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No abstract available
Parkinson und Demenz
(1993)
Auf der Delegierten-Konferenz der dPV in Hannover waren eine Reihe von Fragen wr Demenz im Zusammenhang mit dem Morbus Parkinson gestellt worden, zu denen hier Stellung genommen werden soll. Die Fragen und Antworten sind jeweil mit einem ? für die Fragen und einem ! für die Antworten gekennzeichnet.
Streßbewältigung
(1993)
No abstract available
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In accordance with various other studies. the present longitudinal study gave no clues for specific personality variables or traits 01' drug addicts. Personality factors did not allow a valid prediction of the kind 01' th~apy termination. nor were there clear deviations from the norm. Analyzed as a group. the addicts showed only minor changes that appeared over the course of treatment. These results correspond to data reported on alcohol dependency (cf. Wanke 1987). A more differentiated picture is gained when stable and changeable components of personality and analyzed separately. Changeable components are of special relevance for treatment. From the current study these were characteristics of action regulation, that is, activation and impulse control, social interaction, and somatic reactions (sleep disorders, bodily reactions to drug deprivation). For relapse prevention, attention should be given to stable, persistent, problematic components. Persistent suicidal ideas turned out to be one such aspect. Like the differentiation between state and trait anxiety, stable and variable components could also be separated for other domains of personality when they are used to describe the course of treatment. How can personality concepts and instruments for assessment be utilized for treatment? The claim of therapists to predict the outcome of a treatment may be realized for only a delimited period of time. Especially at such critical points as shortly before relapse, a firm prediction might be possible only rarely (Wanke 1987). Lack of predictability could be a warning which, however, can be verified only afterward. According to the current results, one benefit of personality concepts could be to specify targets of change on an individual basis and thus clarify effects of therapeutic interventions. Personality concepts can help patients to better understand their problems and to recognize changes as weil as persistent areas of vulnerability.
This paper describes the influence of neuroleptic therapy on facial action in drug-naive schizophrenics. In a comparative study of medicated and unmedicated schizophrenic patients, the coordinates of 12 small light-reflecting points, attached to subjects' faces, were computer-recorded and analyzed automatically during a semistandardized clinical interview. In addition, facial activity in videotaped interviews was coded using the Facial Action Coding System (FACS). Each sample group comprised of eight patients with the DSMIII- R diagnostic criteria "schizophrenia" or "schizophreniform disorder". Subjects were studied on two occasions, one shortly after admission to the hospital, the other three weeks later. Group I was unmedicated during the first session, whereas group2 was medicated throughout the study. Three weeks after the start of medication, at the second interview, both recording methods showed a reduction in facial activity and facial expression across all subjects in group 1. The facial action of patients in group2, however, remained unchanged.
In this study, the influence of partnership on depression and coping with Parkinson's disease has been investigated. Twentythree single female patients, 46 married patients (23 female, 23 male) with unimpaired partnership and 42 patients (21 female, 21 male) whose partnership had worsened since the onset of disease, were compared with regard to depression and self reported extent of psychosocial distress. Single female patients tended to have higher depression scores than patients in a stable partnership, especially in items concerning personal worthlessness and senselessness of life. Patients differed in the extent of distress concerning social behavior, psychological problems/anxiety and efficiency. Within the group of single female patients two subgroups emerged: (1) patients with low extent of distress in all aspects; (2) patients who were highly distressed by psychological problems and physical disability but weakly distressed from social interaction. Male and female patients living in a stable partnership reported only a generally low to moderate extent of distress. More than half of the male and female patients who reported an impairment of their relationship also had scores of moderate to severe depression. These patients also had the h~ghest extent of distress in each ofthe aspects assessed. The results are dicussed with regard to possible interactive effects ofthe disease, quality of the partnership and availability of coping strategies.
