Evidenzbasierte Psychotherapie der Depression

Depressive disorders are among the most frequent reasons for utilizing the health care system. Despite the availability of efficacious treatments and further advances throughout the last years, there is still a need for improving diagnostic and therapeutic procedures. A promising approach is the implementation of evidence- and consensus-based guidelines. The German “Nationale VersorgungsLeitlinie Unipolare Depression” are evidence- and consensus-based clinical practise guidelines for patients with unipolar depression. All relevant stakeholders have been involved in its development and have passed the final version at the end of 2009 to foster compliance throughout. The available evidence allows the derivation of differentiated treatment recommendations, also with regard to concomitant antidepressant medication or as alternative treatment options. In acute therapy watchful waiting over 14 days is recommended for mild depression and psychotherapy after persistence of symptoms. In cases of moderate depression, psychotherapy and pharmacotherapy are equally recommended, in cases of severe depression a combination of both is recommended.     

Bedside ethics and health system catastrophe: imagine if you will..

Preparations for large-scale disasters have tended to focus on triage schema, stockpiling of materials, and other logistical concerns. Less attention has been given to the myriad of distressing and almost unthinkable ethically charged dilemmas that will emerge at the bedside during a catastrophe, and how they may be best managed. Yet, it is these bedside issues that may limit or thwart the effectiveness of disaster planning, and, therefore, they ought to be carefully considered.     

Pandemic preparedness planning: will provisions for involuntary termination of life support invite active euthanasia?

A number of influential reports on influenza pandemic preparedness include recommendations for extra-autonomous decisions to withdraw mechanical ventilation from some patients, who might still benefit from this technology, when demand for ventilators exceeds supply. An unintended implication of recommendations for nonvoluntary and involuntary termination of life support is that it make pandemic preparedness plans vulnerable to patients' claims for assisted suicide and active euthanasia. Supporters of nonvoluntary passive euthanasia need to articulate why it is both morally different and morally superior to voluntary active euthanasia if they do not wish to invite expansion of end-of-life options during health system catastrophe.     

Predictors of verdict and punitive damages in high-stakes civil litigation

This research investigated demographic and attitudinal- psychological predictors of verdict and amount of punitive damages awarded in high-stakes civil litigation. Four hundred and forty-six surrogate jurors, selected to be representative of actual jurors, were exposed to realistic case presentations in insurance, tobacco, and pharmaceutical cases that were about to go to trial. Hierarchical regression revealed that perceptions of the existence of a litigation crisis predicted verdict in the tobacco and pharmaceutical cases after controlling for all other variables. Demographic variables predicted verdict and punitive damage awards only modestly and in different ways in the three cases. Need for cognition, strength of will and rationality, and a perception that there is a litigation crisis predicted the amount of punitive damages awarded in the tobacco case. Litigation crisis also predicted the amount of punitive damages awarded in the pharmaceutical case. Implications for jury selection are discussed.     

Von anderen Patienten lernen

Today, internet-based technologies are used at all levels of psychosocial services. Current psychotherapeutic applications concentrate on the implementation of traditional approaches in the internet. Self-help programs are posted onto the net, therapies are conducted via e-mail and groups meet in virtual chat rooms. If one looks at the development of the web over the last 2 years, it becomes clear that the substantial growth and popularity of this medium is due to internet platforms where contents and knowledge can be developed in collaborative environments and experiences can be shared with other users. The present paper addresses this development. On the basis of our example it is discussed how collaborative elements can be integrated into a psychotherapeutic application.     

How and when infants learn to climb stairs

Seven hundred and thirty-two parents reported when and how their infants learned to climb stairs. Children typically mastered stair ascent (mean age=10.97 months) several months after crawling onset and several weeks prior to descent (mean age=12.53 months). Most infants (94%) crawled upstairs the first time they ascended independently. Most infants (76%) turned around and backed at initial descent. Other descent strategies included scooting down sitting, walking, and sliding down face first. Children with stairs in their home were more likely to learn to ascend stairs at a younger age, devise backing as a descent strategy, and be explicitly taught to descend by their parents than children without stairs in their home. However, all infants learned to descend stairs at the same age, regardless of the presence of stairs in their home. Parents' teaching strategies and infants' access to stairs worked together to constrain development and to influence the acquisition of stair climbing milestones.     

Mass Media and Religious Identity: A Case Study of Young Witches

Drawing on interviews with 90 young people who have become Witches, we explore the visual media's influence on identity formation and maintenance. Witchcraft is a late modern religion that is highly individualistic and many young people report they have become a Witch without any interaction with other Witches. The rapid growth of interest in this religion among the young since The Craft was first shown provides an important example of the mass media's role in formation of contemporary religious identity. We argue that representations of Witchcraft in the visual mass media (along with other cultural trends such as environmentalism, feminism, and individualism) and cultural resources such as books, Internet sites, and magazines provide a mediated form of social interaction that sustains the plausibility of Witchcraft as a religion. It also helps the young to develop and legitimate their beliefs and practices and develop their Witchcraft persona.     

Sense of Coherence and Mood States: Exploring the Causal Relationships

The current study seeks to explore the effect of an academic course on sense of coherence (SOC) and transitory mood states. Moreover, the causal relationships between SOC and transitory mood states was evaluated. Second-year pharmacology students completed pencil-and-paper questionnaires at the beginning of the semester and 3-1/2 months later. The study group ( n  = 37) participated in an academic course developed to teach cognitive behavior concept and practice, whereas the control group ( n  = 43) had additional sessions of laboratory work. SOC increased significantly after the course while tension–anxiety and confusion decreased significantly. Structural equation analyses in the study group suggested that SOC was modified by confusion and perceived stress. No such pattern was observed in the control group.