Psychotherapeutische Kurzintervention bei somatisierenden Patienten im Krankenhaus

The manual describes the psychotherapeutic procedure for somatizing patients who are admitted to hospital for diagnostics and therapy of unclear physical complaints. An essential goal of the psychotherapeutic interventions is to achieve an understanding for the disease, in which body, psyche and social relationships are experienced as interrelated. By addressing the health fears and subjective concepts about the onset and maintenance of his physical complaints, the patient feels that he is being taken seriously and understood. Connections between physical symptoms and the suppression of undesirable affects like anger, rage and disappointment are verbalized and understood in greater depth, based on body perception exercises and a symptom diary. The positive experience of understanding and symptom relief obtained in the psychotherapeutic sessions is used for the main goal of the intervention: to motivate the (out- and in-)patient for a regular psychotherapy. Experience up to now has shown that three to five sequential sessions of about 45–60 minutes suffice to attain this therapy goal. Implementation is most successful within an established consultant or liaison service in close cooperation with the ward doctors.     

Category membership moderates the inhibition of social identities

Although all people belong to a multitude of different social categories and occupy various social roles, the mechanism(s) through which people manage such a complex and potentially incoherent self-concept is not well understood. We report a study showing that excitatory and inhibitory processes act in tandem to keep potentially conflicting self-categorizations from simultaneously occurring. Specifically, when members of the fraternity/sorority system activated their “Greek” identities, the mental representation of their normatively conflicting identity as university students was inhibited below baseline. Importantly, participants who were non-members of the Greek system, although equally familiar with the relevant stereotypes, did not show this pattern of inhibition, indicating that it is only when one experiences conflict between two relevant social categories that such inhibitory processes are engaged.     

Randomized controlled trial of brief interventions to reduce college students' drinking and risky sex

The present study tested the proposition that an intervention to reduce alcohol use among college students will also reduce their risky sexual behavior. In a randomized controlled trial, 154 heavy-drinking, predominantly White, heterosexual college students at behavioral risk for infection with HIV and other sexually transmitted diseases were assigned to receive no intervention or a two-session, in-person, motivational interviewing-based intervention focused on (a) reducing alcohol risk behavior, (b) reducing HIV risk behavior, or (c) reducing both alcohol and HIV risk behavior. Three-month retrospective assessments of alcohol use and sexual behavior were conducted at intake and at 3-, 6-, 9-, 12-, and 15-month follow-up appointments. During follow-up, participants who received the single-focus alcohol risk-reduction intervention drank less frequently and consumed fewer drinks per drinking day as compared with no-intervention control participants, but did not differ from control participants in their frequency of intercourse without a condom or number of sexual partners. Participants who received the single-focus HIV risk-reduction intervention evidenced fewer unprotected sex events during follow-up, as compared with control participants. The number of sexual partners reported during follow-up did not differ by condition. Effects of the interventions did not vary significantly over time and were not moderated by participant gender. Results suggest that intervening to reduce alcohol use may not reduce risky sexual behavior among nonminority college students, but that a brief motivational intervention targeting HIV risk behavior may have utility for reducing the frequency of unprotected sex in this population.     

Einzel- und Paarintervention f��r depressive Koronarpatienten

Depressive symptoms in patients presenting with coronary heart disease have an impact on quality of life, health behavior, and prognosis. The psychotherapeutic interventions which had been tested for their efficacy in previous randomized controlled trials, showed only minor effects. A stepwise approach consisting of individual and group psychotherapeutic interventions was tested for efficacy in a German multicenter study. The presented paper describes the therapeutic procedure for two individual sessions and one couple session by means of case examples. The main focus was to determine depressive symptoms along with underlying maladaptive personality traits such as negative affectivity and social inhibition (type D pattern). Depressive mood, disappointments and mortifications both in private and professional life and also during the previous treatment are verbalized. Dysfunctional relation patterns and maladaptive sickness behavior are taken up by the psychotherapist and alternative behavior patterns are developed. The objective of the couple session is strengthening the partnership resources and offering relief of fears and worries relative to the heart disease. The psychotherapeutic procedure is psychodynamically oriented but also contains cognitive-behavioral and interactional treatment approaches.     

