Evidenzbasierte Diagnostik und Psychotherapie der Zwangsstörung

For a long time obsessive-compulsive disorder (OCD) was considered to be a mental disorder which is very difficult or practically impossible to treat. Based on comprehensive basic research on different models and derived treatment approaches empirical research has shown remarkable improvement in the psychotherapeutic treatment of OCD. Recently, S-3 treatment guidelines have been published on behalf of the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlich Medizinischen Fachgesellschaften, AWMF). Based on these guidelines clinical diagnostic measures and state-of-the-art treatment recommendations are proposed. Specifically, the current article focuses on the step-by-step procedure in cognitive-behavioral intervention strategies and in particular on exposure and response prevention.     

Impulsive Responses In Children with Conduct Disorder and Borderline Intellectual Functioning

The study is designed to investigate response inhibition in children with conduct disorder and borderline intellectual functioning. To this end, children are compared to a normal peer control group using the Alertness test. The test has two conditions. In one condition, children are instructed to push a response button after a visual “go” signal is presented on the screen. In a second condition the “go” signal is preceded by an auditory signal, telling the child that a target stimulus will occur soon. Compared to the control group, the group carrying the dual diagnosis made many preliminary responses (responses before the presentation of the “go” signal), especially in the condition with an auditory signal. This impulsive response style was controlled for attention deficit/hyperactivity disorder characteristics of the children.     

Very Low Birth Weight and Attention Deficit/Hyperactivity Disorder

It is well recognized that reaction time performance of term-born children with a normal birth weight (NBW > 2500 g) who fulfill the DSM-IV criteria for attention deficit/hyperactivity disorder (ADHD) in the primary school age is sensitive for the presentation rate of stimuli. They have been found to perform more poorly in conditions of relatively slow event rates as compared with fast event rates. The purpose of the current study was to explore whether reaction time performance of children with very low birth weight (VLBW < 1500 g) with or without ADHD showed the same sensitivity for the factor presentation rate of stimuli compared to children with a normal birth weight plus ADHD. To this end, reaction time performance of four groups of children was compared on a Go/No-Go test with a fast presentation rate of 1 second and a slow presentation rate of 6 seconds. Groups were: children with VLBW plus ADHD, children with VLBW only, children born full term with normal birth weight (NBW >2500 g) plus ADHD, and children born full term without ADHD (the control group). Findings indicated that, compared to the non-ADHD groups, the groups with ADHD (NBW and VLBW) showed a more dramatic decline in their reaction time performance in the slow condition: a state regulation deficit. In addition, both groups showed a response inhibition deficit. No difference was found in reaction time performance between the groups of children with VLBW only and the control group.     

Visual orientation in hospitalized boys with early onset conduct disorder and borderline intellectual functioning

The aim of the present study is to investigate visual orientation in hospitalized boys with severe early onset conduct disorder and borderline intellectual functioning. It is tested whether boys with the dual diagnosis have a stronger action-oriented response style to visual-cued go signals than the norm. To this end, boys with the dual diagnosis were compared with a peer control group on Posner's (1980) Posner, M. I. 1980. Orienting of attention. Quarterly Journal of Experimental Psychology, 32: 3–25. [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar] visual-spatial detection test. Here, on each trial, a visual cue points either in the direction of the location of a subsequent go signal (valid cue), or points in the opposite direction away from the location of the subsequent go signal (invalid cue). Findings indicated superior orientation (a strong action-oriented response style) of children with the dual diagnosis in valid-cued trials as well as in invalid-cued trials in both the left and the right visual hemifield. Findings were controlled for attention scores on the Child Behavior Checklist -Teacher Form and IQ scores.     

Subtly offending feedback

Providing acceptable negative feedback is difficult because it may threaten the receiver's self‐esteem. Studies have established that destructive feedback elicits stronger negative reactions than constructive feedback. However, these destructive conditions were quite strong, implying a clear threat to the self. Because of the importance of protecting one's self‐concept, negative evaluations might be provoked by more subtle cues. Such cues should also be detected by observers. We developed three variants of subtly offending feedback in which mistakes appeared disproportionately serious. In an experimental pilot study, 132 student observers judged the fairness of feedback given to another student. The subtly offending conditions were evaluated as less fair than constructive feedback but as more fair than destructive feedback.     

