been repeatedly confirmed. Thus the aim of this study was to investigate the effect of psychoeducation in individuals with increased risk of psychosis in the EIPS.

Method

A total of 128 help-seeking outpatients in the EIPS participated in a randomized controlled multicentre trial of 12 months of either psychoeducation as part of an integrated psychological intervention (IPI) or supportive counseling (SC). The time to transition to psychosis at 12-month and 24-month follow-up as well as the social adjustment at baseline, time of transition or post-treatment by means of the social adjustment scale (SAS?II) were assessed.

Results

The IPI was superior to SC in preventing progression to psychosis at 12-month (3.2% versus 16.9%, p?=0.008) and 24-month follow-up (6.3% versus 20.0%, p?=0.019). Both treatments resulted in significant pre-post improvements in SAS?II with no significant differences between the two groups.

Conclusions

Psychoeducation as part of an integrated intervention is effective for preventing the onset of psychosis over a 24-month time period in people in an EIPS. Moreover patients at risk of developing first episode psychosis seem to benefit from a specific psychoeducational intervention in the context of other treatments as well as from SC.     

Motivational determinants of motor performance: The hidden second task

Summary The present study was designed to test facilitating and debilitating effects of motivational processes on motor behavior. It was predicted that motivational processes have a more pronounced effect on motor performance when control is frequently transferred to attentional mechanisms (i. e., early in the acquisition phase). The results were consistent with this expectation. A strong motive to achieve success and pretreatment designed to enhance achievement motivation were associated with an increase in the quality of performance. A strong tendency to engage in state-oriented cognitive activities, by contrast, (e.g., thinking about the potential threat to one's selfesteem resulting from failure) was associated with poorer performance, It is concluded that experiments on motor behavior in which subjects are instructed to perform a single motor task may actually involve dual-task (or even multiple-task) performance if some part of the subjects' attentional capacity is used for task-irrelevant cognitive activities.     

Coordination in visual working memory

Coordination of mental procedures is considered in terms of control processes (Baddeley, 1989) in visual working memory and appears to be a separable aspect of the demand imposed by cascaded serial processes (Carlson & Lundy, 1992). The main task required subjects to indicate whether symbolically suggested rotations and reflections correctly describe the difference between matrix patterns of filled-in squares within a 3 x 3 grid or between line drawings. Experiments were carried out to show that coordination is a separable component in this transformation task. A marker for coordination is the difference between the time taken to execute two transformations as a whole and the sum of the component transformations in isolation. The separate coordination demand was found in an experiment with matrix patterns mentioned, in an experiment with letter-like line drawings, and also in an experiment that forced subjects to maintain whole-pattern representations. A last experiment checked whether coordination is carried out by an autonomous control unit. There was a self-paced control of serial presentation of transformation symbols instead of a simultaneous presentation of those symbols. This additional external triggering resulted in a substantial decrease in the demand for coordination. Coordination of mental procedures and temporary representations is a fundamental constraint on the use of working-memory processes.     

Coping with a Paraphrenic World in Late Life

This study deals with late paraphrenia from a psychological coping perspective. Analyses of coping behavior in relation to paraphrenic delusions and hallucinations revealed rational choices of coping efforts and generally consistent emotional reactions to the subjectively perceived problem. The majority of the patients did not display evidence of premorbid abnormal personalities or life courses. The creation and sustainment of psychotic thoughts are discussed in relation to lack of correcting social feedback due to social isolation and weakened cognitive source monitoring. The implications of a psychological coping perspective for intervention are indicated.     

Words may not be enough! No increased emotional Stroop effect in obsessive-compulsive disorder

Conflicting evidence has been obtained whether or not patients diagnosed with obsessive-compulsive disorder (OCD) share an attentional bias towards disorder-related stimuli. Some of these inconsistencies can be accounted for by suboptimal stimuli selection. In consideration of the heterogeneity of OCD, we investigated Stroop interference effects for two classes of OCD items (i.e., washing and checking) in 23 OCD patients and 23 healthy controls. In order to cover prevalent OCD concerns, item compilation was based on experts' appraisals. Patients neither displayed greater immediate as well as delayed Stroop interference nor any bias for OCD and subtype-congruent stimuli. On the contrary, for washing-related items, OCD patients, and here especially washers, displayed facilitation relative to healthy controls. Although the present study at first sight refutes the notion of an attentional bias in OCD in contrast to other anxiety disorders, several potential moderators need to be considered before this account is ultimately dismissed. In particular, an attentional bias may only be elicited using visual material that is more attention-grabbing than verbal stimuli. Finally, blockwise instead of random item administration and greater consideration of individual relevance may be crucial prerequisites for the effect to emerge.     

The effects of transformational and change leadership on employees' commitment to a change: a multilevel study

The effects of transformational leadership on the outcomes of specific change initiatives are not well understood. Conversely, organizational change studies have examined leader behaviors during specific change implementations yet have failed to link these to broader leadership theories. In this study, the authors investigate the relationship between transformational and change leadership and followers' commitment to a particular change initiative as a function of the personal impact of the changes. Transformational leadership was found to be more strongly related to followers' change commitment than change-specific leadership practices, especially when the change had significant personal impact. For leaders who were not viewed as transformational, good change-management practices were found to be associated with higher levels of change commitment.     

