Die Behandlung von Borderline-Persönlichkeitsstörungen

Zusammenfassung Bereits 1681 beklagte sich ein englischer Arzt in einem Brief über Patienten, die ohne jedes Ma? jene lieben, die sie alsbald ohne jeden Grund hassen würden. Weiterhin seien pl?tzliche Ausbrüche von Wut, Schmerz, Angst oder ?hnlichen Emotionen zu beobachten. Mit dieser frühen Beschreibung typischer Borderline-Symptome wird die Darstellung der Entwicklung der Theorie der Borderline-St?rung von den Anf?ngen bis heute eingeleitet. Vor diesem Hintergrund werden der Stand der Diagnostik und die derzeit wichtigen Behandlungskonzepte umrissen, und zwar die psychodynamischen, verhaltenstherapeutischen und klientenzentrierten Ans?tze. Es wird dargelegt, welche Antworten es auf die Frage gibt, was das angemessene therapeutische Setting ist, insbesondere mit Blick auf station?re Behandlungskonzepte. Die vorliegenden empirischen Studien best?tigen die Wirksamkeit von Psychotherapie bei Borderline-St?rungen. Die geringe Zahl der Studien belegt aber auch die Schwierigkeit der empirischen Forschung in diesem Bereich. Der abschlie?ende Ausblick in die Zukunft der Psychotherapie der Borderline-Pers?nlichkeitsst?rungen prognostiziert eine weitere Zunahme von Pers?nlichkeitsst?rungen im Spektrum psychiatrischer Erkrankungen und eine zunehmende Differenzierung des Behandlungsangebots bzw. Spezialisierung der Behandler.      

Theology: Reduction or Autonomy?

Issues of the nature and task of theology remain important to the science-theology dialogue. This paper lays out a framework for understanding the nature of theology in relation to the other sciences. In particular, I argue that the primary question remains one of autonomy and reduction. If theology is a genuine academic discipline, then it should be an autonomous field with its own subject matter and norms. Wolfhart Pannenberg argues that theology is the science of God, but I suggest that theology be more broadly understood as the science of meaning. If we recognize this, the modes of interaction between theology and the other sciences becomes clearer.     

Evidence for distinct attentional bottlenecks in attention switching and attentional blink tasks

E. Weichselgartner and G. A. Sperling (1987), using rapid serial visual presentation (RSVP), estimated that attention could be moved to a new spatial location within 300-400 ms. H. J. Müller and P. M. Rabbit (1989) used a spatial cuing task and found a similar time course for voluntarily redeploying attention. A separate phenomenon known as the attentional blink (AB) also follows a similar time course, yet occurs when participants attend to a single spatial location. The present study found that attention can be shifted more quickly than previously estimated and that part of the deficit observed during searches of spatially distinct RSVP streams is due to an AB. The results support some early and late selection accounts for the temporal dynamics of visual attention and suggest different bottlenecks during visual selection. The implications for visual search and visual processing are discussed.     

Attachment style as a piedictor of sexual attitudes and behavior in late Adolescence

Abstract This research applied attachment theory to the study of sexual attitudes and behaviors in a sample of late adolescents. Four hundred and seventy heterosexual undergraduate students completed questionnaires assessing attachment (discomfort with closeness; anxiety over relationships). relationship history, communication about sex. sexual self-efficacy and locus of control, and attitudes to condoms. Eight weeks later, participants reported on sexual behaviors occurring during the eight-week interval. and perceived risk of these activities. Both discomfort with closeness and anxiety over relationships were associated with external locus of control for sexual outcomes, and with use of drugs before sexual contact. Anxiety over relationships was linked to unsafe sex and to negative attitudes to condoms, but discomfort with closeness was associated with a more cautious approach to sexual risk-taking. Some results were qualified by gender differences. and by differences between the full sample and those who were sexually active. The findings arc discussed in terms of attachment style and its links with communication and affect regulation. SUMMARY AND CONCLUSIONS This study indicates that attachment dimensions are reliably related to many aspects of sexual attitudes and behaviors among late adolescents. Insecure attachment was linked to increased drug use before sexual contact. Anxiety over relationships was also linked to less safe sexual practice, but discomfort with closeness was associated with a tendency for males to be cautious about sexual risk-taking. The results support the utility of the attachment perspective on adolescent sexuality, but also highlight the complex relations between attachment dimensions and sexual outcomes. Future research would benefit from more detailed investigations of the attitudes, emotions, and cognitions which may mediate the link between attachment style and sexual behavior. For example, those who are highly anxious about their relationships may engage in more risky sexual practices because they fear that non-compliance with partners' wishes will jeopardize their relationship; the tendency to engage in drug use before sexual cpntact may reflect their attempts to boost self-confidence or to manage negative mood states. Research into these issues has the potential to explain how attachment insecurity is played out in patterns of sexual activity.     

