Schwierigkeiten in der psychotherapeutischen Arbeit

Dealing with difficult clients, situations and their own emotions is an integral part of psychotherapists’ daily work; however, what is the nature of difficulties in psychotherapy and how should therapists’ deal with them? In spite of the high relevance of these topics for therapeutic practice, scientific research in this area lacks consistent definitions of difficulties and the respective coping strategies. This article summarizes the development of current research approaches and respective results.     

Academic self-regulation as a function of age: the mediating role of autonomy support and differentiation in school

Numerous studies in the tradition of the self-determination theory (Deci and Ryan in Can Psychol 49(1):14–23, 2008) point out the significance of self-determined academic motivation and its relevance for learning processes and well-being. Whereas these results sketch a rather heterogeneous picture of the development of intrinsic and extrinsic motivation, only a limited amount of research results are dedicated to the development of academic self-regulation. This cross-sectional research is based on the data of 432 pupils aged 6–20 from primary to secondary school. With the aid of questionnaires, participants provided information concerning their academic self-regulation and how much autonomy support and differentiation they perceive in school. The results of cluster analysis and structural equation modelling indicated that age is negatively related to academic self-regulation, while intrinsic and (rather) controlled regulation decreased the older the pupils are. The values for rather self-determined regulation remained comparatively stable. In addition, the longer pupils attended school, the less they reported perceived autonomy support and differentiation. Perceived autonomy support had an impact on intrinsic and rather self-determined regulation but not on controlled regulation, whereas perceived differentiation was not related to academic self-regulation. These findings offer novel explanations why settings in schools—especially in secondary schools—can become less suitable for learners (Eccles and Roeser in Handbook of adolescent psychology, Wiley, Hoboken, pp 404–434, 2009) and how they can assist educators in designing autonomous learning environments that contribute to maintaining and developing intrinsic and self-determined academic regulation strategies.     

Perceived teasing experiences in body dysmorphic disorder

Individuals with body dysmorphic disorder (BDD) are excessively concerned about imagined or slight defects in their appearance (e.g., asymmetrical facial features). Cognitive-behavioral models of BDD propose that several factors, including dysfunctional appearance-related beliefs and life experiences, such as teasing, contribute to the avoidance behaviors or rituals (e.g., mirror checking, grooming) characteristic of BDD. Previous research has demonstrated an association between perceived teasing and body dissatisfaction. In the current study, we examined whether individuals with BDD (n = 16) report to have been teased more often than do mentally healthy controls (n = 17). The group comprising individuals with BDD reported more appearance- and competency-related teasing than did control participants. This study provides preliminary evidence for the association between perceived teasing and BDD.     

Comparison of treatment seeking compulsive buyers in Germany and the United States

OBJECTIVE: The aim of this pilot study was to compare a German (Bavaria) and an American (North Dakota) sample of women suffering from compulsive buying. METHOD: Thirty-eight German and 39 American female compulsive buyers were screened with the Compulsive Buying Scale (CBS), and the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV) prior to entering a group treatment study. Psychiatric co-morbidity was assessed with the Structured Clinical Interview for DSM-IV Axis I disorders (SCID). RESULTS: There were no statistically significant differences between the German sample and the American sample with regard to age (mean 43.7 and 45 years, respectively), and with regard to the scores on the CBS and the Y-BOCS-SV. A high lifetime co-morbidity rate with Axis I disorders, especially mood disorders, anxiety disorders, substance use disorders, OCD, and binge eating disorder was detected in both samples. Almost all participants met criteria for at least one lifetime Axis I disorder. However, German compulsive buyers showed significantly higher current prevalence rates of any affective disorder, and higher current and lifetime prevalence rates of any anxiety disorder and somatoform disorder. In addition, German compulsive buyers were significantly more likely to have more than one Axis I disorder. CONCLUSION: The groups did not differ with regard to age and with regard to the severity of compulsive buying and showed a high co-morbidity with Axis I disorders. However, the German compulsive buying sample presented with significantly more psychiatric co-morbidity compared to the American sample. Further research is needed to provide a better understanding of this disorder in general and cross-culturally.     