Heart rate responses to induced challenge situations in greylag geese (Anser anser)

Adequate short-term responses to stressors are of great importance for the health and well-being of individuals and factors modulating the physiological stress response (e.g., controllability, suddenness, familiarity) of a stimulus are well described under laboratory conditions. In the present study we aimed at investigating the stress response in greylag geese (Anser anser) in the field, confronting individuals with naturally occurring stressors. We measured beat-to-beat heart rate (HR) via fully implanted transmitters during three different experimental challenges: (1) catching and holding, (2) confrontation with a model predator, and (3) approach by different humans. We compared this to a control period and HR during agonistic encounters, a naturally occurring stressor. All three experimental situations evoked a HR increase. Highest HR responses were elicited by catching and holding the animals. In the third experiment, HR responses were greatest when the geese were approached by a human stranger (i.e., somebody the geese have never seen before). Hence, geese discriminated between different kinds of stressors and adjusted their physiological response depending on the type of stressor. Our results show that geese were able to discriminate between individual humans. In line with a number of lab studies, we suggest that particularly the controllability of certain situation determines the intensity of the HR response, also in a natural setting in the field.     

The goal of consistency as a cause of information distortion

Why, during a decision between new alternatives, do people bias their evaluations of information to support a tentatively preferred option? The authors test the following 3 decision process goals as the potential drivers of such distortion of information: (a) to reduce the effort of evaluating new information, (b) to increase the separation between alternatives, and (c) to achieve consistency between old and new units of information. Two methods, the nonconscious priming of each goal and assessing the ambient activation levels of multiple goals, reveal that the goal of consistency drives information distortion. Results suggest the potential value of combining these methods in studying the dynamics of multiple, simultaneously active goals.     

Heart rate modulation by social contexts in greylag geese (Anser anser).

Physical activity is generally considered as most relevant for modulating heart rate (HR). The authors show here that HR is not only modulated by physical activity but even more by social contexts. HR modulation in three free-ranging, socially embedded, male greylag geese fitted with implanted radiotransmitters was investigated. Measured HR ranged from 40 beats per minute (bpm) during rest to a maximum over 400 bpm during takeoff. Almost the same maximum HRs (400 bpm) were reached during social interactions, which however, generally require less bodily action. Mean HR during social interactions (agonistic interactions, vocalizations) was significantly higher than during behaviors with a less obvious social context (e.g., resting, comfort or feeding behavior), but with comparable physical activity involved. The authors also found significant and consistent differences in HR between the three focal individuals, probably because of individual behavioral phenotype. Our results show that social context has a strong modulatory effect on the sympathico-adrenergic activity in a social bird and conclude that particularly the latter may pose considerable energetic costs. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

Reconsidering qualitative and quantitative research approaches: A cognitive developmental perspective

Rather than embracing the notion that contextualism requires purely qualitative methodologies, Westerman and Yanchar argue that there is a place for quantification in post-positivist research. Both authors provide compelling arguments for this position. From our cognitive developmental perspective, we see this as a move toward a new level of integration in psychology. Whereas reactive shifts between positivist quantification and radical contextualism exemplify the kind of pendulum swing we see in individual development immediately before the emergence of a new developmental level, the moves suggested by Westerman and Yanchar are in the direction of a qualitative shift—a new level of differentiation and integration. We argue that the arguments put forward by Westerman and Yanchar do not quite achieve consolidation at this new level, because they remain embedded in a post-positivist contextualism that demands an a priori rejection of psychological universals and strong forms of quantification. In our view, consolidation at this new level requires a shift to a problem-focused methodological pluralism that assimilates a wide range of methodological approaches, critiques them, and adapts them in light of the problems researchers seek to solve.     

Psychodynamische Kurzzeittherapie mit erlebnisaktivierenden Interventionen

This short-term therapy model with experiential interventions is based on the basic assumptions of psychodynamic psychotherapy. The focus of treatment is the current psychosocial situation, in which dysfunctional emotional patterns are elicited by specific triggers. These emotional patterns are evidence of anconscious intrapsychic conflict, which has biographically relevant precursors. This conflict and the associated dysfunctional relationships are explored in a supportive therapeutic relationship, formulated in cooperation with the patient and then made accessible in an experience-activating process in the present. The effect is, in addition to the reduction of clinical symptoms, the improvement in managing relationships and improved social competence. The transference is noticed, but it is only addressed if it has a lasting compromising effect on the therapeutic relationship. This therapy model is especially suitable for psychotherapy with time limits of 25–40 hours.