Interevent differences in event memory: Why are some events more recallable than others?

Interitem differences in the free recall of action events were studied in five experiments. The action events were presented in three different formats: minitasks performed by the subjects in response to verbal instructions from the experimenter (SPTs), minitasks performed by the experimenter (EPTs), and task instructions (TIs). Not only were reliable interevent differences in recall probability demonstrated within each format, but these differences tended to correlate across formats, especially between the SPTs and EPTs; thus, a highly recallable SPT also tended to be a highly recallable EPT. Attempts to explain interitem recall differences in terms of differences in familiarity, vividness, and the availability of environmental cues were largely unsuccessful. An experimental analysis of the action events into action and object components showed the recall probabilities of our events to be mainly dependent on the recall probabilities of their action components, with only a minor dependence on the recall probabilities of their object components.     

What makes a good story

Three different ways have been selected for analyzing a story's structure, each focusing on different types of information. (a) Episodic or story grammar approaches stories as problem-solving episodes, emphasizing goals and activities to achieve them. (b) Labov's high point structure emphasizes affective information and sees stories as organized around emotional high points or crisis events. (c) Deese's dependency analysis emphasizes linguistic complexity and, in particular, the way propositions are related to each other through a relationship of either coordination or subordination. Stories were scored according to how well they realized good structure in each system, and the three scoring systems were relatively independent of each other. Adults were asked to rate 3-to 9-year old children's personal narratives in terms of how good a story each was, and their ratings were compared to how the stories were scored in terms of all three systems. None of the systems completely explained the subjective quality ratings; rather, all three seemed to contribute in different ways to subjects' ratings, with the best narratives generally deemed sophisticated and complex in at least two of the three systems.The authors wish to acknowledge their great debt to James Deese and Christine Glenn. This research was supported by the National Sciences and Engineering Research Council of Canada Grant A-7911 to Carole Peterson.     

Reviews

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C obb , N oel . Prospero's Island.
Z iegler , A lfred J. Archetypal Medicine.
L ichtenberg , J oseph . Psychoanalysis and Infant Research.
H artocollis , P eter . Time and Timelessness.
P ruyser , P aul W. The Play of the Imagination: towards a Psychoanalysis of Culture.     

TEACHING HOME SAFETY AND SURVIVAL SKILLS TO LATCH-KEY CHILDREN: A COMPARISON OF TWO MANUALS AND METHODS

I evaluated the influence of two training manuals on latch-key children's acquisition of home safety and survival skills. The widely used, discussion-oriented “Prepared for Today” manual was compared with a behaviorally oriented “Safe at Home” manual. Data were scored by response criteria developed by experts and by parents' and experts' ratings of children's spontaneous answers. With both methods of scoring, three behaviorally trained children demonstrated clear and abrupt increases in skill following training in each of seven trained modules, and these increases largely persisted in real world generalization probes and at 5-month follow-up. Smaller and less stable increases in skill were found in the three discussion-trained children across the seven modules; lower skill levels were also seen in real world generalization probes and at follow-up. Neither group of children demonstrated skill increases in home safety areas that were not explicitly trained. Both training methods produced small decreases in children's self-report of general anxiety and anxiety concerning home safety. Results are discussed in terms of their implications for cost-effective training of latch-key children.