Ethik in der Psychotherapie

This contribution discusses some fundamental questions of medical ethics in psychotherapy. The problems discussed arise when ?care ethics“, which is based mainly on the Hippocratic Oath as the basis of medical ethics, is rejected. After a short overview of the relevant ethical theories, we ask for values and principles which might serve as a foundation for philosophical reasoning on the doctor-patient-relationship. In particular, we discuss the role of autonomy and informed consent in this relationship, following Beauchamp’s and Childress’ ethical principlism. We try to show the limited scope of the principle of autonomy in psychotherapy. Finally, we make a plea for a dynamic conception of patient autonomy for which we offer some pragmatic reasons. To round this conception off it is illustrated by the metaphor of the lighthouse.     

Defining the boundary of childhood amnesia

When adults are asked to recall their earliest autobiographical memories most can recall nothing about their infancy and early childhood, a phenomenon commonly referred to as childhood amnesia. There is general consensus regarding the existence of childhood amnesia, but there remains considerable debate over its boundary. Most researchers have argued that the boundary of childhood amnesia occurs between the ages of 3 and 4 years, but in 1993 Usher and Neisser published a highly influential paper, which has subsequently been used to argue that the boundary may be as low as 2 years. In the present experiment we examined how changes in scoring criteria influence our estimates of the age of adults' earliest memories. We conclude that some coding criteria are more valid than others and that the best estimates of childhood amnesia will include measures of free recall in addition to the specific questions that have dominated prior research in this area.     

GreekLex: A lexical database of Modern Greek

To conduct experimental investigations into the orthographic processing of Modern Greek, information is needed about the lexical properties known to influence visual word recognition. In this article we introduce GreekLex, a lexical database for Modern Greek, which presents collectively for the first time a series of orthographic measures that can be used for psycholinguistic research. GreekLex consists of 35,304 Modern Greek words ranging in length from 1 to 22 letters, and for each word includes the following statistical information: word length, word-form frequency, lemma frequency, neighborhood density and frequency, transposition neighbors, and addition and deletion neighbors. Furthermore, type and token frequency measures of single letters and bigrams derived from the database are also available. The complete database can be accessed and downloaded freely from www.psychology.nottingham.ac.uk/GreekLex.     

Cross-national comparisons of the association between alcohol consumption and deliberate self-harm in adolescents

How differences in drinking patterns may affect the impact of alcohol consumption on deliberate self-harm among adolescents is explored in this international comparative study. Schools in Australia, Belgium, England, Hungary, Ireland, the Netherlands, and Norway (N = 30,532) were surveyed. In all countries the risk of deliberate self-harm was significantly elevated among adolescents who reported some or numerous episodes of intoxication, controlling for confounding factors. The results support the assumption that intoxication is significantly related to the association between alcohol consumption and deliberate self-harm in adolescents.     

Short-Term Repeatability of Stabilometric Assessments

The authors evaluated the short-term (within-day, between-days) repeatability of center of pressure (COP) displacements. COP sway area and speed were obtained in the morning and afternoon of two separate days, both with open (EO) and closed (EC) eyes, in 10 healthy adults. Agreement and variability among conditions were tested by ANOVA and Bland-Altman plots. Mode (EO/EC, area: p = .032; speed: p < .004), and day (day1/day2, area: p = .006; speed: p = .02) showed significant differences. The EC condition and the second test day showed the largest values, with medium-large effect sizes. Time-of-day did not influence COP displacements. Speed had better agreement than area (Bland-Altman plots). COP displacements were well reproducible within-day, but had significant between-days variations. COP assessments should be performed in the same session.     

Facilitating empathy through virtual reality

This research experimentally investigated whether virtual reality experience can prompt greater empathy and whether greater engagement with a virtual reality connects this virtual reality experience to empathy. Randomly assigned participants viewed a documentary featuring a young girl living in a refugee camp either in a virtual reality format or in a control two-dimensional format. Results indicated that the virtual reality experience resulted in greater engagement and a higher level of empathy for the refugee girl compared to the control condition. Greater engagement was a process connecting the virtual reality experience to empathy. Virtual reality has the potential to influence interpersonal emotions such as empathy.     

A Kid-Friendly Tool to Assess Rumination in Children and Early Adolescents: Relationships with Mother Psychopathology and Family Functioning

The early identification of ruminative processes in children and early adolescents is particularly important to prevent the development of a stable ruminative style in later stages of development. The present study first aimed at validating a child-friendly tool, Kid Rumination Interview (KRI), to be used in a sample aged 7–12 years (n?=?100; 50% females). Second, we hypothesized that maternal depression, family functioning and participants’ emotion regulation skills would be associated with children’ levels of rumination. Factor analysis on KRI scores yielded two main factors: personal life-related rumination and school-related rumination. Older and female participants showed higher tendencies to ruminate about school issues compared to their younger and male counterparts. A low-to-moderate correlation emerged between school-related rumination and child/early adolescent’s emotion regulation capacities. Mothers’ depressive rumination and mothers’ depressive symptoms were positively associated with children/early adolescents’ rumination about personal life and rumination about school issues. Conversely, an adequate and positive family functioning was negatively correlated with both school-related rumination and rumination about personal life. Hierarchical regression analyses pointed to a crucial role of maternal rumination and familiar rigidity in both types of rumination. Personal life-related rumination was also specifically predicted by maternal depression and family enmeshment, whereas school-related rumination was significantly associated with children/early adolescents’ emotional control and gender. Overall, the KRI appears as a promising tool to assess rumination in children/early adolescents. Results suggests partially different pathways to specific forms of ruminative thoughts.     

Investigating the outcome of the initial assessment at a national transgender health service: Time to review the process?

Background: Globally, there is a lack of a standardized assessment process prior to the initiation of gender affirming medical interventions and consequently there is a discrepancy in this process among different transgender health services.

Aim: The main objective of this study is to investigate the outcome of the initial assessment process at a national transgender health service.

Method: The outcome of people over the age of 17 years, assessed at a large national transgender health service in the United Kingdom during a 2-year period was categorized into: (1) recommendation for cross-sex hormone treatment, or (2) no recommendation for cross-sex hormone treatment. In addition, 200 case notes were reviewed in order to investigate the level of agreement between the two clinicians involved in the assessment process.

Results: During the study period, a total number of 617 people completed their assessment at the service. Following assessment 380 (61.6%) patients were recommended for cross-sex hormone treatment, leaving 237 (38.4%) patients who required a longer assessment period or were discharged. The factors associated with being recommended for cross-sex hormone treatment were having socially transitioned, not smoking, having initiated cross-sex hormones prior to assessment, being older, and assigned male at birth. Out of the 200 case notes reviewed, agreement between assessor 1 and 2 (3 months apart) was found in 88% (n = 176) of the cases.

Discussion: Although the results of the study may not be generalizable to other international centers, questioning the assessment process and the role of the assessors is important to ensure treatment is offered in a timely and efficient manner. The findings from this study suggest that the routine inclusion of two assessors needs to be reviewed.