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.     

Supervision in der psychotherapeutischen Ausbildung in Deutschland

One of the functions of supervision in psychotherapy training is quality assurance. In order to fulfill this function the quality of supervision itself needs to be high and needs to be controlled. Thus in a large survey of psychotherapy training in Germany questions related to the quality of supervision were included in the survey. Answers to those questions from different samples (trainees, alumni, trainers, training institutes, expert organizations) were compiled. Quantitative and qualitative methods were used. Satisfaction and usefulness ratings with individual and group supervision were high to very high. Supervision amount, group size and frequency were rated as adequate. Criticism pertained to the lack of systematic evaluation, insufficient qualification of the supervisors and lacking integration of supervision into the whole training. As supervision is a very important part of psychotherapy training measures for quality assurance and improvement are necessary.     

Great ape foresight is looking great

Suddendorf, Corballis and Collier-Baker (Anim Cogn 12: 751–754, 2009) comment on a study on great ape foresight (Osvath and Osvath, Anim Cogn 11: 661–674, 2008). That study consisted of four experiments investigating foresight in chimpanzees and orangutans, examining in particular whether the planning they exhibit is best explained by assuming an episodic cognitive system. This system has widely been regarded as exclusive to humans. Indeed, the Bischof-Köhler hypothesis explicitly states that planning for a future need is outside the abilities of non-humans. In our paper, we argued that the results implied the presence of episodic abilities and challenged the Bischof-Köhler hypothesis. Suddendorf et al. are not ready to accept this claim. They critique each experiment in detail and maintain their view that episodic cognition is unique to humans. Here, I point out the misapprehensions and weaknesses in their critique notably a lack of appreciation for how the experiments in the study are interrelated and serve as controls for each other and for the baseline experiment. I reinforce my earlier conclusions with a number of recently published findings.     

Der Exzess einer Tugend

Querulous behavior and querulous paranoia are seldom in forensic settings, but produce major problems because of the chronicity and severity of the disorders. Aspects of psychopathology and differential diagnosis are discussed, especially characteristics of volition, of cognition and of behavior control. Regarding criminal responsibility the capacity of understanding the wrongfulness of behavior will usually not be severely impaired. In cases of strong deformation of personality structure with transition into paranoid disorder the capacity for behavior control may be significantly diminished. Irresponsibility will only occur in the rare cases of psychotic disorders. Because of a poor prognosis detention in forensic hospitals may be necessary when threats and manifest aggressive behavior occur.     

Zusammenhang zwischen Art der strafbaren Handlung und Suizid in Haftanstalten der USA

Does the nature of the criminal charge or conviction influence whether a jail or prison inmate will take his life? In the United States several nationwide surveys provide relevant information for answering this question. Studies of jail suicides in 1979, 1985 and 1986 respectively indicated that most inmates who committed suicide were charged with nonviolent offenses including drug related or minor offenses. In more recent national surveys the rate of suicide among jail inmates charged with violent offenses was triple that for those charged with nonviolent offenses. Offenses with the highest rates of suicide were kidnapping, rape and homicide. In prisons, where the rate of suicide is much lower than in jails, the rate of suicide for violent prisoners was twice that for nonviolent prisoners. Violent offenses with the highest rates of suicide in prisons included kidnapping, homicide, sexual assault and assault. Discussion addresses the discrepant results between the early surveys of jail suicides and the more recent surveys of suicides in jails and prisons. Further explored are possible explanations for the earlier predominance of nonviolent offenses among suicide victims, the recently elevated rates among violent offenses, and the elevated rates among specific criminal offenses. Commentary is also given to the practical implications of these findings.     

Cognitive and linguistic skills in Swedish children with cochlear implants - measures of accuracy and latency as indicators of development

The purpose of the present study was to examine working memory (WM) capacity, lexical access and phonological skills in 19 children with cochlear implants (CI) (5;7-13;4 years of age) attending grades 0-2, 4, 5 and 6 and to compare their performance with 56 children with normal hearing. Their performance was also studied in relation to demographic factors. The findings indicate that children with CI had visuospatial WM capacities equivalent to the comparison group. They had lower performance levels on most of the other cognitive tests. Significant differences between the groups were not found in all grades and a number of children with CI performed within 1 SD of the mean of their respective grade-matched comparison group on most of the cognitive measures. The differences between the groups were particularly prominent in tasks of phonological WM. The results are discussed with respect to the effects of cochlear implants on cognitive development.     

