Diagnostik von Persönlichkeitsstörungen

Diagnosing and classifying personality disorders is complex and difficult from both the scientific and clinical perspectives. Dimensional and categorical models and assessment instruments of personality disorders, and different (behavioral and psychodynamic orientated) clinical procedures are described. Furthermore, an integrative view on clinical practice is presented.     

Sexualit?t in Zeiten des Internet

The Internet shows several more or less specific characteristics, in particular accessibility, anonymity, affordability, worldwide connectivity and interactivity. These characteristics hold chances as well as risks for the development of sexuality and sexual relationships. Rarely stressed and investigated are the possible positive effects, such as easier sexual contacts especially for individuals with social deficits, for sexual minorities (e.g. gay, lesbian, transgender, sadomasochists or fetishists), reducing sexual prejudices and stereotypes, better partner matching and easy access to reliable information and counseling platforms about sexual issues. The psychotherapist more often encounters the problematic effects of Internet pornography and cybersex, such as avoiding real life (offline) sexual and non-sexual social contacts, the stress on relationships (e.g. through cyber infidelity), intensifying fantasies and impulses that are harmful to oneself or others up to criminal behavior (e.g. use and circulation of child pornography). Describing a case history this review discusses the role of the Internet in the development of sexual addictive or compulsive symptomatology, including treatment options. Only a differentiated analysis of the chances and risks can counterbalance the increasing tendencies to demonize and pathologize the use of the Internet for sexual purposes.     

Ungedeckte psychotherapeutische Bedarfe bei Stimulanzienkonsumenten

Background

Despite changes in the regulations concerning outpatient psychotherapy in Germany, relatively few patients with substance use disorders receive this type of treatment.

Objectives

The results of a recent study among stimulant users are taken as an example to illustrate the psychotherapeutic needs of patients with substance use disorders.

Materials and methods

A total of 392 individuals with active use of amphetamine and/or methamphetamine were included using a broad range of recruitment strategies. In a mixed methods approach, qualitative as well as quantitative data were gathered regarding the history of substance use, the motives for use, and traumatic experiences during childhood.

Results

Psychological distress was a frequent motive even at the initiation of stimulant use. About two thirds of the participants (65.1?%) reported at least one form of childhood trauma (sexual, physical or emotional abuse, emotional or physical neglect).

Conclusion

The findings suggest a high need for psychotherapy among patients with substance use disorders. It seems important to further improve the information as well as the training of psychotherapists to work with these clients.     

Internal Employment Opportunity and External Employment Opportunity: Independent or Interactive Retention Effects?

Contemporary attrition/retention frameworks suggest that internal mobility opportunities (e.g., promotions) and external mobility opportunities (i.e., alternative sources of employment) impact turnover decisions. The present study used data collected' from 413 U.S. Air Force enlistees to estimate the joint effects of internal mobility opportunities (i.e., training/career broadening opportunities) and external mobility opportunities (e.g., existing job offers) on reenlistment. Logistic regression analysis revealed that internal and external mobility opportunities had additive effects on the study's attrition criterion. Moderated regressions failed to detect interactive effects among the study's mobility variables. Implications of the findings for turnover frameworks and retention of military personnel are discussed.     

Psychotherapeuten und Internet

Background

Communication is part and parcel of every interaction. This raises the question of the role of modern media in mental health care. The aim of this explorative study was to investigate the use of modern media in the clinical practice.

Material and methodology

In an Internet survey 234 psychotherapists from Nordrhein-Westfalen (NRW) were surveyed about the extent to which they integrate new media in the practice and their opinion about this integration. For this purpose a questionnaire was developed based on the questionnaire of Wangberg et al. (2007).

Results

Most of the psychotherapists already use e-mails as well as mobile communication to contact their patients. The main reason for choosing this modern way of communication is the possibility to simplify the management of formal issues. Psychotherapists were indifferent about the idea of web-based counseling.

Conclusion

Forms of digital media are used as an addition to conventional ways of therapeutic communication but face-to-face interaction cannot be replaced completely which is also indicated by the fact that professionals still highly value personal contact.     

Procrastination's Impact in the Workplace and the Workplace's Impact on Procrastination

Procrastination is a self‐regulatory failure, whose costs are debated. Here, we establish its impact in the workplace. Using an Internet sample, we assessed 22,053 individuals in terms of their sex, employment status, employment duration, income, occupational attainment and level of procrastination. High levels of procrastination is associated with lower salaries, shorter durations of employment, and a greater likelihood of being unemployed or under employed rather than working full‐time. Also, procrastination partially mediates sex's relationship with these work variables. Women tend to procrastinate less than men, evidently giving women an employment advantage. If women procrastinated the same as men, there should be 1.5 million fewer women in full‐time employment in the US. alone. Determining the causes of procrastination in the workplace, we also examined it at an occupational level. The results strongly support the gravitational hypothesis: jobs that require higher levels of motivational skills are less likely to retain procrastinators. However, there was some support that jobs can foster procrastination. Procrastinators tend to have jobs that are lower in intrinsically rewarding qualities.     

Eine Schlafstörung kommt selten allein

In the clinical routine insomnia disorders are often merely seen as symptoms of the underlying disease and are therefore not considered relevant enough for diagnostic clarification and initiation of specific treatment. The following article intends to give an overview of the differential diagnosis of nonorganic insomnia and underlines the importance of cognitive behavioral therapy in this context, which is substantiated by two case studies.     

Assessing and predicting supervisors' evaluations of psychotherapists – an empirical study

Objective: The aim of this study was to analyze the dimensions used by supervisors to evaluate trainee therapists and to detect how supervisors' assessments are influenced by features of the case and of the therapist.

Method: Data from 226 patients with diverse mental and social disorders who had been treated by 22 trainee therapists under the supervision of 12 supervisors were analyzed by factor- and regression analyses. Supervision was implemented as part of a psychotherapy training program. After treatment, each supervisor was asked to evaluate the trainee by using a list of 38 items proposed by Kanfer, Reinecker and Schmelzer (1996 Kanfer, FH, Reinecker, H and Schmelzer, D. 1996. Selbstmanagement-Therapie, Berlin: Springer.  [Google Scholar]). Case characteristics and therapists' features were assessed by questionnaires and checklists and related to the supervisors' evaluations.

Results: The statistical analyses indicated that supervisors could not easily integrate the multitude of relevant aspects into a differentiated schema of evaluation. A two-factor model best fitted the data. The two factors focus on specific aspects of therapeutic behavior. The evaluations were mainly related to the experience of the trainee therapist and to therapy outcome. For trainee therapists with more experience, the standards of comparison were set higher resulting in less positive evaluations.

Discussion: The results are discussed with reference to a process-oriented view of supervision and therapist evaluation. It was concluded that supervisors of behavior therapy seem to weight therapist-related and case-related information differently. However, the way supervisors integrate these types of information into evaluations of trainee therapists still remains rather vague.