Postpartale psychische Störungen

Any postpartum mental disorder in a mother can influence the mother-child relationship and communication and lead to the development of psychosomatic disorders or disorders of behavioral regulation with diagnostic status. These can have a long-term impact on the mother-child relationship and the child’s mental development. Based on research findings on mother-child interaction, the authors expound why including the child in treatment is crucial. Accordingly, possible contraindications for mother-infant treatment are described. Clinical parent-infant treatment practice is reviewed as an interdisciplinary and multiprofessional challenge and the necessity of adhering to minimum standards, beside adult psychiatric skills, of child psychiatric and developmental expertise in diagnostics and intervention for quality assurance.     

The precuneus and the insula in self-attributional processes

Attributions are constantly assigned in everyday life. A well-known phenomenon is the self-serving bias: that is, people’s tendency to attribute positive events to internal causes (themselves) and negative events to external causes (other persons/circumstances). Here, we investigated the neural correlates of the cognitive processes implicated in self-serving attributions using social situations that differed in their emotional saliences. We administered an attributional bias task during fMRI scanning in a large sample of healthy subjects (n = 71). Eighty sentences describing positive or negative social situations were presented, and subjects decided via buttonpress whether the situation had been caused by themselves or by the other person involved. Comparing positive with negative sentences revealed activations of the bilateral posterior cingulate cortex (PCC). Self-attribution correlated with activation of the posterior portion of the precuneus. However, self-attributed positive versus negative sentences showed activation of the anterior portion of the precuneus, and self-attributed negative versus positive sentences demonstrated activation of the bilateral insular cortex. All significant activations were reported with a statistical threshold of p ≤ .001, uncorrected. In addition, a comparison of our fMRI task with data from the Internal, Personal and Situational Attributions Questionnaire, Revised German Version, demonstrated convergent validity. Our findings suggest that the precuneus and the PCC are involved in the evaluation of social events with particular regional specificities: The PCC is activated during emotional evaluation, the posterior precuneus during attributional evaluation, and the anterior precuneus during self-serving processes. Furthermore, we assume that insula activation is a correlate of awareness of personal agency in negative situations.     

Eye movements across viewpoint changes in multiple object tracking

Observers can visually track multiple objects that move independently even if the scene containing the moving objects is rotated in a smooth way. Abrupt scene rotations yield tracking more difficult but not impossible. For nonrotated, stable dynamic displays, the strategy of looking at the targets' centroid has been shown to be of importance for visual tracking. But which factors determine successful visual tracking in a nonstable dynamic display? We report two eye tracking experiments that present evidence for centroid looking. Across abrupt viewpoint changes, gaze on the centroid is more stable than gaze on targets indicating a process of realigning targets as a group. Further, we show that the relative importance of centroid looking increases with object speed.     

Health numeracy and cognitive decline in advanced age

ABSTRACT

The study aimed at investigating health numeracy in cognitively well performing healthy participants aged from 50 to 95 years as well as in participants with cognitive impairment, but no dementia (CIND). In cognitively well performing participants (n = 401), demographic variables and cognitive abilities (executive functions, reading comprehension, mental calculation, vocabulary) were associated with health numeracy. Older age, lower education, female gender as well as lower cognitive functions predicted low health numeracy. The effect of older age was partly mediated by executive functions and calculation abilities. Participants with CIND (n = 51) performed significantly lower than healthy controls in health numeracy. The findings suggest that cognitively well performing old individuals have difficulties in understanding health-related numerical information. The risk of misunderstanding health-related numerical information is increased in persons with CIND. As these population groups are frequently involved in health care decisions, particular attention has to be paid to providing numerical information in comprehensible form.     

