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"Chronisch-entzuendliche Darmerkrankungen ( Morbus Crohn , Colitis ulcerosa ) werden traditionellerweise zu den psychosomatischen Erkrankungen gezaehlt . In juengster 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 koennten . Die vorliegende Uebersichtsarbeit hat das Ziel , den aktuellen Stand der biomedizinischen und psychosomatischen Forschung zur Aetiologie und Verlaufsgestaltung bei chronisch-entzuendlichen Darmerkrankungen darzustellen und unter methodischen Gesichtspunkten kritisch zu bewerten . Forschungsergebnisse zu folgenden Themenbereichen werden referiert Epidemiologie ; : soziodemographische Merkmale ; Genetik ; diaetetische Faktoren und Zigarettenrauchen ; Medikamente ; Permeabilitaetsstoerung der Darmepithelien ; immunologische Faktoren ; mikrobiologische Faktoren ; psychiatrische Stoerung ; emotionale Symptomatik , Persoenlichkeitsmerkmale ; kritische Lebensereignisse und psychosozialer Stress ; Lebensqualitaet und Krankheitsbewaeltigung ."
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"Wirkfaktoren von Psychotherapien werden in juengster Zeit gerne aus empirischen Studien abgeleitet . Diese Bemuehungen sind wichtig , stossen jedoch notwendigerweise auf ihre Grenzen , wenn sie menschliche und psychotherapeutische Kommunikation zu ihrem Gegenstand waehlen . Allgemeine Psychotherapie und Integrative Psychotherapie beduerfen eines grundlegenden Verstaendnisses der psychotherapeutischen Kommunikation . Eine solche Grundlage kann aus der philosophisch-anthropologischen Konzeption \" kommunikativer Existenz \" von H. G. Gadamer abgeleitet werden . Die anthropologische Bestimmung der psychotherapeutischen Kommunikation als Spielweise menschlicher Begegnung fuehrt zu einer integrativen \" Hermeneutischen Grundhaltung \" fuer verstehende Psychotherapien im allgemeinen . Darueber hinausgehend lassen sich spezifische Wirkfaktoren tiefenpsychologisch fundierter Psychotherapien beschreiben , deren gezielte Anwendung unter den Begriffen der Hermeneutischen Beratung \" \" und der \" Hermeneutischen Psychotherapie \" zusammengefasst werden . \" Hermeneutische Beratung \" und \" Hermeneutische Psychotherapie \" bedienen sich systematisch dreier menschlicher Faehigkeiten , um desintegrative Erfahrungen zu bewaeltigen : Gestaltung von Erinnerung , Erschaffung praesentativer Vorstellungen und interaktionelles Erleben ."
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Psychotherapeut.60410361.ger.abstr | Psychotherapeut.60410361.ger.abstr | [
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"Im Zusammenhang mit aktuellen gesundheitspolitischen Veraenderungen geraet die Psychoanalyse als Therapieverfahren zunehmend in Bedraengnis . In der satten Selbstzufriedenheit eines 20 Jahre bestehenden Therapiemonopols in der gesetzlichen Krankenversorgung ( 1967-1987 ) wurde uebersehen , wie sich andere Methoden zu womoeglich ueberlegenen Konkurrenten entwickelt haben . Ploetzlich wird immer offensichtlicher , dass Favorisierung der Langzeittherapie und puristische Abgrenzung gegen andere methodische Ansaetze in eine Sackgasse gefuehrt haben . Wenn die Psychoanalyse ihrer Bedeutung entsprechend in der Krankenversorgung vertreten bleiben will , muessen die bisher gering geschaetzten kurz- und mittelfristigen Verfahren gefoerdert und ihre Effizienzsteigerung durch Integration anderer Methodenelemente auch forschungsmaessig unterstuetzt werden . Als ein bereits bewaehrtes integratives Modell wird die psychoanalytisch-systemische Psychotherapie nach Fuerstenau vorgestellt und ihre Anwendung im Rahmen der tiefenpsychologisch fundierten Psychotherapie skizziert . Dabei werden sowohl die Anstrengungen beschrieben , die der psychoanalytisch ausgebildete Therapeut erbringen muss , wenn er sich von methodenbedingten Einengungen befreien will , als auch der Gewinn an therapeutischer Kompetenz und Effizienz , mit dem seine Muehe belohnt wird ."
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"Waehrend im ersten Teil der Uebersicht ueber die Relevanz der Bindungstheorie Grundlagen und Methoden der Bindungsforschung skizziert wurden , werden nun die moeglichen Implikationen der Theorie fuer die Psychotherapie und Psychosomatik eroertert . Ueberlegungen zur allgemeinen klinischen Relevanz und zum Verhaeltnis der Bindungstheorie zur Psychoanalyse bilden die Basis fuer die Darstellung konkreter Anwendungen von Ergebnissen der Bindungsforschung in der therapeutischen Praxis . Es folgen zusammenfassende Darstellungen von Untersuchungen , die sich mit der Bedeutung von Bindungscharakteristika fuer die Entwicklung psychosomatischer Stoerungen und die Krankheits- bzw. Stressverarbeitung befassen sowie von Studien , in denen Bindungscharakteristika psychischen Stoerungen zugeordnet wurden . Schliesslich wird die Bedeutung der Theorie fuer die Psychotherapie und die Psychotherapieforschung dargestellt ."