Cognitive functioning, behavior, and quality of life after stroke in childhood.

Rationale: To provide a better understanding of cognitive functioning, motor outcome, behavior and quality of life after childhood stroke and to study the relationship between variables expected to influence rehabilitation and outcome (age at stroke, time elapsed since stroke, lateralization, location and size of lesion). Methods: Children who suffered from stroke between birth and their eighteenth year of life underwent an assessment consisting of cognitive tests (WISC-III, WAIS-R, K-ABC, TAP, Rey-Figure, German Version of the CVLT) and questionnaires (Conner's Scales, KIDSCREEN). Results: Twenty-one patients after stroke in childhood (15 males, mean 11;11 years, SD 4;3, range 6;10-21;2) participated in the study. Mean Intelligence Quotients (IQ) were situated within the normal range (mean Full Scale IQ 96.5, range IQ 79-129). However, significantly more patients showed deficits in various cognitive domains than expected from a healthy population (Performance IQ p = .000; Digit Span p = .000, Arithmetic's p = .007, Divided Attention p = .028, Alertness p = .002). Verbal IQ was significantly better than Performance IQ in 13 of 17 patients, independent of the hemispheric side of lesion. Symptoms of ADHD occurred more often in the patients' sample than in a healthy population (learning difficulties/inattention p = .000; impulsivity/hyperactivity p = .006; psychosomatics p = .006). Certain aspects of quality of life were reduced (autonomy p = .003; parents' relation p = .003; social acceptance p = .037). Three patients had a right-sided hemiparesis, mean values of motor functions of the other patients were slightly impaired (sequential finger movements p = .000, hand alternation p = .001, foot tapping p = .043). In patients without hemiparesis, there was no relation between the lateralization of lesion and motor outcome. Lesion that occurred in the midst of childhood (5-10 years) led to better cognitive outcome than lesion in the very early (0-5 years) or late childhood (10-18 years). Other variables such as presence of seizure, elapsed time since stroke and size of lesion had a small to no impact on prognosis. Conclusion: Moderate cognitive and motor deficits, behavioral problems, and impairment in some aspects of quality of life frequently remain after stroke in childhood. Visuospatial functions are more often reduced than verbal functions, independent of the hemispheric side of lesion. This indicates a functional superiority of verbal skills compared to visuospatial skills in the process of recovery after brain injury. Compared to the cognitive outcome following stroke in adults, cognitive sequelae after childhood stroke do indicate neither the lateralization nor the location of the lesion focus. Age at stroke seems to be the only determining factor influencing cognitive outcome.     

Language specific prosodic preferences during the first half year of life: Evidence from German and French infants

There is converging evidence that infants are sensitive to prosodic cues from birth onwards and use this kind of information in their earliest steps into the acquisition of words and syntactic regularities of their target language. Regarding word segmentation, it has been found that English-learning infants segment trochaic words by 7.5 months of age, and iambic words only by 10.5 months of age [Jusczyk, P. W., Houston, D. M., & Newsome, M. (1999). The beginnings of word segmentation in English-learning infants. Cognitive Psychology, 39, 159–207]. The question remains how to interpret this finding in relation to results showing that English-learning infants develop a preference for trochaic over iambic words between 6 and 9 months of age [Jusczyk, P. W., Cutler, A., & Redanz, N. (1993). Preference for the predominant stress patterns of English words. Child Development, 64, 675–687]. In the following, we report the results of four experiments using the headturn preference procedure (HPP) to explore the trochaic bias issue in German- and French-learning infants. For German, a trochaic preference was found at 6 but not at 4 months, suggesting an emergence of this preference between both ages (Experiments 1 and 2). For French, 6-month-old infants did not show a preference for either stress pattern (Experiment 3) while they were found to discriminate between the two stress patterns (Experiment 4). Our findings are the first to demonstrate that the trochaic bias is acquired by 6 months of age, is language specific and can be predicted by the rhythmic properties of the language in acquisition. We discuss the implications of this very early acquisition for our understanding of the emergence of segmentation abilities.     

No evidence for object alternation impairment in obsessive-compulsive disorder (OCD)

Recent neuroimaging studies have consistently ascribed the orbito-frontal cortex (OFC) a pivotal role in the pathogenesis of obsessive-compulsive disorder (OCD). Cognitive tests presumed sensitive to this region, such as the Object Alternation Task (OAT), are considered important tools to verify this assumption and to investigate the impact of cortical dysfunction on behavior. The aim of the present study was to assess if patients with OCD show enhanced perseveration errors on the OAT relative to healthy controls taking into account several potential moderators, especially comorbid depression and OCD subtype. Thirty-five OCD patients and 18 healthy controls underwent the OAT as well as the Trail-Making Tests (TMT) A and B. In line with prior studies, OCD patients were slowed on both TMT tasks. In contrast, samples performed similarly on the OAT. While the latter finding does not invalidate the assumption that the OFC is affected in OCD, dysfunctions involving this region may be more subtle than often claimed and likely encompass only a small subset of functional domains hosted in the OFC.