Conceptual and perceptual factors in the picture superiority effect

This study tested the hypothesis that separate mechanisms mediate the planning of reaching and keypress responses. Participants performed a spatial precueing task with two preparation intervals (100 ms and 1000 ms) and three response sets: (a) pressing one of four response keys; (b) reaching with one of two hands; and (c) reaching with one hand. Reaction time results showed a pattern of precueing effects that strongly depended on the number of effectors in the response set and on the preparation interval. This outcome was interpreted as evidence that distinct mechanisms mediate the planning of multiple-effector and single-effector actions, with effector selection being relevant in the former but not in the latter. The theoretical implications of this conclusion are discussed.     

个人目标相关性对非临床抑郁者未来想象的影响

通过两个实验考查了非临床抑郁者未来想象的异常是否受到个人目标相关性的调节。实验1采用未来想象任务, 实验2采用可能性评估范式, 两个实验一致发现, 抑郁倾向者想象未来积极事件的异常, 受到了与个人目标相关性的调节：相对于非抑郁倾向者, 抑郁倾向者对未来与个人目标相关的积极事件的预期减弱, 而对未来与个人目标无关的积极事件的预期则没有表现出异常; 同时还发现, 抑郁倾向者表现出了对未来消极预期的普遍增强, 不受与个人目标相关性的影响。     

Acceptance and Commitment Therapy for Anxiety Disorders: Three Case Studies Exemplifying a Unified Treatment Protocol

Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that has been applied broadly and successfully to treat a variety of clinical problems, including the anxiety disorders. Throughout treatment ACT balances acceptance and mindfulness processes with commitment and behavior change processes. As applied to anxiety disorders, ACT seeks to undermine excessive struggle with anxiety and experiential avoidance––attempts to down-regulate and control unwanted private events (thoughts, images, bodily sensations). The goal is to foster more flexible and mindful ways of relating to anxiety so individuals can pursue life goals important to them. This article describes in some detail a unified ACT protocol that can be adapted for use with persons presenting with any of the major anxiety disorders. To exemplify this approach, we present pre- and posttreatment data from three individuals with different anxiety disorders who underwent treatment over a 12-week period. The results showed positive pre- to posttreatment changes in ACT-relevant process measures (e.g., reductions in experiential avoidance, increases in acceptance and mindfulness skills), increases in quality of life, as well as significant reductions in traditional anxiety and distress measures. All three clients reported maintaining or improving on their posttreatment level of functioning.     

Using Acceptance and Commitment Therapy to Treat Infertility Stress

Women and men diagnosed with infertility experience a variety of infertility-related stressors, including changes to their family and social networks, strain on their sexual relationship, and difficulties and unexpected challenges in their relationship. Infertility stress is linked with depression and psychological distress, and can lead to premature dropout from medical treatments and unresolved feelings of loss and grief. The current study examined the effectiveness of treating infertility stress using Acceptance and Commitment Therapy (ACT), a promising new behavior therapy that targets experiential avoidance through mindfulness, acceptance strategies, and value-directed action. This single-case study followed a couple experiencing infertility-related stress following a failed in vitro fertilization (IVF) procedure. The couple completed 6 self-report measures at 7 time points, including a second failed IVF attempt and a 1-year follow-up. Measures included both distress-focused instruments and therapy process-related questionnaires. The female participant reported higher pretreatment stress and depression scores compared to her partner. She reported significant decreases in global infertility stress, social infertility stress, sexual infertility stress, psychological distress, and depression from pretherapy to 1-year follow-up. She also reported a decrease in infertility stress following her second failed in vitro fertilization (IVF) attempt. The male participant reported significant decreases in sexual infertility stress. The study suggests that acceptance-based therapy shows promise in treating infertility stress in patients experiencing infertility who undergo medical treatments. The data from this preliminary case study also suggest that ACT may be helpful for couples following IVF treatment failure. Treatment gains were maintained 1-year posttherapy, indicating that an ACT approach to treating infertility has the potential to produce lasting change.     

Misalignment Between Research Hypotheses and Statistical Hypotheses: A Threat to Evidence-Based Medicine?

Topoi - Evidence-based medicine frequently uses statistical hypothesis testing. In this paradigm, data can only disconfirm a research hypothesis’ competitors: One tests the negation...