Kaum ein anderer Teil des menschlichen Körpers ist in der Lage, gefühlsmäßige Regungen in derart differenzierter Form auszudrücken wie die Mimik. Über den Zusammenhang zwischen muskulärer Aktivität und Emotionen wird versucht, in einigen Aspekten auch die Beziehung von Stimmungen zur Rückenmuskulatur herzustellen. Vor allem wird jedoch auf die Mimik als Verständigungsmittel eingegangen. Die neuroanatomische und neurophysiologische Basis der Mimik wird dargestellt sowie der Zusammenhang zwischen Stimulus-Situation und Emotionen einerseits und Emotionen und Ausdruck andererseits. Störungen dieser Beziehungen werden anhand von psychiatrischen und neurologischen Erkrankungen erläutert. Aus dem Ausdruck von Konflikten in der Mimik werden einige Bedingungen für psychosomatische Störungen nicht nur im Rückenbereich, sondern auch bei Kopfschmerzzuständen und Streßverhalten abgeleitet.
Im Zuge der Breitbandverkabelung in Europa wird angestrebt, den Einsatz neuer möglichst kostengünstiger Kommunikationsmedien zu fördern. Dazu zählt im Rahmen eines von der EG geförderten Projektes der Einsatz von Bildtelefbtten in klinisch-psychiatrischen Einrichtungen. Da die Bildqualität der bisher entwickelten Prototypen (Low-cost-video-communication, LCVC) in Bezug auf Bildauflösung und Graustufen noch stark. reduziert ist, ist beim Einsatz evtl. mit Effekten auf die verbale und nonverbale Interaktion der Teilnehmer zu rechnen. Da gerade im klinisch-psychiatrischen Bereich 'di~ Öekodicrung von nonverbalen Signalen von großer Bedeutung ist, wurde in der vqdiegenden Studie,untersucht, inwieweit sich Emotionen anhand der Mimik auch bei stark eingeschränkter Bildqualität erk.enn~n lassen. Trotz sehr geringer Auflösung und Grauschattierung war (jie Dekodierung von diskreten Emotionen unerwartet hoch. . , Die Befunde zu einzelnen'Emotionen sowie crsut'SClllllßfolgertlngen ftir den Einsatz des LCVC im klinischen Bereich wer<Jen diskutien.
No abstract available
The effects of 19 meals of different caloric content on slides on palatability and hypothetical duration of consumption were investigated in 7 patients with anorexia nervosa, 17 patients with bulimia nervosa at the beginning and after 8 weeks of hospital treatment. Nine healthy females served as controls. At the beginning of treatment, palatability of low caloric food was significantly higher and hypothetical duration of consumption of high caloric food was significantly longer in patients when compared to controls. After 8 weeks, in the patients palatability of low caloric food had decreased. Dislike for high caloric food remained stable in anorexics.
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Introduction Although symptomatic therapy is available for Parkinson's disease, patients and relatives are faced with continuous severe psychological problems. These psychological problems include: 1. lack of emotional expression, 2. bradephrenia, 3. depression, 4. lack of motivation,S. social anxiety, 6. stress induced increase of symptoms. The first four of these may be at least in part due to the dopamine deficiency. However, even as part of the primary symptoms they have social and communicative impact for patients and relatives. Social anxiety and stress induced increase of symptoms on the other hand clearly result from an interaction of somatic and psychological factors. Social anxiety mainly develops in Parkinson I s disease as an indirect consequence of the motor symptoms. Patients are afraid of being negatively evaluated in the public, of receiving negative comments etc. Thus r social withdrawal increases and the improvement of neurological symptoms following drug treatment may not be fully exploited on the psychosocial level. Stress induced increase of motor symptoms is a commonly observed phenomenon in Parkinson's disease. Even minor stressors, mainly social in nature, can have extreme effects and may elicit or increase tremor or rigidity. A patient can be well in one moment, but unable to move in the next when being aware that he has to leave the house in an hour. Given this situation, patients and relatives have to develop strategies fo~ an emotional balance in the presence of a continuous confrontation with the direct and indirect consequences of the disease. A precondition for developing new psychologically based strategies is an optimwn medical treatment. The integrated approach for neurological and psychological support has the following goals: 1. improving medical treatment for the individual patient, 2. improving psychological coping and psychosocial adaptation for patients and relatives, and 3. evaluating and improving medical and psychological therapy. CONCLUSION Psychological intervention can provide considerable help for a substantial part of Parkinson patients. The main target is coping with stressful social situations. Relaxation and cognitive restructuring together with situational behavioral analysis and training of social skills specifically adapted to the disease are" the main strategies. Various problems remain open at the moment, like the maintenance of motivation which is especially critical for Parkinson patients. Parkins on 's disease is a neurological disease with a known pathological substrate and a therapy which is effective at least for several years on a symptomatic level. The symptoms are tightly connected with psychological emotional and cognitive processes. Moreover, patients and relatives have to cope with symptoms which strongly influence social interaction. And they have to cope together with this situation over a period of ten or twenty years. Thus not only for the patient but also for the health of the relatives, psychological aid is urgently needed. We suggest to integrate psychological approach into the neurological diagnosis and treatment.
