Technological Advances and the Future of Suicide Prevention: Ethical,Legal, and Empirical Challenges

Technological advancements have brought multiple and diverse benefits to our human existence. In suicide prevention, new technologies have spurred great interest in and reports of the applicability to assessing, monitoring, and intervening in various community and clinical populations. We argue in this article that we need to better understand the complexities of implementation of technological advances; especially the accuracy, effectiveness, safety, ethical, and legal issues, even as implementation occurs at individual, clinical, and population levels, in order to achieve that measure of public health impact we all desire (i.e., greater benefit than harm).     

Physiological foundations of behaviour

Ohne Zusammenfassung

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Physiological foundations of behaviour

     

Child-care effect sizes for the NICHD Study of Early Child Care and Youth Development

This report summarizes findings from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development as effect sizes for exclusive maternal care and--for children in child care--type, quality, and quantity of care. Children (n = 1,261) were recruited at birth and assessed at 15, 24, 36, and 54 months. Exclusive maternal care did not predict child outcomes, but multiple features of child-care experience were modestly to moderately predictive. Higher quality child care was related to advanced cognitive, language, and preacademic outcomes at every age and better socioemotional and peer outcomes at some ages. More child-care hours predicted more behavior problems and conflict, according to care providers. More center-care time was related to higher cognitive and language scores and more problem and fewer prosocial behaviors, according to care providers. Child-care effect sizes are discussed from 3 perspectives: (a) absolute effect sizes, reflecting established guidelines; (b) relative effect sizes, comparing child-care and parenting effects; and (c) possible individual and collective implications for the large numbers of children experiencing child care.     

The Influence of Neighborhood Aesthetics,Safety, and Social Cohesion on Perceived Stress in Disadvantaged Communities

Limited research has explored how specific elements of physical and social environments influence mental health indicators such as perceived stress, or whether such associations are moderated by gender. This study examined the relationship between selected neighborhood characteristics and perceived stress levels within a primarily low‐income, older, African‐American population in a mid‐sized city in the Southeastern U.S. Residents (n = 394; mean age=55.3 years, 70.9% female, 89.3% African American) from eight historically disadvantaged neighborhoods completed surveys measuring perceptions of neighborhood safety, social cohesion, aesthetics, and stress. Multivariate linear regression models examined the association between each of the three neighborhood characteristics and perceived stress. Greater perceived safety, improved neighborhood aesthetics, and social cohesion were significantly associated with lower perceived stress. These associations were not moderated by gender. These findings suggest that improving social attributes of neighborhoods may have positive impacts on stress and related benefits for population health. Future research should examine how neighborhood characteristics influence stress over time.     

Passt oder passt nicht?

Differential indication in psychotherapy should be a process of decision making, that takes multiple factors into account, and not just the assignment of a particular disorder to the adequate therapeutic method. Unspecific characteristics of the patient, instead of disorder-specific features, as well as personality characteristics of the therapist having therapeutic relevance are important factors either. In this way decisions for an indication then turn into the crucial question of matching between patient and therapist. The receptivity of the patient is a central component. As a result of successful maching, the therapeutic relationship will improve which has a positive influence on the outcome of psychotherapy. According to the generic model of psychotherapy 4 levels of the decision-making process are defined. They serve as orientation for a differential indication taking into account both persons and methods. The realization of this indication model in in-patient treatment has some preconditions. Obligatory is the availability of a variety of therapists differing in therapeutic methods and personal characteristics. The mostly applied principles of matching decisions are listed in tabular form and illustrated by a case report.     

„Da wirst du ja auch bekloppt bei“

Given a growing demand of psychotherapeutic care the interest of students in a psychotherapeutic occupation is gaining relevance. At the same time psychoanalytic training institutions and societies have been confronted with a continuous decrease of candidates over the last decades. Psychology students, medical students and students of educational sciences (the latter only in the child and adolescent treatment sector) are admitted for a psychotherapeutic training approved by the health care insurances in Germany and have the possibility to choose between a behavioral or a psychodynamic oriented training. In the present multimethodological cross-sectional study those student groups (N?=?679) were questioned about their interest in a psychotherapeutic training in general and, if they proved to be interested, about their specific choice of training. Amongst psychology students the largest group of those interested in a psychotherapeutic training would opt for a behavioral education. Amongst medical students and students of pedagogy and social pedagogy a psychotherapeutic training is less frequently an option for their future career plans. Amongst the students of educational sciences, for those interested in training, psychodynamic methods are more often of interest. Possible reasons for the students' decisions in the context of the specific German legal situation are discussed.     

Wittgenstein, Dreaming and Anti-Realism: A Reply to Richard Scheer

I have argued that Wittgenstein's treatment of dreaming involves a kind of anti-realism about the past: what makes "I dreamed p " true is, roughly, that I wake with the feeling or impression of having dreamed p . Richard Scheer raises three objections. First, that the texts do not support my interpretation. Second, that the anti-realist view of dreaming does not make sense, so cannot be Wittgenstein's view. Third, that the anti-realist view leaves it a mystery why someone who reports having dreamed such-and-such is inclined to report what she does. The Reply defends my reading of Wittgenstein against these objections.     

An account of a time-limited therapeutic group in an NHS setting for women with a history of incest

Group therapy may be a useful treatment modality for women who have been sexually abused as children. The group described here involved patients referred to the British NHS psychiatric service. This closed time-limited group was run by male and female cotherapists. Reasons are advanced for advocating a mixed-sex cotherapy team. The progress of the group is described. Issues of selection, preparatory individual therapy, further individual therapy following the group, and stress on the therapists are discussed. It is suggested that the mode of referral influences the severity of presenting problems and the level of additional support likely to be required by group members. The participants' views concerning the most helpful components of therapy are recorded and self-report measures are considered alongside the assessments of the therapists.