Evidenzbasierte Psychotherapie der Depression

Depressive disorders are among the most frequent reasons for utilizing the health care system. Despite the availability of efficacious treatments and further advances throughout the last years, there is still a need for improving diagnostic and therapeutic procedures. A promising approach is the implementation of evidence- and consensus-based guidelines. The German “Nationale VersorgungsLeitlinie Unipolare Depression” are evidence- and consensus-based clinical practise guidelines for patients with unipolar depression. All relevant stakeholders have been involved in its development and have passed the final version at the end of 2009 to foster compliance throughout. The available evidence allows the derivation of differentiated treatment recommendations, also with regard to concomitant antidepressant medication or as alternative treatment options. In acute therapy watchful waiting over 14 days is recommended for mild depression and psychotherapy after persistence of symptoms. In cases of moderate depression, psychotherapy and pharmacotherapy are equally recommended, in cases of severe depression a combination of both is recommended.     

Drivers’ propensity to have different types of intelligent speed adaptation installed in their cars

The aim of the present study was to examine if there are differences in drivers’ propensity to have different types of intelligent speed adaptation installed in their cars depending on the sample of drivers (i.e. Swedish or Turkish), their aberrant driving behaviours (i.e. violations and errors), and/or the technical solution used (i.e. speed limit information, advisory, supportive and intervening systems). A sample of 224 Swedish and 316 Turkish drivers completed a questionnaire including questions based on the driver behaviour questionnaire (DBQ) as well as questions about the drivers’ propensity to have different types of intelligent speed adaptation installed in their cars. The results showed that the Swedish sample of drivers was less positive than the Turkish sample of drivers towards having the advisory, supportive and intervening systems installed. Furthermore, drivers who frequently commit violations were less positive towards having any of these systems installed than were drivers who commit violations less frequently, while drivers who frequently make errors were more positive towards having the systems installed than were drivers who make errors less frequently. Both the Swedish and the Turkish sample of drivers were most positive towards having the speed limit information system installed, followed by the advisory system on second place, the supportive system on third place and lastly the intervening system on fourth place.     

Continuity of father-rated temperament from infancy to middle childhood

Continuity of father-rated temperament in Finnish children (n = 115) aged from 6 months (the IBQ) to 5.5 years (the CBQ) was explored within the theoretical framework developed by Rothbart. Father-rated activity level, smiling and laughter and distress to limitations showed significant differential homotypic and heterotypic continuity, while soothability, duration of orienting and fear showed significant differential heterotypic continuity. On the level of latent superconstructs, father-rated positive and negative infant affectivity accounted for 5.1, 22.7 and 10.0% of the variance in childhood extraversion, effortful control and negative affectivity, respectively. Inter-parental comparisons (n = 109 family units) revealed that father-rated continuity was similar to mother-rated continuity. These findings give empirical credence to Rothbart's theory and to father-rated temperamental continuity from infancy onwards.     

Structural and functional MRI- findings in children and adolescents with antisocial behavior

BACKGROUND: The developmental course of children with conduct disorder (CD) is heterogeneous. Especially children who exhibit symptoms early in their lifetimes are characterized by a negative outcome. Neurobiological aspects of CD have been investigated in these children but little is known about structural and functional brain aberrations. METHODS: We describe the developmental taxonomy of children with CD and focus on those with the early onset subtype. Structural MRI data of these children and antisocial adults are recapitulated. The impact of investigating neurobiological underpinnings of antisocial behavior and how this might contribute to future forensic and psychiatric assessments is discussed. RESULTS/ CONCLUSION: Children display similar structural aberrations of fronto-limbic structures to adults with antisocial behavior, and amygdala dysfunction might be closely related to dysregulated emotions. Though the investigation of biological factors in antisocial subjects has made great progress in recent years, today MRI is still a rather complex, expensive and indistinct method for forensic assessment.     

BDNF is a novel marker of cognitive function in ageing women: the DR's EXTRA Study

Brain-derived neurotrophic factor (BDNF) is one of the key molecules modulating brain plasticity. While low circulating levels of BDNF have been suggested to predispose to Alzheimer's disease, very little data are available on its association with cognitive function in general population. We evaluated the association between plasma BDNF levels and cognition in a representative population sample of ageing men and women. The subjects (n=1389) were participants of the Dose-Responses to Exercise Training (DR's EXTRA) Study and represent a random sample of Eastern Finnish people (684 men and 705 women), 57-79 years of age at baseline of the study. Plasma BDNF levels were measured by enzyme-linked immunosorbent assay (ELISA). Cognitive function was evaluated using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological test battery. Women had a higher mean (+/-SEM) plasma BDNF level than men (1721+/-55vs. 1495+/-54pg/ml, P<0.001). In women, 1 SD decrease in BDNF increased the risk for a low score in Naming Test by 53% (95% CI 1.21-1.92, P<0.001), in Mini-Mental State Examination by 63% (95% CI 1.21-2.20, P=0.001), in Word List Memory by 56% (95% CI 1.08-2.26, P=0.019), in Word List Recall by 50% (95% CI 1.10-2.05, P=0.010), in Word List Saving by 49% (95% CI 1.12-1.99, P=0.007), and in Word List Recognition by 64% (95% CI 1.19-2.25, P=0.002). Data were adjusted for age, education, depression, impaired glucose metabolism, cardiovascular disease, antihypertensive medication, lipid lowering medication, use of sex hormones, smoking, alcohol consumption, storing time of plasma in the freezer and platelet count. BDNF was not associated with cognition in men. Present data suggest that plasma BDNF is a biomarker of impaired memory and general cognitive function in ageing women.     

