Psychosoziale Versorgungsforschung

Health is of high value. Therefore, an effective and efficient care is a widely accepted societal objective. Correspondingly, health service research in general and for the psychosocial area in particular receives increasing attention from politics, health and pension insurance companies and professional organisations. These stakeholders promote health service research with considerable financial means. The various promotional programs are described and their implications are discussed. The relationship between content, purposes and methodology for the definition of research in health care is clarified. Finally, current research questions are exemplified by five key topics.     

The visual orientation memory of Drosophila requires Foraging (PKG) upstream of Ignorant (RSK2) in ring neurons of the central complex

Orientation and navigation in a complex environment requires path planning and recall to exert goal-driven behavior. Walking Drosophila flies possess a visual orientation memory for attractive targets which is localized in the central complex of the adult brain. Here we show that this type of working memory requires the cGMP-dependent protein kinase encoded by the foraging gene in just one type of ellipsoid-body ring neurons. Moreover, genetic and epistatic interaction studies provide evidence that Foraging functions upstream of the Ignorant Ribosomal-S6 Kinase 2, thus revealing a novel neuronal signaling pathway necessary for this type of memory in Drosophila.     

Common and specific cognitive deficits in schizophrenia: relationships to function

The goals of the present study were to assess the interrelationships among tasks from the MATRICS and CNTRACS batteries, to determine the degree to which tasks from each battery capture unique variance in cognitive dysfunction in schizophrenia, and to determine the ability of tasks from each battery to predict functional outcome. Subjects were 104 schizophrenia patients and 132 healthy control subjects recruited as part of the CNTRACS initiative. All subjects completed four CNTRACS tasks and two tasks from the MATRICS battery: Brief Assessment of Cognition in Schizophrenia Symbol Coding and the Hopkins Verbal Learning Test. Functional outcome was also assessed in the schizophrenia subjects. In both the patient and control groups, we found significant intercorrelations between all higher order cognitive tasks (episodic memory, goal maintenance, processing speed, verbal learning) but minimal relationships with the visual task. For almost all tasks, scores were significantly related to measures of functional outcome, with higher associations between CNTRACS tasks and performance-based measures of function and between one of the MATRICS tasks and self-reported functioning, relative to the other functioning measures. After regressing out variance shared by other tasks, we continued to observe group differences in performance among task residuals, particularly for measures of episodic memory from both batteries, although these residuals did not correlate as robustly with functional outcome as raw test scores. These findings suggest that there exists both shared and specific variance across cognitive tasks related to cognitive and functional impairments in schizophrenia and that measures derived from cognitive neuroscience can predict functional capacity and status in schizophrenia.     

Personal Growth of Mothers of Preterms: Objective Severity of the Event,Subjective Stress,Personal Resources,and Maternal Emotional Support

This prospective study investigated the personal growth of Israeli mothers of premature babies at two medically defined risk levels (infants at low risk, n = 42; infants at moderate-high risk, n = 52), examining the contribution to the five dimensions of personal growth of objective event characteristics (baby’s risk level), perceived levels of mother’s stress (linear and curvilinear associations), and mother’s personal resources (self-esteem, attachment styles, perceived emotional support from her own mother). In addition, the role of the event severity as a moderator of the association between perceived maternal emotional support and personal growth was explored. Findings indicate that mothers in the two risk groups did not differ in level of perceived stress. Mothers of infants at moderate-high risk, however, experienced more spiritual change. In addition, consistent curvilinear associations emerged between perceived levels of stress and personal growth for three dimensions of growth: new possibilities, personal strength, and relations with others (with a similar trend for appreciation of life). Thus, mothers reporting moderate stress levels experienced the highest personal growth. Finally, risk group played a moderating role in the association between perceived maternal emotional support and personal growth on the dimensions of new possibilities, personal strength, and relations with others. On these dimensions, only among mothers of low-risk babies were higher levels of maternal emotional support associated with greater personal growth. The results highlight the importance of the subjective experience and the value of maternal emotional support for the personal growth of mothers of preterms. These findings may help in designing measures to identify populations at risk and developing appropriate interventions, as well as impact on the working procedures and support currently offered in most neonatal intensive care units.     

