Psychoanalytisch-orientierte Fokaltherapie der Depression bei Krebskranken

Emotional distress connected to a cancer disease may result in comorbid mental and especially depressive disorders. Although psychodynamic therapy is one of the most frequently applied forms of psychotherapy of depression in cancer patients there is a lack of empirical studies which meet the criteria of evidence-based psychotherapy research. This is especially true with regard to randomized controlled trials of psychodynamic psychotherapy. As far as we know no manual for psychodynamic treatment of cancer patients has yet been published. In this article a manual for a 20-session short-term psychodynamic treatment is presented. The treatment is based on Luborsky’s supportive-expressive (SE) therapy. The SE treatment manual of depressions in cancer patients presented here is an adaptation of the general SET manual as well as the SE manual for depression. In the first part the general principles of SE therapy are presented. In the second part a manual specifically adapted to the treatment of depressive cancer patients is described. The treatment manual is presently being used in a large-scale randomized controlled multi-centered study comparing short-term psychodynamic psychotherapy and treatment as usual.     

On defining “mental disorder”: Purposes and conditions of adequacy

All definitions of mental disorder are backed up by arguments that rely on general criteria (e.g., that a definition should be consistent with ordinary language). These desiderata are rarely explicitly stated, and there has been no systematic discussion of how different definitions should be assessed. To arrive at a well-founded list of desiderata, we need to know the purpose of a definition. I argue that this purpose must be practical; it should, for example, help us determine who is entitled to publicly funded health care. I then propose eight conditions of adequacy that can be used to assess competing definitions (e.g., the ordinary language condition, the coherence condition, and the condition of normative adequacy). These conditions pull in different directions, however, and we must decide which are most important. I also suggest that there is no single definition that can help us deal with all the relevant practical issues.     

Ordinary experience and the epoché: Husserl and Heidegger versus Rosen (and Cavell)

In various publications, Stanley Cavell and Stanley Rosen have emphasized the philosophical importance of what they both call “the ordinary.” They both contrast their recovery of “the ordinary” with traditional philosophy, including the phenomenological philosophy of Edmund Husserl. In this paper, I address Rosen’s claims in particular. I argue that Rosen turns the real situation on its head. Contra Rosen, it is not the case that the employment of Husserl’s epoché distorts the authentic voice of “the” ordinary—a voice that is clearly audible only from within everyday life. For (pace both Cavell and Rosen) there is no single “voice” of the ordinary: There are many such “voices,” not all of which are to be relied upon. Therefore, if we want to achieve an adequate grasp of ordinary experience, and Rosen does want this, we precisely need the epoché to curtail the misleading messages of certain other “voices of the ordinary.” Moreover, and somewhat surprisingly, this positive evaluation of the Husserlian epoché finds support in Heidegger’s writings from the twenties. I argue that Heidegger, too, believed that the epoché was an indispensable tool for the philosophical attempt to capture ordinary experience.     

Auditory verbal hallucinations: Dialoguing between the cognitive sciences and phenomenology

Auditory verbal hallucinations (AVHs) are a highly complex and rich phenomena, and this has a number of important clinical, theoretical and methodological implications. However, until recently, this fact has not always been incorporated into the experimental designs and theoretical paradigms used by researchers within the cognitive sciences. In this paper, we will briefly outline two recent examples of phenomenologically informed approaches to the study of AVHs taken from a cognitive science perspective. In the first example, based on Larøi and Woodward (Harv Rev Psychiatry 15:109–117, 2007), it is argued that reality monitoring studies examining the cognitive underpinnings of hallucinations have not reflected the phenomenological complexity of AVHs in their experimental designs and theoretical framework. The second example, based on Jones (Schizophr Bull, in press, 2010), involves a critical examination of the phenomenology of AVHs in the context of two other prominent cognitive models: inner speech and intrusions from memory. It will be shown that, for both examples, the integration of a phenomenological analysis provides important improvements both on a methodological, theoretical and clinical level. This will be followed by insights and critiques from philosophy and clinical psychiatry—both of which offer a phenomenological alternative to the empiricist–rationalist conceptualisation of AVHs inherent to the cognitive sciences approach. Finally, the paper will conclude with ideas as to how the cognitive sciences may integrate these latter perspectives into their methodological and theoretical programmes.     

