Begriffsgeschichte und Konzeptualisierung des psychischen Traumas

In contrast to historical debates, which will be looked at in more detail below, it is common sense today that a traumatic experience must basically be considered the cause even for persisting mental disturbances. Nevertheless, the traumatic event as such remains a great conceptual challenge despite today??s definitions. Since the first investigations were made in the nineteenth century, the term trauma has gained an increasingly expanding scope. Today??s view has shifted more towards post-traumatic events, individual assessments, personal experiences and ways of coping. It is its expanded scope which exposes the term trauma to the danger of being trivialized once each subjectively felt misfortune or any sort of loss is defined as a trauma. A clear distinction must be made between a trauma and other difficult circumstances in life to establish and evaluate the individual extent to which people may be exposed to burdens or strain. Since the beginning of scientific debates about trauma and its consequences, the controversial subjects have always involved the question from which point on the term trauma is applicable and what the connection is between the type, intensity and duration of an encumbering event and the kind and intensity of a traumatically caused mental disturbance.     

Patientenpfade im psychiatrischen Ma?regelvollzug �C Intensivere Behandlung, k��rzerer Freiheitsentzug?

This article reports on the results of two workshops which attempted to register and characterize clinical pathways in special hospitals for schizophrenic offenders. The starting point for both workshops was the analysis of the stages and elements which naturally constitute long-term therapy in schizophrenic patients. Based on this analysis it was aimed to develop standardized operating procedures: which mode of action is most sensible in which phase of treatment? How to respond to the different problems arising during therapy? How to prevent therapeutic stagnation? How to retain up-to-date knowledge on the patient? How to manage a faster and more effective transfer into outpatient care? This article focuses particularly on the course of patientsduring the process of in-patient care in special hospitals for schizophrenic offenders.     

Separating mental transformations and spatial compatibility effects in the own body transformation task

Laterality judgments about the left or right hand of a schematic human figure, made from the perspective of the figure, are faster and more accurate when the figure is presented in back-facing view as compared to front-facing view. Mental perspective transformation accounts of this finding have recently been challenged on grounds of a confounding of facing direction with spatial stimulus-response (S-R) compatibility (Gardner and Potts in Acta Psychol 137: 371-381, 2011). We report two experiments that introduced stimulus figures in an orientation that was neutral in terms of spatial S-R compatibility. Results revealed a stable back-facing advantage that cannot be explained by compatibility conflicts. Comparisons of these neutral stimuli and conditions with figures presented in upright or upside-down orientation, however, confirmed a substantial impact of spatial S-R compatibility in the latter conditions. The present experiments show that it is possible to distinguish between mental transformation and incompatibility costs allowing future work to focus on the specialized mental spatial transformation processes.     

A long-term follow-up case study of crossed aphasia assessed by single-photon emission tomography (SPECT), language, and neuropsychological testing

A 65-year-old man with well-defined crossed aphasia secondary to right cerebral infarction 10 years previously was studied for current language and cognitive abilities and regional cerebral blood flow (rCBF) during cognitive activation measured by single-photon emission tomography (SPECT). Reversed hemispheric lateralization was demonstrated by qualitative aspects of the patient's constructional deficits, dominant parietal lobe signs, and absence of the neglect syndrome. Language activation procedures during SPECT produced focal increases in rCBF to both frontal lobes with a phoneme detection task and to right temporal and parietal lobes with a math task. The authors stress the complexities of assessing brain/language mechanisms in vivo and demonstrate variabilities in rCBF during language activation dependent on task selection.     

Location-specific versus hemisphere-specific adaptation of processing selectivity

Current theories of cognitive control assume that processing selectivity is adjusted according to the utility of processing task-irrelevant stimulus features. Consistently, interference evoked by flanker stimuli is reduced when the proportion of incompatible trials—in which flankers are associated with an incorrect response—is increased. Consistent with the idea that the cerebral hemispheres select processing strategies independently of each other, Corballis and Gratton (2003) demonstrated that flanker interference for stimuli presented in either the left or right visual hemifield is affected by the ratio of compatible and incompatible target-flanker pairings presented in the same—but not in the other—hemifield. Presenting stimuli at four different locations, we demonstrated independent effects of the ratio of compatible and incompatible trials for stimulus locations in different hemifields as well as for stimulus locations within the same hemifield. Independent selectivity adjustment regarding the left and right visual hemifields thus appears to be a special case of a larger class of location-specific adaptation effects and might not be informative regarding hemisphere-specific processing.     

For an indeterministic ethics. The emptiness of the rule in dubio pro vita and life cessation decisions

It is generally claimed that there exist exceptional circumstances when taking human life may be approved and when such actions may be justified on moral grounds. Precise guidelines in the medical field for making such decisions concerning patients who are terminally ill or have irreparable injuries incompatible with a bearable life, are difficult to establish. Recommendations that take the particular logical form of a rule, such as "in dubio pro vita", "when in doubt favour life") have been suggested and in some countries incorporated into legal texts (Germany). We claim here that such a rule is of no value since it is open-ended and always allows for doubt, and a decision to employ measures that would support human life could always be argued to be a valid choice. Preservation of this rule could be encouraged, but giving it the force of law may put physicians at risk, as they may be challenged for choosing to terminate life in otherwise ethically and medically uncontroversial circumstances.     

Wo steht der Jugendmaßregelvollzug in Deutschland aktuell?

With up to 67% of all young offenders suffering from mental illnesses, the question of how professional care should be arranged for them arises. The ability to detain a young offender for an indefinite period of time in a forensic psychiatric institution represents the final solution in juvenile law. This currently affects approximately 300 patients nationwide, of which there is precise data available only for patients who were detained before the age of 18. This is due to the differing nationwide organisational structures within specific forensic psychiatric institutions for adolescents. There is currently a lack of forensic psychiatric units in several federal states providing treatment for adolescents. When examining under what basis, and when the relocation of a person from a young forensic psychiatric institution into the corresponding adult one occurred, and how long specific pedagogic facilities were provided to these individuals, the differences between various adolescent forensic psychiatric institutions become apparent. This especially concerns young adolescent offenders suffering from delayed mental development.