How do group meetings make a community Therapeutic?

Summary Following an abrupt shift from a therapeutic community with emphasis on group meetings to a hierarchical medical model on a mental hospital floor, disturbed patients required extensive individual nursing care. This increased work load for the nursing staff resulted in admissions having to be limited to the rare cases who needed little or no nursing care. As patients were discharged, the vacancy rate went up to approximately 20% for a week and remained high for another two weeks. Nursing staff-patient relations deteriorated.Subsequently, it was possible to resume the emphasis on the groups of a therapeutic community and to observe the contrast. The experience showed how groups can effect and support a therapeutic community. It clarified some of the mechanisms by which groups positively affected disturbed patients. Some mechanisms by which the staff, community, and group meetings favorably influenced the nursing staff-patient relationship and intrastaff communications became clear also.     

Getting older and living up to implicit followership theories: Implications for employee psychological health and job attitudes

Age discrimination at work is a widespread destructive phenomenon that often takes subtle forms. Based on negative stereotypes about older employees, we argue that older employees often experience that they are perceived as less ideal followers than younger employees. We propose that older and younger employees do not differ in what they assume their supervisors expect of an ideal follower (implicit followership theories, IFTs). Thus, we hypothesize that older employees perceive that they compare less favorably to their supervisors' IFTs than younger employees (i.e., worse IFT-fit). This should entail lower quality of the relationship between leader and follower (leader-member-exchange, LMX), which, in turn, should have detrimental effects on employees' health (i.e., burnout) and job attitudes (i.e., job satisfaction, turnover intentions, and identification). We tested our model in a field study with 379 employees. Results differed for ideal and counter-ideal follower attributes. Concerning counter-ideal follower attributes (e.g., being incompetent), age had the proposed negative effect on psychological health and job attitudes that mediated through IFT-fit and LMX. Concerning ideal follower attributes (e.g., thinking ahead), older employees expected their supervisors not only to think less of them than of their younger colleagues, but also expected them to have less demanding IFTs—contrary to our expectations. Employee age was negatively related to psychological health and job attitudes, mediated through lower perceived IFTs, worse perceived appraisal of the actual employee and their joint effects on LMX.     

Decreased levels of N-acetylaspartate in dorsolateral prefrontal cortex in a case of intractable severe sympathetically mediated chronic pain (complex regional pain syndrome,type I)

In our previous in vivo proton magnetic resonance spectroscopy ((1)H MRS) study we found reduced levels of N-acetylaspartate in dorsolateral prefrontal cortex of chronic back pain patients. This study tests whether these chemical abnormalities can be detected in other pain states. Using (1)H MRS, we measured levels for N-acetylaspartate and other identifiable chemicals relative to creatine in four bilateral brain regions, including dorsolateral prefrontal cortex, orbitofrontal cortex, cingulate, and thalamus, in a case of intractable severe sympathetically mediated chronic pain [complex regional pain syndrome (CRPS) type I]. The subject's chemical variations in the brain were compared to the same regional chemicals in 10 normal subjects (age- and sex-matched). Univariate statistics showed reduced levels of N-acetylaspartate in bilateral dorsolateral prefrontal cortex and increased levels of myo-inositol in left orbitofrontal cortex of the patient with intractable severe CRPS type I. These data support our original hypothesis that depletion of N-acetylaspartate in dorsolateral prefrontal cortex is a chemical marker of chronic pain, indicating for neuronal degeneration. Unpredicted changes of orbitofrontal myo-inositol may be related to the specific mood/affective state in an extreme pain perception. This is the first report, which identifies chemical markers in the prefrontal cortex for objective measurement and monitoring of CRPS type I. This information might lead to valuable insights into diagnosis and future effective interventions of CRPS type I (e.g., prefrontal brain stimulation).     

The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.

Educational objectives: The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.     

Logic and Philosophy of Logic in Wittgenstein

This essay discusses Wittgenstein's conception of logic, early and late, and some of the types of logical system that he constructed. The essay shows that the common view according to which Wittgenstein had stopped engaging in logic as a philosophical discipline by the time of writing Philosophical Investigations is mistaken. It is argued that, on the contrary, logic continued to figure at the very heart of later Wittgenstein's philosophy; and that Wittgenstein's mature philosophy of logic contains many interesting thoughts that have gone widely unnoticed.     

Linderung depressiver Symptomatik

Standard interventions, such as antidepressive medication or psychotherapy, show only medium effect sizes in the reduction of depressive symptomatology. In addition, medication has problematic and not well accepted side-effects therefore it seems reasonable to look for alternative, cost-effective, easily available treatments which show no side-effects. A large number of studies have demonstrated similar neurophysiological effects of sport as antidepressants or psychotherapies but the crucial question remains unanswered: does sport show antidepressive effects by alleviating depressive symptomatology? Some randomized, controlled studies and all available recent meta-analysis addressing this question are reviewed. This review concludes that randomized control trials including sport activities have similar positive effect sizes as psychotherapy or antidepressant studies. The pre-post effects are in the medium to high range. Such a conclusion is jeopardized by a limited number of methodolically sound studies. It is too early to make evidence-based recommendations about the antidepressive effect of sport. Currently, it can only be speculated about moderators and mechanisms mediating outcome.     

Prospective memory in young and older adults: the effects of ongoing-task load

Prospective memory involves remembering to perform intended actions in the future. Previous work with the multinomial model of event-based prospective memory indicated that adult age-related differences in prospective-memory performance were due to the prospective (not the retrospective) component of the task (Smith & Bayen, 2006 , Journal of Experimental Psychology: Learning, Memory, and Cognition, 32, 623). However, ongoing-task performance was also lower in older adults in that study. In the current study with young and older adults, the difficulty of the ongoing task was manipulated by varying the number of colors per trial to create easier and harder versions of the ongoing task for each age group. The easier version included 2 colors per trial for older adults and 4 colors for young adults. The harder version included 4 colors for older adults and 6 colors for young adults. By adjusting the ongoing-task difficulty, older adults were able to perform the ongoing task as well or better than the young adults. Analyses with the multinomial model revealed that making the ongoing task easier for older adults (or more difficult for young adults) did not eliminate age-related differences in prospective-memory performance and the underlying prospective component.