Ambulante Psychotherapie der Substanzstörungen

Background

The revision of the psychotherapy guidelines in 2011 broadened the options for treating substance use disorders (SUD) in outpatient psychotherapy (OP).

Aim

The aims of this study were to answer the following questions: how frequently are SUDs treated in OP? What opinions do psychotherapists (PT) hold concerning the new treatment possibilities?

Material and methods

In this study the frequency of OP for patients with SUD, e.g. harmful use and abuse of as well as dependence on psychotropic substances according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10), by private practice PTs as well as their attitude towards the treatment of patients with these diagnoses were investigated. Private practice PTs in five states in East Germany were asked to participate in a postal survey.

Results

Of the 1,382 PTs contacted, 229 (16.6 %) participated in the study. Of the respondents 94.3 % had treated at least one patient with SUD (4-week prevalence including nicotine dependence). These rates ranged from 3.1 % to 26.6 % depending on the substance and diagnosis (SUD as primary reason for treatment). The highest rates of strong affirmation for OP of approximately 20?% were found for disorders related to alcohol, tobacco and medication.

Conclusion

Most PTs treated at least one patient with SUD in OP. However, this particular type of treatment offer should be further extended. Information about the options of treating SUD in OP should be further disseminated and conducting such treatment should be supported by (e.g.) therapist training.     

Erziehungsfähigkeit in familienrechtlichen Begutachtungen

Parental competence describes the multidimensional ability of parents to take responsibility for their children and to bring them up. There is a multitude of criteria and guidelines for the assessment of parental competence in the context of family court procedures, when a child’s well-being is at risk or in the case of divorce and separation. However, little is known about what forensic experts in Germany understand by the term parental competence. In a nationwide study  600 forensic experts were questioned about the contents and their methods of assessment concerning parental competence. Of the 104 participating psychologists and doctors (response rate 17.3 %) 90 % follow a schema while assessing parental competence and include the factors interaction and communication skills, care and nurturing, relationship skills, attachment capabilities, teaching rules and complying with them, and the ability to foster a child. While 99 % conduct a talk with the mother, 98 % conduct at least one talk with the father; 27 % talk to both parents together, 94% talk to the child systematically, 84 % use free play and 78 % combine playing and talking. The most frequently mentioned third persons include social workers, new partners, nursery school teachers and child protective services. Approximately 77 % use standardized tests. Although the study revealed a large heterogeneity in the procedures used by forensic experts, there is more accordance concerning the understanding of the term parental competence and the assessment procedure. Possibilities to assess parental competence in more general and standardized terms are discussed.     

Brain potentials during language production in children and adults: An ERP study of the English past tense

The current study examines the neural correlates of 8-to-12-year-old children and adults producing inflected word forms, specifically regular vs. irregular past-tense forms in English, using a silent production paradigm. ERPs were time-locked to a visual cue for silent production of either a regular or irregular past-tense form or a 3rd person singular present tense form of a given verb (e.g., walked/sang vs. walks/sings). Subsequently, another visual stimulus cued participants for an overt vocalization of their response. ERP results for the adult group revealed a negativity 300–450 ms after the silent-production cue for regular compared to irregular past-tense forms. There was no difference in the present form condition. Children’s brain potentials revealed developmental changes, with the older children demonstrating more adult-like ERP responses than the younger ones. We interpret the observed ERP responses as reflecting combinatorial processing involved in regular (but not irregular) past-tense formation.     

Posttraumatic Reactions among Firefighters after Critical Incidents: Cross-National Data

The presence of posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) following a critical incident were examined among firefighters from eight predominantly European countries. A sample of 1916 firefighters completed the Impact of Event Scale–Revised (IES–R) and the Posttraumatic Growth Inventory–Short Form (PTGI–SF) with reference to a critical incident they had experienced. Analyses indicated both negative and positive posttraumatic outcomes could derive from experiencing critical incidents in the line of duty. The analyses also showed country differences exist regarding firefighters’ PTSD symptoms and PTG. It is recommended that future researchers examine factors that could evoke such national differences.     

FATHER–CHILD PLAY DURING THE PRESCHOOL YEARS AND CHILD INTERNALIZING BEHAVIORS: BETWEEN ROBUSTNESS AND VULNERABILITY

Play observations with a total of 400 toddlers and preschoolers were videotaped and rated for Intensity and Quality of play with their parents. Parents were asked about perceived stress and personality characteristics (Big 5). Child's motor, cognitive skills, temperament, and internalizing behaviors were assessed. Study 1 investigated the robustness of play across child age and gender, and examined differences between fathers and mothers. Study 2 explored the vulnerability of play with fathers of children born preterm (PT‐fathers) and fathers who had experienced adverse childhoods (AC‐fathers). Study 3 investigated child internalizing behaviors. Intensity of play was maintained almost independently of child age and gender. It was similar for AC‐ and PT‐fathers, and similar to maternal Intensity. In contrast, paternal Quality of play was higher with boys and independent of fathers’ personality and perceived parenting stress whereas maternal Quality of play was higher with girls and linked to mothers’ perceived parenting competence, acceptability of the child, and neuroticism. AC‐fathers scored significantly low on Quality, as did PT‐fathers, but the Quality of their play became better with growing child age, birth weight, and cognitive (but not motor and temperament) scores. Finally, child internalizing behaviors were negatively related to paternal Quality of play.     

Creativity and personality in professional dancers

In this study three different groups of professional dancers (ballet, modern/contemporary and jazz/musical), which considerably vary with respect to the creativity-related demands involved in the respective dancing style, are compared with respect to psychometrically determined creativity, general mental ability and different facets of personality. Results indicate that modern/contemporary dancers, who are often required to freely improvise on stage, exhibited relatively high levels of verbal and figural creativity (as it was measured by means of psychometric creativity tests), followed by jazz/musical and finally by ballet dancers. With respect to personality, modern/contemporary dancers can be characterized as being less conscientious, higher on psychoticism and more open to experiences than the remaining experimental groups. In line with relevant research in this field, this study reveals some central personality characteristics of highly creative individuals which may be considered as important ingredients in the acquisition or actualization of exceptional creative potential.     

Illness Identity in Adults with a Chronic Illness

The present study examines the concept of illness identity, the degree to which a chronic illness is integrated into one’s identity, in adults with a chronic illness by validating a new self-report questionnaire, the Illness Identity Questionnaire (IIQ). Self-report questionnaires on illness identity, psychological, and physical functioning were assessed in two samples: adults with congenital heart disease (22–78 year old; n?=?276) and with multisystem connective tissue disorders (systemic lupus erythematosus or systemic sclerosis; 17–81 year old; n?=?241). The IIQ could differentiate four illness identity states (i.e., engulfment, rejection, acceptance, and enrichment) in both samples, based on exploratory and confirmatory factor analysis. All four subscales proved to be reliable. Rejection and engulfment were related to maladaptive psychological and physical functioning, whereas acceptance and enrichment were related to adaptive psychological and physical functioning. The present findings underscore the importance of the concept of illness identity. The IIQ, a self-report questionnaire, is introduced to measure four different illness identity states in adults with a chronic illness.