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Psychotherapeut.70420017.ger.abstr | Psychotherapeut.70420017.ger.abstr | [
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"In dieser sehr persoenlichen Meinungsaeusserung versucht der Autor , unabhaengig von jeglichen Psychotherapieschulen auszuleuchten , wie bestimmte Merkmale der Professionalisierung von Psychotherapie zu Entfremdungen und Einengungen bei der Begegnungsfaehigkeit fuehren koennen . Er plaediert fuer die Neuentdeckung eines Menschenbilds , welches jeden Menschen expliziter als es in den meisten Theorien der psychotherapeutischen Medizin der Fall ist , als Teil einer hoeheren Ordnung der gesamten Natur und als aktiven Forscher zur eigenen Lebenskunst wuerdigt . Eine am Konzept der Salutogenese orientierte wissenschaftlich fundierte Lebensberatung , ist in diesem Sinne prinzipiell genauso wertvoll wie eine kurativ intendierte Psychotherapie . Wollen wir die Gestaltungskraft und Entwicklungsfaehigkeit von Menschen ( z . B. hinsichtlich des Lebenslaufs als Gesamtentwurf ) unverstellt erkunden , so koennen die gaengigen professionell-diagnostischen Denkschablonen nuetzlich , aber zugleich auch sehr stoerend sein . Viele Selektionsinstrumente der therapeutischen Professionen , z . B. das Gutachterwesen der Krankenkassen , lenken zu stark von der Lebenskunst ab und bergen das Risiko einer zu einseitigen Pathologisierung , Vereinnahmung und sogar Ausbeutung ratsuchender Menschen in sich . Als Korrektivmassnahme schlaegt der Autor vor , die therapeutische Aufmerksamkeit viel konsequenter als bisher auch auf die Frage zu zentrieren , wie man beim Gegenueber dessen elementare leib-seelische Lebenskraft noch bewusster erkennen kann . Dazu gehoert auch die stetige Kultivierung der eigenen Liebesfaehigkeit . Zur Weiterentwicklung einer moeglichst umfassenden interpersonellen Resonanzfaehigkeit kann die Selbsterfahrung des Therapeuten mit musischen Erlebens- und Ausdrucksmoeglichkeiten ein hilfreiches Stimulans sein . Auch die Heilkundigen sollten sich von Zeit zu Zeit fragen , inwieweit sie fuer andere als Lebenskuenstler erkennbar sind ."
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Psychotherapeut.70420034.ger.abstr | Psychotherapeut.70420034.ger.abstr | [
{
"id": "Psychotherapeut.70420034.ger.abstr-passage-0",
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"text": [
"Ein androgynes Symbol wird anhand von Malereien aus dem Unbewussten im Verlauf eines psychoanalytischen Prozesses interpretiert . Dabei entscheiden die von der Klientin gegebenen Kommentare ueber den Fortgang des psychoanalytischen Prozesses . Ueberlegungen ueber Sein und Seinsgrund schliessen sich an und fuehren hinweisend auf die heutige Situation zwischenmenschlicher Bezuege ."
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Psychotherapeut.70420042.ger.abstr | Psychotherapeut.70420042.ger.abstr | [
{
"id": "Psychotherapeut.70420042.ger.abstr-passage-0",
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"text": [
"Die Morita-Therapie ( MT ) will vorrangig im Rahmen einer stationaeren Einzeltherapie die Arbeits- und Gemeinschaftsfaehigkeit von Patienten mit neurotischen Stoerungen wiederherstellen . Das therapeutische Ziel der reinen Seele \" ( \" jun na kokoro ) und seine Variationen werden untersucht und unter dem Begriff des Morita-Mythos zusammengefasst . Zwei empirische Studien zur MT wurden mit dem Beurteilungsbogen des Metaanalyseprojekts von Grawe et al. ( 1994 ) evaluiert . Aus der Sicht dieses Metaanalyseprojekts ist eine empirisch begruendete Basis zur Anwendung gegenwaertig nicht gegeben . Folgt man dem im Forschungsgutachten zum Psychotherapeutengesetz von Meyer et al. ( 1991 ) geforderten Standard , faende die MT derzeit kaum Anerkennung . Es wird vorgeschlagen , ausserklinische Selbsterfahrung und Supervision zum Bestandteil der Praxis von Morita-Therapeuten zu machen ."
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Psychotherapeut.70420069.ger.abstr | Psychotherapeut.70420069.ger.abstr | [
{
"id": "Psychotherapeut.70420069.ger.abstr-passage-0",
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"Der Begriff des Narzissmus wird aus historischen , soziologischen , anthropologischen , mythologischen und etymologischen Quellen hergeleitet und dann in die verschiedenen psychoanalytischen Theorien eingeordnet . Die theoretischen Grundpositionen zum Narzissmus und zur Auffassung narzisstischer Persoenlichkeitsstoerungen werden ausfuehrlich erlaeutert . Die Annahme eines primaeren Narzissmus wird anhand der theoretischen Vorstellungen von Freud , Grunberger , Mahler und Kohut erklaert , die Annahme einer primaeren Objektbeziehung durch die Theorien von Ferenczi , Balint , Klein und Winnicott illustriert . Anschliessend werden die Konzeptionen des Narzissmus im Rahmen der Triebtheorie bzw. als eigenstaendige Entwicklungslinie ( Kohut ) erlaeutert . Grunberger nimmt dabei eine Mittelstellung ein . Kohut und Kernberg stehen sich gegenueber , wenn es um die Einordnung des Narzissmus als pathologisches Phaenomen ( Kernberg ) oder als Entwicklungsarretierung ( Kohut ) geht . Es schliesst sich ein Abschnitt ueber die klassifikatorisch-deskriptive Erfassung des Narzissmus an , in dem die Auffassungen der narzisstischen Persoenlichkeitsstoerung im Rahmen der gaengigen Klassifikationssysteme ( DSM-IV , ICD-10, OPD ) beschrieben werden . Ebenso finden die Testdiagnostik sowie interpersonelle Ansaetze Beruecksichtigung . Danach werden die Befunde der modernen Saeuglingsforschung und deren Auswirkungen auf ein veraendertes Verstaendnis der narzisstischen Persoenlichkeitsstoerung dargestellt . Die Uebersicht schliesst mit einer differenzierten Betrachtung der unterschiedlichen therapeutischen Vorgehensweisen ."
