Der Einfluß somatischer und psychosozialer Faktoren auf Entstehung und Verlauf chronisch-entzündlicher Darmerkrankungen

Zusammenfassung Chronisch-entzündliche Darmerkrankungen (Morbus Crohn, Colitis ulcerosa) werden traditionellerweise zu den psychosomatischen Erkrankungen gez?hlt. In jüngster Zeit wurde diese Zuordnung aber mehrfach in Frage gestellt; zugleich wurden biomedizinische Faktoren beschrieben, die in der Entstehung und im Verlauf der Erkrankungen eine Rolle spielen k?nnten. Die vorliegende übersichtsarbeit hat das Ziel, den aktuellen Stand der biomedizinischen und psychosomatischen Forschung zur ?tiologie und Verlaufsgestaltung bei chronisch-entzündlichen Darmerkrankungen darzustellen und unter methodischen Gesichtspunkten kritisch zu bewerten. Forschungsergebnisse zu folgenden Themenbereichen werden referiert: Epidemiologie; soziodemographische Merkmale; Genetik; di?tetische Faktoren und Zigarettenrauchen; Medikamente; Permeabilit?tsst?rung der Darmepithelien; immunologische Faktoren; mikrobiologische Faktoren; psychiatrische St?rung; emotionale Symptomatik, Pers?nlichkeitsmerkmale; kritische Lebensereignisse und psychosozialer Stre?; Lebensqualit?t und Krankheitsbew?ltigung.      

The problem of moral absolutes in the ethics of Vladimir Solov'ëv

Conclusion Moral absolutes were perceived, by Solov'?v, in a dual manner: a) from the side of content, of psychology, as when we speak of feelings, emotions, etc.; and b) under a formal aspect, as “ideas,” i.e. logically. Neither of these can be treated without relating to moral absolutes astrue, and without a rationalbelief in their truth, a truth that cannot be logically proved. In my opinion, our time has become keenly aware of the universally human value of Vladimir Solov'?v's ethics, of its humanist nature, oriented towards the everyday and the ideal tasks of man, and of the concrete direction of his philosophy of “practical idealism”.     

Die Bindungstheorie und ihre Relevanz für die Psychotherapie

Zusammenfassung Die ursprünglich von John Bowlby entwickelte Bindungstheorie gewinnt zunehmend an Relevanz im Bereich der Psychotherapie(forschung). Diese übersicht beginnt mit einer Kl?rung der zentralen Begriffe und Annahmen dieser Theorie und fa?t einige Befunde zur Entwicklung und den Korrelaten von Bindung zusammen, die vornehmlich aus entwicklungspsychologischen Untersuchungen stammen. übertragen auf Erwachsene, bedürfen die Konzepte der Bindungstheorie einer Revision, die in dieser Arbeit skizziert wird. Schlie?lich werden auf dieser Basis einige heute übliche Methoden zur Erfassung von Bindungsstilen und Bindungsverhalten im Erwachsenenalter dargestellt, die bei Untersuchungen im klinischen Feld (Inhalt des 2. Teils der übersichtsarbeit) eine wichtige Rolle spielen.      

Clinical Supervision of Couple and Family Therapy during COVID-19

This paper addresses the need for a swift transition from in-person clinical supervision to telesupervision during the time of the COVID-19 global pandemic. Five specific areas will be discussed in the effort to enhance the quality of clinical supervision provided to couple and family therapists in training at this time including the following: (1) COVID-19 and the structural changes and technological adaptation of supervision; (2) culturally and contextually sensitive guidelines for clinical supervision during COVID-19; (3) the supervisee’s competence and the clinical supervisory process; (4) the new set of boundaries and the supervisory role; (5) and the supervisory alliance and supervisees’ vulnerabilities in the face of COVID-19.     

Archetypal images emerging in the therapy of Lithuanian cancer patients

The goal of this paper is to show through clinical examples how archetypal images connected with nature emerged in Lithuanian cancer patients, to analyze how these images helped them to get in touch with their emotions and meaningful personal experiences, and to discuss how these archetypal images are related to the Lithuanian cultural unconscious, and may also assist the psychological treatment of cancer. The analyzed examples permit the preliminary conclusion that when ill with cancer, a person's psyche generates universal archetypal images that constitute an important part of the process of coping psychologically with the disease.     

