Update der psychoanalytischen Links im Internet

Das Forum der Psychoanalyse hat zuletzt in Heft 1/2007 nützliche Internetadressen für Psychoanalytikerinnen und Psychoanalytiker publiziert. Hier folgt, zusammengestellt von Parfen Laszig und Kathy Rieg, ein aktuelles Update. Ausführlichere Informationen zu den angeführten und weiteren Adressen finden sich auf der Internetseite www.psychoanalytische-ressourcen.de     

A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face

OBJECTIVE: A major problem in the delivery of mental health services is the lack of availability of empirically supported treatment, particularly in rural areas. To date no studies have evaluated the administration of an empirically supported manual-based psychotherapy for a psychiatric condition via telemedicine. The aim of this study was to compare the relative efficacy and acceptability of a manual-based cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) delivered in person to a comparable therapy delivered via telemedicine. METHOD: One hundred twenty-eight adults meeting DSM-IV criteria for BN or eating disorder-not otherwise specified with binge eating or purging at least once per week were recruited through referrals from clinicians and media advertisements in the targeted geographical areas. Participants were randomly assigned to receive 20 sessions of manual-based, CBT for BN over 16 weeks delivered either face-to-face (FTF-CBT) or via telemedicine (TV-CBT) by trained therapists. The primary outcome measures were binge eating and purging frequency as assessed by interview at the end of treatment, and again at 3- and 12-month follow-ups. Secondary outcome measures included other bulimic symptoms and changes in mood. RESULTS: Retention in treatment was comparable for TV-CBT and FTF-CBT. Abstinence rates at end-of-treatment were generally slightly higher for FTF-CBT compared with TV-CBT, but differences were not statistically significant. FTF-CBT patients also experienced significantly greater reductions in eating disordered cognitions and interview-assessed depression. However, the differences overall were few in number and of marginal clinical significance. CONCLUSIONS: CBT for BN delivered via telemedicine was both acceptable to participants and roughly equivalent in outcome to therapy delivered in person.     

Is hypnotic suggestibility a stable trait?

The present study examined the trait-like nature of hypnotic suggestibility by examining the stability of hypnotic responsiveness in a test-retest design in which the procedures were administered either live or by audiotape. Contrary to the idea that hypnotizability is a largely immutable, stable trait, scores on the scale of hypnotic responsiveness decreased significantly at the second session. Measures of subjective experiences and expectancies accounted for a sizable portion of the variance in hypnotic responding, both at initial test and at retest. Participants became disengaged with the hypnotic procedures at retest. Participants who received the hypnotic induction by audiotape did not differ from participants who received it live. The results are consistent with sociocognitive and altered state theories of hypnosis, and underline the important role of subjective experiences in hypnotic responding.     

The production of bimanual percussion in 12- to 24-month-old children

Bimanual coordination represents a complex self-organizing system that is subject to both internal and contextual constraints. Although there has been interest in examining bimanual development throughout the lifespan, few data exist relative to the bimanual activity of children between 1 and 4 years of age. The study reported here represents an initial effort to address this gap. Twenty-seven children who were either 12, 18 or 24 months old were videotaped while drumming with sticks on a plastic drum. Two independent observers recorded bout length as well as number and phase relation of movement cycles within bouts. Kinematic analysis provided more detailed information about the timing and form of children's activity. Results indicate that bimanual drumming becomes preferred over unimanual drumming by 2 years of age, that the proportions of different phase relations exhibited by children change between 1 and 2 years of age, and that the behavior appears to go through periods of stability and variability within this age range. These results are discussed in the context of the child's physical development and interactions with the environment during this period.     

A model for teaching research ethics

A model is described for implementing a program in research ethics education in the face of federal and institutional mandates and current resource, disciplinary, and infrastructure limitations. Also discussed are the historical background, content and evaluation process of the workshop at the heart of the program, which reaches a diverse group of over 250 students per year—from first-year graduate students in basic research labs to clinical fellows. The workshop addresses central issues in both everyday laboratory ethics and in larger societal questions. Goals include improving overall awareness of ethics guidelines and philosophy and enhancing skills in identifying and then analyzing the ethical components of situations. Pedagogies used and their effectiveness and that of the overall workshop and extended program are addressed. Programs like these have initiated a shift in the culture of basic research, which is a critical need given the current atmosphere.     

Explanatory limitations of cognitive-developmental approaches to morality

In response to Gibbs' defense of neo-Kohlbergian models of morality, the authors question whether revisions in Kohlberg's model constitute a coherent refinement of the cognitive-developmental approach. The authors argue that neo-Kohlbergian measures of moral development assess an aspect of morality (the most sophisticated forms of moral reasoning available to people) that plays a relatively minor role in determining the moral judgments and behavioral decisions people make in their everyday lives. Attempts to conceptualize stages as schema and to redefine moral decision-making in terms of automaticity will not solve these problems. Flexibility is an important aspect of moral maturity. Observed relations between stages of moral development and various forms of social conduct do not establish that the structures of moral reasoning that define stages of moral development exert a significant causal impact on moral behavior. Although cognitive-developmental approaches are equipped to account for some aspects of morality, a more general framework that organizes the insights from other theoretical approaches is needed.