Wohlbefinden,Burn-out und Ressourcen bei Psychotherapeuten

Background

Well-being and its correlates have rarely been investigated in psychotherapists. Results from research on other occupational groups have shown that subjective and work-related well-being are both associated with performance and motivation as well as with mental and physical health. Therefore, personal and job-related resources of practicing psychotherapists were investigated in this study in order to assess their associations with well-being.

Method

A total of 771 psychotherapists filled in an online questionnaire including questions concerning well-being (WHO-Five Well-being Index, WBI-5), burnout (Maslach Burnout Inventory, MBI), and personal (Psychological Capital Questionnaire, PCQ) as well as job-related (Dutch Questionnaire on Work Experience, VBBA) resources.

Outcomes

Of the participants 45?% reported that they were suffering from high emotional exhaustion. Over 30?% reported a reduced subjective well-being, while more extensive professional experience was associated with better well-being. Psychotherapists reported optimism and hope to be the most important personal resources, whereas opportunities for personal and professional development were the most important job-related resources.

Conclusions

The study identified personal and job-related resources which may be relevant for different aspects of well-being in psychotherapists.     

Congestive Heart Failure and Quality of Life

Our study aimed to assess the quality of life (QoL) of patients with congestive heart failure (CHF) and to correlate the different aspects of QoL with relevant socio-demographic variables, CHF severity, somatic comorbidities, other clinical variables and depressive symptomatology. In a cross-sectional study design, a community sample of 103 adult patients with CHF (mean age 68 years, 73 % male) was recruited from an outpatient cardiology practice. CHF severity was assessed with physician ratings of the New York Heart Association (NYHA) functional class and measurement of brain natriuretic peptide (BNP) levels. The psychometric evaluation of quality of life was made using the Medical Outcomes Study Short Form-36 (SF-36) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Beck Depression Inventory Second Edition (BDI-II) assessed depressive symptoms. Using multiple linear regression, predictors of poorer QoL included being a female, being older, living alone, NYHA functional class ≥ II, higher levels of BNP comorbidity (such as renal insufficiency and cerebrovascular disease), fluid retention, depressive symptomatology (assessed by BDI-II) and treatment with anti-dyslipidemics, diuretics and β-blockers. Among these correlates, psychological distress was the most strongly related to QoL. Also, functional status measured by NYHA demonstrated a high impact on QoL. Our findings suggest the need to address such factors in developing effective care to improve psychological and functional status in order to enhance QoL in these patients.     

Predictors of College Students' Alcohol Consumption: Implications for Student Education

Understanding why young adults consume alcohol the way they do can lead to more effective educational programming for promotion of students' personal health and safety. The authors examined the predictive role of expectations about alcohol, perceived peer norms of consumption, awareness of rules, and individual self-efficacy in conjunction with demographic variables for male and female college students' weekly alcohol consumption. The sample of 4,960 students analyzed here is 10 to 20 times larger and more nationally representative than the samples used in similar studies. The authors used a general linear model; 41% of the men's variance and 33% of the women's variance in self-reported weekly alcohol consumption were explained by the set of predictors. In descending order of variance accounted for in male and female students' self-reported weekly alcohol consumption, perceived gender-specific norms of consumption, expectations about the effects of alcohol, and the importance of drinking in high school were significant predictors for both men and women. The salience of psychological variables for young adults' consumption of alcohol underscores the importance of recognizing individual predictors of behavior in the broader ecological context in which those behaviors are performed.     

Trauma,perversion and marital bond

Abstract

The purpose of this article is to study in the clinic the incidence of so-called perverse phenomena in relationships, in order to find out when these phenomena depend on a perverse organization and when they are only a kind of erotic game between the couple, in both hetero- and homosexual aspects. The first difficulty was to find a definition of “perversion” shared by the authors who have carried out research on the subject and consequently to determine what characterizes a perverse marital bond. In contrast to neurosis, which can be defined by the use of the repression mechanism, the mechanism of disavowal is not exclusive for perversion since it can be found even in other psychical arrangements. Is it, then, a structure or a psychological organization? It is also considered to be a “truth” in psychoanalysis that the pervert cannot be analyzed. But is it the pervert who cannot be analyzed, or is it the analyst who cannot bear listening to him? Do the theoretical references of the analyst not give sufficient theoretical support to maintain his listening? This paper presents the hypothesis that perversion is an attempt – always a frustrated one, and for this reason indefinitely repeated – to elaborate a trauma in which the pervert, identified with the traumatic agent, touches a point equally traumatic for his partner, turning the partner into an object of enjoyment. This arrangement allows the pervert, at least in his imagination, to leave the suffered trauma behind, adopting towards the object a position of activity and domination. Identifying with the aggressor, he leaves his partner paralyzed in the traumatic point, a situation that he knows all too well.