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Verhaltensmedizin
(1990)
No abstract available
This article gives an overview of possibilities for the assessment offacial behavior. With regard to validity, results from a longitudinal study of 36 depressed patients and nine controls as weil as often schizophrenic patients and their relatives will be referred to. These results are used to illustrate the following principles which have to be taken into account when studying facial behavior: a) communication strongly facilitates facial expression, b) activation of facial behavior follows the "principle of least effort", and c) the principle of individual specificity applies to the association of nonverbal behavior and mood states. Making allowance for these principles has, among others, consequences a) for situations or conditions under which to asses behavior (specifically conditions of communication), b) for data analysis (e.g., dealing with frequent and rare events), and c) for empirical or experimental strategies (e.g., aggregation of single-case longitudinal comparisons). From the results on facial behavior during depression it can be concluded that the nonverbal reaction tendencies of endogenous and neurotic depressed patients differ. Moreover, the differential behavioral pattems observed cast doubt on the assumption of a homogeneity of affects in depression. Taking into account the conditions which govern it, facial behavior has proved to be a valid and, especially, a differential indicator for pathoIogic affective states and their changes. Given the fact that a psychiatric illness generally incorporates emotional problems it is more than surprising that little attention has been paid to the systematic study of emotional behavior. Some of the reasons for this will be clarified in the following.
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Anhand eines geschichtlichen Rückblicks und einer Zusammenfassung jüngerer Emotionstheorien wird die Bedeutung der Emotionen für die Verhaltenstherapie abgeleitet. Die Ursprünge in der verhaltenstherapeutischen Angstbehandlung zeigen, daß für die Verhaltenstherapie seit ihrem Beginn die Veränderung von emotionalen Störungen eine zentrale Aufgabe war. Aus jüngeren Theorien zu diskreten Emotionen und deren Komponenten lassen sich diagnostische und therapeutische Zielrichtungen spezifizieren. Als Komponenten der Emotionen werden die Bewertung der Situation, physiologische Aktivierung, Motivierung, Handlungsvorbereitung, Signal zum Organismus und Signal zur Umgebung erläutert. Von den verschiedenen Funktionen der Emotionen sind die Funktion des Antriebs für unser Verhalten, die Funktion der Koppelung zwischen Reizen und Reaktionen und die verhaltenssteuernde Funktion für die Therapie besonders bedeutsam. Beispiele von verschiedenen Ansätzen auf der somatisch-physiologischen Ebene, der kognitiven Ebene und der Verhaltens-Ebene geben einen Einblick in die Möglichkeiten der Verhaltenstherapiefür die Veränderung negativer emotionaler Zustände. Nach der kognitiven Wende scheint die emotionale Wende in der Verhaltenstherapie angezeigt.
