Leitlinie für die Begutachtung von Schmerzen

The present guidelines for expert testimony have been elaborated for the first time in 2004 by medico-legal representatives from several German professional academic societies (neurology, orthopedic surgery, psychiatry, psychosomatic medicine, psychotherapy). Their aim is to standardize the course and the content of expert testimony in subjects, who complain about chronic pain as the leading symptom for seeking pension or other compensation. In 2006, the guidelines have been revised and completed by adding detailed data about classification and prognosis of chronic pain, about causality questions, and about estimation of functional impairment in different legal areas.     

Fibromyalgie und Leistungseinschränkung

Interdisciplinary guidelines allowed for new quality standards in pain appraisal. Simultaneously, the scientific notion of fibromyalgia changed from a subjectively overvalued malaise to a central disturbance of coping with stress, which is neurobiologically determined. Therefore, in this article a psychosomatics-based guide is given for the socio-medical appraisal of fibromyalgia with reference to the new International Classification for Functioning and Disability (ICF) of the World Health Organization (WHO). As illustration a case study is presented.     

Counselling the dead!

The paper discusses the author's meeting and a counselling encounter in Varanasi (formerly known as Banaras) with a former High Court Judge, who has renounced the material world, excised all his attachments, abandoned his wife, his children, his grandchildren and a luxurious and prestigious life-style, and taken on the mantle of a sanyasi in search of enlightenment and nirvana. He has left his hometown and for the past two to three years has been living on the banks of the river Ganges in Varanasi, the holiest of holy cities in India, leading the life of a mendicant, living off the charity of the hordes of pilgrims who come to Varanasi all around the year.     

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.