Diagnostic Discrimination of Patients with Different OCD Main Symptom Domains from each Other and from Anxious and Depressive Controls

The extent to which the subscales of multidimensional OCD measures accurately distinguish patients with specific OCD main symptom domains from controls at different cutscores has not yet been examined. Diagnostic accuracy of OCD measures usually is determined by comparing the total scores of heterogeneous OCD samples and controls and therefore may underestimate the measures’ discrimination potential. In the current study, subtype-specific diagnostic accuracy and criterion-related validity of the Obsessive-Compulsive Inventory-Revised (OCI-R) subscales were examined in 327 patients with OCD, anxiety, and/or depressive disorders. All subscales demonstrated good to excellent criterion-related validity and diagnostic accuracy for distinguishing patients with specific OCD main symptom domains from controls. As expected, the single OCI-R subscales lead to more accurate diagnostic decisions than the total scale. Thus, the subscale-specific cutscores significantly improve the OCI-R’s utility for subtype-specific treatment planning and outcome measurement. Furthermore, an alternative classification algorithm distinguishing patients with OCD from controls based on subscale cutscores leads to a better sensitivity, but also to a lower specificity than discrimination based on the total scale cutscore.     

Cannabiskonsum und -missbrauch bei Jugendlichen und jungen Erwachsenen

After a long time of growth current studies on representative samples of adolescents indicate that the number of adolescent cannabis users in Germany is possibly decreasing. However, it may be presumptuous to expect a similar trend concerning the number of clients with cannabis-related disorders. Even if there is in fact a downward trend which is not yet proven, the rapidly growing number of clients presenting with these disorders in recent years cannot be explained by a similar growth in the number of regular cannabis users. Treatment centres should therefore expect a further inreasing number of especially male adolescents and young adults seeking help for problems related to cannabis use. The development, evaluation and implementation of specific treatment options concerning cannabis use disorders will be increasingly needed in the future. Cognitive-behavioral and motivational interventions have been shown to be evidence-based treatments. The paper describes some promising or already successful treatment approaches and related research projects in Germany.     

Goethes Studienkrise, Depression und seine Selbstbehandlungsstrategien

From a present day diagnostic viewpoint Goethe suffered from several episodes of depression beginning with his study crisis. In addition he wrote that he had a tendency towards dysthymic moods. In terms of modern psychotherapeutic procedures the various levels of Goethe’s self-therapy strategies are remarkable: acceptance of helpful bonding and relationships, correction of dysfunctional behavior and modification of pathogenic conceptions and beliefs as well as remembrance, enactment and mentalization of psychodynamic conflicts. Finally at an existential level his salutogenic strategies served to invoke a sence of coherence often threatened in his life. Anxieties, dysthymic moods, lack of self-esteem and existential conflicts were for him not only the reason and motive for realization of his extraordinary artistic potential. For modern psychotherapists and patients it is interesting that the acceptance of dysthymic moods and psychological conflicts and the transformation through relationships, cognitive behavior-oriented and psychodynamic strategies as well as an existential self-effective striving also lead to everyday creativity, i.e. coping with life.     

Psychotherapeutenausbildung aus Sicht der Absolventen

Background

A survey was performed to assess the current situation in education and to identify critical issues 10 years after the inception of the psychotherapy act in Germany.

Methods

In August 2008 all non-medical psychotherapists who had graduated since 2002 according the psychotherapy act were invited to take part in the survey and a total of 863 persons participated. The answers from 666 could be evaluated corresponding to a participation rate of 20%.

Results

A total of 57.6% of the graduates had completed a full-time training and approximately 50% of the graduates had completed the training within the allotted time. In the majority of cases evaluation occurred only for the theoretical courses. During the practical work (PT I) 36.8% of the graduates did not receive any salary or remuneration, 82% had their own field of activity and of these 38% treated patients without the presence of qualified tutor.

Conclusions

The training often lasts longer than intended, the financial situation in the PT I is exceptionally critical and in clear contrast to the field of activity in this section of training. Further detailed results will be presented and discussed.     

Go no-go performance under psychosocial stress: beneficial effects of implementation intentions

Acute stress has been found to have negative and implementation intentions (IIs) to have positive effects on cognitive performance. This study was the first to examine the effects of IIs on executive action control under acute psychosocial stress. Forty-two male subjects aged 21-39 years were randomly assigned to the Trier Social Stress Test (TSST) versus a rest condition. In addition, the instruction to the executive task (a go no-go task) was manipulated (IIs versus standard instruction). After the stress test, a dual-task procedure including a go no-go task was conducted. The TSST resulted in increases in cortisol response, heart rate and state anxiety compared to the rest condition. Acute stress significantly impaired go no-go performance, but only in the group without IIs. We conclude that under acute stress conditions executive functioning is reduced, but the use of IIs can be an effective strategy to overcome this negative effect.     

A novel technology for investigating the dynamics of infant perseverative reaching

We designed and tested a novel technology that enables us to capture the entire stream of behavior in perseverative reaching tasks. Beyond fitting the criteria of the conventional A-not-B task, the novel technology gives us better access to the core features of perseverative reaching, such as timing, behavior history, and reinforcement. The technology allows us to quantitatively manipulate reinforcement characteristics, to accurately program onsets, delays, and stimulus durations as well as locations and salience of the targets, and to automatically record the number of reaches to each target and compute timing. We did a validation study on this new technology, investigating the influence of a number of novel factors on perseverative reaching. We replicated the A-not-B phenomenon and associated developmental changes. In addition, results demonstrated that the new technology offers insights into infants' behavior beyond the first reaching action. Moreover, data collection is fully automated, yielding precise, quantitative data. Future studies using this technology will capitalize on the salient advantages of this technology to more precisely measure goal-directed actions and understand the development of reaching skill.     

On the expression and experience of surprise: no evidence for facial feedback, but evidence for a reverse self-inference effect

Three studies examined the effects of experimentally manipulated surprise expressions on the experience of surprise. Surprise was induced by a sudden, unannounced change of the stimulus presentation during a computerized task. Facial expression was manipulated by leading participants to adopt an expression akin to surprise, or by forcing them to look up steeply to a monitor. The expression manipulations had no intensifying effect on the experience of surprise, whereas manipulations of unexpectedness and mental load had strong effects. In addition, mental load was found to affect beliefs about facial expression, suggesting that the participants used their feelings of surprise to infer their probable facial displays. Path analyses supported this reverse self-inference hypothesis.     

Building information systems as universalized locals

We report on our experiences in a participatory design project to develop ICTs in a hospital ward working with deliberate self-harm patients. This project involves the creation and constant re-creation of socio-technical ensembles that satisfy the various, changing and often contradictory and conflicting needs in this context. Such systems are shaped in locally meaningful ways but nevertheless reach beyond their immediate context to gain wider importance and to be integrated with the larger environment. currently working on a participatory design project developing IT systems for psychiatrists working in a toxicology ward of a large general hospital. His research focuses on the local co-production of technologies which he currently explores in a production management context. His research interests lie in the field of human factors and interactive systems design, particularly approaches to IT systems design and development, the relationships between work and technology, and inter-disciplinary approaches to the design of dependable computing systems. carrying out a number of ethnomethodologically informed studies in a variety of applications. He holds a Ph.D. in ethnomethodology from the University of Manchester and is currently involved in research on computer-aided prompting systems for radiological work. He has interests in ethnomethodology, CSCW, SSK and the philosophy of social sciences. where he convenes an interdisciplinary research programme on ‘the social shaping of technology’.