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Psychotherapeut.70420085.ger.abstr | Psychotherapeut.70420085.ger.abstr | [
{
"id": "Psychotherapeut.70420085.ger.abstr-passage-0",
"type": "abstract",
"text": [
"Obwohl romantische Verliebtheit und Liebe fuer die meisten Menschen sehr grosse Bedeutung haben , wird erst in juengerer Zeit darueber empirisch geforscht . In der vorliegenden Studie wurden 606 Personen ueber Verliebtsein befragt . Intensives Verliebtsein ist ein fast allen Befragten bekanntes Phaenomen . Nach den Selbstauskuenften unterscheiden sich Maenner und Frauen nicht in der Haeufigkeit des Verliebtseins . Beide Geschlechter verlieben sich angeblich gleich schnell ; Frauen glauben aber haeufiger , dass die Maenner sich auf den ersten Blick in sie verliebt haetten , waehrend Maenner davon ausgehen , ihre Partnerin haette sich erst spaeter in sie verliebt . Beide Geschlechter zeigen deutliche Veraenderungen im koerperlichen und seelischen Befinden bei Verliebtsein , wobei die Frauen noch groessere Veraenderungen beschreiben als die Maenner . Wer verliebt war bzw. die grosse Liebe geheiratet hat , beschreibt sich als gluecklicher in der Partnerschaft als diejenigen , bei denen dies nicht zutrifft . Aus paartherapeutischer Sicht scheint das Ausmass der Verliebtheit weniger wichtig zu sein als der weitere Umgang mit dem , was vorhanden ist oder fehlt bzw. mit dem Konfliktpotential , das dem romantischen Beziehungsideal innewohnt ."
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Psychotherapeut.70420092.ger.abstr | Psychotherapeut.70420092.ger.abstr | [
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"Wilhelm Reich schuf seit den 20er Jahren aus der Psychoanalyse heraus die Grundlage fuer eine koerperbezogene Psychotherapie . Er ging dabei von Ueberlegungen zur Ich-Pathologie , zur Sexualfunktion und zur Widerstands- und Charakteranalyse aus . Charakterliche Haltungen und Koerperhaltungen verstand er als Muster einer Affektabwehr , die nicht nur psychisch , sondern auch koerperlich erfolgt . So kam er dazu , ueber die Arbeit an muskulaeren Verspannungen und am Koerperausdruck abgewehrte Affekte zu mobilisieren , zu ihrem lebensgeschichtlichen Sinn vorzudringen und damit Selbstheilungsprozesse einzuleiten . Auf diesen Ansatz , gebundene affektive Energie freizusetzen und neu zu integrieren , gehen die neoreichianischen Schulen der Koerperpsychotherapie wie Bioenergetik , Biodynamik , Biosynthese u.a. zurueck , deren Menschenbild und Heilungstheorie den Humanistischen Psychotherapieverfahren nahesteht . Koerperliche Prozesse werden mit als Indikatoren fuer Verlauf und Erfolg einer Therapie genutzt , daneben finden sich in der modernen Koerperpsychotherapie Ansaetze zur Arbeit mit dem Koerper im Beziehungs- und Uebertragungsgeschehen und Ueberlegungen zur Reintegration mit psychoanalytischen Konzepten ."
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Psychotherapeut.70420098.ger.abstr | Psychotherapeut.70420098.ger.abstr | [
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"Gewaltbereites Verhalten entwickelt sich in sozialen Rueckkopplungsprozessen und ist durch eskalierende innerseelische , interpersonelle und soziale Konflikte gekennzeichnet . Anhand einer Kasuistik eines 12jaehrigen misshandelten und missbrauchten Jungen werden die aetiopathogenetisch wirksam werdenden Faktoren diskutiert , die wiederum ihn zur Gewaltbereitschaft und zum Missbrauch gegenueber anderen disponieren : die Empathiestoerung in den relevanten Beziehungen des Kindes , die Tradierung einer archaischen Ueber-Ich-Stoerung , die unsichere Bindungsqualitaet zu den Bezugspersonen , die intrapsychische und intrafamiliaere Grenzenstoerung , die Stoerung des Selbstwertgefuehls und der Identitaet ."
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Psychotherapeut.70420132.ger.abstr | Psychotherapeut.70420132.ger.abstr | [
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"Koerperorientierte Psychotherapie wird heute stationaer und ambulant , einzeln oder in Gruppen , alleine oder in Kombination mit anderen Methoden angewandt . Besondere Bedeutung haben diese Methoden bei den Patienten , deren Koerpergefuehl vermindert , die in ihrer Emotionalitaet eingeschraenkt oder , aufgrund von Charakterwiderstaenden , in einer verbalen Psychotherapie schwer zu erreichen sind . Die heute am haeufigsten angewandten Methoden werden mit kurzen Beispielen angefuehrt , auf andere Verfahren wird hingewiesen . Als wirkende Faktoren werden u.a. die Verbindung der Affekte zum vegetativen und willkuerlichen Nervensystem genannt sowie die besonders am Beginn des Lebens bestehende enge Verbindung psychischer und koerperlicher Vorgaenge , die sich mit der jeweilig erlebten Form der Interaktion verbindet und psychobiologische Auswirkungen hat . In der weiteren Entwicklung erhalten der Koerper und bestimmte Koerperregionen auch eine symbolische und fuer die Therapie wichtige Bedeutung . Die Beziehung der koerperorientierten Verfahren zur verbalen Psychotherapie , besonders zur Psychoanalyse , wird diskutiert . Auf Ansaetze zur empirischen Forschung wird hingewiesen ."
