Anxiety and post-traumatic stress symptoms following wisdom tooth removal

The purpose of the present study was to determine the psychological impact of wisdom teeth removal and to identify the psychological risk factors for the development of dental anxiety and post-traumatic stress symptoms. Participants were 34 consecutive elective patients referred for surgical removal of a wisdom tooth under local anesthesia. Frequency of previous distressing dental events and general traumatic life events were assessed at baseline (t1), and emotional distress (pain, state anxiety and disturbance) immediately after treatment (t2). Post-traumatic stress responses were determined three days after treatment (t3), and at four weeks follow-up (t4), while severity of dental trait anxiety was assessed at t1 and at t4. Two patients (8%) met screening criteria for Post-Traumatic Stress Disorder (PTSD) at t4. Multivariate analysis revealed that previous exposure to distressing dental events and pre-operative anxiety level predicted anxiety level at t4, accounting for 71% of the variance. Severity of pain during treatment was a significant predictor variable of PTSD symptom severity at t4 (25% explained variance). The findings underline the importance of pain-free treatments and awareness of patients' individual predisposition to anxiety or trauma-related symptoms to reduce the risk of iatrogenic psychological harm.     

Group processes and process evaluations in a new treatment setting: inpatient group psychotherapy followed by internet-chat aftercare groups

Little is known about processes characterizing therapeutic Internet-chat groups, which offer a novel way of providing group therapy over distances. In this study group processes and group evaluations were examined in a treatment setting where face-to-face inpatient groups are followed by chat aftercare groups. For a sample of 121 patients who participated in both treatment modalities, group processes and group evaluations were modeled using hierarchical linear modeling. The group evaluations followed a consistent upward course from the beginning of therapy until the end of chat aftercare. For the process measures Activity and Emotional Reactivity, the initial scores at the beginning of the chat groups were lower than at the end of the inpatient treatment, but higher than at admission. During chat aftercare, Activity and Emotional Reactivity scores increased less than during the inpatient phase, but on average Activity and Emotional Reactivity were higher during Internet-chat aftercare. The predictive value of the acquaintance of the therapist from inpatient treatment and the course of group evaluations during inpatient treatment on the course of group evaluations during chat aftercare were examined.     

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).     

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.