Visual categorization of natural stimuli by domestic dogs

One of the fundamental issues in the study of animal cognition concerns categorization. Although domestic dogs (Canis familiaris) are on the brink to become one of the model animals in animal psychology, their categorization abilities are unknown. This is probably largely due to the absence of an adequate method for testing dogs’ ability to discriminate between large sets of pictures in the absence of human cueing. Here we present a computer-automated touch-screen testing procedure, which enabled us to test visual discrimination in dogs while social cueing was ruled out. Using a simultaneous discrimination procedure, we first trained dogs (N = 4) to differentiate between a set of dog pictures (N = 40) and an equally large set of landscape pictures. All subjects learned to discriminate between the two sets and showed successful transfer to novel pictures. Interestingly, presentation of pictures providing contradictive information (novel dog pictures mounted on familiar landscape pictures) did not disrupt performance, which suggests that the dogs made use of a category-based response rule with classification being coupled to category-relevant features (of the dog) rather than to item-specific features (of the background). We conclude that dogs are able to classify photographs of natural stimuli by means of a perceptual response rule using a newly established touch-screen procedure. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Bindungsrelevante Situationen in der Psychotherapie

Background

The therapeutic relationship is a central factor for psychotherapy, which may be at least partially explained by attachment theory. However, research concerning the conditions under which attachment-related needs are activated in treatment followed by possibly dysfunctional coping strategies is rare.

Patients and methods

Semi-structured interviews on attachment-related situations in psychotherapies were conducted with 36 inpatients and then rated with regard to content.

Results

Triggers for attachment-related needs in therapies were interpersonal conflict and loss, beginning and end of therapy, symptom burden, specific interventions, addressing the therapeutic relationship and change of setting from outpatient to inpatient treatment. This was related to themes of desire for help and support, experience of rejection, self-disclosure and desire for understanding.

Conclusions

The attachment system is activated in therapies similar to other interpersonal situations. The results may help to become more sensitive to attachment-related situations and needs.     

When we like what we know – A parametric fMRI analysis of beauty and familiarity

This paper presents a neuroscientific study of aesthetic judgments on written texts. In an fMRI experiment participants read a number of proverbs without explicitly evaluating them. In a post-scan rating they rated each item for familiarity and beauty. These individual ratings were correlated with the functional data to investigate the neural correlates of implicit aesthetic judgments. We identified clusters in which BOLD activity was correlated with individual post-scan beauty ratings. This indicates that some spontaneous aesthetic evaluation takes place during reading, even if not required by the task. Positive correlations were found in the ventral striatum and in medial prefrontal cortex, likely reflecting the rewarding nature of sentences that are aesthetically pleasing. On the contrary, negative correlations were observed in the classic left frontotemporal reading network. Midline structures and bilateral temporo-parietal regions correlated positively with familiarity, suggesting a shift from the task-network towards the default network with increasing familiarity.     

Psychological Well-Being as an Additional Outcome Parameter in the Treatment of Patients with Gambling Disorder: Results from a Clinical Multicenter Follow-Up Study

According to the World Health Organization well-being has been defined as one outcome parameter indicating successful recovery from diseases. One disease causing significant psychosocial problems and distress is Gambling Disorder that is being characterized as a poorly controlled excessive engagement in gambling activities. While there are several studies investigating treatment-effects in patients with Gambling Disorder, the role of well-being as a complementary treatment outcome has not been studied so far. In our research project it was aimed to fill this gap by gathering data on changes of eudaimonic dimensions of well-being from 76 patients with Gambling Disorder before and 1 year after receiving inpatient treatment. At both waves (pretreatment and follow-up) we collected data regarding well-being (Ryff Scales of Well-being), psychopathological symptoms (SCL-9), and diagnostic criteria for Gambling Disorder (Lie/Bet-Questionnaire). We found some dimensions of well-being changing 1 year after treatment and that patients recovered from Gambling Disorder displayed significant increments in Autonomy and Environmental Mastery. In contrast, patients still meeting criteria for Gambling Disorder displayed well-being increments only in Environmental Mastery and decreases in Personal Growth and Positive Relations with Others. Only changes in Environmental Mastery and Self-Acceptance were significantly associated with decreases in psychosocial distress indicating that well-being is an additional indicator for treatment outcome. It was also intended to identify factors predicting increments in well-being. However, no relationships were found regarding demographics, clinical variables, or treatment parameters. It is proposed to acknowledge well-being as an additional indicator for treatment effects and suggested to implement therapeutic strategies for an early enhancement of well-being.     

Acceptance and commitment therapy versus tinnitus retraining therapy in the treatment of tinnitus: a randomised controlled trial

The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60 min sessions. The TRT treatment consisted of one 150 min session, one 30 min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8 h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen’s d = 1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen’s d = 0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.