Psychotherapierichtlinien: seit 40 Jahren Bewährung in der Praxis

Looking back at 40 years application of psychotherapy guidelines, a positive balance can be drawn. Benchmarks of the guidelines are the biopsychosocial conception of psychic disturbances requiring treatment and the congruent expertise procedure. The latter is considered by many psychotherapists as unreasonable and by the health insurances as not effective enough because of a rejection quota of only 5%. Nevertheless, it proved to be useful in historical, therapeutic and textual aspects. The biopsychosocial conception of psychic disturbances according to the psychotherapy guidelines is an important counterbalance to the objectifying view and evaluation of psychic processes. This concept implies also a complementary view of the ill compared to somatic medicine which allows a better comprehension and understanding of the individual suffering. The most important modification in the psychotherapy guidelines was the inclusion of behavior therapy as the guideline therapy. It succeeded in surpassing the hallmark of (higher) effectivity by offering shorter therapies and objectifiable verification, as an important complementary object-view into psychic processes. Meanwhile, however, this object-view threatens to displace the ?subject-view“ of the psychotherapy guidelines, especially supported by new developments in evidence-based medicine.     

Gender Typed Advertisements and Impression Formation: The Role of Chronic and Temporary Accessibility

In this research, we tested the effects of chronic and temporary sources of accessibility on impression formation. Although some research suggests that chronicity amplifies temporary effects because of greater susceptibility to external primes, other research suggests that chronicity masks temporary effects because of redundance. We demonstrate in a thought listing study that in the domain of gender stereotypes, trait stereotypes may be routinely applied by those with a medium or high tendency to stereotype women, making external primes redundant. Based on this redundancy, we proposed that gender stereotypical primes will have little influence on subsequent judgments of those with a medium or high tendency to gender stereotype. In contrast, gender stereotypical primes will result in the classic assimilation effect for those with a low tendency to gender stereotype. We tested these propositions in the domain of female role portrayals in advertising and examined the effect of advertisements that feature women as homemakers (vs. do not feature women) on trait judgments of a target woman whose behaviors are ambiguously described. Results from 2 experiments show that, as predicted by the redundancy hypothesis, judgments of medium and high tendency to stereotype participants are not affected by advertisements portraying homemakers. Also as expected, judgments of low tendency to stereotype participants are assimilated to the homemaker prime. These results hold across tendency to trait stereotype (Experiment 1) and tendency to role stereotype (Experiment 2) and for trait judgments as well as gift choice. Theoretical and practical implications of these findings are discussed.     

Detection of visual-tactile contingency in the first year after birth

It is well documented that in the first year after birth, infants are able to identify self-performed actions. This ability has been regarded as the basis of conscious self-perception. However, it is not yet known whether infants are also sensitive to aspects of the self when they cannot control the sensory feedback by means of self-performed actions. Therefore, we investigated the contribution of visual–tactile contingency to self-perception in infants. In Experiment 1, 7- and 10-month-olds were presented with two video displays of lifelike baby doll legs. The infant’s left leg was stroked contingently with only one of the video displays. The results showed that 7- and 10-month-olds looked significantly longer at the contingent display than at the non-contingent display. Experiment 2 was conducted to investigate the role of morphological characteristics in contingency detection. Ten-month-olds were presented with video displays of two neutral objects (i.e., oblong wooden blocks of approximately the same size as the doll legs) being stroked in the same way as in Experiment 1. No preference was found for either the contingent or the non-contingent display but our results confirm a significant decrease in looking time to the contingent display compared to Experiment 1. These results indicate that detection of visual–tactile contingency as one important aspect of self-perception is present very early in ontogeny. Furthermore, this ability appears to be limited to the perception of objects that strongly resemble the infant’s body, suggesting an early sensitivity to the morphology of one’s own body.