Internistische Psychosomatik

Die psychische Komorbidität internistischer Patienten im Sinne einer ICD-Diagnose des Kapitels F beträgt mehr als 35%: Neurotische, besonders somatoforme, Schmerz-, affektive Störungen und Suchterkrankungen sind häufig. Die Liegedauer ist bei psychischer Komorbidität deutlich erhöht. Es benötigen 5% der internistischen Patienten ein psychosomatisches Konsil. Neue, komplexe Behandlungsstrategien, wie Transplantationen, Kardioverter-Defibrillatoren, Medikamentenpumpen, erfordern häufig spezifische psychosoziale Interventionen. Ältere Patienten haben Erkrankungen, die zunehmend chronifizieren und komplexer werden. Damit werden Lebensqualität und psychische Komorbidität zu zentralen Outcomevariablen der Volkskrankheiten. Das zweite große Aufgabenfeld internistischer Psychosomatik ist die Untersuchung und die Behandlung psychosomatischer Patienten im engeren Sinne (Essstörungen, Schmerz- und somatoforme Störungen), weil internistische Diagnostik und Therapie erforderlich oder die Motivation der Patienten primär somatisch ist. Organisationsmodelle reichen von Konsil-/Liaisondiensten bis zu integrierten psychosomatischen Abteilungen oder Fachabteilungen an Allgemeinkrankenhäusern. Aussichtsreiche Forschungsstrategien werden neben der Erforschung psychosomatischer Mechanismen in der Entwicklung pragmatischer Behandlungsprogramme, ihrer Überprüfung in klinischen Studien und der Versorgungsforschung gesehen. Darüber hinaus sollte eine Intensivierung nationaler und internationaler Forschungsnetze erfolgen, wenn immer möglich unter Beteiligung anderer Disziplinen, um auch im Bereich der Forschung konkurrenzfähig zu bleiben.     

The attentional blink is susceptible to concurrent perceptual processing demands

In a rapid serial visual presentation stream processing of a first target (T1) impairs detection or identification of a second target (T2) that appears within 500 ms after T1. This effect characterizes the so-called attentional blink (AB). To evaluate contemporary information-processing accounts of the AB phenomenon in terms of the underlying processing mechanisms the present study examined the potential influence of Task 1 difficulty on the AB effect. To this end, T1 contrast and T1 response requirements were systematically varied across four experiments. Experiment 1 ruled out a mere sensory basis of the contrast manipulation on T2 performance. When only T2 had to be reported (Experiment 2) an AB effect occurred that was slightly modulated by T1 contrast. When report of both T1 and T2 was required in a standard AB task (Experiment 3), the magnitude of the AB depended to a larger extent on stimulus contrast, and it increased further when speeded T1 choice responses were additionally required (Experiment 4). On the basis of the present impact of Task 1 difficulty on the AB effect we conclude that processing limitations cause the AB phenomenon. We discuss such limitations in terms of perceptual (T1 consolidation) and central (response selection) bottleneck processes.     

Training propositional reasoning

Two experiments compared the effects of four training conditions on propositional reasoning. A syntactic training demonstrated formal derivations, in an abstract semantic training the standard truth-table definitions of logical connectives were explained, and a domain-specific semantic training provided thematic contexts for the premises of the reasoning task. In a control training, an inductive reasoning task was practised. In line with the account by mental models, both kinds of semantic training were significantly more effective than the control and the syntactic training, whereas there were no significant differences between the control and the syntactic training, nor between the two kinds of semantic training. Experiment 2 replicated this pattern of effects using a different set of syntactic and domain-specific training conditions.     

The Distillation of “VISCI”: Towards a Better Identification of Suicidal Inmates

The “Viennese Instrument for Suicidality in Correctional Institutions” (VISCI) presented here is based on the results of a large case‐control study and on research on literature examining suicide prevention in general and in the prison population in particular. The aim of this study was to validate the properties of the VISCI to differentiate between suicides and nonsuicides. The sensitivity and specificity of the VISCI was tested in the files of 55 correctional suicides, and 110 controls. VISCI differentiated well between suicides and nonsuicides. The routine administration of the VISCI may help to direct the existing professional attention to inmates with the highest need.     

