Komplexe Traumatisierungen und körperliche Gesundheit

Trauma in childhood, which is considered to be the “prototype” of complex traumatization, is associated with numerous physical diseases, in particular with coronary artery disease (CAD). In this review we present the current state of research on this issue. Despite inconsistencies in details between reported findings, numerous studies consistently show a clear relationship between childhood maltreatment and CAD. This association holds not only for clinical endpoints, e.?g. myocardial infarct and angina pectoris but also for subclinical markers of CAD. In this article three distinct etiopathogenetic pathways are defined linking childhood maltreatment to CAD, namely mental alterations, behavioral alterations, such as harmful health behavior and pathophysiological changes including somatic comorbidities. Methodology critical aspects and future research issues as well as the clinical implications of these findings are briefly discussed.     

The need and ability to achieve cognitive structuring: individual differences that moderate the effect of stress on information processing.

The authors examined the hypothesis that the interaction between the need for cognitive structure (NCS) and the ability to achieve cognitive structure (AACS) moderates the effect of stress on information processing. NCS is the preference for using cognitive structuring, as opposed to piecemeal processes, as a means to achieve certainty. AACS is the extent to which individuals are able to apply information processes that are consistent with their levels of NCS. The hypothesis was validated in 4 studies, which showed that stress increased high-AACS participants' use of cognitive structuring if they had high NCS and reduced it if they had low NCS. An opposite effect was found for low-AACS participants. The implications of these results for the understanding of the mechanisms responsible for the effect of stress on information processing are discussed.     

Case Report: A Systems Approach to Genetic Counseling for Albinism

A systems approach to family therapy assumes that a person and his/her problems do not operate in a social vacuum but instead are imbedded in a social context. This context includes fairly small social systems such as a nuclear family and larger social systems such as school systems and cultural beliefs. A case of a girl with albinism born to a couple from India will be used to discuss how a systems approach might be useful in a genetic counseling setting.     

Environmental determinants of memory improvement in late adulthood

Two studies were conducted with nursing home residents to determine whether memory could be improved. This was accomplished by increasing the cognitive demand of the environment and then varying the extent to which residents were motivated to attend to and remember these environmental factors. In Study 1, motivation to practice recommended cognitive activities was manipulated by varying the degree of reciprocal self-disclosure offered by interviewers in a series of dyadic interactions. In Study 2, motivation to practice recommended cognitive activities was manipulated by varying whether positive outcomes were contingent on attending to and remembering these activities, which increased in demand over time. Whether as a function of interpersonal (Study 1) or practical (Study 2) incentives, engaging in cognitive activity resulted in improvement on standard short-term memory tests, including probe recall and pattern recall, as well as in improvement on nurses' ratings of alertness, mental activity, and social adjustment for experimental groups relative to controls.     

Right Hemisphere Activation during Indirect Semantic Priming: Evidence from Event-Related Potentials

Healthy subjects performed a lexical decision task in a semantic priming paradigm while event-related potentials (ERPs) were recorded from 64 channels. Semantic distance between prime and target was varied by including directly, indirectly, and nonrelated word pairs. At centro-parietal electrodes an N400 to nonrelated pairs was elicited bilaterally which was sensitive only to direct, but not to indirect semantic priming. These N400 priming effects were mirrored by the RT data. At inferior fronto-temporal sites directly related words showed ERP priming effects over both hemispheres. However, indirectly related words only elicited ERP priming effects over the right hemisphere. These results support the hypothesis that the right hemisphere semantic system is involved in processing of remote semantic information.     

Misserfolge in der station?ren Therapie von Patienten mit Pers?nlichkeitsst?rungen

While psychotherapy has proven its efficacy and effectiveness in the treatment of personality disorders (PD) there is a lack of studies on treatment failure, i.e. non-response or deterioration of psychopathology. In a naturalistic approach the failed treatment of1,239 inpatients with PD was studied by means of direct and indirect assessment of change from patient and therapist perspectives. For indirect assessment the global severity index of the symptom checklist SCL-90-R (self-report by patients) and the impairment severity score (judgement by therapists) were used. Depending on the method between 11% and 31% of inpatients did not show any relevant improvement in symptoms but concordance between the methods was poor (Cohen’s kappa between 0.10 and 0.30). Patients with treatment failure did not differ from those with successful treatment with respect to sociodemographic and clinical features. The findings are discussed with respect to methodological limitations but also reflect possible clinical and therapeutic implications as well as future research approaches.