Das Symptom Schwindel im Fokus der Psychiatrie

Das Symptom Schwindel wird in der klinischen Praxis organisch meist regelrecht durch die zuständige Fachrichtung abgeklärt. Ein möglicher psychiatrischer Impact im Symptom Schwindel wird oft übersehen und somit vernachlässigt. Die Folge ist ein Persistieren und Chronifizieren einer Symptomatik, die unter dem Namen phobischer Schwindel bekannt ist. Neuere Begriffe wie die somatische Symptomstörung des DSM‑5 und der heute stigmatisierende Begriff des somatoformen Schwindels werden in diesem Fallbericht klinisch und theoretisch umrissen. Sofern der phobische Schwindel richtig diagnostiziert wird, kann im Rahmen eines Gesamtbehandlungsplanes unter Einbeziehen von Physiotherapie, dem Erlernen von Angstbewältigungsstrategien und adäquater Aufklärung und Information des Betroffenen konkret an Beschwerden gearbeitet werden. Voraussetzung dafür ist ein interdisziplinäres Denken beim behandelnden Arzt. Im Fallbericht geht es um einen älteren Patienten, der neben schwerwiegenden körperlichen Ursachen für Schwindelsymptome letztlich einen phobischen Schwindel bietet, der nach der richtigen Diagnosestellung umfassend behandelt werden kann.     

Consumer engagement on social media: Evidence from small retailers

This study investigates which characteristics of the social media posts of small firms in Tasmania, Australia elicit higher levels of consumer engagement. Results from an analysis of small retail firms’ social media postings (Facebook, Instagram and Twitter) (N = 2,607) illustrate the importance of the content of the post (i.e., businesses‐related vs. non‐business‐related), the activity (i.e., text, image or video), the time of day of the posting and the platform on which the activity was posted, in eliciting responses from followers. Results show Facebook received significantly higher levels of engagement, compared with Twitter and Instagram. Contrary to expectations, the specific day of the week did not have any impact on levels of engagement. This research demonstrates how small businesses can improve their use of social media marketing to engage more effectively with customers and followers.     

Resistance and outcome expectations in cognitive‐behavioural therapy for generalised anxiety disorder

Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, p < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.     

Where and when to look: Sequential effects at the millisecond level

Attention, Perception, & Psychophysics - Learning and imitating a complex motor action requires to visually follow complex movements, but conscious perception seems too slow for such tasks....     

The assessment of individual “Aggressiveness” in pigeons by a variety of means

Pigeons attack or threaten animate and inanimate targets. The assessment of their aggressiveness was studied by exposing them in their home cages to three different stimuli: the experimenter's hand, a live pigeon, and a rear-projected conspecific image when the birds were exposed to intermittent access to food. A positive correlation between the hand test and live pigeon test was evident, but no relationship between either of these responses and the response to a pictorial image was observed. These results combined with other ethological observations cast doubts on the usefulness of schedule-induced responses to pictorial targets in the assessment of the individual aggressiveness in pigeons, but suggest that the hand test is an adequate and reliable procedure for such evaluations.     

Elevation and reduction of plasma tryptophan and their effects on aggression and perceptual sensitivity in normal males

Data from experimental animals suggest that 5-hydroxytryptamine (5HT) may have an inhibitory effect on aggression, while clinical studies have found a correlation between pathological aggression and low brain 5HT. To investigate this relationship further we used amino acid mixtures designed to raise or lower the levels of the 5HT precursor, tryptophan. Normal male subjects were given tryptophan-depleted, balanced, or tryptophan-supplemented ammo acid mixtures and tested for aggression 5 hours later. The balanced amino acid mixture served as a control for the tryptophan depletion and supplementation. Testing for aggression was done using the Buss paradigm in which subjects deliver electric shocks to a (nonexistent) partner in response to stimulus tones. Duration and intensity of shock delivered were the measures of aggression, while responsivity to the stimulus tones was the measure of perceptual sensitivity. Neither tryptophan supplementation nor tryptophan depletion had any effect on these measures of aggression or perceptual sensitivity. We conclude that raising or lowering the synthesis of brain 5HT through alterations in tryptophan availability does not influence aggression in normal males as measured by the Buss task.     

Virtual reality: A new track in psychological research

One major challenge of social interaction research is to achieve high experimental control over social interactions to allow for rigorous scientific reasoning. Virtual reality (VR) promises this level of control. Pan and Hamilton guide us with a detailed review on existing and future possibilities and challenges of using VR for social interaction research. Here, we extend the discussion to methodological and practical implications when using VR.     

Psychoanalytic patients in the U.S., CANADA,and Australia: I. DSM-III-R disorders,indications, previous treatment,medications, and length of treatment

To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I, Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD = 3.66; median = 4; mode = 3). There are no statistically significant differences across countries. Mood, anxiety, sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.     

The relation between hiding skill and judgment of eye direction in preschool children

This study examines J. H. Flavell, S. G. Shipstead, and K. Croft's (1978) finding that 2 1/2-year-old children can hide an object behind a screen but cannot achieve the same result by placing the screen in front of the object. Experiment 1 replicated this finding alongside a task in which children judged what a person in a picture was looking at. Performance on the move-object task approached ceiling; performances on the move-screen and looking-where tasks were highly correlated even after age and control task performance were partialed out (r = .54, p < .01). Experiment 2 examined whether the finding resulted because the object was more interesting to manipulate than the screen. The move-object task remained easier than the move-screen task with an interesting screen and a dull object. The move-screen task again correlated specifically with the looking-where task. Results are explained in terms of engagement, a precursor to a mature understanding of attention.     

The course of anhedonia during 10 years of schizophrenic illness

Although anhedonia has been proposed to be a trait-like characteristic in schizophrenia patients, its persistence and stability have not been tested using multiple assessments over a multiyear period. Specific definitions of anhedonia vary across studies, and relationships between different types of anhedonia as well as their relationship to schizophrenic symptoms over the course of illness have not been addressed. The current research, using prospectively collected longitudinal data covering a 10-year span for 127 individuals with schizophrenic illness, found that (a) physical, but not depressive, anhedonia is a stable characteristic over a 10-year period; (b) physical anhedonia does not show strong and consistent relationships with psychotic, negative, or depressive symptoms; and (c) the relationship between some premorbid characteristics and physical anhedonia are significant even 10 years into the course of illness.