Tinnitus als soziale Infektion?

Background

11 out of 35 male employees of a central alert team with rescue coordination function developed a tinnitus disorder. This clinical case-study highlights the psychodynamic background of this accumulation.

Methods

Employees were investigated by psychometric questionnaires and semistructured psychodynamic biografical interviews. Additionally aspects of group dynamics and organisational structure were assessed.

Results

All staff members reported adverse work conditions. Medical and psychometric examination of the tinnitus patients did not reveal severe pathological findings. The interviews identified psychodynamic conflicts dealing with autonomy and regulation of self-esteem. All tinnitus patients reported a very adverse or punitive father relation and difficulties in performing a stabile male role and self-image. Group dynamics was dominated by paranoid and regressive tendencies complicated by maladaptive coping, crude perception of external facts and a pronounced experience of aggressive impulses.

Conclusion

The remobilisation of infantile powerlessness, ineffectiveness and helplessness triggered by adverse work conditions and the introduction of a new culture of personal responsibility within the work organisation together with an impaired coping of separation conflicts enforced by traumatic aspects of the relation with the father may have promoted the tinnitus symptomatology. Additionally, due to the missing awareness of the importance of such group dynamical processes the employers contributed to an increasing psychosocial distress, which promoted the accumulated manifestation of tinnitus as a conflict expressive symptom.     

How global versus local perception fits regulatory focus

We propose a reciprocal relation between regulatory-focus systems and global versus local processing styles-specifically, that global processing fits a promotion focus on advancement, whereas local processing fits a prevention focus on security. In Study 1, participants were shown large letters made of small letters and decided if either of two specific letters appeared on the screen. Strength of promotion focus was positively correlated with speed of processing global letters and negatively correlated with speed of processing local letters, whereas the reverse was true for strength of prevention focus. In Study 2, participants first worked on a global or local task and later chose between two objects. Consistent with our fit proposal, participants who had performed the global task assigned a higher price to their chosen object if they had chosen it in a promotive, eager manner than if they had chosen it in a preventive, vigilant manner, whereas the reverse was true for participants who had performed the local task.     

Anchors distort estimates of expected duration

This research explored the effect of presenting participants an anchor, which is a salient standard of comparison, before asking them to estimate the amount of time they believe they will need to complete a task (expected duration estimation). Such anchors can be assumed to be common in real-life situations, e.g., duration suggestions made by work colleagues. Participants were 32 students (M age = 23.1 yr., SD = 3.2; 28 women) who received course credit for participating. In the presence or absence of one of two anchors they had to estimate how much time they would need to work on a catalogue task. Actual time needed for the task was also measured. As predicted, analysis showed that estimates of expected duration were distorted in the direction of the anchors, i.e., estimations were assimilated into the presented anchor value. The implications for time management are discussed.     

Stability, growth, and decline in adult life span development of declarative memory: cross-sectional and longitudinal data from a population-based study

Five-year changes in episodic and semantic memory were examined in a sample of 829 participants (35-80 years). A cohort-matched sample (N=967) was assessed to control for practice effects. For episodic memory, cross-sectional analyses indicated gradual age-related decrements, whereas the longitudinal data revealed no decrements before age 60, even when practice effects were adjusted for. Longitudinally, semantic memory showed minor increments until age 55, with smaller decrements in old age as compared with episodic memory. Cohort differences in educational attainment appear to account for the discrepancies between cross-sectional and longitudinal data. Collectively, the results show that age trajectories for episodic and semantic memory differ and underscore the need to control for cohort and retest effects in cross-sectional and longitudinal studies, respectively.     

Entstehung und Verlauf der Panikstörung

Zusammenfassung Das Konzept der Panikstörung ging ursprünglich auf neurobiologische Modellvorstellungen zurück, die rasch von verhaltenstherapeutischen Ansätzen aufgegriffen und differenziert wurden, während die Rezeption durch psychoanalytische Ansätze zurückhaltend erfolgte. In dieser Übersicht werden aktuelle neurobiologische, verhaltenstherapeutische und psychodynamische Modelle dargestellt. Neurobiologische Ansätze beschreiben die zentrale und periphere Fehlsteuerung des Stresshormonsystems. Verhaltenstherapeutische Modelle erklären die Aufrechterhaltung der Störung durch konditionierte Furchtreaktionen, Fehlinterpretation körperlicher Sensationen bzw. dispositionale Angstsensitivität. Neuere psychodynamische Konzepte beschreiben mangelnde Toleranz für intensive Affekte und Trennungserfahrungen aufgrund unsicherer Objektbeziehungsrepäsentanzen als Ursachenfaktoren für Panik. Sie schaffen damit Verbindungen zu tierexperimentellen und neurobiologischen Studien, die die Bedeutung vorzeitiger Trennungserfahrungen für lebenslang erhöhte Stressreagibilität und Furchtsamkeit herausgearbeitet haben. Neurobiologische, verhaltenstherapeutische und psychodynamische Ansätze ergänzen sich beim Verständnis dieses heterogenen Krankheitsbildes.     