Relative effects of breastfeeding intention and practice on maternal responsiveness

Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother–infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months’ postpartum. The outcome was maternal responsiveness assessed at 12 months’ postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.     

Early childhood mental health consultation: Care providers’ experiences of the consultative relationship

This article presents findings from a qualitative research study exploring child care teachers’ experiences receiving early childhood mental health consultation (ECMHC). As an emerging intervention in early childhood education, ECMHC is already yielding promising results, namely in helping teachers better address challenging behaviors in their classroom and promote a more nurturing classroom environment. However, there remains a lack of personal testimony from teachers who receive this intervention. Considering that teachers are the primary focus of most ECMHC interventions, the purpose of this study was to examine child care teachers’ personal experiences receiving consultation. Eight child care teachers were interviewed for this study. Results from this study illuminate key interpersonal processes in the development of the consultant–consultee relationship, indicate what teachers consider to be the most helpful components of consultation, and speak to the challenges that teachers experience in consultation. By examining the personal testimony of child care teachers who have received ECMHC services, consultants and researchers can consider ways to expand and improve future implementation of ECMHC.     

Antenatal caregiving representations and perinatal behavior in mothers with severe lifetime psychopathology

Psychopathology poses a risk for optimal parenting. The current study explored antenatal caregiving representations as markers for later risk of nonoptimal maternal behavior among mothers with severe mental illness. Sixty-five mothers diagnosed with psychosis, bipolar disorder, depression (psychopathology group), and nonclinical controls participated in a longitudinal study from pregnancy to 16 weeks after birth. Mental health diagnoses and caregiving representations were assessed during pregnancy. Maternal behavior was assessed during the 5-min recovery phase of the still-face paradigm at 16 weeks. Mothers with psychopathology reported significantly higher levels of “heightened” caregiving representations (i.e., separation anxiety from the child) than did controls. The only significant diagnostic group difference in perinatal maternal behavior was that mothers diagnosed with depression exhibited more overriding-intrusive behavior than did nonclinical control mothers. Regression modeling results showed that antenatal caregiving representations of “role reversal” predicted significantly lower levels of sensitivity and higher levels of overriding-intrusive behavior independent of the effect of psychopathology. The findings can be interpreted in the context of representational transformation to motherhood during pregnancy. The results provide preliminary evidence for the potential of a new questionnaire measure of caregiving representations as a screening instrument for antenatal representational risk.     

Unglücklich machende Familienideale

Zusammenfassung Der Artikel konstrastiert familiäre Lebensrealitäten und familiäre Idealvorstellungen miteinander. Für Patienten, bei denen beide weit auseinander klaffen, werden Anregungen für die Dekonstruktion selbstquälerischer Familienideale in der Psychotherapie entwickelt. Als potenziell unglücklich machend werden Familienideale beschrieben, nach denen Kinder (nur) eine Familie und Familien (nur) ein Heim brauchen; dass Familien gemeinsam verbrachte Zeit, Söhne ihre Väter und überhaupt Kinder heterosexuelle Eltern bräuchten; dass Eltern einander lieben und ihre Kinder bei sich behalten sollten; dass Kinder sich von ihren Eltern ablösen sollten. Als psychotherapeutisch nützlich werden aus Familiensoziologie und systemischer Psychotherapie die Ideen der Wahlverwandtschaft, der konsensentlasteten Diskurse und der systemischen Selbstbeobachtung empfohlen, ferner als therapeutische Techniken die zirkulären Fragen, speziell Verschlimmerungsfragen und die positive Umdeutung. Die Konstruktion neuer Rituale und die Nutzung von Netzwerkressourcen stehen am Ende der Untersuchung.Überarbeitete Fassung des Eröffnungsvortrags der Lübecker Psychotherapiewoche, 17.10.1999.