Inanspruchnahme, Verlauf und Ergebnis ambulanter Psychotherapie

This paper summarizes the major results of the study ?Optimizing psychotherapy service provision via transparency and outcome orientation: evaluating outpatient psychotherapy“ (TRANS-OP). Between September 1998 and February 2000, all insured persons of a major German health insurance company (?Deutsche Krankenversicherung“) who requested reimbursement of outpatient psychotherapy were asked to participate in the study. Comprehensive data concerning structural, process and outcome criteria of outpatient psychotherapy were collected from 714 participants and from the majority of their psychotherapists during a 2-year observation period. Participants applied for the following treatments eligible for reimbursement in the German health insurance system: psychodynamically oriented psychotherapy (52%), cognitive behavioral therapy (31%), and psychoanalytic psychotherapy (17%). The amounts of sessions claimed for reimbursement were approved almost without exception. Participants in the three treatment modalities did not differ in socio-demographic characteristics, or in initial symptom severity as assessed by standardized measures. Even though courses of improvement of the symptoms varied, therapy outcome after 2 years was similar in the three forms of treatment. In addition, a cost offset was found, i.e. medical costs, especially for hospital days, substantially decreased during the course of psychotherapy. These findings support the effectiveness as well as the economic significance of outpatient psychotherapy across different treatment modalities in routine care. However, allocation of psychotherapeutic resources should be more considerate of individual patient needs and treatment outcome.     

Pavlovian influences on goal-directed behavior in mice: the role of cue-reinforcer relations

Two experiments refined procedures to study Pavlovian influences on goal-directed behavior in mice and studied the effects of CS-US relations in Pavlovian-instrumental interactions. Independent groups of mice underwent Pavlovian training to associate either a 10-sec or 2-min auditory stimulus (CS) with reward. We next assessed the ability of the response-contingent CS presentations to reinforce novel instrumental responding (conditioned reinforcement; CRf) or the ability of noncontingent CS presentations to increase ongoing instrumental responding (Pavlovian-instrumental transfer; PIT). Whereas 10-sec training conditions produced strong CRf (and no PIT), 2-min training conditions produced robust PIT (but no CRf).     

Effects of trauma and religiosity on self-esteem

Self-esteem is often lower among persons who have experienced trauma, but religiosity may ameliorate these psychological effects. The purpose of this paper was to examine the relationships among religiosity, self-esteem, and childhood exposure to trauma, utilizing data from the National Comorbidity Survey, a large (N = 8,098) nationally representative population survey in the 48 contiguous states of the USA that assessed religious practices, self-esteem, and exposure to trauma. Exposure to trauma in childhood was assessed through self-report of presence or absence of childhood physical abuse, sexual abuse, or neglect. Religiosity was assessed as the sum of responses to 4 self-report items (religious service attendance, use of religion for comfort and guidance, and importance of religion). Self-esteem was assessed on 9 self-report items adapted from the Rosenberg Self-Esteem Scale. Analysis of variance compared scores for persons who reported exposure to childhood abuse and differed in the value they placed on various religious practices on self-esteem. Persons who reported physical abuse, sexual abuse, or neglect in childhood had significantly lower mean self-esteem than those who did not report these events. There was also a main effect for religiosity in a comparison of persons who reported childhood sexual abuse with those who reported none. The High Religiosity group had higher mean self-esteem than the Medium and Low Religiosity groups. There was a significant interaction as those who reported childhood sexual abuse had lower mean self-esteem than peers who reported none in the Low and Medium Religiosity groups. Mean self-esteem for those who reported childhood sexual abuse was comparable to that of those who reported none in the High Religiosity group.     

The Secret of My Success

In an information state where various agents have both factual knowledge and knowledge about each other, announcements can be made that change the state of information. Such informative announcements can have the curious property that they become false because they are announced. The most typical example of that is ‘fact p is true and you don’t know that’, after which you know that p, which entails the negation of the announcement formula. The announcement of such a formula in a given information state is called an unsuccessful update. A successful formula is a formula that always becomes common knowledge after being announced. Analysis of information systems and ‘philosophical puzzles’ reveals a growing number of dynamic phenomena that can be described or explained by unsuccessful updates. This increases our understanding of such philosophical problems. We also investigate the syntactic characterization of the successful formulas. An erratum to this article is available at .     

Der Religiöse Glaube Und Die Religionskritik Der Aufklärung. Beschränkungen Des Vernunftgebrauchs Im Lichte Kritischer Philosophie

Summary   Religious Faith and Criticism of Religion of Enlightenment. Restrictions of the Use of Reason in the Light of Critical Philosophy. In the this paper I analyse the present problem situation of the christian faith with respect to the assumption of the existence of God and the role of Jesus and I criticize the problem-solutions offered by Bultmann, Ratzinger, Küng and Habermas. I try to show that all these solutions imply a similar arbitrary restriction of the use of reason.     

An application of DSM-IV's outline for cultural formulation: Understanding conduct disorder in Latino adolescents

In the established guidelines for providers of services to ethnic, linguistic, and culturally diverse populations, the American Psychological Association addressed the need for practitioners to consider the role that culture and ethnicity plays in the psychosocial development of culturally diverse populations. Currently, there are over 24 million Latinos in the United States, and this population is expected to quadruple in size to over 81 million in the year 2050. This discussion of a case example highlights the appropriateness of utilizing the outline for cultural formulation in working with Latino adolescents diagnosed with Conduct Disorder. As indicated by the DSM-IV's outline for cultural formulation, this discussion addresses the importance of assessing the following: 1) Cultural identity of the individual; 2) Cultural explanations of the individual's illness; 3) Cultural factors related to psychosocial environment and levels of functioning; 4) Cultural elements of the relationship between the individual and the clinician; 5) Overall cultural assessment for diagnosis and care. In particular, the discussion focuses on specific reasons why the utilization of the outline for cultural formulation can greatly assist the clinician in understanding many psychosocial elements unique to treating Conduct Disorder in the Latino adolescent.