Patientensuizid im psychiatrischen Fachkrankenhaus

Suicide prevention especially with psychiatric inpatients is traditionally a very important aspect of psychiatric treatment. During the 1970s and 1980s there was a noticeable increase in so-called hospital suicides in Germany, especially suicides of schizophrenic inpatients. The number of psychiatric inpatient suicides has currently decreased again and a shift to more depressive suicides has also been observed. Furthermore questions which are asked in court are presented and discussed.     

Sozial-emotionales Lernen mit FAUSTLOS

Maltreatment, sexual and emotional abuse and neglect during childhood contribute to the development of psychic and somatic disorders. Therefore interventions against violence are necessary to support psychological health. The development of social-emotional competences became an elementary part of psychosocial prevention programs. Children with good capacities in problem solving are less at risk to show violent behaviour in difficult emotional conflicts, because they don’t tend to stabilize and compensate their self esteem in these situations. Relevant core dimensions concerning psychological development can be taught systematically in social- emotional learning lessons. Teachers in kindergardens and schools are presenting the series of lessons. A growing number of studies in this field show good effects. In Germany FAUSTLOS has been developed as an evaluated and systematically constructed tool for preventing aggressive behaviour in children visiting kindergardens and elementary schools. During these programs 28 lessons are presented in kindergardens and 51 lessons in elementary schools. Follow-up studies with FAUSTLOS show significant changes in emotional competences and prosocial developments in children.     

A psychometric evaluation of behavioral inhibition and approach self-report measures

Despite the putative applicability and unquestioned heuristic value of capturing individual variation in behavioral inhibition (BIS) and approach system (BAS) sensitivities, the field has yet to achieve widespread agreement regarding a self-report instrument of choice. The current study evaluates perhaps the two strongest candidates, the BIS/BAS scales (Carver & White, 1994) and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ; Torrubia, Avila, Molto, & Caseras, 2001). Using both confirmatory and exploratory factor analytic techniques in two university samples, we determined that neither measure achieved adequate fit to our data set, and both contain multiple items we deemed to be problematic. Models trimmed of the poor items achieved better fit than the full models. However, even after trimming the data, model fit was marginal at best. Caution is urged in the continued use of both measures on conceptual and psychometric grounds.     

Prävention

Ohne Zusammenfassung     

The influence of prematurity,maternal anxiety,and infants' neurobiological risk on mother–infant interactions

In this study, we investigated how the birth of a very low birth weight preterm (VLBW) infant influences the mother–infant interaction at 3 months. We also focused on the impact of the infant's neurobiological risk and maternal anxiety, and their interaction. The comparison of the VLBW preterm sample (n = 79) with an external full‐term sample (n = 35) showed mother–infant interactions of the families with the preterm infant to be more vocally responsive during the interaction, but less facially responsive during the interaction. Additionally, higher levels of maternal anxiety were associated with preterm infants being less facially responsive in interaction with their mother. While neurobiological risk of the infant played a part in this association, with higher risk infants also being less facially responsive, the relationship with maternal anxiety and the mother–child interaction was stronger. How these findings may influence therapeutic interventions is discussed.     

Die Artistik der Psychoanalyse

Zusammenfasssung  Die Psychoanalyse wird im Rückgriff auf die Praxis Freuds als artistisches Handwerk begriffen, das der Phantasie als Erkenntnismittel und -zweck die entscheidende Bedeutung zuweist. Sie ist eine Imaginationslehre und der Phantasieschlüssel, die produktive Einbildungskraft eines Therapeuten, der Zentralbegriff für dessen Güte: Gegen das Klischee des Standardsettings werden die Fähigkeit und das Ausmaß phantastischer Induktion durch den Therapeuten gestellt, gegen die Fiktion von rekonstruktiver Arbeit der produktive Konstruktivismus der Psychoanalyse. Die antizipatorische Kompetenz des Therapeuten erweist sich als Quelle der Heilkraft, die dem Patienten eine sinnvolle Benennung für seine unerklärlichen und fremden Erfahrungen der Symptome gibt. Der Analytiker ist, wie der Künstler, ein Experte phantasierenden Umdenkens und Umgestaltens der vorfindlichen Wahrnehmungsrealität. Seine kompositorischen Fähigkeiten sind die Bedingung, dem Patienten das Noch-Nicht-Bekannte, Nichterfahrene aus dem Fundus seines Phantasievermögens hinzuzufügen. In diesem hermeneutischen Ergänzungsprinzip der Psychoanalyse, ihrem gestaltschaffenden Entdeckungsprinzip, liegt die Hauptquelle der therapeutischen Wirksamkeit. Die von uns entwickelte Technik der korrigierenden kognitiven Erfahrung ist eine Methode zur produktiven Sinnbestimmung der Symptome und wird in ihrer klinischen Bedeutung für alle Strukturen dargestellt. Die Wahrheit der psychoanalytischen Methode offenbart sich gleichwie das Wahre in der Kunst durch eine andere und neue Selbst- und Weltanschauung des Patienten.

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The artistic quality of psychoanalysisIngeniousity and the corrective cognitive experience

Taking up the practice of Freud, psychoanalysis is regarded here as an artistic skill attaching central importance to phantasy as a means and also goal of insight. Psychoanalysis is a science of imagination. The key, the productive imaginative ability of the therapist is the central concept for its quality. The clichee of the standard setting is contrasted with the ability and the extent of phantasy induction by the therapist, as well as the fiction of reconstructive work with the productive contructivism of psychoanalysis. The anticipatory competence of the therapist is the source of the healing force offering a meaningful designation to the patients inexplicable and strange experiences and symptoms. The psychoanalyst is in the same way as an artist an expert of imaginative rethinking and reshaping of the given perceptional reality. His compositional abilities are the pre-condition for amplifying out of his imaginative resources the patients experience by still unknown and new experiences. The main source of therapeutic effectivity is this hermeneutic completion principle of psychoanalysis by which it creates through discovery new Gestalts. Our technique of the corrective cognitive experience is a method of productive sense-giving to the symptoms and is presented in its importance for all structures. The truth of the psychoanalytic method reveals itself just as the truth of arts in the patients new and different view of the self and the world.

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Prof. Dr. Manfred Pohlen ist emeritierter Direktor der Klinik für Psychotherapie der Philipps-Universität, Marburg.* Der vorliegende Exkurs über die Artistik der Psychoanalyse folgt den umfassenderen Ausführungen zu diesem Thema in der von M. Polen und M. Bautz-Holzherr vorgelegten Monographie: Eine andere Psychodynamik - Psychotherapie als Programm zur Selbstbemächtigung des Subjekts (Huber 2001), in der wir eine psychodynamische Praxistheorie unter der Perspektive der Selbstbemächtigung des therapeutischen Subjekts veröffentlicht haben.

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