Suchttherapie bei abhängigen Ärzten

Background

International studies indicate an increased incidence of substance abuse disorders among physicians. This article investigates specific variables in the work field and describes existing treatment programs.

Patients and methods

In a cross-sectional study 107 physicians with and 468 without substance abuse disorders were compared. Two highly developed treatment programs in Germany and Canada are described.

Results

The high work-load associated with the medical work environment leads to reduced performance and social isolation. Treatment programs for addicted physicians work with the concept of ?help before restriction“. The abstinence rate of the 5-year Canadian program is over 90%.

Conclusions

As a form of prevention, medical students should be systematically informed about work-related stress in the medical profession. Structured treatment programs should be implemented nationwide. The expert team ?Risk of addiction in physicians“ of the German Addiction Foundation, whose members are authors of this article, may be a small step in this direction.     

Emotion und Psychotherapie

Considering the fact that all psychic disturbances are emotional disturbances as well, we develop based on our research on the modular structure of the emotional system a systematisation of the disturbance-specific concatenation of these modules within the patient’s social relationships. Subsequently, we discuss treatment possibilities and contraindications for each clinical empirically validated constellation. We describe a fundamental mechanism of affect induction keeping the disturbances alive and transporting them to the next generation. We conclude in stating that treatment recommendations focusing on a standard algorithm of handling the emotions system fail because there is no general indication for such enterprises.     

No inhibitory deficit in older adults' episodic memory

Selectively retrieving a subset of previously studied material can cause forgetting of the unpracticed material. Such retrieval-induced forgetting is attributed to an inhibitory mechanism recruited to resolve interference among competing items. According to the inhibition-deficit hypothesis, older people experience a specific decline in inhibitory function and thus should show reduced retrieval-induced forgetting. However, the results of the two experiments reported here show the same amount of retrieval-induced forgetting in younger and older adults. These results indicate that retrieval inhibition is intact in older adults' episodic recall. The findings suggest that the common view of a general inhibitory deficit in older adults needs to be updated and that older adults show intact inhibition in some cognitive tasks and deficient inhibition in others.     

Overgeneral memory and suppression of trauma memories in post-traumatic stress disorder

The study investigated the relationship between the suppression of trauma memories and overgeneral memory in 42 assault survivors with and without PTSD. Overgeneral memory (OGM) was assessed with a standard autobiographical memory test (AMT). Participants completed two further AMTs under the instructions to either suppress or not suppress assault memories, in counterbalanced order. Participants with PTSD retrieved fewer and more general memories when following the suppression instruction than participants without PTSD, but not under the control instruction. OGM correlated with PTSD symptom severity, and measures of cognitive avoidance. The results are discussed with reference to current theories of overgeneral memory and its possible relationship with PTSD.     

Optimism, pessimism, and change of psychological well-being in cancer patients

Whereas most previous studies have assessed optimism/pessimism as a unidimensional construct, there is increasing awareness that optimism and pessimism may represent two partially independent dimensions. In this study, the role of optimism and pessimism for the maintenance of psychological well-being was assessed in 161 newly diagnosed cancer patients. Before the start of chemotherapy, more positive affect balance was associated with higher optimism and lower pessimism. Over the course of 9 months following diagnosis, pessimism predicted negative change in affect balance, whereas no effect of optimism appeared. Higher levels of perceived side-effects of chemotherapy were associated with negative change in affect balance. However, an interaction effect of perceived side-effects with pessimism indicated that this was only the case in patients with above-median levels of pessimism. The conclusion is drawn that it may be more important to be less pessimistic than to be optimistic when diagnosed with cancer.     

Different types—Different rights

Drawing on a social construction theory of ownership in biological material this paper discusses which differences in biological material might motivate differences in treatment and ownership rights. The analysis covers both the perspective of the person from whom the material originates and that of the potential recipient. Seven components of bundles of rights, drawing on the analytical tradition of Tony Honoré, and their relationship to various types of biological material are investigated. To exemplify these categories the cases of a heart, a kidney, stem cells and hair are used.     

Ethical Problems Inherent in Psychological Research based on Internet Communication as Stored Information

This paper deals with certain ethical problems inherent in psychological research based on internet communication as stored information. Section 1 contains an analysis of research on Internet debates. In particular, it takes into account a famous example of deception for psychology research purposes. In section 2, the focus is on research on personal data in texts published on the Internet. Section 3 includes an attempt to formulate some ethical principles and guidelines, which should be regarded as fundamental in research on stored information.