Psychotherapie und Internet

The Internet plays an important role in healthcare. Approximately two thirds of Internet users search the medium for, e.g. personal questions of health, including aspects of mental health. In countless discussion forums or blogs mentally stressed people discuss their problems and search for contact to other affected individuals but also to professional helpers. In this article an attempt is made to systematize the interface between Internet and psychotherapy in the narrower and broader sense. In particular five topics and problem areas will be dealt with: (1) as information medium Internet delivers an immense number of resources on mental disorders, which raises the problem of quality assurance. (2) As a communication medium it can provide support for therapeutic interventions. Psychological online counseling has now been proven to be effective. (3) Internet alters the traditional therapeutic relationship in one way or another. In particular e-mail communications supplement a face-to-face treatment. (4) Use of the Internet also brings along clinically relevant problems and because of this patients visit psychotherapeutic practices increasingly more often. (5) Internet can be fruitful for psychotherapy research.     

Gender Segregation and Gender-Typing in Adolescence

We investigated correlates of gender segregation among adolescent (15–17 yrs) boys (N?=?60) and girls (N?=?85) from the Mid-Atlantic United States. Seventy-two percent of peers nominated for “hanging out” were the same gender as the adolescent. Girls’ gender segregation was correlated with gender reference-group identity and believing girls are more responsive communicative partners than boys. Girls were more likely to endorse feminine, expressive traits, a cooperative activity orientation, and to believe in the greater communicative responsiveness of same- vs. other-gender peers. Boys and girls were equally likely to endorse masculine, instrumental traits, competitive activity orientations, and to identify same-gender others as a reference group. We consider implications of the developmental persistence of gender segregation for gender-typing.     

Sexueller Sadismus und Sexualkriminalität

The categorization of sadism has turned out to be a versatile phenomenon, which covers a spectrum from harmless symbolic rituals to extremely violent acts where strong impulses or prolonged fantasies and rituals are involved. As the phenomenon is versatile its causes and appearances vary as well, although so-called BDSM (bondage & discipline & dominance & submission & sadism & masochism) practitioners and persons with severe sadism in a forensic context share only few common preferences. Based on own clinical experiences with sadism in forensic patients the authors support the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) especially the diagnostic disjuncture of sadism and masochism. Sexual sadism appears more frequently in forensic contexts in combination with sadistic, antisocial and borderline personality disorders but rarely with masochism. Masochism is otherwise reported to be more prevalent in patients of general psychiatry, however, combined with depression or dependent personality traits rather than with sadism. Moreover, the authors believe that if use of the diagnostic term sadism is perpetuated the establishment of the proposed new diagnosis “paraphilic coercive disorder” is unnecessary. The diagnostic term is also important for treatment and assessment. Despite the lack of reliable long-term studies with larger samples, it is reasonable to assume that medication, sometimes even anti-androgenic treatment, can be indicated in patients with severe sadism.     

Psychotherapie bei lebensbedrohlich Erkrankten

In den letzten 20 Jahren ist die begleitende psychotherapeutische Behandlung bei körperlich Schwerkranken fester Bestandteil der Tätigkeit von psychosomatischen Konsiliar- und Liaisondiensten im Krankenhaus geworden. Eine Konzeptualisierung dieser Tätigkeit auf psychodynamischer Basis wird beschrieben. Ziele der psychotherapeutischen Interventionen sind die Stabilisierung der Abwehr des Patienten und die Rückgewinnung eines strukturierten Umgangs mit der Krankheit, mit den Behandlern und den nahen Bezugspersonen. Therapiebausteine sind eine narrative Gesprächsstruktur, ein psychodynamisches Verständnis der aktuellen Krankheitssituation auf dem Hintergrund der Lebensgeschichte, aktives Zuhören, Fokusformulierung und systemische Sichtweise. Wichtige Wirkfaktoren sind eine empathische Beziehung, Verbalisierung von belastenden, negativen Gefühlen, Fokussieren auf aktuelle Probleme und Ressourcenorientierung. Probleme entstehen durch negative Gegenübertragung des Psychotherapeuten und ausgeprägte Verleugnungsvorgänge auf Patientenseite. Die Umsetzung erfordert vom Psychotherapeuten kontinuierliche Präsenz und regelmäßige Rücksprachen und Konsultationen mit dem behandelnden Team.     

