Evidenzbasierte Psychotherapie

Zusammenfassung Seit einiger Zeit wird auch in der Psychotherapie – so wie in anderen Bereichen der Medizin – eine intensive und kontroverse Diskussion über die wissenschaftlichen Standards und deren Praxisrelevanz geführt. Dabei nehmen Fragen der Qualitätssicherung und der Entwicklung von Leitlinien einen zunehmenden Raum ein. Von besonderer Bedeutung sind in diesem Zusammenhang die Evidence Based Medicine (EbM) und ihre methodischen Standards, in deren Mittelpunkt experimentelle Therapiestudien stehen. Im Beitrag wird das Konzept der Evidence Based Medicine im Kontext der Psychotherapie (Evidence based Psychotherapy) vorgestellt und unter methodischen und inhaltlichen Gesichtspunkten diskutiert. Eine zentrale Frage ist dabei die inhaltliche Aussagekraft und die Übertragbarkeit von wissenschaftlichen Befunden auf die klinische Praxis.      

Bedürfnis- und Motivorientierte Beziehungsgestaltung

According to the Bernese concept of motivational attunement therapists are supposed to offer each patient a custom tailored relationship taking into account the patients’ individual motivational goals. While empirical studies validate the concept, concrete implementation of motivational attunement into practice is not always easy. Therapists have to be able to correctly identify the patients’ motivational goals and attune their behavior to them flexibly. In the following article concrete instructions for therapists are given in order to better realize motivational attunement.     

Posttraumatische Belastungssymptome als Spätfolge von Kindheiten im Zweiten Weltkrieg

Psychological late-life sequelae of war childhood have rarely been examined. The study evaluated posttraumatic symptoms and current psychopathology in a sample of former German war children of which 10.8% reported significant posttraumatic symptoms indicating a possible posttraumatic stress disorder (PTSD). The presence of PTSD symptoms was significantly associated with current psychopathological distress, even 6 decades after World War II. Our data underline the urgent need for research in this field. Clinical implications for a psychotherapeutic approach are discussed.     

Aging, Executive Functioning, and Social Control

ABSTRACT— Aging is associated with atrophy of the frontal lobes of the brain, which are the seat of executive functions. Because successful social functioning often requires executive control, aging can lead to unintended social changes via deficits in executive control. In this article I review evidence that, due to losses in executive control, aging leads to increased prejudice and social inappropriateness and, under certain circumstances, increased depression and problem gambling. I then discuss theory and research suggesting possible interventions that might ameliorate unwanted social changes brought about by executive decline.     

Nonnormality and divergence in posttreatment alcohol use: reexamining the Project MATCH data "another way."

Alcohol lapses are the modal outcome following treatment for alcohol use disorders, yet many alcohol researchers have encountered limited success in the prediction and prevention of relapse. One hypothesis is that lapses are unpredictable, but another possibility is the complexity of the relapse process is not captured by traditional statistical methods. Data from Project Matching Alcohol Treatments to Client Heterogeneity (Project MATCH), a multisite alcohol treatment study, were reanalyzed with 2 statistical methodologies: catastrophe and 2-part growth mixture modeling. Drawing on previous investigations of self-efficacy as a dynamic predictor of relapse, the current study revisits the self-efficacy matching hypothesis, which was not statistically supported in Project MATCH. Results from both the catastrophe and growth mixture analyses demonstrated a dynamic relationship between self-efficacy and drinking outcomes. The growth mixture analyses provided evidence in support of the original matching hypothesis: Individuals with lower self-efficacy who received cognitive behavior therapy drank far less frequently than did those with low self-efficacy who received motivational therapy. These results highlight the dynamical nature of the relapse process and the importance of the use of methodologies that accommodate this complexity when evaluating treatment outcomes.     

Fitting objects into holes: on the development of spatial cognition skills

The authors examined 14- to 26-month-old infants' understanding of the spatial relationships between objects and apertures in an object manipulation task. The task was to insert objects with various cross-sections (circular, square, rectangular, ellipsoid, and triangular) into fitting apertures. A successful solution required the infant to mentally rotate the object to be fit into the aperture and use that information to plan the action. The object was presented standing up in half of the trials; in the other half, it was lying down. The results showed that infants solved the problem consistently from age 22 months and that a successful solution was associated with appropriate preadjustments before the hand arrived with the block to the aperture. No sex differences were found.     

Towards better computational models of the balance scale task: a reply to Shultz and Takane

In contrast to Shultz and Takane [Shultz, T.R., & Takane, Y. (2007). Rule following and rule use in the balance-scale task. Cognition, in press, doi:10.1016/j.cognition.2006.12.004.] we do not accept that the traditional Rule Assessment Method (RAM) of scoring responses on the balance scale task has advantages over latent class analysis (LCA): RAM is similar to a very restricted form of LCA. The apparent shortcomings of LCA are also less severe than they suggest. Via new simulations we show that LCA detects small classes reliably. We also counter their concerns regarding the torque difference effect and we underline the problems connectionist models have with correctly responding to balance items. Despite these differences in opinion we agree with Shultz and Takane on the possible avenues for future research.     

The absence of an auditory-visual attentional blink is not due to echoic memory

The second of two targets is often missed when presented shortly after the first target--a phenomenon referred to as the attentional blink (AB). Whereas the AB is a robust phenomenon within sensory modalities, the evidence for cross-modal ABs is rather mixed. Here, we test the possibility that the absence of an auditory-visual AB for visual letter recognition when streams of tones are used is due to the efficient use of echoic memory, allowing for the postponement of auditory processing. However, forcing participants to immediately process the auditory target, either by presenting interfering sounds during retrieval or by making the first target directly relevant for a speeded response to the second target, did not result in a return of a cross-modal AB. Thefindings argue against echoic memory as an explanation for efficient cross-modal processing. Instead, we hypothesized that a cross-modal AB may be observed when the different modalities use common representations, such as semantic representations. In support of this, a deficit for visual letter recognition returned when the auditory task required a distinction between spoken digits and letters.