Mentalisierungsbasierte Psychotherapie bei schizophrenen Psychosen

Recently, there has been growing interest in new methods of psychotherapeutic interventions for schizophrenic patients. Social cognition, social functioning and quality of life are central objectives. Mentalization-based therapy (MBT) is a specific psychodynamic method developed from the fundament of attachment theory and empirical psychotherapy research for the treatment of borderline personality disorder, particularly focusing on attachment relationships, mentalizing capacity and affect regulation. Studies have shown that MBT is able to ameliorate interpersonal experience and social life. The latest neuroscientific findings support this view and encourage the application of a modified form of MBT in the treatment of schizophrenic patients. The authors present a concept for disorder-specific interventions in schizophrenia, including psychoeducational aspects and mentalizing exercises which step-by-step lead to a more reflective work in mentalization-based group psychotherapy.     

Echoing the emotions of others: empathy is related to how adults and children map emotion onto the body

ABSTRACT

Empathy involves a mapping between the emotions observed in others and those experienced in one’s self. However, effective social functioning also requires an ability to differentiate one’s own emotional state from that of others. Here, we sought to examine the relationship between trait measures of empathy and the self-other distinction during emotional experience in both children and adults. We used a topographical self-report method (emBODY tool) in which participants drew on a silhouette of a human body where they felt an emotional response while watching film and music clips, as well as where they believed the character in the film or performer was feeling an emotion. We then assessed how the degree of overlap between the bodily representation of self versus other emotions related to trait empathy. In adults, the degree of overlap in the body maps was correlated with Perspective Taking. This relationship between cognitive empathy and degree of overlap between self and other was also found with children (8–11 years old), even though children performed worse on the task overall. The results suggest that mapping emotions observed or imagined in other’s bodies onto our own is related to the development of empathy.     

The liberty principle and universal health care

A universal entitlement to health care can be grounded in the liberty principle. A detailed examination of Rawls's discussion of health care in Justice as Fairness shows that Rawls himself recognized that illness is a threat to the basic liberties, yet failed to recognize the implications of this fact for health resource allocation. The problem is that one cannot know how to allocate health care dollars until one knows which basic liberties one seeks to protect, and yet one cannot know which basic liberties to protect until one knows how health care dollars will be allocated. The solution is to design the list of basic liberties and the health care system in tandem so as to fit each other, such that every citizen is guaranteed a set of basic liberties and access to the health services needed to secure them.     

Personality traits in patients with narcolepsy

Narcolepsy is a lifelong disorder with the main symptoms of sleep attacks and cataplexy. In this study 49 narcoleptic patients were investigated with a battery of personality inventories, covering the following personality dimensions: anxiety-neuroticism, extraversion and socialization. The results were compared with three groups: normal subject, psychiatric inpatients with anxiety and outpatients with psychosomatic complaints. The main aim was to evaluate a clinical impression of a high degree of extraversion in narcoleptic patients, which according to Eysenck's model could be related to a disturbance in the arousal regulation. Narcoleptic patients had higher anxiety-neuroticism scores than normal individuals, particularly in terms of Somatic Anxiety. They had unexpectedly low scores in some socialization scales, and were contrary to our hypothesis slightly lower in the extraversion variables, than the comparison groups. The high scores in anxiety-neuroticism personality scales may depend on an anxiety-provoking effect of central stimulant drugs and/or a lability of the autonomic regulation associated with the disorder. Further, the strain caused by the narcoleptic symptoms may result in high scores in anxiety-neuroticism scales and low scores in socialization scales, via social-learning mechanisms. However, there may also be a coupling between the genetics of narcolepsy and biologically based personality traits.     

Rorschach indicators of Multiple Personality Disorder.

The increase in reported cases of Multiple Personality Disorder underscores a great need to differentiate clearly this from other psychiatric disorders and from simulation of Multiple Personality Disorder. Two sets of Rorschach signs have been advanced as clinical markers by their developers, namely Barach and also Wagner, Allison, and Wagner. As the Wagner signs are prevalent in much of the research on Rorschach responses in Multiple Personality Disorder, the purpose of the present study was to evaluate these signs using Wagner's administration and the resulting Rorschach protocols of 16 Multiple Personality Disorder patients and 16 psychiatric controls. Analysis indicated that this system was deficient in correctly classifying these 32 protocols. A new marker, the Splitting Response, emerged, however, which was more useful. This response, in combination with at least one Dissociative response, produced an accuracy rate of 94%. These new criteria may be useful aids in the detection of Multiple Personality Disorder from Rorschach protocols. Replication is urged.     

Electrolyte disorders, EEG changes and epileptic seizures in alcohol withdrawal delirium

For 180 patients suffering alcohol-withdrawal induced delirium, electrolytic concentration in the serum of Na, K, Ca, and Mg was determined in the early withdrawal phase, and the electroencephalograms of 95 delirium patients evaluated in respect of local and diffuse changes and epileptic activity, and compared in delirium patients with and without initial seizures. Delirium patients who had initial seizures suffered significantly longer-lasting periods of delirium and significantly more frequent electrolytic changes in the form of hypomagnesemia and hypopotassemia (hypokalemia). There was no significant difference in the EEG changes. A temporary metabolic disorder in the initial phase of the two-phase withdrawal process should be assumed to be the cause of seizures during alcohol withdrawal, and the pathogenetic significance of hypomagnesemia and hypopotassemia should be taken into consideration.