dos Reis Filho JT, et al Trauma, Perversion und eheliche Bande

Der Artikel untersucht klinische Fällen von sogenannter Perversion in Beziehungen, mit dem Ziel herauszufinden, wann es sich um eine perverse Organisation und wann es sich lediglich um eine spezielle Art von erotischem Spiel zwischen dem Paar handelt, dies sowohl in hetero- wie in homosexuellen Beziehungen. Die erste Schwierigkeit war, eine für alle Autoren akzeptable Definition von Perversion zu finden. Alle hatten Erfahrung in Forschung in diesem Gebiet und mussten sich auf Vorstellungen einigen, wodurch eine perverse eheliche Beziehung gekennzeichnet ist. Im Gegensatz zur Neurose, gekennzeichnet ausschliesslich von Verdrängungsmechanismen, kommt Ablehnung nicht ausschliesslich bei der Perversion vor sondern auch bei anderen psychischen Strukturen. Ist Perversion demnach eine psychische Struktur oder eine psychologische Organisation? Es wird auch als erwiesen betrachtet, dass ein Perverser nicht analysiert werden kann. Aber, ist es wirklich der Perverse, der nicht analysiert werden kann? Ist es nicht vielleicht der Analytiker, der es nicht ertragen kann, dem Perversen zuzuhören? Gibt der theoretische analytische Hintergrund des Analytikers ihm möglicherweise nicht genug Unterstützung, um das Zuhören aufrechterhalten zu können? Dieser Aufsatz vertritt die Hypothese, dass die Perversion ein unaufhörlich wiederholter, immer misslingender Versuch ist, ein Trauma aufzuarbeiten. Der Perverse ist identifiziert mit dem Täter im damaligen Trauma. Er trifft einen traumatisierten Punkt beim Partner und macht aus ihm ein Objekt seiner Lusterfüllung. Dieses Arrangement erlaubt dem Perversen-wenigstens in seiner Phantasie – das von ihm erlittene Trauma hinter sich zu lassen, indem er gegenüber dem Objekt eine Position der Aktivität und Dominanz einnimmt. Identifiziert mit dem Aggressor belässt er seinen Partner gelähmt am traumatischen Punkt-eine Situation, die er nur allzu gut an sich selbst kennt.

dos Reis Filho JT et al. Trauma, perversión y el vínculo marital

El propósito del presente trabajo es estudiar en la clínica la incidencia de los cada vez más llamados fenómenos perversos en las relaciones, para descubrir cuando este fenómeno depende de una organización perversa y cuando se trata de un tipo de juego erótico en las parejas, tanto en sus aspectos homosexuales como heterosexuales. La primera dificultad fue encontrar una definición de perversión compartida por los autores estudiosos de este tema y consecuentemente determinar las características de un vínculo marital perverso. En contraste con la neurosis que puede ser definida por el uso del mecanismo de la represión, el mecanismo de la negación no es característico de la perversión únicamente sino que se puede también encontrar en otras organizaciones psíquicas. ¿Se trata entonces de una estructura o de una organización psicológica? Se considera también que en psicoanálisis, es cierto que se trata al perverso como inanalizable. Bueno, ¿es el perverso el que no es analizable o es el psicoanalista que no puede soportar escucharlo? Acaso las referencias teóricas del analista no ofrecen suficientes soportes teóricos para mantener la escucha? Este trabajo presenta la hipótesis de que la perversión es un intento – siempre frustrado, y por lo mismo indefinidamente repetido- para elaborar un trauma en el que el perverso está identificado con el agente traumático, tocando un punto igualmente traumático en su pareja, convirtiendo a su pareja en objeto de su disfrute. Este arreglo permite al perverso, al menos en su imaginación, dejar atrás el trauma sufrido, adoptando con su objeto una posición de actividad y dominación. Identificándose con el agresor, deja a su pareja paralizada en el punto traumático, situación que el perverso sabe muy bien.     

