Evidenzbasierte Psychotherapie der Depression

Depressive disorders are among the most frequent reasons for utilizing the health care system. Despite the availability of efficacious treatments and further advances throughout the last years, there is still a need for improving diagnostic and therapeutic procedures. A promising approach is the implementation of evidence- and consensus-based guidelines. The German “Nationale VersorgungsLeitlinie Unipolare Depression” are evidence- and consensus-based clinical practise guidelines for patients with unipolar depression. All relevant stakeholders have been involved in its development and have passed the final version at the end of 2009 to foster compliance throughout. The available evidence allows the derivation of differentiated treatment recommendations, also with regard to concomitant antidepressant medication or as alternative treatment options. In acute therapy watchful waiting over 14 days is recommended for mild depression and psychotherapy after persistence of symptoms. In cases of moderate depression, psychotherapy and pharmacotherapy are equally recommended, in cases of severe depression a combination of both is recommended.     

Psychoanalytisch-orientierte Fokaltherapie der Depression bei Krebskranken

Emotional distress connected to a cancer disease may result in comorbid mental and especially depressive disorders. Although psychodynamic therapy is one of the most frequently applied forms of psychotherapy of depression in cancer patients there is a lack of empirical studies which meet the criteria of evidence-based psychotherapy research. This is especially true with regard to randomized controlled trials of psychodynamic psychotherapy. As far as we know no manual for psychodynamic treatment of cancer patients has yet been published. In this article a manual for a 20-session short-term psychodynamic treatment is presented. The treatment is based on Luborsky’s supportive-expressive (SE) therapy. The SE treatment manual of depressions in cancer patients presented here is an adaptation of the general SET manual as well as the SE manual for depression. In the first part the general principles of SE therapy are presented. In the second part a manual specifically adapted to the treatment of depressive cancer patients is described. The treatment manual is presently being used in a large-scale randomized controlled multi-centered study comparing short-term psychodynamic psychotherapy and treatment as usual.     

The development of joint visual attention: a longitudinal study of gaze following during interactions with mothers and strangers

Two- to 8-month-old infants interacted with their mother or a stranger in a prospective longitudinal gaze following study. Gaze following, as assessed by eye tracking, emerged between 2 and 4 months and stabilized between 6 and 8 months of age. Overall, infants followed the gaze of a stranger more than they followed the gaze of their mothers, demonstrating a stranger preference that emerged between 4 and 6 months of age. These findings do not support the notion that infants acquire gaze following through reinforcement learning. Instead, the findings are discussed with respect to the social cognitive framework, suggesting that young infants are driven by social cognitive motives in their interactions with others.     

Pharmakotherapie der Begleitdepression

Depressive St?rungen geh?ren bei Allgemeinkrankenhauspatienten zu den h?ufigsten psychischen St?rungen. Sie haben oft negative Auswirkungen auf die Prognose und die Behandlung k?rperlicher Erkrankungen. Selbst für den routinierten und erfahrenen Arzt stellt die antidepressive Pharmakotherapie depressiver Patienten mit somatischen Krankheiten oftmals eine besondere Herausforderung dar. In diesem Kontext gilt es in der Regel, unerwünschte Arzneimittelwirkungen bei Komedikation mit anderen Pharmaka – wie zum Beispiel den Wirkverlust eines zuvor in stabilen Erhaltungsdosen verabreichten Medikaments oder ein erh?htes Risiko für die Entwicklung von Arzneimittelnebenwirkungen – zu vermeiden.     

Response priming driven by local contrast, not subjective brightness

We demonstrate qualitative dissociations of brightness processing in visuomotor priming and conscious vision. Speeded keypress responses to the brighter of two luminance targets were performed in the presence of preceding dark and bright primes (clearly visible and flanking the targets) whose apparent brightness values were enhanced or attenuated by a visual illusion. Response times to the targets were greatly affected by consistent versus inconsistent arrangements of the primes, relative to the targets (response priming). Priming effects could systematically contradict subjective brightness matches, such that one prime could appear brighter than the other but could prime as if it were darker. Systematic variation of the illusion showed that response-priming effects depended only on local flanker-background contrast, not on the subjective appearance of the flankers. Our findings suggest that speeded motor responses, as opposed to conscious perceptual judgments, access an early phase of lightness and brightness processing prior to full lightness constancy.     

Continuity of father-rated temperament from infancy to middle childhood

Continuity of father-rated temperament in Finnish children (n = 115) aged from 6 months (the IBQ) to 5.5 years (the CBQ) was explored within the theoretical framework developed by Rothbart. Father-rated activity level, smiling and laughter and distress to limitations showed significant differential homotypic and heterotypic continuity, while soothability, duration of orienting and fear showed significant differential heterotypic continuity. On the level of latent superconstructs, father-rated positive and negative infant affectivity accounted for 5.1, 22.7 and 10.0% of the variance in childhood extraversion, effortful control and negative affectivity, respectively. Inter-parental comparisons (n = 109 family units) revealed that father-rated continuity was similar to mother-rated continuity. These findings give empirical credence to Rothbart's theory and to father-rated temperamental continuity from infancy onwards.     

The earliest electrophysiological correlate of visual awareness?

To examine the neural correlates and timing of human visual awareness, we recorded event-related potentials (ERPs) in two experiments while the observers were detecting a grey dot that was presented near subjective threshold. ERPs were averaged for conscious detections of the stimulus (hits) and nondetections (misses) separately. Our results revealed that hits, as compared to misses, showed a negativity around 180-350 ms at occipital and posterior temporal sites. It was followed by a positive wave after 400-500 ms, peaking at parietal sites. These correlates were not affected by a manipulation of attention. The early negativity, called 'visual awareness negativity' (VAN), may be a general, primary electrophysiological correlate of visual awareness. The present data show that it can be observed in response to appearance of a stimulus in visual awareness and that it generalizes across different manipulations of stimulus visibility.