Mechanisms underlying corruption of working memory in Parkinson's disease

Working memory (WM) impairments are reported to occur in patients with Parkinson's disease (PD). However, the mechanisms are unclear. Here, we investigate several putative factors that might drive poor performance, by examining the precision of recall, the order in which items are recalled and whether memories are corrupted by random guessing (attentional lapses). We used two separate tasks that examined the quality of WM recall under different loads and retention periods, as well as a traditional digit span test. Firstly, on a simple measure of WM recall, where patients were asked to reproduce the orientation of a centrally presented arrow, overall recall was not significantly impaired. However, there was some evidence for increased guessing (attentional lapses). On a new analogue version of the Corsi-span task, where participants had to reproduce on a touchscreen the exact spatial pattern of presented stimuli in the order and locations in which they appeared, there was a reduction in the precision of spatial WM at higher loads. This deficit was due to misremembering item order. At the highest load, there was reduced recall precision, whereas increased guessing was only observed at intermediate set sizes. Finally, PD patients had impaired backward, but not forward, digit spans. Overall, these results reveal the task- and load-dependent nature of WM deficits in PD. On simple low-load tasks, attentional lapses predominate, whereas at higher loads, in the spatial domain, the corruption of mnemonic information—both order item and precision—emerge as the main driver of impairment.     

Suchttherapie bei abhängigen Ärzten

Background

International studies indicate an increased incidence of substance abuse disorders among physicians. This article investigates specific variables in the work field and describes existing treatment programs.

Patients and methods

In a cross-sectional study 107 physicians with and 468 without substance abuse disorders were compared. Two highly developed treatment programs in Germany and Canada are described.

Results

The high work-load associated with the medical work environment leads to reduced performance and social isolation. Treatment programs for addicted physicians work with the concept of ?help before restriction“. The abstinence rate of the 5-year Canadian program is over 90%.

Conclusions

As a form of prevention, medical students should be systematically informed about work-related stress in the medical profession. Structured treatment programs should be implemented nationwide. The expert team ?Risk of addiction in physicians“ of the German Addiction Foundation, whose members are authors of this article, may be a small step in this direction.     

Patientenziele in der Psychotherapie

Zusammenfassung  Im vorliegenden Artikel wird ein Überblick zum Stand der Forschung zu Patientenzielen in der Psychotherapie gegeben. Auf vier Aspekte wird dabei besonders eingegangen: (1) auf grundlagenwissenschaftliche Modelle und Befunde zu Lebenszielen, (2) auf allgemeine Lebensziele von Patienten und deren Zusammenhang zu ihrem psychopathologischen Zustand, (3) auf explizite Therapieziele und (4) auf zielbezogene therapeutische Interventionen. Durch diesen Überblick soll zum einen deutlich gemacht werden, wie grundlagenwissenschaftliche Forschung zu persönlichen Zielen klinische Forschung beeinflusst und bereichert hat. Zum anderen werden die therapeutischen Implikationen der Zielforschung herausgearbeitet.

Systemische Therapie bei Störungen des Erwachsenenalters

Background

Systemic therapy is a scientifically acknowledged form of psychotherapy in the US and many European countries, but not yet in Germany.

Method

All randomized (or parallelized) controlled trials (RCT) evaluating systemic couples/family/individual therapy with adult index patients published in English, German or Spanish up to the end of 2004 were identified via data base searches and cross-references in other meta-analyses and reviews. A meta-analysis of the identified RCT was performed.

Results

28 RCT (43 publications) evaluating systemic therapy with adult index patients suffering from clinical disorders (ICD-10) were identified. Systemic therapy is efficacious with regard to substance disorders, mental/social factors interacting with somatic disorders, schizophrenia, depression and eating disorders. The results are stable across follow-up periods of up to 5 years.

Conclusion

According to the criteria of the German Scientific Advisory Board Psychotherapy (Wissenschaftlicher Beirat Psychotherapie) there seems to be good evidence for the efficacy of systemic therapy in at least four fields of application of adult psychotherapy.     

Dissociative tendencies and memory performance on directed-forgetting tasks

The current article presents two studies that aimed to replicate DePrince and Freyd's (2001, 2004) studies demonstrating that high and low dissociators differentially recall neutral and trauma words under conditions of varying cognitive load. We did not find this effect. This lack of replication was apparent for both free recall and word recognition memory and in both studies. In effect, we found little evidence to support betrayal trauma theory, yet observed increased memory fallibility, as demonstrated by lower general recall and (in one study) commission errors, in high dissociators.     

Topografie der Jugenddelinquenz

The article shows that the registered juvenile delinquency has decreased in recent years. Serious violent crime partially exists, but this is only a small part of the overall juvenile delinquency. Forms of appearance of these violent crimes are outlined. With the help of a dark field study it is illustrated that there is a great variety of delinquency among young people. There are young people showing mostly law-abiding behavior, infrequent offenders and a group with a significant burden of crimes.