Cognitive processes in dissociation: an analysis of core theoretical assumptions

Dissociation is typically defined as the lack of normal integration of thoughts, feelings, and experiences into consciousness and memory. The present article critically evaluates the research literature on cognitive processes in dissociation. The authors' review indicates that dissociation is characterized by subtle deficits in neuropsychological performance (e.g., heightened distractibility). Some of the cognitive phenomena (e.g., weakened cognitive inhibition) associated with dissociation appear to be dependent on the emotional or attentional context. Contrary to a widespread assumption in the clinical literature, dissociation does not appear to be related to avoidant information processing. Rather, it is associated with an enhanced propensity toward pseudo-memories, possibly mediated by heightened levels of interrogative suggestibility, fantasy proneness, and cognitive failures. Evidence for a link between dissociation and either memory fragmentation or early trauma based on objective measures is conspicuously lacking. The authors identify a variety of methodological issues and discrepancies that make it difficult to articulate a comprehensive framework for cognitive mechanisms in dissociation. The authors conclude with a discussion of research domains (e.g., sleep-related experiences, drug-related dissociation) that promise to advance our understanding of cognition and dissociation.     

Stressed parents: a dyadic perspective on perceived infant temperament

The study employed the actor–partner interdependence model (APIM) to test whether one parent's experiences of recent life events as more stressful (the PSS) are associated with the same parent's own (the actor effect) and the other parent's (the partner effect) perceptions of the infant temperament as more negatively and/or less positively tuned (the IBQ; n=584 parents, 292 dyads). The results indicated that the more stress one parent reported the more negatively tuned were the same parent's own, and the other parent's perceptions of the infant. Perceptions of the infant temperament were least positive for members of parent dyads who were more, relative to less, similar in the experienced stress. The associations were independent of the parent gender and the parent‐reported level of trait anxiety. The findings augment prior knowledge on the factors that steer parental perceptions, and suggest that the dyadic perspective may offer valuable insight into the dynamics of interacting within a family consisting of two biological parents and an infant. Copyright © 2006 John Wiley & Sons, Ltd.     

Acute dissociation after 1 night of sleep loss

Recent research has shown that dissociative symptoms are related to self-reports of deviant sleep experiences. The present study is the 1st to explore whether sleep loss can fuel dissociative symptoms. Twenty-five healthy volunteers were deprived of sleep for 1 night. Sleepiness and dissociative symptoms were assessed every 6 hr. The authors measured both spontaneous dissociative symptoms and dissociative symptoms induced by dot-staring during sensory deprivation. Sleepiness as well as spontaneous and induced dissociative symptoms were stable throughout the day but increased during the night. These findings provide further evidence for a robust relationship between disruptions in sleep patterns and dissociative symptoms.     

Personality and accident liability: are extraversion, neuroticism and psychoticism related to traffic and occupational fatalities?

The aim of the present study was to investigate the relationship between extraversion, neuroticism and psychoticism, and road traffic fatalities in a data set of 34 nations. In addition to traffic fatalities per 100,000 vehicles, work-related fatalities were included in the study. Results showed that extraversion had a positive relation to the number of traffic fatalities whereas neuroticism correlated negatively with road fatalities. Occupational fatalities were strongly related to deaths on the roads but not to personality dimensions. Countries with high extraversion scores had more traffic fatalities than countries with moderate or low extraversion scores. The need for well-designed studies investigating the link between personality factors and traffic accident liability via driver behaviour was expressed.     

Acting or listening: Adult age differences in source recall of enacted and nonenacted statements

This study explored age-related differences in item and source recall of enacted and nonenacted items in a sample of healthy adults between the ages of 35 and 80 years (N=1,000). Participants were screened on a variety of demographic, psychometric, and biological variables. They were presented with sentences (e.g., Lift the book) that they either read or enacted. They were then asked to recall the object of each stimulus sentence (item recall) and to identify its format of encoding (source recall). Age-related decrements were observed both in item and source memory, although age differences in source memory were more accentuated than in item memory. Further, the results indicated an overall impairment of source memory across age when individual differences in the demographic, psychometric, and biological variables were taken into consideration.