Abh?ngigkeitserkrankungen und Pers?nlichkeitsst?rungen

Substance use disorders and personality disorders often co-occur in clinical treatment. In this review the association between substance use disorders and personality disorders is described and discussed. Clinical and neurobiological data as well as psychodynamic concepts are included to focus on the therapeutic implications for patients with these comorbidities. The consumption of substances often begins as a kind of self-medication. Patients suffering from severe personality disorders need these substance effects to avoid severe destructive affects and to regulate their self-esteem. Patients with chronic substance dependence often show changes in brain structure. In the dependency stage of addiction clinical symptoms can make the diagnosis of a specific personality disorder very difficult. The treatments can be classified by the severity of substance use disorders and personality disorders. Substance misuse can be treated with psychotherapy. In substance dependence, specific forms of addiction therapy should be included. In patients with the frequent comorbidity of substance use disorders and severe personality disorders, disorder-specific treatment can be used with good results.     

Different standards are not double standards: all elective surgical patients are not alike

Testa and colleagues argue that evaluation for suitability for living donor surgery is rooted in paternalism in contrast with the evaluation for most operative interventions, which is rooted in the autonomy of patients. We examine two key ethical concepts that Testa and colleagues use: paternalism and autonomy, and two related ethical concepts: moral agency and shared decision making. We show that by moving the conversation from paternalism, negative autonomy, and informed consent to moral agency, relational autonomy, and shared decision making, one better understands why the arguments given by Testa and colleagues fail. We argue (1) why the hurdles that one must overcome to become a living donor are appropriate; and (2) that the similarities between living donor transplant surgery and cosmetic plastic surgery that the authors describe are inaccurate. Finally, we consider the recommendation to treat plastic surgery patients and living donors more similarly. We argue that any change should not be in the direction of becoming less protective of living donors, but more protective of cosmetic plastic surgery candidates.     

The Role of Threat in Attitudes Toward Affirmative Action and Its Beneficiaries1

This set of two studies employed the integrated threat theory to examine attitudes toward affirmative action (AA). The first study found that opposition to the policy of AA was predicted by realistic threats, symbolic threats, and personal relevance; while attitudes toward the beneficiaries of AA were predicted by three of the four threat variables (symbolic threats, intergroup anxiety, and negative stereotypes), and in‐group identity. The second study replicated and expanded on the first study and found that the effects of several individual‐difference variables (racism, anti‐Black affect, and political conservatism) on opposition to AA were mediated by three of the threats in the integrated threat theory (realistic threats, symbolic threats, and negative stereotypes). The implications of the results are discussed.     

Applying Meta-theory to Achieve Generalisability and Precision in Personality Science

In contrast to traditional theories of personality, the CAPS perspective is a meta-theory that is deliberately "content-free". The generalisability of the theory depends on how widely its basic, common principles and methods can be applied to identify the constructs (e.g. situation-specific encodings, beliefs, values, etc.) relevant to a given domain of behavior and situations. In this commentary we will discuss how the target article illustrates the use of the CAPS meta-theory for developing domain-specific content-full models for smoking cessation, psychopathology, and organisational behavior.     

Word-association responses to time-altered stimuli by schizophrenic adults

This research addressed the relationship between the speed of presentation of stimuli through the auditory and visual modalities and the number of syntagmatic and paradigmatic word-association responses of 49 chronic undifferentiated schizophrenic adults. In word-association tests administered to subjects stimuli were balanced for frequency of occurrence in written English language (frequent, infrequent), word length (long, short), abstraction level (low, medium, high), and part of speech (noun, verb, adjective). The words were presented auditorily at normal speed (equivalent to 10 phonemes per second) and at half speed (equivalent to 5 phonemes per second) speech. Words were also presented visually, using a tachistoscope, at extended fixation speed (equivalent to 1,000 msec.) and at sweep speed (equivalent to 10 msec.). More paradigmatic responses occurred on word stimuli if nouns, long, and frequently occurring presented auditorily; and if concrete, nouns, and presented slowly and visually. Results were compared to previously reported data for aphasic and normal adults, and differentiating features and clinical implications were discussed.     

Characteristic patterns of word association responses in institutionalized elderly with and without senile dementia

This study examined the responses of 91 institutionalized elderly persons to the Goldfarb-Halpern Word Association Test (1981), Journal of Speech and Hearing Research, 24, 233–246. Subjects with senile dementia evidenced a characteristic pattern of responses which included marked reduction of paradigmatic responses, no decrease in syntagmatic responses, and a marked increase in unclassifiable and multiword responses not previously reported in the literature. The declines and increases appeared linear and progressive with severity of dementia. The pattern was distinct from that of any other adult group previously tested with this tool. Institutionalized elderly subjects without senile dementia performed similarly to previously tested noninstitutionalized elderly. Theoretical and clinical implications are discussed.     

Family constellations and friendship systems

An individual friendship system is composed of the friends a person has had and/or still has. Individual friendship systems can be characterized objectively in similar ways as can family constellations. The data of a questionnaire study of individual friendship systems and respective family backgrounds of more than 400 subjects revealed greater differentiation and variation with age as well as with the presumed absence of conflict, disruption, and loss in a person's social development. Various interactions between family backgrounds could be traced. To illustrate the practical use of characteristics of a person's individual friendship system two clinical cases matched for age and family background, one with a mild neurotic problem and the other severely disturbed, were compared.Based on a lecture first given at the Family Therapy Symposium of Georgetown University, Washington, DC, on November 9, 1986.