Sexuell übergriffiges und aggressives Verhalten im Kindesalter Einflüsse entwicklungsrelevanter Faktoren

During the last years increasing attention has been paid to young children and adolescents with sexual coercive behaviour. During the year 2007 altogether 232 boys and 30 girls under the age of 14 years were reported to the police because of sexual assaults. In NRW an increasing number of in- and out-patient institutions offers specific and unspecific treatment programs for these children. The major aim of our study, which is supported by the Ministry of Employment, Health and Social Affairs of the state of NRW, is to evaluate the wide range of different treatment programs and to find predictors for successful or difficult treatment outcomes. Furthermore we are interested in differences between children with sexual problem behaviour and children with exclusively aggressive problems. So far 23 institutions take part in our research project and our total sample currently consists of 75 boys between 9 - 15 years. A psychometric test battery is applied at the beginning of individual treatment. Our first results highlight differences in socio-demographic data between children with sexual coercive behaviour and children with exclusively aggressive behaviour problems. Compared to children with exclusively aggressive problem behaviour, children with sexual problem behaviour come more often from incomplete families with no male parent, have experienced more psychological and physical violence and have been more often victims of sexual abuse. Compared to children with exclusively aggressive behaviour problems they score significantly higher on the “Depression / Anxiety” scale of the SPS-J, although average T-scores for both groups are within the normal range. Regarding cognitive functioning there are no significant differences between both groups.     

Verläufe bei sexuellen Tötungen

This article summarizes main results of studies on forensic psychiatric court reports on 166 men who had been persecuted between 1963 and 1991 for a sexual offence leading to the death of the victim. Comparing perpetrators with a single victim and those with multiple victims we found similar results as in two previous studies with smaller samples: Multiple sexual homicide perpetrators showed more often sexual sadism and other paraphilias, as well as antisocial, schizoid and sadistic personality disorders. Follow-up data from the federal criminal records could be obtained for 139 offenders. Ninety perpetrators had been released after a mean detention of 12.2 years, whereas the 49 offenders who were still in prison or forensic psychiatric hospitals had been detained for a mean period of 20.6 years. The non-released offenders showed more often paraphilias as well as antisocial and sadistic personality disorders than the released perpetrators. Paraphilias and antisocial personality traits are empirically well proven risk factors for criminal recidivism with sexual reoffences. In addition, the non-released sexual homicide perpetrators had higher scores in all applied risk assessment instruments (PCL-R, HCR-20, SVR-20, Static-99). Among the released offenders only 1.1% (n=1) reoffended with a completed homicide and 2.2% (n=2) with attempted homicide. The recidivism rates with sexual and other violent reoffences in this sample of sexual homicide perpetrators were similar to those in a large meta-analysis on recidivism in sexual offenders by Hanson and Morton-Bourgon (4). Since well established risk factors had apparently been “used-up” for the decisions about release or non-release, in the follow-up data about the released offenders only age at the sexual homicide and age at the time of release were found as risk factors for recidivism with any violent (sexual or non-sexual) reoffence, i.e. the younger the offender at the time of the homicide and the younger at the time of release, the more likely is the risk of violent reoffending.     

Wurden schizophrene Maßregelpatienten zuvor in der Allgemeinpsychiatrie unzureichend behandelt?

Since 1996 we have had a marked increase in the number of admissions to special psychiatric hospitals for mentally ill offenders in Germany. Still higher was the increase in schizophrenic patients admitted to these facilities. The question arose whether deficits of the psychiatric health system are contributing to these changes. We studied the medical history of 50 schizophrenic patients, each of whom was hopitalized in the Berlin special hospital in the periods of 1985-1988 and 2002-2004. Surprisingly, there was no difference in the duration of former psychiatric hospitalizations and medical treatment. There was also no difference in the number of dubious releases from the general psychiatric hospital. But we found a marked increase of co-morbid drug abuse and of noncompliance to treatment.     

Internet Versus Group Cognitive-Behavioral Treatment of Distress Associated With Tinnitus: A Randomized Controlled Trial

Tinnitus distress can be reduced by means of cognitive-behavior therapy (CBT), and the treatment can be delivered in different ways. The most recent format is Internet-based self-help. The aim of this study was to compare this treatment (n = 26) with standard group-based CBT (n = 25) in a randomized controlled trial. Outcomes on self-report inventories measuring tinnitus distress were evaluated immediately after and 1 year after treatment. Results showed that both groups had improved, and there were few differences between them. The effect size for the Internet treatment was d = 0.73 (95% CI = 0.16–1.30) and for the group treatment was d = 0.64 (95% CI = 0.07–1.21). The Internet treatment consumed less therapist time and was 1.7 times as cost-effective as the group treatment. At pretreatment patients rated the Internet treatment as less credible than the group treatment. In conclusion, Internet treatment for tinnitus distress merits further investigation, as the outcomes achieved are promising.     

