Schwere Anorexia nervosa

Background

Psychosomatic support during acute medical treatment of patients with anorexia nervosa is a special need but up to now a rare constellation. These patients can barely accept necessary somatic procedures even if they suffer from severe consequences of the eating disorder. The ambivalence of patients towards treatment is explained by the loss of the right perception of their bodies and the strong obsession with further weight loss.

Methods

This article reports on eight consecutively treated patients on a medical ward who received a liaison psychosomatic, psychotherapeutic visit twice a week. The aim was to maintain better therapy adherence, to support oral food intake and understanding of the disorder as well as to motivate patients for further psychosomatic treatment.

Results

By means of a respectful cooperation between the departments of internal medicine and psychosomatics it was possible to gain psychotherapeutic access to the patients in this highly complicated situation.

Consequence

The psychodynamic aspects of this collaboration are discussed with a focus on the triangulation of the therapeutic process.     

Auditory Hallucinations as Social Self-Positions: A Theoretical Discussion from a Single-Case Study

This work uses social positioning analysis to investigate the phenomenon of the auditory verbal hallucination (AVH) in schizophrenia in order to describe its social and interactive nature. We focus in detail on a single-case study of a patient who verbalized her AVHs. We analyze 3 significant excerpts from an interview with a person with paranoid schizophrenia. This interview is part of a larger study conducted with 18 participants about life narrative construction in the sociocultural context of care homes. The interaction between the patient and her voices is examined closely to reveal the dynamic between interviewer, patient, and voices. The analysis differentiates the voice of the patient from that of the hallucination and reveals “social interaction” between this dyad and the interviewer. We discuss a possible social and interactive framework to understand the origin of AVHs and the self-construction process.     

The semantic specificity of gestures when verbal communication is not possible: The case of emergency evacuation

The aim of the present study was to examine the comprehension of gesture in a situation in which the communicator cannot (or can only with difficulty) use verbal communication. Based on theoretical considerations, we expected to obtain higher semantic comprehension for emblems (gestures with a direct verbal definition or translation that is well known by all members of a group, or culture) compared to illustrators (gestures regarded as spontaneous and idiosyncratic and that do not have a conventional definition). Based on the extant literature, we predicted higher semantic specificity associated with arbitrarily coded and iconically coded emblems compared to intrinsically coded illustrators. Using a scenario of emergency evacuation, we tested the difference in semantic specificity between different categories of gestures. 138 participants saw 10 videos each illustrating a gesture performed by a firefighter. They were requested to imagine themselves in a dangerous situation and to report the meaning associated with each gesture. The results showed that intrinsically coded illustrators were more successfully understood than arbitrarily coded emblems, probably because the meaning of intrinsically coded illustrators is immediately comprehensible without recourse to symbolic interpretation. Furthermore, there was no significant difference between the comprehension of iconically coded emblems and that of both arbitrarily coded emblems and intrinsically coded illustrators. It seems that the difference between the latter two types of gestures was supported by their difference in semantic specificity, although in a direction opposite to that predicted. These results are in line with those of Hadar and Pinchas‐Zamir (2004), which showed that iconic gestures have higher semantic specificity than conventional gestures.     

Structural Inference from Conditional Knowledge Bases

There are several approaches implementing reasoning based on conditional knowledge bases, one of the most popular being System Z (Pearl, Proceedings of the 3rd conference on theoretical aspects of reasoning about knowledge, TARK ’90, Morgan Kaufmann Publishers Inc., San Francisco, CA, USA, pp. 121–135, 1990). We look at ranking functions (Spohn, The Laws of Belief: Ranking Theory and Its Philosophical Applications, Oxford University Press, Oxford, 2012) in general, conditional structures and c-representations (Kern-Isberner, Conditionals in Nonmonotonic Reasoning and Belief Revision: Considering Conditionals as Agents, vol. 2087 of LNCS, Springer, Berlin, 2001) in order to examine the reasoning strength of the different approaches by learning which of the known calculi of nonmonotonic reasoning (System P and R) and Direct Inference are applicable to these inference relations. Furthermore we use the recently proposed Enforcement-postulate (Kern-Isberner and Krümpelmann, Proceedings of the 22nd international joint conference on artificial intelligence, vol. 2, IJCAI’11, AAAI Press, pp. 937–942, 2011) to show dependencies between these approaches.     

Extending the Common Sense Model to Explore the Impact of the Fear of COVID-19 on Quality of Life in an International Inflammatory Bowel Disease Cohort

The aim of this cross-sectional study was to use an extended common sense model (CSM) to evaluate the impact of fear of COVID-19 on quality of life (QoL) in an international inflammatory bowel disease cohort. An online study involving 319 adults (75% female, mean (SD) 14.06 (15.57) years of symptoms) completed the Gastrointestinal Symptom Rating Scale, Brief Illness Perceptions Questionnaire, Fear of Contracting COVID-19 Scale, Brief-COPE, Depression, Anxiety and Stress Scale, and the EUROHIS-QOL. The extended CSM had an excellent fit (χ² (9)?=?17.06, p?=?.05, χ²/N?=?1.90, RMSEA?=?0.05, SRMR?=?0.04, CFI?=?.99, TLI?=?.97, GFI?=?0.99), indicating the influence of gastrointestinal symptoms on QoL was mediated by illness perceptions, fear of COVID-19, adaptive and maladaptive coping, and psychological distress. Interventions targeting the fear of COVID-19 in the context of an individual’s perceptions will likely enhance QoL during the pandemic.