Constitutivism and Inescapability: A Diagnosis

A central element of constitutivist accounts of categorical normativity is the claim that the ultimate foundation of the relevant kind of practical authority is sourced in certain tasks, features, and aims that every person inevitably possesses and inescapably has to deal with. We have no choice but to be agents and this fact is responsible for the norms and principles that condition our agency-related activities to have anunconditional normative grip on us. Critics of constitutivism argue that it is exactly because of itsinescapability that agency is a powerless source of normative authority. I investigate why our intuitionsconcerning the appeal to inescapability point into such contrary directions. Why do we feel the attraction ofgrounding categorical normativity in phenomena that not even the skeptic can ignore, on the one hand, butseem to hold dear the principle that “ought implies need not,” on the other? Instead of fully developing thethird, neutral, way of conceptualizing the relationship between inescapability and normativity that theimpasse between constitutivists and their critics suggests, this paper diagnoses the disagreement at hand.That agency is inescapable does neither guarantee nor rule out its status qua source of categoricalnormativity. Both camps of the debate overlook this option and depict their opponents as adhering to animplausible perspective of how appeals to inescapability and unconditional normativity are related. Sincethe debate relies on a false dichotomy it is not surprising that its participants so often talk past each other.     

Negation in context: Evidence from the visual world paradigm

Literature assumes that negation is more difficult to understand than affirmation, but this might depend on the pragmatic context. The goal of this paper is to show that pragmatic knowledge modulates the unfolding processing of negation due to the previous activation of the negated situation. To test this, we used the visual world paradigm. In this task, we presented affirmative (e.g., her dad was rich) and negative sentences (e.g., her dad was not poor) while viewing two images of the affirmed and denied entities. The critical sentence in each item was preceded by one of three types of contexts: an inconsistent context (e.g., She supposed that her dad had little savings) that activates the negated situation (a poor man), a consistent context (e.g., She supposed that her dad had enough savings) that activates the actual situation (a rich man), or a neutral context (e.g., her dad lived on the other side of town) that activates neither of the two models previously suggested. The results corroborated our hypothesis. Pragmatics is implicated in the unfolding processing of negation. We found an increase in fixations on the target compared to the baseline for negative sentences at 800?ms in the neutral context, 600?ms in the inconsistent context, and 1450?ms in the consistent context. Thus, when the negated situation has been previously introduced via an inconsistent context, negation is facilitated.     

Do you feel better or worse? The validity of perceived deviations of mood states from mood traits

The advantages of assessing self‐perceived deviations of mood states from mood traits in cross‐sectional as well as longitudinal studies are discussed in detail. The validity of self‐perceived mood deviations is analysed in a longitudinal study with three occasions of measurement and 176 participants. In order to assess self‐perceived mood deviations, participants rated the deviation of their momentary mood from how they felt in general with respect to 32 mood adjectives belonging to three mood scales (pleasant–unpleasant, calm–restless, awake–sleepy). Furthermore, mood states, mood traits, and other personality variables (hedonic level, neuroticism, extraversion, openness, agreeableness, conscientiousness) are assessed by self‐report. Using models of latent state–trait theory, it is shown that the self‐perceived mood deviation scales are reliable (reliabilities between 0.73 and 0.95) and sensitive to occasion‐specific fluctuations (occasion specificities between 0.38 and 0.72). The self‐perceived deviation scales show high correlations with latent occasion‐specific deviation variables defined on the basis of repeatedly measured mood states (high convergent validity). In contrast to self‐reported mood states, however, self‐perceived mood deviations show much smaller and in most cases non‐significant correlations with personality variables (high discriminant validity). Furthermore, it is shown that self‐perceived mood deviations can be used to suppress stable situation‐specific variance in mood traits defined as aggregated states. Therefore, it can be demonstrated that including self‐perceived mood deviations in analyses on mood–personality associations enhances the association coefficients considerably. Finally, the implications of the results for the individual assessment of mood deviations, as well as for studies on affect and personality, are discussed. Copyright © 1999 John Wiley & Sons, Ltd.