Stabilität posttraumatischer Intrusionen bei Polizeibeamten

Objectives

This prospective study examined the course of posttraumatic symptoms of police officers across a time span of 12 months (T1: directly, T2: 6 months and T3: 12 months) after confrontation with an event of potentially traumatic nature while on duty.

Method

A total of 50 police officers were diagnosed 6 months after the event (T2) using a structured interview (SCID-I and SCID-II). The global functioning was operationalized at T1 and T2 by the Global Assessment of Functioning Scale (GAF) and the degree of impairment by the Impairment Score (IS). Furthermore, the intensity of posttraumatic symptoms was assessed at T1 and T2 by the Impact of Event Scale - Revised (IES-R). After 12 months (T3) the intensity of posttraumatic symptoms of 40 police officers was assessed again by a mail enquiry.

Results

Of the police officers 14 (28%) received the diagnosis of post-traumatic stress disorder (PTSD) after 6 months. In the PTSD group a significant drop in the level of functioning and a significant increase in the degree of psychiatric impairment could be found. Concerning the stability of the intensity of posttraumatic intrusions (IES-R subscale intrusions) the PTSD group showed in comparison to the non-PTSD group a slower decrease of symptoms over the period of 12 months (ordinal interaction) and no such strong amelioration of the symptoms as for avoidance and hyperarousal could be found.

Conclusions

Although the police force are, due to pre-employment screening and the professional training, both mentally and physically healthy in comparison with the general population, the results point at the risk potential of exceptional events for police officers. Due to the fact that the intensity of posttraumatic intrusions remained on a relatively stable level it seems indispensable to render these police officers further professional support.     

Fallgruppensystem der "diagnosis related groups" in Deutschland

Ohne Zusammenfassung     

Dokumentation auf einer Station für psychosomatische Medizin und Psychotherapie

The documentation system for a psychosomatic-psychotherapeutic ward must integrate and process medical and psychotherapeutic treatment in a way that allows, over and above transparence and completeness, the constructive use of the collected information. But how to describe the increasingly complex picture of the patient during a stay on the ward, and how to utilize it effectively for his treatment? The search for satisfying answers has led the Department of Psychosomatics and Psychotherapy of the Clinic of the University of Münster to develop a new documentation system that will meet such demands. The system is innovative in visualizing and using the progression of the different therapeutic offers, in addition to introducing a “synopsis” of the dysfunctional relationship patterns and the individual psychodynamic background, which permits a swift overview of a patient’s treatment during his whole stay. This allows optimization of the multimodal treatment concept.     

Neural correlates of the first-person-perspective

Human self-consciousness depends on the metarepresentation of mental and bodily states as one's own mental and bodily states. First-person-perspective taking is not sufficient, but necessary for human self-consciousness. To assign a first-person-perspective is to center one's own multimodal experiential space upon one's own body, thus operating in an egocentric reference frame. The brain regions involved in assigning first-person-perspective comprise medial prefrontal, medial parietal and lateral temporoparietal cortex. These empirical findings complement recent neurobiologically oriented theories of self-consciousness which focus on the relation between the subject and his/her environment by supplying a neural basis for its key components.     

Zur Validität der Operationalisierten Psychodynamischen Diagnostik (OPD)

In this paper the validity of the Operationalized Psychodynamic Diagnosis System is discussed. The discussion for each OPD axis is guided by the common scientific criteria like content-, criterion-, and construct validity. Reliability studies on OPD are summarized as an introduction to the validity issue. The studies show good to satisfying scores for interrater agreement for the research context. The results derived from the validity studies support the validity of the OPD system. There are also hints for improvements of multiple categories or items within each axis. For clinical routine OPD should become even more practice oriented. Therefore the OPD task force intends to construct a shorter version which will base on the results discussed in this article.     

Minds at rest? Social cognition as the default mode of cognizing and its putative relationship to the "default system" of the brain

The “default system” of the brain has been described as a set of regions which are ‘activated’ during rest and ‘deactivated’ during cognitively effortful tasks. To investigate the reliability of task-related deactivations, we performed a meta-analysis across 12 fMRI studies. Our results replicate previous findings by implicating medial frontal and parietal brain regions as part of the “default system”.However, the cognitive correlates of these deactivations remain unclear. In light of the importance of social cognitive abilities for human beings and their propensity to engage in such activities, we relate our results to findings from neuroimaging studies of social cognition. This demonstrates a remarkable overlap between the brain regions typically involved in social cognitive processes and the “default system”.We, henceforth, suggest that the physiological ‘baseline’ of the brain is intimately linked to a psychological ‘baseline’: human beings have a predisposition for social cognition as the default mode of cognizing which is implemented in the robust pattern of intrinsic brain activity known as the “default system”.