Einsatz von Technik in der Psychotherapie

Leser dieses Beitrags sollen das Spektrum technologischer Anwendungen in der Psychotherapie, Supervision und Psychotherapieausbildung kennenlernen und die Hintergründe, Funktionen und Vorteile der verschiedenen Anwendungen diskutieren können. Dabei geht es insbesondere um die Beantwortung der Frage, welche Aufgaben technische Hilfsmittel übernehmen können, die einerseits für die Optimierung von Psychotherapie relevant sind, und andererseits ohne die Technik nicht oder nur eingeschränkt realisiert werden können

Examining carer stress in dementia: the role of subtype diagnosis and neuropsychiatric symptoms

INTRODUCTION: Caring for people with dementia incurs significant stress for carers. Stress has been related to the duration of caring role, the number of weekly hours provided and severity of cognitive impairment. What remains less clear is the impact of neuropsychiatric symptoms and subtype of dementia on carer stress and this study aimed to examine these. METHODS: Dementia carers were recruited for people with a range of dementia subtypes. Carers were interviewed using the Neuropsychiatric Inventory with the Carer Distress Scale. Cognitive fluctuations were assessed using the Dementia Cognitive Fluctuations Scale. All patients were also examined with The Cambridge Assessment for mental disorders in the elderly. RESULTS: Dementia diagnostic subtype, the presence of cognitive fluctuations and some neuropsychiatric symptoms (psychosis and mood disturbance) did predict carer stress (all at p < 0.01) but age, gender and severity of cognitive impairment did not (all p > 0.33). Carers of people with dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) experienced more stress than those caring for patients with Alzheimer's disease and vascular dementia. Carer stress was associated with higher levels of psychosis, mood disturbances, daytime sleep and cognitive fluctuations in the person with dementia. CONCLUSIONS: This study identified the significant impact on carers of providing care for people with DLB and PDD dementia subtypes and also highlighted the significant impact of providing care for patients with high levels of psychosis, mood disturbances and cognitive fluctuations.

Atypical visual processing in posttraumatic stress disorder

BACKGROUND: Many patients with Posttraumatic Stress Disorder (PTSD) feel overwhelmed in situations with high levels of sensory input, as in crowded situations with complex sensory characteristics. These difficulties might be related to subtle sensory processing deficits similar to those that have been found for sounds in electrophysiological studies. METHOD: Visual processing was investigated with functional magnetic resonance imaging in trauma-exposed participants with (N = 18) and without PTSD (N = 21) employing a picture-viewing task. RESULTS: Activity observed in response to visual scenes was lower in PTSD participants 1) in the ventral stream of the visual system, including striate and extrastriate, inferior temporal, and entorhinal cortices, and 2) in dorsal and ventral attention systems (P < 0.05, FWE-corrected). These effects could not be explained by the emotional salience of the pictures. CONCLUSIONS: Visual processing was substantially altered in PTSD in the ventral visual stream, a component of the visual system thought to be responsible for object property processing. Together with previous reports of subtle auditory deficits in PTSD, these findings provide strong support for potentially important sensory processing deficits, whose origins may be related to dysfunctional attention processes.

Impact of delay in reducing carbon dioxide emissions

Recent downward revisions in the climate response to rising CO2 levels, and opportunities for reducing non-CO2 climate warming, have both been cited as evidence that the case for reducing CO2 emissions is less urgent than previously thought. Evaluating the impact of delay is complicated by the fact that CO2 emissions accumulate over time, so what happens after they peak is as relevant for long-term warming as the size and timing of the peak itself. Previous discussions have focused on how the rate of reduction required to meet any given temperature target rises asymptotically the later the emissions peak. Here we focus on a complementary question: how fast is peak CO2-induced warming increasing while mitigation is delayed, assuming no increase in rates of reduction after the emissions peak? We show that this peak-committed warming is increasing at the same rate as cumulative CO2 emissions, about 2% per year, much faster than observed warming, independent of the climate response.

Bodily and Embodied: Being Human in the Tradition of the Hebrew Bible

A depiction of the ancient Hebrew understanding of the human being must take into account the fact that the Bible does not contain a systematic anthropology, but unfolds the multiplicity of human existence inductively, aspectively, and in narrative fashion. In comparison to Greek body/soul dualism, but also in the context of body-(de-)construction and gender debates, this circumstance makes it a treasure trove of interesting, often contrasting recollections and insights with liberating potential. This assertion will be illustrated concretely in terms of the nexus points of the human body (throat, heart, and womb), the relationship of humans to animals and angels, and the questions of the power and value of a human being.

