Mentalisierung und externalisierende Verhaltensstörungen in der Adoleszenz

Social cognition creates the conditions for successful human interaction. Externalizing disorders are characterized by a failure of adequate social cooperation. Therefore, social cognition seems to be a key factor in understanding externalizing behavior, its etiology and treatment options. The present article combines the clinical theory of mentalization with the state-of-the-art of empirical data on externalizing behavior and of the theory-of-mind research as well as research on social information processing. Empirical evidence suggests that there are distinct deficits in social cognition depending on the type of aggression (proactive or reactive). However, even though it is known from a neurobiological perspective that social cognition is reorganized in adolescence, research on externalizing behavior and social cognition in adolescence is limited. Hence the analysis of two studies is presented which compared reflective functioning between a group of late adolescent violent offenders and a control group. A total of 42 young men participated in the studies and were interviewed with the adult attachment interview. Interviews were coded with the reflective functioning scale. Results showed that violent offenders scored significantly lower on the reflective functioning scale than age and gender matched controls. This result is independent of intelligence. Instrumental proactive aggression and psychopathic tendencies are also strongly associated with lower reflective functioning. The results underline the importance of therapeutic interventions for externalizing adolescents which enhance reflective functioning.     

Testpsychologische Ansätze der Beschwerdenvalidierung

The presence of cognitive impairment has been documented for a large number of diseases, conditions and mental disorders. Due to their impact on functioning in professional life and in everyday activities, there appears to be an increasing demand of qualified neuropsychological examinations in civil forensic contexts. While neuropsychological testing is the method of choice for determining the presence and the profile of cognitive impairment, it is easy to underperform in such tests. The authenticity of test results has to be thoroughly checked using modern approaches of symptom validity assessment. Without adequate validity checks, forensic psychological examinations are incomplete.     

Offener und verdeckter Narzissmus

Psychoanalytic theories and clinical practice refer to 2 types of narcissism which differ in the visibility of the narcissistic features: while overt narcissism is observable in open behaviour, covert narcissism is concealed behind an insecure appearance. This distinction was tested empirically by relating the two types of narcissism to self-esteem and the attachment dimensions avoidance and anxiety. Patients in a psychosomatic out-patient department (n=102) were examined with self-report measure. Overt narcissism is associated with a high, covert narcissism with a low self-esteem. Furthermore, while overt narcissism is not related to the attachment dimensions, covert narcissism is accompanied by high levels of attachment anxiety. The results support the theory that narcissism is divided into 2 subtypes which have different profiles in terms of self-esteem and attachment.     

Sexualität und Gewalt

Sexual assault as defined by law, psychiatry and sociological research is contrasted to the everyday definition of rape. Official figures on the frequency of sexual assaults as communicated in annual reports by the police differ greatly from figures found by research on sexual victimization or representative studies using different definitions of violence and abuse in sexual relations. Overpowering and violence is not a rare phenomenon in sexual relations – nearly every second woman and 10% of men are familiar with such situations. There are not only biological conditions (individual variance in neurophysiological parameters) but also psychological conditions favoring the use of power and threat instead of courting in sexual partnerships. External conditions are certain popular opinions in parts of society and certain subcultures which may also be more or less in favor of male superiority, thus helping the perpetrator to justify his assault or on the contrary helping the victim to find support in court procedures and therapy if necessary. Prevention therefore has two targets: a general one by changing popular opinions which are in favor of the use of power in sexual relations and informing persons in danger of becoming victims about the risks and the possibilities to protect themselves and an individual one by treating victims to overcome their psychological injuries and to treat perpetrators inside and outside the judicial system. The current discussion on increased availability of pornography in the internet shows both aspects: a general target to reduce negative influences of pornography which produces devaluating views on sexuality and women and the more individual task of tackling new forms of pathology created by the media at least for some of the consumers.     

Over‐imitation in children with autism and Down syndrome

Typically developing children have been shown to imitate the specific means used by an adult to achieve an object‐directed outcome, even if a more efficient method is available. It has been argued that this behaviour can be attributed to social and communicative motivations. The purpose of this study was to investigate whether children with autism spectrum disorders (ASD), relative to children with Down syndrome (DS), show a reduced tendency to copy the exact means used by an adult to produce a novel outcome. To achieve this a sample of 34 children (22 with ASD and 12 with DS) were given a test of object‐directed imitation. Contrary to expectation, children in both groups imitated the specific method of the model to the same high extent. This finding is in line with suggestions that object‐directed imitation is relatively spared in children with autism but is surprising given arguments linking such imitation to socially based motivations. Nevertheless, children's ability to successfully copy the model was associated with their communicative ability, providing some support for the link between imitation and communication.     

Academic success in adolescence: Relationships among verbal IQ,social support and emotional intelligence

The objective of this study was to examine, by gender, whether emotional intelligence (EI), peer social support, and/or family social support partially mediated the influence of verbal IQ on Grade 10 grade point average (GPA) for 192 students (96 male, 96 female). For male students, EI and peer social support predicted GPA and EI mediated the association between verbal IQ and GPA. For female students, EI, peer social support, and family support predicted GPA but did not mediate the association between verbal IQ and GPA. This study further examined whether subscales of EI (intrapersonal, interpersonal, adaptability, and stress management abilities), peer social support and family social support (emotional, socialising, practical, financial, and advice) added to the prediction of GPA after verbal IQ, gender, and socioeconomic status were controlled. Adaptability, stress management and practical family social support each added to the explanation of variability. None of the peer social support subscales predicted additional variance in GPA.     

Psychopharmakotherapie der Essstörungen

Es gibt eine Reihe von Studien zur Pharmakotherapie der Essst?rungen. Empfehlungen für die pharmakologische Behandlung von Essst?rungen (Anorexia nervosa (AN), Bulimia nervosa (BN), Binge Eating Disorder (BED)), basierend auf der verfügbaren Literatur, werden vorgestellt: Für AN gibt es Hinweise, dass eine ,,Zinksupplementierung“ oder der Einsatz von atypischen Antipsychotika hilfreich sein kann. Für BN zeigen die Studien positive Ergebnisse hinsichtlich des Einsatzes von Antidepressiva, insbesondere für Fluvoxamin und Fluoxetin. Auch für das Antiepilektum Topiramat gibt es positive Studienergebnisse. Bei BED k?nnen bestimmte Antidepressiva und Antiepileptika erfolgreich eingesetzt werden. Jedoch wird weitere Forschung für die Verbesserung der Behandlung von Essst?rungen ben?tigt. Speziell für Anorexia nervosa besteht ein Bedarf für weitere pharmakologische Behandlungsstrategien.     

Medikamentöse Therapieoptionen bei sekundär progredienter Multipler Sklerose

Anders als bei Patienten mit schubf?rmiger Multipler Sklerose, insbesondere jenen, die erst kurze Zeit erkrankt sind, sind unsere therapeutischen M?glichkeiten für Patienten mit sekund?r chronisch progredienter Multipler Sklerose leider noch immer nicht ausreichend. Dies bedeutet erstens, dass wir unsere zur Verfügung stehenden Therapien frühzeitig im Verlauf der Erkrankung einsetzen müssen, um überhaupt erst einen übergang in eine sekund?re Progredienz zu verhindern. Andererseits kann man, wenn ein Patient bereits in der sekund?r progredienten Phase ist, durch sorgf?ltig überlegten Einsatz Krankheitsmodifizierender medikament?ser Therapien, symptomatischer Therapien und Rehabilitation eine lange Stabilisierung der Multiplen Sklerose bei guter Lebensqualit?t erreichen.