Phenomenal,Normative, and Other Explanatory Gaps: A General Diagnosis

I assume that there exists a general phenomenon, the phenomenon of the explanatory gap , that surrounds consciousness, normativity, intentionality, and more. Explanatory gaps are often thought to foreclose reductive possibilities wherever they appear. In response, reductivists who grant the existence of these gaps have offered countless local solutions. But typically such reductivist responses have a serious shortcoming: because they appeal to essentially domain‐specific features, they are impossible to fully generalize. Here I do better. Taking for granted that the explanatory gap is a genuine phenomenon, I offer a fully general diagnosis that unifies these previously fragmented reductivist responses.     

A WAY FORWARD FOR SOCIOLOGICAL RESEARCH ON SCIENCE AND RELIGION: A REVIEW AND A RIFF

John Evans’s new book Morals Not Knowledge pushes scholars to rethink contemporary debates about religion and science by moving past the rhetoric of societal elites to examine the perspectives of everyday Americans, identifying the moral conflicts at the heart of debates. We review Evans’s key contributions while also extending and challenging his arguments, urging consideration of how renewed moral debates might be informed by a broader set of U.S. “publics.” Drawing on empirical research, we highlight four sets of voices that are missing from Evans’s analysis. Specifically, we highlight the voices of racial and ethnic minorities, religious communities (as opposed to individuals), members of minority religious traditions, and everyday religious scientists. Through doing so we offer avenues for future research on these diverse publics that will help facilitate a broader set of better and more informed debates about moral conflict between religious and scientific communities.     

Collaboration with Urban Community Stakeholders: Refining Paraprofessional‐led Services to Promote Positive Parenting

This paper describes the process of a community–academic partnership to navigate implementation challenges for a school‐based service model led by paraprofessionals to promote positive parenting in high poverty urban communities. We describe the process by which we (a) identified implementation challenges, (b) sustained a university–community collaboration to redesign the paraprofessional service model, and (c) assessed the feasibility of the new model involving four social service agencies in 16 schools with over 600 families. The structure and process of the collaboration and refinement are described with attention to who was best positioned to engage in the collaboration and how the partnership worked to balance scientific rigor with responsiveness to paraprofessional workforce strengths. Feasibility data indicated that the revised model was successfully implemented by paraprofessional staff; 92.2% of possible staff monthly reports were completed and discussion of key goals was incorporated into 94.2% of interactions. Continual monitoring provided critical feedback from stakeholders as we drew on and interpreted these various sources of information to build and refine the service model. We suggest that these processes are critical steps to bridge the research‐to‐practice gap, by promoting practices that are aligned with the needs of children and families, and the staff who serve them.     

The mismatch effect: when testosterone and status are at odds

Why do some people strive for high status, whereas others actively avoid it? In the present studies, the authors examined the psychological and physiological consequences of a mismatch between baseline testosterone and a person's current level of status. The authors tested this mismatch effect by placing high and low testosterone individuals into high or low status positions using a rigged competition. In Study 1, low testosterone participants reported greater emotional arousal, focused more on their status, and showed worse cognitive functioning in a high status position. High testosterone participants showed this pattern in a low status position. In Study 2, the emotional arousal findings were replicated with heart rate, and the cognitive findings were replicated using a math test. In Study 3, the authors demonstrate that testosterone is a better predictor of behavior than self-report measures of the need for dominance. Discussion focuses on the value of measuring hormones in personality and social psychology.     

A computer program for automated scoring of exteroceptive suppression periods

Exteroceptive suppression (ES) of temporalis muscle activity has received recent attention as a method of investigating central mechanisms in the pathogenesis of chronic headache disorders. Unfortunately, the resolution of conflicting findings has been hampered by the use of different assessment and scoring methodologies across laboratories, which has limited the direct comparison of findings across studies. A computer program was developed with the goal of providing an automated and reliable method of scoring ES responses. Processing an ES response with this software provides both visual and quantitative information relating to various response parameters. Multiple levels of smoothing the raw waveform data are available, and the software offers scoring on the basis of multiple depth-of-suppression criteria. The program also generates values for a variety of ES parameters: latency, duration, area, maximum level of suppression with its corresponding time (msec), and baseline level of muscle activity. It is likely that a reliable and standardized scoring protocol would enhance comparability of ES data generated across different settings.