Die Sachverständigenexpertise im Spannungsfeld zwischen Justiz und Psychiatrie am Beispiel des Hangbegriffes des § 66 StGB (Sicherungsverwahrung)

Using the example of psychiatric expert opinions in trials leading to preventive detention, we analysed how far the corresponding orders by the courts were suited to guide the psychiatric experts and restrict them to their area of expertise. Furthermore we concentrated on the question, what reasons were given for preventive detention on both psychiatric and judicial side and how psychiatric arguments were adopted by the judges. Our results show clearly, that placing an order with the psychiatric expert as well as adopting the psychiatric arguments for preventive detention occur mainly in a stereotypic way. Psychiatric and judicial arguments for preventive detention refer both to previous delinquency. Aspects concerning the offenders personality appear to be secondary, although they play a major role in the decision for preventive detention. The article shows the controversy associated with forensic-psychiatric expertise in the courtroom and the need for communication and clarification between psychiatry and law.     

Die therapeutische Beziehung

The therapeutic relationship is deserving of special consideration. Both knowledge of the widely varying aspects of proposals in terms of possible relationship regulation and acquisition of the different forms of therapeutic relationship management are crucial for therapeutic success. Impact factors are used in the psychotherapeutic process (resource activation, problem activation, problem identification and problem solving), which are predominantly used in rapid succession or even simultaneously. This is also true of the relationship proposals intended and deployed by the therapist, which can also be conceptualised on the basis of impact factors. It has been shown that a single relationship quality can have very different mechanisms of action (e.g. on problem updating and identification). Successful therapeutic relationship regulation is characterized by high flexibility on the part of the therapist, who is able to move between the poles of understanding/confirmation, guidance/support and leadership/control. A good therapeutic relationship in terms of effecting an improvement in the patient is characterized according to the therapist’s flexibility as regards what he/she can offer in the relationship, a flexibility which can no longer be squarely attributed to one therapy discipline alone. In order to take the significance of the therapeutic relationship into account, the training and specific skills required for this need to be taught during training and supervision. A prerequisite to this, in addition to a sound theoretical training in the relevant aspects of relationship regulation, is relationship regulation skills in terms of both concept and own practical experience.     

Beyond Single-Mindedness: A Figure-Ground Reversal for the Cognitive Sciences

A fundamental fact about human minds is that they are never truly alone: all minds are steeped in situated interaction. That social interaction matters is recognized by any experimentalist who seeks to exclude its influence by studying individuals in isolation. On this view, interaction complicates cognition. Here, we explore the more radical stance that interaction co-constitutes cognition: that we benefit from looking beyond single minds toward cognition as a process involving interacting minds. All around the cognitive sciences, there are approaches that put interaction center stage. Their diverse and pluralistic origins may obscure the fact that collectively, they harbor insights and methods that can respecify foundational assumptions and fuel novel interdisciplinary work. What might the cognitive sciences gain from stronger interactional foundations? This represents, we believe, one of the key questions for the future. Writing as a transdisciplinary collective assembled from across the classic cognitive science hexagon and beyond, we highlight the opportunity for a figure-ground reversal that puts interaction at the heart of cognition. The interactive stance is a way of seeing that deserves to be a key part of the conceptual toolkit of cognitive scientists.     

Kulturdynamisches Modell der bikulturellen Identit?t

In intercultural psychotherapeutic treatment, the psychological integration of different cultures within an individual has to be involved as an additional developmental dimension. Individual change during the process of migration considered as desirable adaptation has often been conceptualized in terms of a bicultural identity, which includes aspects of the culture of origin as well as aspects of the host culture. The theoretical foundation of the concept of bicultural identity, however, has remained insufficient. The culture-dynamic model presented here differentiates personal and social identity according to the identity concept proposed by Mead (Geist, Identit?t und Gesellschaft, 1988, Suhrkamp, Frankfurt a.?M.). Personal identity is essentially formed by an individual??s culture of origin, while influences of the host culture primarily affect the social identity. For healthy coping with the challenges associated with migration and adequate support of this process in intercultural psychotherapy, it can be assumed that a stabilization of personal identity is required to allow for a dynamization of social identity. Implications for identity constitution in second generation immigrants, in different stages of lifespan development and in the process of learning the language of the host culture are discussed.     

Psychologische Mess- und Testverfahren

The use of psychological assessment methods is flawed by incorrect assumptions of their capacity. Some of these assumptions are discussed. It is argued that psychological tests are necessary to expand the database for expert reports about the impact of mental disorders on work and different levels of functioning. Tests help to protect psychological assessments against errors and chance bias. With respect to levels of functioning, examples of German tests and questionnaires are given. Test-based information requires objective validation methods and should not be subordinated to an intuitive assessment strategy.     

Literatur in Examensarbeiten

After the Second World War up to the 1980s Harald Schultz-Hencke’s so-called German neopsychoanalysis was an important theoretical reference for psychoanalysts in the German Psychoanalytical Society (DPG). Simultaneously, however, references were increasingly being made to quintessential psychoanalytical sources which of course had an impact on the psychoanalytical training. The references in final papers of a DPG psychoanalytical institute from 1971–2008 were compared to the references in clinical papers of the International Journal of Psychoanalysis. It can be shown that the influence of German neopsychoanalysis in the final theses of the psychoanalytical institute in question has diminished since the 1990s and has become irrelevant in the twenty-first century.     

„Die Umwelt macht mich krank“

Fears and physical complaints are frequently attributed to the environment. In the form of environmental illness or environmental syndromes they can often reach clinical relevance, even if no causal relationship between subjective stimuli and symptoms can even if be found. The role of psychotherapy is controversial, especially because patients fear for the legitimacy of their complaints and preferably seek somatic or alternative forms of treatment. In addition, there is limited evidence for the effectiveness of psychotherapy. In view of the high degree of suffering, especially as anticipatory anxiety, avoidance behavior, social retreat and distrust, and comorbidity with mental illness, psychotherapy can frequently enable patients to reach more self-efficacy, trust, a wider range of activities and thus a better quality of life.     

Internet als Ratgeber bei psychischen Problemen

Communication serves as an integral part of every psychotherapeutic treatment. Consequently, in the last decade modern information and communication technologies in the therapeutic context gained in importance. How important are Internet-based therapeutic information and intervention sources for potential patients and how are they appraised when already known or used? In the course of a representative study the health-related Internet use behavior of 2,411 Germans was examined. There was a focus on the usage of health-related websites and counseling services in the past and (potentially) in the future. More than one third (37.3%) of the German population and almost two thirds (63.5%) of German Internet users search for medical information on Internet. However, physicians, psychologists, pharmacists, family members and friends have a greater impact on health behavior than the Internet. Of German Internet users 54.1% are not informed about the possibilities of psychosocial online counseling. Nevertheless, they would maybe use the Internet in the future. The 2.2% who already used Internet in case of psychosocial problems are content with the service. In fact new media have not yet found their way into psychotherapy and counseling as much as in our daily lives. With regard to manifest mental disorders, Germans would prefer the conventional psychotherapeutic milieu to media-assisted kinds of treatment.     

Athanasios Koukopoulos (1931–2013)

With the death of Athanasios Koukopoulos last year, psychiatry lost one of its most stimulating and scientifically influential representatives has been lost. His main scientific contributions are in the course of manic depressive illnesses and mixed affective states. Perhaps his most important contribution to modern psychiatry are his studies on the use of antidepressants in bipolar disorder. He was able to show that antidepressants attenuate the beneficial effects of lithium, can trigger mania, and can lead to cycle acceleration and rapid cycling.