Therapiekonzeption für traumatisierte Patienten mit schweren Persönlichkeitsstörungen

Comorbidity between severe personality disorder and posttraumatic stress disorder is a frequent clinical problem. Severe personality disorders are characterized by an impaired regulation of emotions, a low mentalization capacity and deficits in personality integration. For severe personality disorders and posttraumatic stress disorder, a variety of evidence-based treatment approaches of psychodynamic and cognitive-behavioral origin are available. However, a closer inspection of these treatment concepts shows that they do not sufficiently take the respective comorbid condition into account. No single concept is able to cover all problem areas presented by patients with this comorbidity. Therefore, an attempt is made to present an integrative psychodynamically oriented therapy concept for traumatized patients with personality disorders which contains elements from psychodynamic, cognitive-behavioral and other concepts. The phase structure of the concept clarifies the sequence hierarchy of the therapeutic interventions. The content of the five phases are: (1) safety, holding and strengthening of coping capacities, (2) emotion regulation and self-care, (3) mentalization and development of stable representations, (4) gentle trauma processing and (5) conflict-oriented psychotherapy and treatment of maladaptive relationship patterns.     

Dissoziative Störungen (Konversionsstörungen)

The ICD-10 diagnostic category of dissociative disorders encompasses very different clinical pictures. The so called dissociative disorders of consciousness are characterized by functional disturbances to the psychic domains of consciousness, identity, autobiographic memory and experience of self and the world. The core features of conversion disorders are functional alterations in the sensorimotor systems. The phenomenological heterogeneity is reflected by prevalence rates ranging from very rare to 30% in clinical populations. Traumatic experiences play a crucial role in the etiology and pathogenesis of these disorders. High rates of comorbid disorders, a tendency to a chronic course and a somatic illness concept in patients with conversion disorders complicate the psychotherapeutic approach. Depending on the therapeutic goals, both psychodynamic and cognitive-behavioral treatment forms are suitable.     

Familienfunktionalität und Therapieerfolg

Background

Even though it is a treatment standard of child psychotherapy to involve the parents, hardly any research has been carried out about the impact of family functioning on treatment outcome. Aims of the present study were to investigate the change in and the prognostic power of family functioning on treatment outcome of short-term psychodynamic psychotherapy in children and adolescents.

Patients and methods

The sample consisted of 54 children and adolescents undergoing outpatient short-term psychodynamic psychotherapy. To assess family functioning, their parents were asked to complete the Family Assessment Measure (FAM).

Results

Patients from families with high levels of functioning in task accomplishment, communication and affective expression were more often treated successfully. Improvement in levels of functioning in role performance, emotionality and control were only found in the group of successfully treated patients.

Conclusion

Family functioning is a decisive factor in the differential indication of psychotherapeutic treatment in children and adolescents.     

Körperbeschwerden bei niedergelassenen Psychologischen Psychotherapeuten

From June until August 2004 we asked 488 freely practising psychological psychotherapists in selected German federal states for the frequency of somatic complaints using the short version of the Gießener Beschwerdebogen (GBB-)24. It turned out that the psychotherapists suffered most from exhaustion and pain. Their somatic complaints were remarkably less influenced by sociodemographic characteristics like age, gender and location of practising (East/West). In comparison to the overall population the psychotherapists in total reported quantitatively the same frequencies of somatic complaints. Qualitatively the psychotherapists reported less problems concerning gastric and heart complaints but more problems concerning exhaustion than the overall population. Compared with a sample of saxonian general practitioners, the psychotherapists suffered from slightly less somatic complaints.     

School-Based Supports and Interventions to Improve Social and Behavioral Outcomes with Racially and Ethnically Minoritized Youth: A Review of Recent Quantitative Research

School discipline disproportionality has long been documented in educational research, primarily impacting Black/African American and non-White Hispanic/Latinx students. In response, federal policymakers have encouraged educators to change their disciplinary practice, emphasizing that more proactive support is critical to promoting students’ social and behavioral outcomes in school. Results from a literature review conducted nearly a decade ago indicated that there was, at that point, a paucity of empirical research related to considering students’ culture (e.g., race, ethnicity) and supporting school behavior. The purpose of this study is to replicate and expand the previous review to summarize the characteristics of the most recent school-based quantitative research addressing interventions to promote social and behavioral outcomes for racially and ethnically minoritized youth. We screened 1687 articles for inclusion in the review. Upon coding 32 eligible research studies, we found that intervention and implementer characteristics within these studies varied, but noted strong intervention effects in studies that included established evidence-based practices, adapted interventions, as well as new practices piloted with student participants. Results inform recommendations to continue to study interventions that promote positive social and behavioral outcomes for racially and ethnically minoritized students to disrupt a long history of subjection to exclusionary discipline disproportionately.

     

Innerdeutsche Migration und psychisches Befinden

In a representative study German migrants within Germany were assigned to two different groups depending on their answers to the following two questions (?Where did you mainly grow up – Eastern Germany or Western Germany?“ and ?Where do you live now?“). The migrants (54 West-East and 68 East-West migrants) were compared with non-migrants (1,136 Western and 294 Eastern Germans) concerning different variables of their psychic condition. Migrants suffered from higher stress, less bodily well-being and more somatic symptoms than non-migrants. Probands migrating from Western to Eastern Germany reported the lowest levels of quality of life.     

Book Review of Sattler and Ryan,Assessment With the WAIS–IV

The Rorschach and Minnesota Multiphasic Personality Inventory (MMPI) are among the most widely used personality assessment tools. However, there is little guidance in the literature about their combined use. In this article, I discuss conceptual and methodological issues of combining these widely used psychological tests, including the use of the test battery and the necessity of rationales for test utilization. Methodological approaches to integrating the test findings are discussed, including score, construct, test by test, and theory-based integrative approaches. The value of a person-centered interpretive and integrative focus is affirmed.