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Psychotherapeut.70420145.ger.abstr | Psychotherapeut.70420145.ger.abstr | [
{
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"Im Dokumentationssystem der Heidelberger Psychosomatischen Klinik werden die routinemaessig durchgefuehrten , psychodiagnostischen und psychotherapeutischen Prozeduren standardisiert beschrieben . Im Hinblick auf die psychodynamische Orientierung der Klinik erfasst das System nicht nur die ueblichen soziodemographischen und klinischen Befunde , sondern vorrangig auch die Aspekte der therapeutischen Beziehung , der zentralen Konflikte und der strukturellen Stoerung , wie sie in der initialen Diagnostik , im Behandlungsverlauf und in der Ergebnisbeurteilung eingeschaetzt werden . Viele der Skalen wurden innerhalb der Arbeitsgruppe entwickelt oder mitentwickelt . Die erhobenen Daten bilden die Grundlage fuer klinische Begleitforschung und , in ihrer Ergaenzung durch weitere Skalen , die Basis fuer spezifische Projekte der Psychotherapieforschung . Indem die Befunde regelmaessig in die Gremien der Klinik ( Ambulanz und Station ) zurueckgespielt werden und dadurch die diagnostisch/therapeutischen Ablaeufe hinsichtlich ihrer Funktionsweise und Effektivitaet transparent machen , liefert das System einen wichtigen Beitrag zur Qualitaetssicherung . In dem Beitrag werden die Item-Gruppen und Skalen im einzelnen charakterisiert , die Arbeitsweise des Systems wird anhand von klinischen Beispielen illustriert ."
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Psychotherapeut.70420156.ger.abstr | Psychotherapeut.70420156.ger.abstr | [
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"Das Qualitaetssicherungsprogramm der Rentenversicherungstraeger wird aus der Perspektive der psychosomatischen Rehabilitation dargestellt . Es wird angestrebt , in die medizinische Rehabilitation sowohl Aspekte der Qualitaetssicherung wie des Qualitaetsmanagements einzufuehren . Die ordnungspolitischen Konsequenzen des Programms werden betont . Die Besonderheiten der einzelnen Programmziele werden heraus- gearbeitet und auf ihre Bedeutung fuer die psychosomatische Rehabilitation hin untersucht . Diese wird sich auf eine Zeitoptimierung und auf eine Ressourcenoptimierung einstellen muessen ."
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Psychotherapeut.70420170.ger.abstr | Psychotherapeut.70420170.ger.abstr | [
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"Der Beitrag entwickelt einen tiefenpsychologisch-systemischen Behandlungsansatz fuer die katathym-imaginative Psychotherapie . Aus der tiefenpsychologisch fundierten Kurztherapie stammt die Zentrierung der Arbeit auf einen Fokus und die aktive Gestaltung einer therapeutisch hilfreichen Beziehung . Die klassische konfliktzentrierte Konzeption des Fokus wird jedoch um eine ressourcen- und loesungsorientierte Perspektive erweitert zu einem bipolaren , entwicklungsorientierten Fokus , und das therapeutische Vorgehen wird ergaenzt durch konfliktaktualisierende , ressourcen- und zielaktivierende Interventionstechniken aus der katathym-imaginativen Psychotherapie . Das resultierende klinische Vorgehen wird an einem Behandlungsverlauf exemplifiziert ."
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Psychotherapeut.70420197.ger.abstr | Psychotherapeut.70420197.ger.abstr | [
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"Diese Uebersichtsarbeit beschreibt die theoretischen Grundlagen und die geschichtliche Entwicklung , das Stoerungskonzept , die therapeutischen Haltungen , Methoden und Settings , den Forschungsstand und die aktuellen Kontroversen um die und in der systemischen Therapie . Abschliessend werden einige Ideen zum Verhaeltnis der systemischen Therapie zu einer kuenftigen allgemeinen Psychotherapie thematisiert ."
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Psychotherapeut.70420211.ger.abstr | Psychotherapeut.70420211.ger.abstr | [
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"In der Literatur ueber selbstschaedigende Handlungen finden sich neben Einzelfalldarstellungen nur wenige empirische Studien mit meist relativ kleinen Gruppengroessen . Ein Vergleich der vielfaeltigen Untersuchungen wurde bisher durch das Fehlen einer einheitlichen Nomenklatur und eines verbindlichen psychopathologischen Schemas erschwert . Das vorgelegte Basisdokumentationsschema ermoeglicht es Klinikern und Forschern - unabhaengig von ihrer psychopathologischen und psychotherapeutischen Orientierung - Basisdaten deskriptiv zu erfassen und systematisch zu klassifzieren . Hierdurch wird der Austausch zwischen Klinikern , die mit selbstschaedigenden Patienten konfrontiert sind , erleichtert . Zugleich wird die Voraussetzung fuer Verbundstudien geschaffen ."
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Psychotherapeut.70420218.ger.abstr | Psychotherapeut.70420218.ger.abstr | [
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"Die Bedeutung des Koerpersymptoms sowie der Umgang mit ihm ist in der Psychotherapie zunehmend in den Mittelpunkt des Interesses gerueckt nach langer Zeit relativer und oft hilfloser Vernachlaessigung . Die vorliegende Arbeit stellt ein Fokaltherapiekonzept vor , in dem das Koerpersymptom als individuelle koerperliche Reaktion auf Beziehungserleben und intrapsychische Konflikte verstanden wird . Die psychodynamische Diagnostik und die Erarbeitung des Behandlungsfokus werden dargestellt . Der Fokus stellt den bei den Patienten nicht erlebten Zusammenhang zwischen Koerpersymptom und dem oft unbewussten dominanten Affekt im zentralen Beziehungskonflikt her ."
