Decision making under risk condition in patients with Parkinson's disease: a behavioural and fMRI study

We aimed to study whether previously described impairment in decision making under risky conditions in patients with Parkinson's disease (PD) is affected by deficits in using information about potential incentives or by processing feedback (in terms of fictitious gains and losses following each decision). Additionally, we studied whether the neural correlates of using explicit information in decision making under risk differ between PD patients and healthy subjects. We investigated ten cognitively intact PD patients and twelve healthy subjects with the Game of Dice Task (GDT) to assess risky decision making, and with an fMRI paradigm to analyse the neural correlates of information integration in the deliberative decision phase. Behaviourally, PD patients showed selective impairment in the GDT but not on the fMRI task that did not include a feedback component. Healthy subjects exhibited lateral prefrontal, anterior cingulate and parietal activations when integrating decision-relevant information. Despite similar behavioural patterns on the fMRI task, patients exhibited reduced parietal activation. Behavioural results suggest that PD patients' deficits in risky decision making are dominated by impaired feedback utilization not compensable by intact cognitive functions. Our fMRI results suggest similarities but also differences in neural correlates when using explicit information for the decision process, potentially indicating different strategy application even if the interfering feedback component is excluded.     

Extreme interpersonal sensitivity in family members

Abstract

The concept of extreme interpersonal sensitivity is introduced and the literature relating to it is reviewed. Although considerable clinical evidence gives credence to the relative ubiquity of this phenomenon in enmeshed families, the concept is only indirectly alluded to by family theorists. Extreme interpersonal sensitivity seems to be characteristic of a lack of individuation in the family system. Clinical examples are offered to clarify this concept.     

Logische analyse des Wahrscheinlichkeitsbegriffs

Ohne Zusammenfassung     

Eins-und Vieles-Problem in biologischer Betrachtung

Ohne Zusammenfassung     

Ambulante psychotherapeutische Versorgung depressiver Patienten

Background

The effectiveness of psychotherapeutic interventions in treating depressive disorders has been shown in manifold ways. However, information is missing from the point of view of psychotherapists concerning diagnostic and therapeutic procedures, their experienced difficulties and barriers, their self-assessment of their competence in the handling of depressive patients and the satisfaction with the cooperation in routine care.

Method

A cross-sectional survey of cognitive-behavioral (n=61) and psychodynamic psychotherapists (n=78) was carried out.

Results

The concordance of clinical diagnoses with diagnoses using the formal ICD-10 criteria was very low. Both groups feel themselves specifically responsible for early detection and differential diagnosis. They neither differ with regard to the frequency of cooperation contacts to other service providers nor with regard to their satisfaction with them or the experienced barriers in the care for depressed patients.

Conclusion

A good psychotherapeutic care exists with options for improvement concerning diagnostic procedures and a stronger connection network.     

Identifying decision strategies: A process- and outcome-based classification method

This article presents a classification method that makes possible the detection of important decision strategies that people use in nonrisky multiattribute decision tasks. The classification method incorporates a multimethod approach that combines elements of both structural modeling and process tracing. We begin with a discussion of nine common characteristics of decision strategies and then classify 13 decision strategies on the basis of these characteristics. Next, we demonstrate that six of the characteristics can be used to develop one outcome-based and three process-based metrics. In addition, we present an algorithm that shows how to use the metrics. We demonstrate that using our metrics in conjunction with a measure for direction of search allows identification of most of the 13 decision strategies. Finally, we outline the potential of our research for the design of decision support systems such as online shops.     

Judgment and action knowledge in speed adjustment tasks: experiments in a virtual environment

Two experiments were conducted to investigate children's and adults’ knowledge of time and speed in action and judgment tasks. Participants had to set the speed of a moving car to a new speed so that it would reach a target line at the same time as a reference car moving at a higher speed and disappearing in a tunnel at the midway point. In Experiment 1 (24 10‐year‐olds, 24 adults), children's and adults’ speed adjustments followed the normative pattern when responses had to be graded linearly as a function of the car's initial speed. In a non‐linear condition, only adults’ action responses corresponded with the normative function. Simplifying the task by shortening the tunnel systematically in Experiment 2 (24 10‐year‐olds, 24 adults) enabled children to grade the speeds adequately in the action conditions only. Adults now produced normative response patterns in both judgment and action. Whether people show linearization biases was thus shown to depend on the interaction of age, task demands and response mode.