The Development of Children's Concepts of Hardness

This study was conducted for three purposes. First, we assessed the development of children's concepts of hardness as an intensive physical quantity. We hypothesized a U-shaped behavioral growth curve for children's judgments on tasks measuring intensive physical quantity, but the hypothesis was not confirmed. The justifications accompanying correct and incorrect judgments for hardness were similar to those where U-shaped behavioral growth was found for other intensive physical quantities (temperature and sweetness). The second purpose was to determine how children solve seriation and transitivity tasks where hardness was the content. More older than younger children solved these tasks, and the transitivity task was correctly solved after the seriation task was correctly solved. One pattern of solutions for transitivity and intensive physical quantity allowed for differentiation between younger and older children who solved the intensivity tasks correctly. The third purpose was to determine whether children think that objects' hardnesses are labile (i.e., hard objects can become soft and vice versa) by simply adding more of that substance. More younger than older children thought that this was true     

The Baby Boomers Meet Menopause: Fertility, Attractiveness, and Affective Response to the Menopausal Transition

The purpose of this study was to identify social factors that affect women’s concerns about menopause. Data from a sample of 1,037 baby-boomer women who took part in two waves of the Midlife in the United States survey (MIDUS) were utilized. Two waves of survey data were collected in 1996 and 2005 from a nationally representative sample of women born between 1946 and 1964 residing in the United States. Women’s concerns about the effects of menopause on attractiveness, fertility, and the cessation of menstruation were examined. Analyses were replicated in Wave I and II of the study. Women who occupied multiple roles had fewer concerns about the loss of fertility. Women who had more symptoms were significantly more concerned about the effects of menopause on attractiveness. Concerns about the effects of menopause were also related significantly to women’s age, education, and financial security.     

A randomised controlled trial of a brief online mindfulness-based intervention

ObjectivesThere is growing evidence that mindfulness has positive consequences for both psychological and physical health in both clinical and non-clinical populations. The potential benefits of mindfulness underpin a range of therapeutic intervention approaches designed to increase mindfulness in both clinical and community contexts. Self-guided mindfulness-based interventions may be a way to increase access to the benefits of mindfulness. This study explored whether a brief, online, mindfulness-based intervention can increase mindfulness and reduce perceived stress and anxiety/depression symptoms within a student population.MethodOne hundred and four students were randomly allocated to either immediately start a two-week, self-guided, online, mindfulness-based intervention or a wait-list control. Measures of mindfulness, perceived stress and anxiety/depression were administered before and after the intervention period.ResultsIntention to treat analysis identified significant group by time interactions for mindfulness skills, perceived stress and anxiety/depression symptoms. Participation in the intervention was associated with significant improvements in all measured domains, where no significant changes on these measures were found for the control group.ConclusionsThis provides evidence in support of the feasibility and effectiveness of shorter self-guided mindfulness-based interventions. The limitations and implications of this study for clinical practice are discussed.     

Mortality-Related Differences and Changes in Episodic Memory Among the Oldest Old: Evidence From a Population-Based Sample of Nonagenarians

We examined cross-sectional differences and longitudinal changes in episodic memory performance related to impending death among a group of very old people, aged 90–101 years. Participants were assessed at 3 measurement points across a 6-year interval. Three groups were identified: those who survived the entire follow-up period (n =40), those who died before the first follow-up (n =44), and those who died after the first follow-up (n =14). Participants completed a battery of episodic memory tasks consisting of face recognition, word recognition, word recall, and object recall with selective reminding. Those who survived performed better than those who were going to die in object recall at baseline. A Cox regression analysis, controlling age, revealed that object recall performance was significantly related to subsequent mortality status. Longitudinal analyses demonstrated significant 3-year decline for both face recognition and object recall, but no evidence of differential decline as a function of mortality group. Thus, longitudinal changes in memory preceding death were not as pronounced as the corresponding cross-sectional differences in this very old sample. In general, the results suggest that mortality-related memory deficits are present in extreme old age, although these deficits are relatively small and task-specific.