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Psychotherapeut.70420223.ger.abstr | Psychotherapeut.70420223.ger.abstr | [
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"Die Formulierung der hier beschriebenen Behandlungsgrundsaetze fuer die Therapie chronisch Schmerzkranker ergaben sich aus der langjaehrigen interdisziplinaeren Zusammenarbeit von Kollegen verschiedener Fachbereiche im Rahmen der Schmerzambulanz der Universitaet Ulm . Sie fokussieren im Unterschied zu anderen Darstellungen in der Literatur explizit auf den Beitrag des Therapeuten bei der Entstehung von Behandlungsproblemen . Acht aus unserer Sicht besonders wichtige Grundsaetze werden hypothesenartig dargestellt und erlaeutert ."
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Psychotherapeut.70420237.ger.abstr | Psychotherapeut.70420237.ger.abstr | [
{
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"text": [
"Anhand einer nach dem systemisch-loesungsorientierten Ansatz durchgefuehrten Paartherapie wurde versucht , die von K Tomm ( 1989 beschriebenen unterschiedlichen Wirkungen ) verschiedener Arten therapeutischer Fragen ( lineale , strategische zirkulaere und reflexive Fragen ) , einer empirischen Ueberpruefung zu unterziehen . Die Reaktionen der Klienten auf diese Fragen wurden in dieser Einzelfallstudie mittels der Methode der Plananalyse nach Caspar ( 1989 ) kategorisiert und zu den vier Fragetypen in Beziehung gesetzt . Erwartungsgemaess sollten lineale und strategische Fragen eher eine stabilisierende , einengende Wirkung haben , waehrend von zirkulaeren und reflexiven Fragen eine fuer Veraenderungen oeffnende Wirkung erwartet wurde . Interessanterweise bestaetigte sich diese Erwartung nur fuer die Frau des Paares , welche in der Therapie die Rolle der identifizierten Klientin hatte und eindeutig die groessere Veraenderungsmotivation mitbrachte . Fuer den Mann , welcher fuer sich eher die Rolle eines Kotherapeuten in Anspruch genommen hatte und eine nur geringe Veraenderungsmotivation fuer sich selbst aufwies , bestaetigten sich die erwarteten Wirkungen nicht , sondern waren teilweise sogar gegensaetzlich . Es laesst sich somit ein Interaktionseffekt mit der therapeutischen Veraenderungsmotivation annehmen ."
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Psychotherapeut.70420269.ger.abstr | Psychotherapeut.70420269.ger.abstr | [
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"text": [
"Psychotherapie ist in den industrialisierten Laendern ein fester Bestandteil der modernen Heilkunst geworden . In diesen Gesellschaften uebernehmen die Psychotherapeutinnen und Psychotherapeuten wichtige soziale und kulturelle Aufgaben . Zunaechst wird deshalb der Kontext dargestellt , in dem das Wissen ueber Psychotherapie als Methode akkumuliert wurde . Eine Betrachtung der impliziten , jedoch widerspruechlichen , Perspektiven , die offenbar die Forscher ueber Psychotherapeuten zu haben scheinen , ist zunaechst notwendig , um die Art und Weise der Fragestellungen in den Studien zu beleuchten . Nach einer Reflexion der gesellschaftspolitischen Aufgaben der Psychotherapie geht es dann in diesem Uebersichtsartikel darum , die unterschiedlichen Studien ueber die Psychotherapeutinnen und Psychotherapeuten und ihren Einfluss auf die Behandlung des Patienten zusammenzufassen . Der rote Faden ergibt sich aus der Fragestellung , welches forschungsbasierte Wissen ueber Psychotherapeuten auf welche Weise klinisch genutzt werden kann ."
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Psychotherapeut.70420282.ger.abstr | Psychotherapeut.70420282.ger.abstr | [
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"Neben der Beschreibung des Ausbildungsstandes von Psychotherapeutinnen und Psychotherapeuten1 in Deutschland und der Schweiz wird der Zusammenhang zwischen Ausbildungserfahrungen und der Kompetenzeinschaetzung von Therapeutinnen und Therapeuten betrachtet . Insgesamt wurden 1065 Personen im Rahmen der Internationalen Studie zur professionellen Entwicklung von Psychotherapeuten befragt . Sie zeichnen sich durch laengere Berufs- und umfangreiche Ausbildungserfahrungen aus , wobei sich die meisten auch nach Abschluss der ersten Therapieausbildung weiter fortbilden . Das Vertrauen in die therapeutische Kompetenz und die Selbstwirksamkeitserwartung als Therapeut wird am ehesten durch Merkmale der Praxistaetigkeit , positive Erfahrungen mit Kursen und Seminaren bzw. Eigentherapie/Selbsterfahrung und den Ausbildungsstand aufgeklaert ; eine breite theoretische Orientierung wirkt sich ebenfalls guenstig aus ."
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Psychotherapeut.70420290.ger.abstr | Psychotherapeut.70420290.ger.abstr | [
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"Die theoretische Orientierung ist nuetzlich , weil sie die Komplexitaet des therapeutischen Geschehens reduziert , dem Therapeuten diagnostische Mittel zur Erfassung der Probleme an die Hand gibt , bestimmte Werte fuer die therapeutischen Zielsetzungen beinhaltet , und nicht zuletzt , weil sie ein bestimmtes Repertoire von therapeutischen Interventionsmethoden offeriert . In diesem Beitrag wird untersucht , welchen Einfluss die theoretische Orientierung auf die praktische Taetigkeit der Psychotherapeuten hat , und zwar anhand der Variablen \" Therapieziele \" und \" Idealer Umgang mit Patienten \" . Die Daten stammen von 2376 Psychotherapeutinnen und Psychotherapeuten1, die den CCQ-Basisfragebogen zur Entwicklung der Therapeuten ausgefuellt hatten . Die Ergebnisse zeigen , dass es bezueglich der wichtigen Therapieziele manche Uebereinstimmungen , aber auch distinktive Unterschiede zwischen Vertretern unterschiedlicher theoretischer Orientierungen gibt . In bezug auf die Frage nach dem idealen Umgang mit Patienten haben Psychotherapeutinnen und Psychotherapeuten jedwelcher Couleur in etwa dieselben Vorstellungen . Jenseits der Graeben zwischen den einzelnen Therapieschulen gibt es demnach auch viel Verbindendes , was erneut die Frage nach der Bedeutung der nonspezifischen Wirkfaktoren in der Psychotherapie aufwirft ."