Age differences in five personality domains across the life span

The present study addresses the issue of age differences in 5 personality domains across the life span in a cross-sectional study. In contrast to most previous studies, the present study follows a methodologically more rigorous approach to warrant that age-related differences in personality structure and mean level can be meaningfully compared. It uses data on 50 items of the Five-Factor Personality Inventory (FFPI) available from a study in a large and representative Dutch sample (N = 2,494; age range: 16 to 91 years) conducted in 1996 for the purpose of establishing norms for the FFPI. After having established strict measurement invariance, tests were made for factor covariances to be equal across age groups, revealing structural continuity of personality. Additionally, factor variances were shown to be equal across age groups. A number of age differences in the mean level of the five personality domains emerged. Specifically, older adults were, on average, more agreeable and, especially, more conscientious than middle-aged and younger adults. Findings from our study suggest that both continuity and change may mark personality over the course of life.     

Long-term correlated change in personality traits in old age

The present study examines long-term correlated change in personality traits in old age across a time period of 12 years. Data from the Interdisciplinary Study on Adult Development were used to investigate different aspects of personality change and stability. The sample consisted of 300 adults ranging from 60 to 64 years of age at Time 1. Personality was measured with the NEO Five-Factor Inventory. Longitudinal structural stability, differential stability, change in interindividual differences, mean-level change, and correlated change of the 5 personality traits were examined utilizing structural equation modeling. After having established strict measurement invariance, factor variances in Openness to Experience and Conscientiousness were found to be different across testing occasions, implying variant covariation patterns over time. Stability coefficients were around .70, indicating high but not perfect differential stability. The amount of interindividual differences increased with respect to Openness to Experience and Conscientiousness. Both mean-level change and stability in personality were observed. Eventually, except for Neuroticism, a number of medium effect-sized correlations among changes in personality traits emerged, implying that personality changes share a substantial amount of commonality.     

Adaptation to visuomotor rotations in younger and older adults

Adaptation to a visuomotor rotation is known to be impaired at older adult age. The authors examined whether the impairment is present already at preretirement age and whether it depends on the difficulty of the adaptation task. Moreover, the authors tested predictions of the hypothesis that the age-related impairment pertains primarily to strategic corrections and the explicit knowledge on which they are based but not to the acquisition of an (implicit) internal model of the novel visuomotor transformation. The authors found an age-related impairment of adaptation and explicit knowledge already at preretirement age but no age-related change of aftereffects. With an incremental simplification of the adaptation task, age-related changes were able to be eliminated. Individual differences of the quality of explicit knowledge were associated with differences of adaptation, but not of aftereffects. When age groups were matched by explicit knowledge, age-related impairments of adaptation largely disappeared. However, a reliable difference remained in one of the experiments, suggesting that other processes of adjustment to a visuomotor rotation might be affected by aging as well.     

Godly play: an intervention for improving physical, emotional, and spiritual responses of chronically ill hospitalized children

An experimental two-group comparison pilot study of forty chronically ill hospitalized children was carried out at Wolfson Children's Hospital in Jacksonville, Florida. Three Godly Play interventions were given to participants in the experimental group. Children in the control group did not participate but received a fairy tale book as a control. The sample was evenly distributed with twenty (20) males and twenty (20) females. Ages ranged from six (6) to fifteen (15) years and all participants were chronically ill. Five (5) variables were studied. Of the five (5), three (3) showed significant differences before and after Godly Play: the Staic-Trait Anxiety Scale (p = .049), the Children's Depression Inventory (p = .011), and the McBride Spirituality Assessment (p = .033). A marginal difference in parent satisfaction with hospital care of children in the experimental and control groups was also determined (p = .058). Findings suggest that Godly Play had a significant effect on anxiety, depression, and spirituality of children and support the idea that the parents of children who participated in Godly Play were more satisfied with hospital care than those parents whose children did not engage in Godly Play.