Monitoring Perceptions of Social Progress and Pride of Place in a South African Community

A social indicators community project was conducted in 2007 to monitor living standards and quality of life in Rhini, a low-income suburb of Grahamstown, Makana Municipality, South Africa. Since 1994, under democratic rule, considerable progress has been made in service delivery to the formerly disadvantaged in South African society in terms of access to housing, infrastructure, and a social safety net to mitigate the high rate of unemployment. A representative cross-sectional household study (n 1020) conducted in 2007 in Rhini found that a positive assessment of the household’s situation and personal life satisfaction did not reflect better living conditions. Lack of income and employment opportunities appeared to dilute gains from higher living standards. The project also inquired into attitudes to place names and a proposed name change for the city under discussion at the time of the survey. It is argued that a place name with which one can identify may be as important as service delivery to enhance community satisfaction and overall quality of life. Dissatisfied residents who had limited access to services and expressed less civic pride were more likely than others to opt for a proposed name change for the city of Grahamstown that would better reflect the country’s new identity and multicultural heritage. It is concluded that a useful pursuit for community quality-of-life studies in countries undergoing social transformation will be to inquire into the complex combination of factors that drive perceptions of material and symbolic progress.     

The earliest electrophysiological correlate of visual awareness?

To examine the neural correlates and timing of human visual awareness, we recorded event-related potentials (ERPs) in two experiments while the observers were detecting a grey dot that was presented near subjective threshold. ERPs were averaged for conscious detections of the stimulus (hits) and nondetections (misses) separately. Our results revealed that hits, as compared to misses, showed a negativity around 180-350 ms at occipital and posterior temporal sites. It was followed by a positive wave after 400-500 ms, peaking at parietal sites. These correlates were not affected by a manipulation of attention. The early negativity, called 'visual awareness negativity' (VAN), may be a general, primary electrophysiological correlate of visual awareness. The present data show that it can be observed in response to appearance of a stimulus in visual awareness and that it generalizes across different manipulations of stimulus visibility.     

Better than average and better with time: relative evaluations of self and others in the past,present, and future

Evaluations of self and others in the past, present, and future were examined by asking 385 students to rate themselves or an acquaintance relative to their peers on a number of personality traits. We predicted, and found, evidence for self‐enhancement, as most participants regarded themselves superior to ‘most others’ at all points in time. We also found a better than average improvement effect, as participants considered themselves more superior now, than they were in the past, and expected to become even more superior in the future. Expected improvement in the future was larger than improvement over an equal span of time in the past. It is suggested that favorable self‐constructions are possible to the extent that the past and the future are perceived as ambiguous. Singular acquaintances were also rated better than most others, and were believed to improve over time, but their rate of improvement in the future was smaller than the expected improvement for oneself. Copyright © 2007 John Wiley & Sons, Ltd.     

Psychosocial Conditions of Women Awaiting Genetic Counseling: A Population-based Study

The decision whether to undergo genetic counseling for hereditary breast and ovarian cancer is complex. Knowledge about the psychosocial conditions of women who are awaiting counseling is sparse. We aimed to compare the psychosocial conditions of women awaiting genetic counseling with those of women in two reference groups. We included 567 women referred to genetic counseling for hereditary risk of breast or ovarian cancer (Genetic Group), 689 women referred to mammography (Mammography Group) and a random sample of 2,000 women from the general population (Population Group). One to 4 weeks before the first counseling session or mammography, data were collected by questionnaires. Both women affected with cancer and unaffected women in the Genetic Group appeared to have a somewhat higher prevalence of cancer-specific-distress than the corresponding reference groups. Further research on the effect of pre- counseling interventions appear warranted in addition with exploring a potential association between waiting time and cancer-specific distress.     

Analysing trends in subjective well-being in 15 European countries, 1973–2002

Previous empirical research has been unable to find a sufficient correlation between subjective well-being and per capita income, being hampered by limited longitudinal information and an inability to account for the predictions of competing theories. We bring new evidence to this question by exploiting a long and complete time-series from the Eurobarometer Survey, 1973–2002 allowing an examination of trends in life satisfaction across 15 European countries employing a modified version of Kendall’s Tau. Our results show that while current GDP growth does not affect trends in well-being, accelerations in GDP growth do. In addition, faster GDP growth and faster growth of government consumption than in neighbouring countries induces positive trends in life satisfaction. Our findings are consistent with the predictions of aspirations theory and the theory of reference group comparisons.     

Chimpanzees do not take into account what others can hear in a competitive situation

Chimpanzees (Pan troglodytes) know what others can and cannot see in a competitive situation. Does this reflect a general understanding the perceptions of others? In a study by Hare et al. (2000) pairs of chimpanzees competed over two pieces of food. Subordinate individuals preferred to approach food that was behind a barrier that the dominant could not see, suggesting that chimpanzees can take the visual perspective of others. We extended this paradigm to the auditory modality to investigate whether chimpanzees are sensitive to whether a competitor can hear food rewards being hidden. Results suggested that the chimpanzees did not take what the competitor had heard into account, despite being able to locate the hiding place themselves by the noise.