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Psychotherapeut.70420307.ger.abstr | Psychotherapeut.70420307.ger.abstr | [
{
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"Es wird auf einige Gefahren aufmerksam gemacht , die bei der Ausuebung des psychotherapeutischen Berufs entstehen koennen . Dieser Thematik wird am Beispiel der Werte und Ideologien von Psychotherapeuten und deren Einfluss auf Patienten sowie an der Darstellung der Problematik des Missbrauchs von Macht und Abhaengigkeit nachgegangen . Es werden einige Erklaerungsmoeglichkeiten fuer diese Phaenomene angeboten und Ueberlegungen zur Praevention solcher Gefahren genannt . Dabei wird besonders auf einige Defizite in den psychotherapeutischen Weiterbildungscurricula hingewiesen ."
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Psychotherapeut.70420314.ger.abstr | Psychotherapeut.70420314.ger.abstr | [
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"Psychotherapeuten leben in einem Spannungsfeld zwischen Familienideal und -realitaet , welche durch verschiedene aktuelle und fruehere Erfahrungen gepraegt worden sind . Die Rolle und Funktion in der eigenen Herkunftsfamilie beeinflussen nicht selten die Berufswahl und die persoenlichen Lebensplaene . Obwohl die psychotherapeutische Taetigkeit dem einzelnen viel Spielraum laesst , zwischen Berufs- und Familienleben einen Kompromiss zu finden , ist es vor allem fuer Psychotherapeutinnen nach wie vor nicht einfach , ein ihnen und ihren Partnern entsprechendes Familienmodell zu realisieren . Drei Modelle werden dargestellt und in ihren Auswirkungen beschrieben . Schliesslich werden positive und negative Aspekte psychotherapeutischer Taetigkeit auf die eigenen Paar- und Familienbeziehungen eroertert . Psychotherapeuten sollten in ihrer Aus- und Fortbildung ihren persoenlichen Beziehungen die gleiche Beachtung schenken wie den therapeutischen Beziehungen zu Patienten ."
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Psychotherapeut.70420336.ger.abstr | Psychotherapeut.70420336.ger.abstr | [
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"Die Transaktionsanalyse ( Berne 1958 ) sollte vom urspruenglichen Konzept her dazu dienen , personale Strukturen und psychodynamische Prozesse auch dem Laien verstehbar und nutzbar zu machen . Obwohl dieser Anspruch bei manchen Autoren zu Oberflaechlichkeit und \" happy-go-lucky \" Sicht verwaesserte , zeigt die vor allem unter europaeischen Transaktionsanalytikern uebliche Rueckbesinnung auf die urspruenglichen Inhalte den Umfang klinischer Relevanz der Konzepte fuer Verstaendnis und Behandlung der verschiedensten Stoerungen . Dies anhand einer sog . fruehen Stoerung , dem Borderlinesyndrom , aufzuzeigen , ist Anliegen des vorliegenden Beitrags . Das Strukturmodell der Ich-Zustaende dient dabei als Beschreibungsansatz fuer die Borderlinestruktur , Bezugsrahmen und Skript als Muster fuer die Entstehung und Aufrechterhaltung der Pathologie , Transaktionen , Spiele , Symbiosen und Passivitaet als Merkmale stabiler Instabilitaet der Beziehungen und Abwertungen und Grandiositaeten als Beispiele fuer Abwehrmuster . Es folgen praxisorientierte Ueberlegungen und Hinweise zum therapeutischen Vertrag als Grundlage des Arbeitsbuendnisses , zu Methoden der Entaengstigung im Therapieprozess , zu Begegnung und Beziehung als Substrat fuer korrigierende Erfahrungen , heilendes Klima und Entdramatisierung des realen Geschehens . Die Ausfuehrungen enden mit transaktionsanalytischen Ueberlegungen zu Uebertragung , Gegenuebertragung und dem Umgang mit Regressionsprozessen ."