Parent Programs for Reducing Adolescent’s Antisocial Behavior and Substance Use: A Randomized Controlled Trial

Two theoretically based parent training programs, delivered in real-world settings by the social services, were examined in this randomized controlled trial for effectiveness in reducing adolescents’ antisocial behavior and substance use. Two hundred and thirty-seven (237) adolescents in ages between 12 and 18 and their parents were assigned to one of two programs or to a wait-list control condition. The programs were the nine weekly group sessions program Comet 12–18 (Swedish Parent Management Training Program) and the six weekly ParentSteps (Swedish shortened version by Strengthening Families Program 10–14). Outcome measures were antisocial behavior, substance use, and delinquency, and psychosocial dysfunction. Data based on adolescents’ and parents’ ratings of the adolescents’ problem behavior at baseline and 6 months later were analyzed with repeated measures ANVOA, Logistic regression, and Kruskal–Wallis H test. The results showed that parents’ ratings of adolescents’ antisocial behaviors decreased significantly over time, but no time by group effect emerged. No program effects were found in the adolescents’ self-reported antisocial behavior, delinquency, or psychosocial functioning. A threefold risk of illicit drug use was found in both intervention groups. The results suggest that neither Comet nor ParentSteps had beneficial effects on adolescent’s antisocial or delinquent behavior, or on alcohol use. The only significant group difference found was a threefold risk of drug use in the intervention adolescents at follow-up, but for several reasons this finding should be interpreted with caution. Trial registration number: ISRCTN76141538.     

Collateral Reports and Cross-Informant Agreement about Adult Psychopathology in 14 Societies

To advance international mental health assessment, instruments that have been internationally validated are needed. To this end, we analyzed ratings from 14 societies on the Adult Behavior Checklist (ABCL), a collateral-report form parallel to the Adult Self-Report (ASR; Achenbach and Rescorla 2003) for ages 18 to 59. Both the ABCL and the ASR assess problems, personal strengths, and adaptive functioning. For a sample of 8322 see note below collaterals, we found strong consistency across societies regarding which ABCL problem items tended to obtain relatively low, medium, or high ratings. Most societal effect sizes (ESs) for problem scale scores were small to medium (< 13.9 %), but the ES for the ABCL Personal Strengths scale was 25 %. For most of the same participants (N = 8,302), we analyzed cross-informant agreement between self-reports on the ASR and collateral reports on the ABCL. Cross-informant correlations for problem scale scores averaged .47, with considerable societal variation. Problem score means were higher on the ASR than the ABCL in every society, but the size of the difference varied across societies. Mean item ratings on the ABCL and ASR were highly correlated within every society (mean r = .92), but within-dyad item rating agreement varied widely in every society (mean r = .39). In all societies, non-corroboration of self-reported deviance and of collateral-reported deviance was common. Overall findings indicated considerable similarity but also some important differences in collateral-reported problems and adaptive functioning across 14 societies.     

The moderator effect that wasn't there: statistical problems in ambivalence research

Ambivalence researchers often collapse separate measures of positivity and negativity into a single numerical index of ambivalence and refer to it as objective, operative, or potential ambivalence. The authors argue that this univariate approach to ambivalence models undermines the validity of subsequent statistical analyses because it confounds the effects of the index and its components. To remedy this situation, they demonstrate how the assumptions underlying the indices derived from the conflicting reactions model and similarity-intensity model can be tested using a multivariate approach to ambivalence models. On the basis of computer simulations and reanalyses of published moderator effects, the authors show that the frequently reported moderating influence of ambivalence on attitude effects may be a statistical artifact resulting from unmodeled correlations of positivity and negativity with attitude and the dependent variable. On the basis of extensive power analyses, they conclude that it may be extremely difficult to detect moderator effects of ambivalence in observational data. Therefore, they encourage ambivalence researchers to take an experimental approach to study design and a multivariate approach to data analysis.