No abstract available
In zwei Therapieeinrichtungen zur Drogen-Entwöhnungsbehandlung wurde bei 194 Dro- , genabhängigen untersucht, inwiefern Anamnesedaten und Persönlichkeits variablen eine Vorhersage der vorzeitigen Therapiebeendigung gestatten. Lediglich eine Variable wies für Patienten beider Behandlungseinrichtungen gleichermaßen prognostische Valenz auf: Patienten mit gerichtlicher Auflage schlossen die Therapie häufiger regulär ab als Patienten ohne Auflage. Oie Art der gerichtlichen Auflage oder auch die Dauer der noch ausstehenden Strafzeit korrelierten dagegen nicht mit der Art der Therapiebeendigung. Ansonsten gab es für beide Therapieeinrichtungen und für die verschiedenen Arten der vorzeitigen Beendigung (Entlassung bzw. Abbruch) unterschiedliche, manchmal auch entgegengesetzte, prognostische Kriterien. Ein Patient, der in einer Einrichtung abbruchgefährdet ist, kann in einer anderen Einrichtung gute Chancen haben, die Behandlung regulär abzuschließen. Aus der Literatur bekannte Kriterien wie zum Beispiel Alter und Schulbildung zeigten in dieser Studie nur in Abhängigkeit von der Einrichtung prognostische Valenz und dies spezifisch für Abbruch bzw. vorzeitige Entlassung. Andere Prädiktoren wie Geschlecht, psychische Auffälligkeiten und Depression korrelierten überhaupt nicht mit vorzeitiger Therapiebeendigung. Auch Patienten, die zu Beginn der Therapie als gering motiviert einzustufen sind, haben gute Chancen, die Behandlung regulär abzuschließen. Auf der Grundlage einer Diskriminanzanalyse der FPI-Items war eine vorzeitige Entlassung besser vorhersag bar als ein Therapieabbruch. Nach den Daten dieser Studie ist zu vermuten, daß bestimmte Kombinationen von Einrichtungs-, Therapeuten- und Patienten variablen einen Einfluß auf die Art der Therapiebeendigung haben.
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Ausdrucksforschung
(1987)
No abstract available
Ausdruck
(1987)
No abstract available
Nichtverbale Kommunikation
(1987)
No abstract available
Es wird gezeigt, daß die digitale Sprachanalyse bei der Messung von Sprechpausen unter bestimmten Umständen Fehler aufweist. Am Beispiel von 16 standardisierten Interviews mit depressiven Patienten wurden Sprechpausen von Patienten und Interviewern nach zwei Methoden gemessen: mit einer einfachen manuellen Methode deren Interraterreliabilität bei .88 und höher lag und nach Methoden der digitalen Sprachverarbeitung. Die Ergebnisse beider Analysen wurden verglichen. Dabei zeigte sich, daß die manuelle Methode für Sprechpausen oberhalb 390 ms reliabel ist und gleiche oder bessere Ergebnisse bringt. Bei qualitativ schlechten Tonaufnahmen ist diese manuelle Methode vorteilhaft.
No abstract available
Nonverbale Kommunikation
(1986)
No abstract available
Nonverbal behavior, especially facial expression, appears as one of the most important means for communicating affective states. Studies on groups of psychiatric patients and control subjects are reported in which nonverbal behavior is analyzed from videotaped dialogues. Using a quantitative approach, results on facial behavior, speech, and gaze are described, which shed light on the expressive and communicative functions of nonverbal behavior. From longitudinal observations on depressed patients it emerged that individualspecific associations have to be taken into account for the relationship between expressive behavior and mood changes. The predominance of facial behavior in the speaker role of an individual found in patients and control groups points to the integrated communicative function of the verbal and nonverbal elements. However, recovered schizophrenic patients exhibited a dissociation of these elements. Implications for our understanding of nonverbal communications are discussed.
No abstract available
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Ethologie
(1984)
No abstract available
Kommunikation
(1983)
No abstract available
No abstract available
Nonverbal communicative behaviours are associated with affective states in a way specific to the individual. This result emerged from longitudinal studies on depressed patients. From the analysis of various nonverbal behaviours it can be concluded that the depressed state is indicated by nonverbal elements in a logical "or-" rather than "and-connection" or in a hierarchical way. It is maintained that the relationship of psychological relevant states (mood) and nonverbal behaviour needs to be studied by intra-individual comparisons to reveal the specifically close relationships effective in everyday communication. With regard to the pragmatic aspect of communication, elements in the nonverbal signalling system seem to possess different levels of generality. However, from decoding studies it can be shown that even very subtle behavioural differences can be detected by an observer. Thus specific signals can become effective in interaction given a familiarity with the idiosyncratic usage.