Standards der sozialmedizinischen Leistungsbegutachtung in der Psychosomatischen Medizin und Psychotherapie

Sociomedical problems are playing an increasingly important role in both psychosomatic medicine and psychotherapy and in psychiatry. The present article examines the standards relating to content and method in sociomedical assessments, primarily in the discipline of psychosomatic medicine and psychotherapy. The focus is on the assessment of performance, highlighting the fact that performance and performance deficits cannot primarily be derived from the medical diagnosis; instead, psychosocial variables that influence the processes of dealing with disease in particular affect the actual performance status. The article pays particular attention to aspects that aggravate or dissimulate performance competence. Finally, the principles of integrating the various findings and results that are incorporated into the assessment report are outlined.     

Two modes of sensorimotor integration in intention-based and stimulus-based actions

Human actions may be driven endogenously (to produce desired environmental effects) or exogenously (to accommodate to environmental demands). There is a large body of evidence indicating that these two kinds of action are controlled by different neural substrates. However, only little is known about what happens—in functional terms—on these different “routes to action”. Ideomotor approaches claim that actions are selected with respect to their perceptual consequences. We report experiments that support the validity of the ideomotor principle and that, at the same time, show that it is subject to a far-reaching constraint: It holds for endogenously driven actions only! Our results suggest that the activity of the two “routes to action” is based on different types of learning: The activity of the system guiding stimulus-based actions is accompanied by stimulus-response (sensorimotor) learning, whereas the activity of the system controlling intention-based actions results in action-effect (ideomotor) learning.     

Improving postswitch performance in the dimensional change card-sorting task: the importance of the switch and of pretraining by redescribing the test cards

The dimensional change card-sorting task (DCCS) is used to assess the executive abilities of young children. Typically, 3-year-olds have difficulty in performing this task. However, the exact nature of this difficulty is still being debated. In the standard DCCS, children need to sort, for example, test cards with a blue flower or a red car into two boxes marked with the target cards. The 3-year-olds commonly have pronounced difficulty in switching from one sorting criterion (e.g., color) to another (e.g., shape). Here two experiments with 3-year-olds showed that making the transition between the sorting criteria more distinct improved performance significantly. This was achieved by taking away the target cards for a brief time period, asking a question irrelevant to the task, and pretraining the children by redescribing the test cards.     

Analogue Mental Transformations in 3‐Year‐Olds: Introducing a New Mental Rotation Paradigm Suitable for Young Children

Until now, a successful application of the mental rotation paradigm was restricted to children 5 years or older. By contrast, recent findings suggest that even infants can perform mental rotation. Unlike the methods used in infant studies (looking time), our new research paradigm allows for the measurement and interpretation of reaction times. Kindergartners (aged 3–6 years) were presented with a stimulus configuration on a touchscreen and asked to bring a rotated stimulus into an upright position using the shortest path. Mean reaction time (RT) increased linearly with angular disparity. The ensuing linear trend was significant not only for the entire sample but also for the youngest age group analysed separately. To exclude the possibility that linearity was due to movement planning, 3‐year‐olds had to manually rotate a stimulus about the same trajectory without the need for a corresponding mental transformation in a second experiment. Here, no linear trend was observed. These results are interpreted as evidence for an analogue mental transformation in 3‐year‐olds, equal to the transformation processes in older children's and adults' mental rotation. Copyright © 2013 John Wiley & Sons, Ltd.     

Binaural loudness gain measured by simple reaction time

In order to yield equal loudness, different studies using scaling or matching methods have found binaural level differences between monaural and diotic presentations ranging from less than 2 dB to as much as 10 dB. In the present study, a reaction time methodology was employed to measure the binaural level difference producing equal reaction time (BLDERT). Participants had to respond to the onset of 1-kHz pure tones with sound pressure levels ranging from 45 to 85 dB, and being presented to the right, the left, or both ears. Equal RTs for monaural and diotic presentation (BLDERTs) were obtained with a level difference of approximately 5 dB. A second experiment showed that different results obtained for the left and right ear are largely due to the responding hand, with ipsilateral responses being faster than contralateral ones. A third experiment investigated the BLDERT for dichotic stimuli, tracing the transition between binaural and monaural stimulation. The results of all three RT experiments are consistent with current models of binaural loudness and contradict earlier claims of perfect binaural summation.     

Zur Theorie der stroboskopischen Bewegung

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