Mapping material distribution in a heterogeneous sand tank by image analysis

Water flow and solute transport through soils are strongly influenced by the spatial arrangement of soil materials with different hydraulic and chemical properties. Knowing the specific or statistical arrangement of these materials is considered as a key toward improved predictions of solute transport. Our aim was to obtain two-dimensional material maps from photographs of exposed profiles. We developed a segmentation and classification procedure and applied it to the images of a very heterogeneous sand tank, which was used for a series of flow and transport experiments. The segmentation was based on thresholds of soil color, estimated from local median gray values, and of soil texture, estimated from local coefficients of variation of gray values. Important steps were the correction of inhomogeneous illumination and reflection, and the incorporation of prior knowledge in filters used to extract the image features and to smooth the results morphologically. We could check and confirm the success of our mapping by comparing the estimated with the designed sand distribution in the tank. The resulting material map was used later as input to model flow and transport through the sand tank. Similar segmentation procedures may be applied to any high-density raster data, including photographs or spectral scans of field profiles.

Translational diffusion of water in compacted clay systems

The translational diffusion of water in compacted clays at a high hydration level has been investigated by quasielastic neutron scattering at a time-of-flight spectrometer FOCUS (SINQ). Four compacted clays with systematic structural differences have been studied: Na-montmorillonite, Na-illite, kaolinite and pyrophyllite. The QENS experiments were performed using two different incident wavelengths in order to access a larger Q range and verify the data analysis. The translational diffusion coefficient for water in Na-montmorillonite and Na-illite are lower than those for bulk water, whereas the preliminary results for kaolinite and pyrophyllite show larger diffusion coefficient.

MODELING REACTIVE GAS UPTAKE, TRANSPORT, AND TRANSFORMATION IN AGGREGATED SOILS

Gas diffusion research in soils covers, to a large extent, the transport behavior of practically insoluble gases. We extend the mathematical description of gas transport to include reactive gaseous components that hydrolyze in water such as SO2 and CO2. The path between the free atmosphere and the microporous niches is modeled by assuming penetration through gas-filled macropores, air-water phase transfer, and diffusion and speciation in the liquid phase. For hydrolyzable gases, the rate of mass transfer into and the total absorption capacity of the soil solution may be high. Both the capacity and the transfer rate are influenced by the soil-solution pH; for high pH, they become extremely high for SO2. The soil absorption of such gases is also influenced by soil structure. Well-aerated, near-neutral soils are a potentially important sink for SO2.

Upscaling of anisotropy in unsaturated Miller-similar porous media

Geological and pedological processes rarely form isotropic media as is usually assumed in transport studies. Anisotropy at the Darcy or field scale may be detected directly by measuring flow parameters or may become indirectly evident from movement and shape of solute plumes. Anisotropic behavior of a soil at one scale may, in many cases, be related to the presence of lower-scale directional structures. Miller similitude with different pore-scale geometries of the basic element is used to model macroscopic flow and transport behavior. Analytical expressions for the anisotropic conductivity tensor are derived based on the dynamic law that governs the flow problem at the pore scale. The effects of anisotropy on transport parameters are estimated by numerical modeling.

PatientInnen mit generalisierter Angststörung lachen oft in der Therapie – oft aus Verlegenheit

Emotionsregulationsprozesse und deren Bedeutung für die Feinsteuerung der Therapie werden bei PatientInnen mit generalisierter Angststörung noch kaum verstanden. Methode: Anhand von über 1000 videoanalysierten Minuten werden Emotionsregulationsprozesse von 20 Patienten-Therapeuten Dyaden beschrieben. Resultate: Die PatientInnen mit generalisierter Angststörung berichten zu Beginn einer Therapie in Sitzung 5 eine überdurchschnittlich hohe Problemaktivierung, die Probleme werden während der Therapie jedoch nur ansatzweise vertiefend bearbeitet. In 50 % der Minuten zeigen die PatientInnen ein deutliches Lachen, in 39 % der Minuten Scham. Die Vergewisserung der eigenen Fähigkeiten und Fertigkeiten zu Beginn der Therapiestunden, geht mit einer vertiefteren Problembearbeitung und Therapieerfolg einher. Positive reframings während der Stunde und positive Vorsätze am Ende der Stunde korrelieren negativ mit Therapieerfolg, Klinische Schlussfolgerungen: "Positive" Perspektiven und Störungsverhalten sind bei PatientInnen mit generalisierter Angststörung engmaschig ineinander verzahnt.