Is it the sound or your relationship to it? The role of acceptance in predicting tinnitus impact

Tinnitus is an experience of sound in the absence of an appropriate external source. A symptom that can accompany most central or peripheral dysfunctions of the auditory system, tinnitus can lead to significant distress, depression, anxiety, and decreases in life quality. This paper investigated the construct of psychological acceptance in a population of tinnitus patients. First, a cross-sectional study (N = 77) was conducted in which a tinnitus specific acceptance questionnaire was developed. Results showed that a Tinnitus Acceptance Questionnaire (TAQ) generated good internal consistency. A factor solution was derived with two factors: activity engagement and tinnitus supression. Second, a longitudinal study (N = 47) investigated the mediating role of acceptance on the relationship between tinnitus distress at baseline and tinnitus distress, anxiety, life quality, and depression at a 7-month follow-up. The results showed full mediation of activity engagement for depression and life quality at follow-up, partial mediation for tinnitus distress, and no mediation for anxiety. The role of acceptance in the negative impact of tinnitus distress merits further investigation.     

Coordination of a discrete response with periodic finger tapping: additional experimental aspects for a subtle mechanism

The authors investigated the coordination of periodic right-hand tapping with single stimulus-evoked discrete lefthand taps to check for task interactions and a possible relationship between phase resetting (see tapping literature; e.g., J. Yamanishi, M. Kawato, & R. Suzuki, 1979) and phase entrainment (see tremor literature; e.g., R. J. Elble, C. Higgins, & L. Hughes, 1994). The experimental paradigm employs a dual-task condition as used by K. Yoshino, K. Takagi, T. Nomura, S. Sato, and M. Tonoike (2002), and it includes normal tapping and isometric tapping with the authors recording finger positions and ground contact forces. Four different types of coordination schemes were observed in tapping behavior: marginal tapping interaction (MTI), periodic tap retardation (PTR), periodic tap hastening (PTH), and discrete tap entrainment (DTE); MTI and PTR correspond to the phase-resetting effect for the coordination of periodic tapping with single discrete taps. The novel aspect of the study described in this article includes the impact of the periodic tapping on the discrete tap timing and the hastening of the periodic tapping due to the discrete tap behaviors resulting in a synchronized execution of the two concurrent tapping tasks. All participants showed a dominant tapping behavior, but they all used the other nondominant forms of the four reported coordination schemes in some trials too, which reflects possible constraints of the sensorimotor system in handling two competing tasks.     

Chronic Pain and Praying to a Higher Power: Useful or Useless?

In the present study a Swedish sample of 118 persons with chronic pain completed online tests on two occasions in association with treatment trials. A three item subscale measuring praying as a coping strategy was derived from the Coping Strategies Questionnaire (CSQ), but adapted to refer to “a higher power” instead of “God”. Measures of pain and anxiety/depression were also included. Results revealed significant associations between praying and pain interference and impairment. Praying was also associated with anxiety and depression scores. Results also showed that prayer predicted depression scores at follow-up, and that follow-up prayer was predicted by pain interference at first measurement occasion. Overall, if prayer had any relation with the other variables it was in the negative direction of more distress being associated with more praying both concurrently and prospectively.

Scham und Berührung

The problem

Are there correlations between shame and touch in healthy persons?

Methods

Data from a questionnaire survey with the Skin Satisfaction Questionnaire (HautZuf) with 140 healthy persons were validated with TAS 26, HADS and the Adult Attachment Scale.

Results

There are significant correlations in the scale shame with all other scales of the used questionnaires TAS-26, AAS and HADS. There was a negative correlation between the scale ?physical closeness“ and ?confidence“ of the AAS, but all other scales correlated positively with the shame scale.

Conclusions

More emotions of shame seem to be present with anxiety, depression and disturbances in the sense of an alexithymia concept. Also high feelings of shame correlated with decreased confidence in the personal environment and greater intolerance for personal nearness. The significant correlations between shame affects and self-touch or touch by partner point to important factors in self-perception also for the psychotherapeutic context.     

Von anderen Patienten lernen

Today, internet-based technologies are used at all levels of psychosocial services. Current psychotherapeutic applications concentrate on the implementation of traditional approaches in the internet. Self-help programs are posted onto the net, therapies are conducted via e-mail and groups meet in virtual chat rooms. If one looks at the development of the web over the last 2 years, it becomes clear that the substantial growth and popularity of this medium is due to internet platforms where contents and knowledge can be developed in collaborative environments and experiences can be shared with other users. The present paper addresses this development. On the basis of our example it is discussed how collaborative elements can be integrated into a psychotherapeutic application.