Unerwünschte und schädliche Wirkungen von Psychotherapie

Unwanted effects or even damage due to psychotherapy are largely neglected issues within psychotherapy research as compared to other fields. On the other hand, it is reasonable to assume that unwanted effects of a treatment which intends to influence patients into a positive direction are very likely. The rate of negative effects of psychotherapy (the deterioration effect according to Bergin) is consistently estimated to be 10% of all cases and shows this same rate in a variety of studies. This review highlights side effects of psychotherapy both on the part of the patients and of the therapists. It reports unwanted effects related to different psychotherapeutic methods, i.e. psychoanalysis, cognitive behaviour therapy, client-centered psychotherapy and – beyond these basic orientations – group psychotherapy. The paper also reports on negative effects of psychotherapy on an untreated partner. Finally, some proposals are given on how negative effects of psychotherapy could be diminished. The authors especially highlight the possibilities of changing the therapist, the treatment technique, or the theoretical treatment approach as a way to reduce negative effects.     

Spousal similarity in coping and depressive symptoms over 10 years.

Following a baseline sample of 184 married couples over 10 years, the present study develops a broadened conceptualization of linkages in spouses' functioning by examining similarity in coping as well as in depressive symptoms. Consistent with hypotheses, results demonstrated (a) similarity in depressive symptoms within couples across 10 years, (b) similarity in coping within couples over 10 years, and (c) the role of coping similarity in strengthening depressive similarity between spouses. Spousal similarity in coping was evident for a composite measure of percent approach coping as well as for component measures of approach and avoidance coping. The role of coping similarity in strengthening depressive symptom similarity was observed for percent approach coping and for avoidance coping. These findings support social contextual models of psychological adjustment that emphasize the importance of dynamic interdependencies between individuals in close relationships.     

New knowledge derived from learned knowledge: functional-anatomic correlates of stimulus equivalence

Forming new knowledge based on knowledge established through prior learning is a central feature of higher cognition that is captured in research on stimulus equivalence (SE). Numerous SE investigations show that reinforcing behavior under control of distinct sets of arbitrary conditional relations gives rise to stimulus control by new, derived relations. This investigation examined whether frontal-subcortical and frontal-parietal networks known to support reinforced conditional relations also support derived conditional relations. Twelve adult subjects completed matching-to-sample (MTS) training with correct/wrong feedback to establish four trained conditional relations within two distinct, three-member stimulus classes: (1) A1-->B1, B1-->C1 and (2) A2-->B2, B2-->C2. Afterwards, functional neuroimaging was performed when MTS trials were presented involving matching two identical circles (a sensorimotor control condition), trained relations (A-->B, B-->C), and derived relations: symmetry (B-->A, C-->B), transitivity (A-->C), and equivalence (C-->A). Conditional responding to trained and derived relations was similarly correlated with bilateral activation in the targeted networks. Comparing trained to derived relations, however, highlighted greater activation in several prefrontal regions, the caudate, thalamus, and putamen, which may represent the effects of extended training or feedback present during imaging. Each derived relation also evidenced a unique activation pattern. Collectively, the findings extend the role of frontal-subcortical and frontal-parietal networks to derived conditional relations and suggest that regional involvement varies with the type of derived conditional relation.     

Whisker: A client—server high-performance multimedia research control system

We describe an original client-server approach to behavioral research control and the Whisker system, a specific implementation of this design. The server process controls several types of hardware, including digital input/output devices, multiple graphical monitors and touchscreens, keyboards, mice, and sound cards. It provides a way to access this hardware for client programs, communicating with them via a simple text-based network protocol based on the standard Internet protocol. Clients to implement behavioral tasks may be written in any network-capable programming language. Applications to date have been in experimental psychology and behavioral and cognitive neuroscience, using rodents, humans, nonhuman primates, dogs, pigs, and birds. This system is flexible and reliable, although there are potential disadvantages in terms of complexity. Its design, features, and performance are described.     

Multicriteria agency theory

This paper extends standard agency theoretic models to explicitly take into account the presence of multiple criteria at the agent level. Two approaches for this extension are discussed. In the first approach we consider only the minimum information that the principal might posses about the agent’s preferences for different criteria. It can be shown that in this context the principal has limited possibilities to influence the agent’s behaviour. In the second approach a richer information set is considered. In this context it is possible to determine probabilities of alternatives being selected by the agent. We also analyse how these probabilities can be influenced by the principal and how this affects the principal’s net profit. © 1998 John Wiley & Sons, Ltd.     

Psychosocial risk and resistance factors among children with chronic illness,healthy siblings,and healthy controls

Psychosocial risk and resistance factors within the domains of parental functioning, family Stressors, and family resources were examined as predictors of psychological adjustment and physical problems in juvenile rheumatic disease patients (N=93), their healthy siblings (N=72), and demographically matched healthy controls (N=93). Family socioeconomic status and background variables showed few consistent relationships with child functioning. However, a constellation of risk and resistance factors tended to show comparable associations with functioning for patients, siblings, and controls. Higher parental depression and medical symptoms and more family Stressors, sibling problems, and burden of illness on the family predicted more problems among the patients. These relationships held when disease duration and severity were controlled. For the siblings, increased parental and patient dysfunction, more family Stressors, and less family cohesion and expressiveness were associated with more problems. Although the associations were not as strong, mothers' depression and lack of family cohesion and expressiveness also were related to more adjustment problems among the control children. These findings imply that there may be a general association between certain risk and resistance factors and childhood adaptation.This research was supported in part by NIH Multipurpose Arthritis Center Grant AM20610, NIMH Grant MH16744, and Veterans Administration Medical and Health Services Research and Development Service Research funds. Jan Gottlieb provided valuable help in all phases of the research. We appreciate the help of the staff of the Pediatric Rheumatology Clinic at Children's Hospital at Stanford and the families who participated in this study.