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Psychotherapeut.70420343.ger.abstr | Psychotherapeut.70420343.ger.abstr | [
{
"id": "Psychotherapeut.70420343.ger.abstr-passage-0",
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"In diesem Beitrag wird ein psychodynamisches Modell der Psychosen dargestellt , welches auch gut mit der deskriptiven Klassifikation ( DSM ICD ) , korrespondiert und sich als kompatibel mit den Ergebnissen der biologischen Psychiatrie erweist . Viele klinische Beobachtungen sprechen dafuer , dass die Psychodynamik des psychotischen Patienten nicht so sehr durch den angeblichen primaeren \" Defekt \" , sondern vielmehr durch die spannungsreiche Widerspruechlichkeit bzw. die zugrundeliegenden Dilemmata charakterisiert ist . Letztere entstehen als pathologische Konfliktualisierungen von normalen \" Bipolaritaeten . \" Dabei geht es entweder ( bei der Schizophrenie ) um das Dilemma Selbstidentitaet versus Fusion oder um das fuer die affektiven Psychosen relevante Dilemma der Selbstwertigkeit versus Objektwertigkeit . Diese Gegenueberstellung ergibt das erste Kriterium bei der psychodynamischen Klassifikation . Es werden aber dann auch folgende zusaetzliche Kriterien beruecksichtigt : Die Selbstbezogenheit versus Objektbezogenheit der Abwehr und Kompensation ( z.B. Autismus versus Fusion , Manie versus Schulddepression ) . Eine weitere Dimension bezieht sich auf den Gegensatz zwischen Ueberstimulation , expandierende Phantasie , Ueberemotionalitaet , Vorherrschen des primaeren Denkprozesses einerseits und Unterstimulation , Restriktion , sekundaerer Denkprozess , emotionelle Entleerung andererseits . Waehrend das gemaessigte \" Pendeln \" zwischen den Polen einer normalen Psychodynamik entspricht , fuehren die defensiven Extremisierungen innerhalb der Psychose dazu , dass entweder eine expansive \" produktive \" oder wiederum eine Minussymptomatik entsteht . Dieses dreidimensionale System der Psychodynamik laesst sich auch auf die Persoenlichkeitsstoerungen , vielleicht auch auf die Neurosen extrapolieren ."
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Psychotherapeut.70420356.ger.abstr | Psychotherapeut.70420356.ger.abstr | [
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"Vorgestellt wird ein neuer Forschungsansatz , der es erlaubt , kognitiv-affektive Regulierungsprozesse in der psychotherapeutischen Interaktion anhand von Videoaufnahmen mikroanalytisch zu untersuchen . Mit Hilfe differenzierter Analysen verbaler und nonverbaler Aspekte der therapeutischen Interaktion werden Zusammenhaenge zwischen Beziehungsmustern untersucht , welche Klienten berichten , und solchen , die unmittelbar mit dem Therapeuten inszeniert werden . Im Zentrum stehen dabei Erzaehlungen und Inszenierungen im Kontext von Schuldgefuehlen . Durch die Anwendung der von uns entwickelten Methoden auf einen Einzelfall konnten mehrere Typen spezifischer interaktiver Muster identifiziert werden , welche im Kontext von Schuldgefuehlen auftreten und sich in aehnlicher Art und Weise wiederholen . Wie solche interaktiven Beziehungsmuster aussehen und welche Funktion sie in der affektiven Regulierung erfuellen , wird anhand der Beschreibung eines sog . chicken trap erlaeutert . Schliesslich wird die Frage aufgeworfen , welche Rolle diese interaktiven Beziehungsmuster im therapeutischen Veraenderungsprozess spielen koennen ."
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Psychotherapeut.70420362.ger.abstr | Psychotherapeut.70420362.ger.abstr | [
{
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"type": "abstract",
"text": [
"Das Verhaeltnis von Psychodiagnostik und klientenzentrierter Psychotherapie wird diskutiert . Rogers wird faelschlicherweise nachgesagt , dass er Diagnostik grundsaetzlich abgelehnt und diese Therapierichtung deshalb ein zumindest zwiespaeltiges Verhaeltnis zu dieser Frage entwickelt habe . Betrachtet man jedoch Psychodiagnostik als etwas Psychodynamisches Symptome - als Abwehrstrategie eines dahinterliegenden Konflikts - dann erscheint selbst eine therapieuebergreifende \" Statusdiagnostik \" im Sinne mehr oder minder traditioneller psychiatrischer Kategorien vereinbar mit theoriegeleiteter klientenzentrierter Diagnostik in der Initialphase und im therapeutischen Verlauf . Klientenzentrierte Psychotherapie kann selbst als fortwaehrender dialogischer Prozess der gemeinsamen Ueberpruefung \" geschaetzter Diagnosen \" aufgefasst werden ( eingebettet in das \" mitfuehlende Wissen des Therapeuten \" ) , in dem der Klient seine Diagnose \" \" im unmittelbaren Erleben verstehen und veraendern lernt ."
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Psychotherapeut.70420369.ger.abstr | Psychotherapeut.70420369.ger.abstr | [
{
"id": "Psychotherapeut.70420369.ger.abstr-passage-0",
"type": "abstract",
"text": [
"Angesichts der breiten Diskussion ethischer Fragen in der Medizin und im Gesundheitswesen finden zentrale Probleme wie die Aufklaerung und Informierte Zustimmung des Patienten/Klienten in der Psychotherapie und psychologischen Beratung bisher vergleichsweise wenig Beachtung . In der Behandlung von Kindern und Jugendlichen , insbesondere im Kontext von Beziehungsproblemen in der Familie , erweisen sich die Schwierigkeiten der Aufklaerung ueber therapeutische Moeglichkeiten sowie Risiken und die Informierte Zustimmung als Herausforderung : Statische und individualistische Konzepte , in Anlehung an eine medizinrechtlich orientierte Interpretation des Informed consent \" \" als Entscheidungsakt - im Gegensatz zu einem dynamischen Prozess zwischen mehreren Beteiligten und Betroffenen - koennen hier nicht weiterhelfen . Die Problematik wird anhand eines Fallbeispiels zur Kindesmisshandlung analysiert ; weiterfuehrende Ueberlegungen werden zur Diskussion gestellt ."
