Drogenabhängige Patienten im Maßregelvollzug gemäß § 64 StGB: Verbesserung der Quote erfolgreicher Behandlung durch suchtspezifische Medikation?

In Germany, addicted offenders can be sentenced to compulsory addiction treatment in forensic mental hospital departments (Art. 64 of the penal code). A presupposition to such a sentence is a fair chance of successful treatment and rehabilitation. Commonly, an expert witness is asked by the court to assess this point in the trial. To date, the treatment in forensic mental hospitals aims at total abstinence from any kind of drugs. But in at least half of the cases, a fair chance of successful treatment is no longer seen after a period of therapy. In most cases, these patients are returned to prison. The paper pleads that in offenders addicted to illegal drugs, a drug specific medication – in particular methadone maintenance treatment or naltrexone medication – might be a useful option. The rate of “treatment failure” might be reduced slightly by using this option with some of the patients.     

The effect of stimulus delivery technique on perceived intensity functions for taste stimuli: Implications for fMRI studies

Classic psychophysical studies have provided significant information on the psychophysical functions for taste stimuli. With the advent of fMRI, studies are being conducted that provide insight into central processing of gustation in humans. However, fMRI experiments impose physical limitations on stimulus delivery. In the present study, we compared psychophysical functions relating perceived intensity to concentration, derived from previous studies that used the traditional sip-and-spit and dorsal flow delivery techniques, to psychophysical functions generated in this study using a simulated stimulus delivery technique (SSDT). The SSDT delivered minute quantities of taste stimuli to the dorsal surface of the tongue, just as in an fMRI scanner. As was hypothesized, the results indicated that slopes of intensity functions were dependent on the type of stimulus delivery technique. The SSDT resulted in slopes that were more similar to those generated by dorsal flow than by sip-andspit stimulus delivery techniques, suggesting the importance of considering the influence of stimulus delivery on psychophysical response in designing and interpreting experiments.     

A meta‐analysis of psychopathy‐, antisocial PD‐ and FFM associations

This research meta‐analytically summarizes the relationships of the Five‐Factor Model (FFM) with psychopathy and Antisocial Personality Disorder (APD). Effect sizes of the associations between psychopathy, APD and the FFM were compiled from 26 independent samples (N = 6913) for psychopathy and 57 independent samples (N = 16 424) for APD. The results revealed predominantly points of similarity and some differences in the FFM associations of both disorders. Symptoms of psychopathy and APD were negatively associated with Conscientiousness and Agreeableness facets and positively with scores on Angry–Hostility (N2), Impulsiveness (N5), Excitement Seeking (E5) and negatively with Warmth (E1). Only psychopathy had a small negative association with Anxiety (N1) and was characterized by stronger negative associations with Agreeableness and Straightforwardness (A2), Compliance (A4) and Modesty (A5) compared to APD. The moderator analyses showed that sample type, use of the NEO‐PI‐R and APD instrument moderated the APD FFM associations, while psychopathy instrument and age group were moderators in the psychopathy MA. Implications of this research for the assessment of APD and psychopathy relying on dimensional models of personality pathology are discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

Interkulturelle Aspekte bei der Behandlung somatoformer Störungen

Patients from family-oriented societies have a different perception of pain and different conceptions of healing, which up to now have not been sufficiently appreciated in modern multimodal therapeutic approaches. Inadequate knowledge of anatomy and bodily functions and traditional perceptions of pain (e.g. magic, curses, punishment, etc.) have a substantial influence on diagnostics. The pain experience is regarded holistically in relation to the body, rather than being confined to a particular part of the body. Limited access to psychological complaints often leads to physical complaints. The ailing body is an expression of the social, the economic, the psychological and cultural state of the patient and the history of migration and status in the collective. A multimodal interdisciplinary and culture-sensitive approach is required for effective pain treatment of patients with a tradition-bound background.     

Cannabiskonsum und -missbrauch bei Jugendlichen und jungen Erwachsenen

After a long time of growth current studies on representative samples of adolescents indicate that the number of adolescent cannabis users in Germany is possibly decreasing. However, it may be presumptuous to expect a similar trend concerning the number of clients with cannabis-related disorders. Even if there is in fact a downward trend which is not yet proven, the rapidly growing number of clients presenting with these disorders in recent years cannot be explained by a similar growth in the number of regular cannabis users. Treatment centres should therefore expect a further inreasing number of especially male adolescents and young adults seeking help for problems related to cannabis use. The development, evaluation and implementation of specific treatment options concerning cannabis use disorders will be increasingly needed in the future. Cognitive-behavioral and motivational interventions have been shown to be evidence-based treatments. The paper describes some promising or already successful treatment approaches and related research projects in Germany.     

PALME

Background

Single mothers and their children are exposed to increased psychosocial burdens and risks. Nevertheless, in Germany offers of help especially designed for the needs of this group are lacking.

Method

An emotion-oriented parental training program (PALME, http://www.palme-elterntraining.de) based on the attachment theory was developed particularly for single mothers with preschool children. The training is guided by trained kindergarten nurses. The effectiveness of the parental training program on the measure of maternal psychological impairment, emotional competence and child problem behavior was investigated within a randomized, controlled study with 61 single mothers suffering from medium grade psychosocial impairment.

Results

Analyses of variance revealed significant group×time interaction effects in favor of the intervention group compared to controls. After the training the mothers showed improvement in their psychological impairment, depression and emotional competence. In addition, evidence suggests that behavioral problems of the children were reduced.

Conclusion

In view of the benefits of this parental training and its low costs it should be recommended as a regular offer of support for single mothers within community settings.     

Psychotherapie für Straftäter

The legal and administrative framework for psychotherapy of offenders in prisons and secure forensic hospitals is outlined. Established treatment programs for offenders are presented including different variations of standardized cognitive behavioral approaches, e. g. relapse prevention programs (RP), dialectic behavioral therapy (DBT), transference-focused psychotherapy (TFP), and mentalization-based treatment (MBT). The foci of the individual programs as well as their integrative tendencies are described. In psychodynamic therapies cognitive processes are taken into consideration and, vice versa, cognitive-behavioral therapists discover the significance of the therapeutic relationship.