Day-to-day living with severe chronic obstructive pulmonary disease: Towards a family-based approach to the illness impacts

Objective: This study explores the perspectives of both patients and family members regarding the impact of chronic obstructive pulmonary disease (COPD) in their family life.

Design: An exploratory qualitative study was conducted with patients and their family members in the chronic phase of COPD. Individual interviews were performed to explore participants’ perspectives and submitted to thematic analysis.

Results: Six major themes emerged from patients’ perspective: (1) impact of COPD symptoms on personal and family daily life; (2) (over)protective family support; (3) difficulties in couple communication; (4) sense of identity loss; (5) fear of COPD progression; and (6) coping resources. Five main themes emerged from the family members’ perspective: (1) restrictions in family’s social life; (2) emotional distress related to COPD exacerbations; (3) tension in couple relationship; (4) financial strain of COPD; and (5) coping resources.

Conclusions: The overall findings illustrate the complex interaction between the experience of living with COPD and communication patterns, emotional states, social support and social roles within the family. The results highlight the need to develop family-based interventions to facilitate a functional adjustment to COPD. However, these interventions in COPD remain undeveloped and empirical evidence is needed.     

Electrophysiological evidence for colour effects on the naming of colour diagnostic and noncolour diagnostic objects

In this study, we investigated the level of visual processing at which surface colour information improves the naming of colour diagnostic and noncolour diagnostic objects. Continuous electroencephalograms were recorded while participants performed a visual object naming task in which coloured and black-and-white versions of both types of objects were presented. The black-and-white and the colour presentations were compared in two groups of event-related potentials (ERPs): (1) The P1 and N1 components, indexing early visual processing; and (2) the N300 and N400 components, which index late visual processing. A colour effect was observed in the P1 and N1 components, for both colour and noncolour diagnostic objects. In addition, for colour diagnostic objects, a colour effect was observed in the N400 component. These results suggest that colour information is important for the naming of colour and noncolour diagnostic objects at different levels of visual processing. It thus appears that the visual system uses colour information, during naming of both object types, at early visual stages; however, for the colour diagnostic objects naming, colour information is also recruited during the late visual processing stages.     

Removal of S6K1 and S6K2 leads to divergent alterations in learning, memory, and synaptic plasticity

Protein synthesis is required for the expression of enduring memories and long-lasting synaptic plasticity. During cellular proliferation and growth, S6 kinases (S6Ks) are activated and coordinate the synthesis of de novo proteins. We hypothesized that protein synthesis mediated by S6Ks is critical for the manifestation of learning, memory, and synaptic plasticity. We have tested this hypothesis with genetically engineered mice deficient for either S6K1 or S6K2. We have found that S6K1-deficient mice express an early-onset contextual fear memory deficit within one hour of training, a deficit in conditioned taste aversion (CTA), impaired Morris water maze acquisition, and hypoactive exploratory behavior. In contrast, S6K2-deficient mice exhibit decreased contextual fear memory seven days after training, a reduction in latent inhibition of CTA, and normal spatial learning in the Morris water maze. Surprisingly, neither S6K1- nor S6K2-deficient mice exhibited alterations in protein synthesis-dependent late-phase long-term potentiation (L-LTP). However, removal of S6K1, but not S6K2, compromised early-phase LTP expression. Furthermore, we observed that S6K1-deficient mice have elevated basal levels of Akt phosphorylation, which is further elevated following induction of L-LTP. Taken together, our findings demonstrate that removal of S6K1 leads to a distinct array of behavioral and synaptic plasticity phenotypes that are not mirrored by the removal of S6K2. Our observations suggest that neither gene by itself is required for L-LTP but instead may be required for other types of synaptic plasticity required for cognitive processing.     

Reinvigorating the concept of situation in social psychology

The concept of situation has a long and venerable history in social psychology. The author argues that recent approaches to the concept of situation have confused certain important elements. Herein, the author proposes that attention to three of these elements will reinvigorate the concept of situation in social psychology: (a) that the analysis of situations should begin with their objective features; (b) that situations should be conceptualized as affordances; and (c) that the interpersonal core of situations, in particular the extent to which they are influenced by relationships, is the proper and most profitable focus for social psychology. These elements are consistent with recent developments in the study of situated social cognition and may help better define social psychology's position within the sciences.