Zwischen Anerkennung und Zur��ckweisung

The paper deals with the question of to what extent the development and application of medical nosologies are dependent upon social, political and economic conditions and which (often utilitarian) considerations decide on the fitness for use of a clinical picture and a diagnosis. The context and the framework of the construct are crucial to understanding, recognition and finally to compensation procedures. With reference to historical and current material supplied by war veterans, processes of recognition and rejection of entitlements to benefits will be illustrated; the significance of psychoanalytical concepts in this process will be reflected.     

Cognitive bias in dizziness: emotional Stroop and autobiographical memories

Dizziness is commonly associated with anxiety, and is often caused by a dysfunction of the balance system. While a link between dizziness and both anxiety disorders and depression has been established, less is known about information processing in dizziness. In the first experiment we tested whether 15 patients with dizziness would display an emotional Stroop effect for panic-related words. Also included was a control group of 15 persons. The Stroop task was preceded by ratings of personal relevance of the Stroop words and followed by a surprise free recall of the words. Results showed a Stroop effect for panic-related words in the dizziness group, but the interaction did not reach significance (p = 0.08). Separate analysis of dizziness-related panic words however resulted in a significant group x condition interaction. In the free recall of Stroop words a main effect of word category was found, with more panic-related words being recalled. The second experiment investigated autobiographical memories in 14 patients with dizziness and 14 matched controls. Results showed a group x condition interaction with less specific memories being recalled following positive cue-words in the dizziness group. The overall pattern of results suggests that dizziness is related to deficits in information processing, which could be targeted in treatment.     

Alkoholabhängigkeit in der psychiatrischen Klinik

In Germany 2.4?% of the population suffer from alcohol dependency and 3.8?% of adults from alcohol abuse. Despite an extensive number of options available for addiction therapy only a minority of affected persons receive addiction-specific therapy. This results in a chronification of the disease and a reduction of approximately 15 years in life expectancy. Background knowledge of the foundations of alcohol addiction leads to a new understanding of the processual course of the disease as well as to new therapy interventions. Individualized treatment includes a combination of outpatient, partial inpatient or inpatient therapeutic measures and range from medical advice for reduction of alcohol consumption, to qualified withdrawal treatment up to pharmacological relapse prophylaxis and long-term weaning treatment. Under current therapeutic conditions abstinence quotas of 50-70?% over 1 year can be achieved. Treating physicians must have sufficient diagnostic certainty and furthermore must be in command of motivating discourse techniques, knowledge on the therapeutic options of outpatient and inpatient withdrawal treatment, pharmaceutical relapse prophylaxis and mediation in rehabilitation measures.     

Sexuelle Funktionsstörungen und ambulante Psychotherapie

Based on a literature review the following questions are discussed: how prevalent are sexual dysfunctions in the community and in treatment samples (particularly in psychotherapy patients)? How many patients with sexual dysfunctions seek help in outpatient psychotherapy and for how many patients would this kind of treatment be indicated? Data show that only relatively few patients with sexual dysfunctions are being treated in outpatient psychotherapy. Deficits concerning detection and monitoring of sexual dysfunctions and in terms of interdisciplinary treatment are obvious. To find possible reasons for these deficits the multifactorial etiology of sexual dysfunctions, the segmentation of care and also psychological variables characterizing the patient (denial of dysfunction) and the therapist (subjective need for specific training) are discussed. It is proposed that routine use of screening questionnaires for sexual dysfunctions should be introduced and it is described how the diagnostics and treatment implementation for sexual dysfunctions can be effectively integrated into clinical practice. Finally, arguments for a broader representation of research on sexual dysfunction in the field of clinical psychology are presented.