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.      

A national survey of U.S. statutes on juvenile transfer: implications for policy and practice

A survey of the statutes on juvenile transfer and cecertification in the U.S. federal and 50 state jurisdictions, and the District of Columbia, was performed. Relevant information was obtained on the procedures in each jurisdiction by which a juvenile can be tried in criminal court, whether there are applicable decertification (“transfer back”) procedures in jurisdictions permitting criminal court processing through automatic file or prosecutorial discretion, and the burden and allocation of proof in relevant proceedings. We also identified four criteria relevant to the mental, emotional, and developmental functioning of juveniles that are used in various jurisdictions in making transfer and decertification decisions: treatment needs and amenability, risk assessment of future criminality, the presence of mental retardation or mental illness, and certain kinds of offense characteristics. The majority of jurisdictions now allow 14-year-old juveniles to be tried in criminal court. Treatment needs/amenability and risk assessment are set forth as criteria relevant to transfer in the majority of jurisdictions as well, with the presence of mental retardation or mental illness explicitly relevant in a small number of jurisdictions. The patterns of these findings are discussed in their implications for social policy and for the forensic mental health assessment of juvenile transfer and decertification, with needed areas of research identified within each. ©1997 John Wiley & Sons, Ltd.     

COVID-19 : quel rôle pour les comités d’éthique ?

Let us take advantage of this state of health crisis to promote within the committees a real ethics of the discussion on research practices.     

Breast cancer: The intention to have a mammography and a clinical breast examination - application of the theory of planned behavior

Abstract

The purpose of these cross sectional studies was to identify the psychosocial factors explaining women's intention to have a mammography within the next two years and their intention to have a clinical breast examination (CBE) by a professional within the next year. Two random samples of women aged 40–69 years (n_a = 354, n_b = 344) completed a self-administered questionnaire that investigated theoretical constructs of the theory of planned behavior. The results of structural equation modeling showed that subjective norms and perceived behavioral control explained 81 % of the variance in intention of having a mammography. Sixty-five percent (65%) of the variance in intention of having a CBE was explained by attitude and perceived behavioral control. In conclusion, women need to be better informed, have better skills to overcome psychological and physical barriers in performing preventive breast behaviors, and promotion of preventive breast cancer methods should consider people significant for women.     

The Influence of Predeployment Training on Coordination in Multinational Headquarters: The Moderating Role of Organizational Obstacles to Information Sharing

Coordination is critical to the success of multinational military operations and may be fostered by predeployment training. We argue that whether such training is related to a high degree of perceived coordination at the individual level is likely to depend on whether individuals experience a low degree of organizational obstacles to information sharing. We examined this using data from the North Atlantic Treaty Organization (NATO) Kosovo Force headquarters (survey: n = 131). We controlled for whether it was the participants’ first deployment, the participants’ background (military or civilian), the amount of time spent in the headquarters by participants, whether differences pertaining to culture and opinions were valued by the organization, the quality of supervisor/subordinate relationships, and the degree of national cultural obstacles to information sharing. The results showed no significant direct effects on coordination from 3 different training configurations: national training, multinational training, and a combination of national and multinational training. However, we found a negative direct effect from organizational obstacles to information sharing on coordination, and support for organizational obstacles to information sharing as negatively moderating the multinational predeployment training and coordination relationship. Qualitative interviews (n = 14) indicated that informal information sharing, and the problems exchanging information from tactical to operational levels could hinder coordination. Interventions to foster coordination could benefit from a focus on multinational training and lowering organizational obstacles to information sharing. Our findings contribute to more precisely pinpointing the types of training that are useful in multinational operations, as well as the factors upon which training transfer is contingent.     

Visual discrimination of species in dogs (Canis familiaris)

In most social interactions, an animal has to determine whether the other animal belongs to its own species. This perception may be visual and may involve several cognitive processes such as discrimination and categorization. Perceptual categorization is likely to be involved in species characterized by a great phenotypic diversity. As a consequence of intensive artificial selection, domestic dogs, Canis familiaris, present the largest phenotypic diversity among domestic mammals. The goal of our study was to determine whether dogs can discriminate any type of dog from other species and can group all dogs whatever their phenotypes within the same category. Nine pet dogs were successfully trained through instrumental conditioning using a clicker and food rewards to choose a rewarded image, S+, out of two images displayed on computer screens. The generalization step consisted in the presentation of a large sample of paired images of heads of dogs from different breeds and cross-breeds with those of other mammal species, included humans. A reversal phase followed the generalization step. Each of the nine subjects was able to group all the images of dogs within the same category. Thus, the dogs have the capacity of species discrimination despite their great phenotypic variability, based only on visual images of heads.     

Genetics of human episodic memory: dealing with complexity

Episodic memory is a polygenic behavioral trait with substantial heritability estimates. Despite its complexity, recent empirical evidence supports the notion that behavioral genetic studies of episodic memory might successfully identify trait-associated molecules and pathways. The development of high-throughput genotyping methods, of elaborated statistical analyses and of phenotypic assessment methods at the neural systems level will facilitate the reliable identification of novel memory-related genes. Importantly, a necessary crosstalk between behavioral genetic studies and investigation of causality by molecular genetic studies will ultimately pave the way towards the identification of biologically important, and hopefully druggable, genes and molecular pathways related to human episodic memory.     

Looking from the Outside/In: Re-thinking Research Ethics Review

This paper shares my reflections on the research ethics review process, from the point of view of both a qualitative researcher and a member of an institutional research ethics review board. By considering research ethics review, first as practice, then as policy, as a relationship and, finally, as a performance, I attempt to outline a new vision of research ethics, one that engages seriously with the relationship between receiving ethics approval, and conducting ethical research.     

Refining the dual-stage account of intertrial feature priming: Does motor response or response feature matter?

Numerous studies have shown that repetition of search-relevant attributes facilitates visual search performance. For example, Maljkovic and Nakayama (1994) showed that when observers search for a target defined by its color and report its shape, repetition of the target color speeds search, an effect known as priming of pop-out. While intertrial feature priming in search was initially thought to affect perceptual processes, the idea that it also affects postselection stages of processing is increasingly acknowledged. However, because in previous studies repetition of the motor response has typically been confounded with repetition of the response feature, it is not clear what mechanisms underlie the postselection effect of intertrial priming. In the present study, we dissociated the two repetition types. The results showed that repetition of the target-defining attribute from the previous trial affects selection of the motor response but not discrimination of the response attribute. The implications for current accounts of intertrial priming are discussed.     

Emotional context influences access of visual stimuli to anxious individuals' awareness

Anxiety has been associated with enhanced unconscious processing of threat and attentional biases towards threat. Here, we focused on the phenomenology of perception in anxiety and examined whether threat-related material more readily enters anxious than non-anxious individuals' awareness. In six experiments, we compared the stimulus exposures required for each anxiety group to become objectively or subjectively aware of masked facial stimuli varying in emotional expression. Crucially, target emotion was task irrelevant. We found that high trait-anxiety individuals required less sensory evidence (shorter stimulus exposure times) to become aware of the face targets. This anxiety-based difference was observed for fearful faces in all experiments, but with non-threat faces, it emerged only when these were presented among threatening faces. Our findings suggest a prominent role for affective context in high-anxiety individuals' conscious perception of visual stimuli. Possible mechanisms underlying the influence of context in lowering awareness thresholds in anxious individuals are discussed.