Psychodynamische Kurzzeittherapie bei dependenter und vermeidender Persönlichkeitsstörung

Although dependent and avoidant personality disorders are frequent in patient populations, there are only few studies in which the efficacy of psychotherapeutic interventions for these two personality disorders was reviewed. The purpose of this study was to examine whether psychodynamic short-term therapy based on the model of the cyclic maladaptive pattern (CMP) is effective for reducing the mental impairment of patients diagnosed with a dependent or an avoidant personality disorder. Data were collected via a self-report scale (Symptom-Checklist, SCL) and expert ratings by therapists [Global Assessment of Functioning (GAF) Scale and Severity of Impairment-Score (Beeinträchtigungsschwere-Score, BSS)]. In the study 20 patients received 25 sessions of outpatient therapy. Mental impairment decreased significantly from the beginning to the end of the therapy; moreover this decrease remained stable over a 2-year period following completion of the therapy. The findings show that psychodynamic short-term therapy can lead to an enduring improvement in the mental health of patients with a dependent or an avoidant personality disorder.     

Patients and agents – or why we need a different narrative: a philosophical analysis

Background

The success of medicine in the treatment of patients brings with it new challenges. More people live on to suffer from functional, chronic or multifactorial diseases, and this has led to calls for more complex analyses of the causal determinants of health and illness.

Methods

Philosophical analysis of background assumptions of the current paradigmatic model.

Results

While these factors do not require a radical paradigm shift, they do give us cause to develop a new narrative, to add to existing narratives that frame our thinking about medical care. In this paper we argue that the increased focus on lifestyle and shared decision making requires a new narrative of agency, to supplement the narrative of “the patient”. This narrative is conceptually linked to the developing philosophy of person-centred care.

Conclusions

If patients are seen also as “agents” this will result in a substantial shift in practical decisions: The development and adoption of this narrative will help practitioners work with patients to their mutual benefit, harnessing the patients’ motivation, shifting the focus from treatment to prevention and preventing unnecessary and harmful treatments that can come out of our preoccupation with the patient narrative. It will also help to shift research efforts, conceptual and empirical, from “treating” and “battling” diseases and their purported “mechanisms” to understanding complex contributing factors and their interplay.

     

When the mask falls: The role of facial motor resonance in memory for emotional language

The recognition and interpretation of emotional information (e.g., about happiness) has been shown to elicit, amongst other bodily reactions, spontaneous facial expressions occurring in accordance to the relevant emotion (e.g. a smile). Theories of embodied cognition act on the assumption that such embodied simulations are not only an accessorial, but a crucial factor in the processing of emotional information. While several studies have confirmed the importance of facial motor resonance during the initial recognition of emotional information, its role at later stages of processing, such as during memory for emotional content, remains unexplored. The present study bridges this gap by exploring the impact of facial motor resonance on the retrieval of emotional stimuli. In a novel approach, the specific effects of embodied simulations were investigated at different stages of emotional memory processing (during encoding and/or retrieval). Eighty participants underwent a memory task involving emotional and neutral words consisting of an encoding and retrieval phase. Depending on the experimental condition, facial muscles were blocked by a hardening facial mask either during encoding, during retrieval, during both encoding and retrieval, or were left free to resonate (control). The results demonstrate that not only initial recognition but also memory of emotional items benefits from embodied simulations occurring during their encoding and retrieval.     

Extinction of conditioned inhibition through nonreinforced presentation of the inhibitor

In previous studies that have tried to extinguish conditioned inhibition through nonreinforced presentations of the inhibitor, researchers have repeatedly failed to find evidence for such extinction. The present study revealed that extinction can be achieved through nonreinforcement of the inhibitor, depending on properties of the reinforcer. In a human causal learning experiment, we found complete extinction in a scenario in which the reinforcer could take on negative values. Thereby, this scenario reflected the assumed symmetrical continuum on which associative strength can vary, according to the Rescorla-Wagner theory of associative learning. In contrast to this, the inhibitory cue retained its inhibitory potential in another condition, in which the scenario did not allow negative values of the reinforcer. nt]mis|Klaus G. Melchers has previously published under the surname “Lober.” Susann Wolff is now working at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany     

Impairment of single-trial memory formation by oral methylphenidate in the rat

High synaptic concentrations of dopamine and/or norepinephrine can impair the working memory function of the prefrontal cortex and impede attention and learning. Methylphenidate, a dopamine and norepinephrine transporter blocker known to facilitate these cognitive processes at low doses, was hypothesized to interfere with memory storage at doses that may raise concentrations of these neurotransmitters to systemically disruptive levels. In the present experiments, a dose of 10.0mg/kg of this drug was administered to female and male Long-Evans rats using a novel oral administration procedure designed to model the normal mode of delivery to humans. It was found to interfere with single-trial memory acquisition in a delayed object recognition test, a spontaneous learning task that involves no appetitive or aversive motivator. The time that the rats spent in overt exploration of the to-be-remembered objects during the acquisition trial was not affected, suggesting that the drug may have impaired processes of memory formation independently of interference with attention.