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Psychotherapeut.80430002.ger.abstr | Psychotherapeut.80430002.ger.abstr | [
{
"id": "Psychotherapeut.80430002.ger.abstr-passage-0",
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"text": [
"Die Transaktionsanalyse ( Berne 1958 ) sollte vom urspruenglichen Konzept her dazu dienen , personale Strukturen und psychodynamische Prozesse auch dem Laien verstehbar und nutzbar zu machen . Obwohl dieser Anspruch bei manchen Autoren zu Oberflaechlichkeit und \" happy-go-lucky \" Sicht verwaesserte , zeigt die vor allem unter europaeischen Transaktionsanalytikern uebliche Rueckbesinnung auf die urspruenglichen Inhalte den Umfang klinischer Relevanz der Konzepte fuer Verstaendnis und Behandlung der verschiedensten Stoerungen . Dies anhand einer sog . fruehen Stoerung , dem Borderlinesyndrom , aufzuzeigen , ist Anliegen des vorliegenden Beitrags . Das Strukturmodell der Ich-Zustaende dient dabei als Beschreibungsansatz fuer die Borderlinestruktur , Bezugsrahmen und Skript als Muster fuer die Entstehung und Aufrechterhaltung der Pathologie , Transaktionen , Spiele , Symbiosen und Passivitaet als Merkmale stabiler Instabilitaet der Beziehungen und Abwertungen und Grandiositaeten als Beispiele fuer Abwehrmuster . Es folgen praxisorientierte Ueberlegungen und Hinweise zum therapeutischen Vertrag als Grundlage des Arbeitsbuendnisses , zu Methoden der Entaengstigung im Therapieprozess , zu Begegnung und Beziehung als Substrat fuer korrigierende Erfahrungen , heilendes Klima und Entdramatisierung des realen Geschehens . Die Ausfuehrungen enden mit transaktionsanalytischen Ueberlegungen zu Uebertragung , Gegenuebertragung und dem Umgang mit Regressionsprozessen ."
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Psychotherapeut.80430008.ger.abstr | Psychotherapeut.80430008.ger.abstr | [
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"Die Vorstellung des Patienten davon , wie die Bewaeltigung seines Problems erreicht werden koenne , ist ein wichtiger Einflussfaktor fuer das Zustandekommen einer psychotherapeutischen Behandlung . In der vorliegenden Untersuchung werden die beim Erstkontakt in einem Fragebogen geaeusserten Behandlungserwartungen von n=195 Patienten einer universitaeren psychotherapeutischen Ambulanz beschrieben . Die 17 Items des Fragebogens koennen faktorenanalytisch durch vier Dimensionen gruppiert werden : 1. Interpersonelle , 2. einsichtsorientierte , 3. passive und 4. somatische Behandlungserwartungen . Einsichtsorientierte Erwartungen stehen im Vordergrund ; danach folgen interpersonelle und schliesslich passive und somatische Behandlungswuensche . Mit hoeherem Alter gehen staerkere passive und somatische Behandlungsbeduerfnisse einher . Niedrigere Schulbildung sowie die Diagnose einer somatoformen Stoerung sind ebenfalls mit hoeherer somatischer Behandlungserwartung verbunden . Kontrollueberzeugungen und Ursachenvorstellungen der Patienten sind mit den Behandlungserwartungen korreliert . Die therapeutische Arbeitsbeziehung wird von den Diagnostikern um so besser beurteilt je geringer passive und somatische Behandlungswuensche , ausgepraegt sind . Clusteranalytisch ergeben sich vier Patientengruppen , die jeweils unterschiedliche Motivierungsstrategien erfordern : 1. Patienten mit insgesamt niedrigen Erwartungen ; 2. Patienten mit generell hohen Erwartungen ; 3. Patienten mit vorwiegend einsichtsorientierten und interpersonellen Erwartungen ; 4. Patienten mit passiven und somatischen Erwartungen . Die Ergebnisse sprechen dafuer , dass Behandlungserwartungen integrale Bestandteile der subjektiven Krankheitstheorie des Patienten sind und bei der differentiellen und adaptiven Indikation fuer Psychotherapie mitberuecksichtigt werden sollten ."
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Psychotherapeut.80430026.ger.abstr | Psychotherapeut.80430026.ger.abstr | [
{
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"Es scheint sinnvoll , der Scham als allgemein menschlicher Emotion in Abgrenzung von der Schuld einen eigenstaendigen Platz zuzuweisen . Dabei sollte neben dem Abwehrcharakter auch die \" Selbst \" -erhaltende Funktion der Scham beachtet werden . Das Auftreten von Scham weist immer auf den Schutz des Wertgefuehls hin , auch wenn es aktuell beim Patienten nicht erkennbar sein sollte . Neben dem bewussten Schamerleben wird beim Kind und Erwachsenen schamaequivalentes Verhalten gesehen . Es wird der Signalcharakter von Scham eroertert und die Frage erwogen , ob Schamsymptome einen Krankheitswert haben . Die Beachtung der Psychogenese und der unbewussten Schamdynamik erweitert den Blick auf potentiell beschaemende Situationen in der Therapie ."
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Psychotherapeut.80430032.ger.abstr | Psychotherapeut.80430032.ger.abstr | [
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"Das Ignorieren unterschiedlicher Wertorientierungen von Therapeuten , Patienten und Psychotherapieschulen in der Psychotherapieforschung zugunsten eines allgemeinen Effektivitaetsfaktors bringt implizit selber eine spezifische , vorwiegend utilitaristische , Werthaltung zum Ausdruck und fuehrt zu zeitweise offenen , vor allem aber auch verdeckten Auseinandersetzungen . Das Herausarbeiten latenter Wertorientierungen kann Konflikte zwischen verschiedenen Psychotherapieschulen , aber auch zwischen Therapeuten und Klienten , verstaendlicher machen und vor allem zu einer Versprachlichung bislang unterbelichteter Bereiche im Streit um die \" richtige Psychotherapie \" beitragen . Zur Analyse und Klaerung der Wertorientierungen unterschiedlicher Therapiekonzepte wird eine ideengeschichtliche Untersuchung des Philosophen Charles Taylor ( 1994 ) zu den Spannungsfeldern der neuzeitlichen Identitaet herangezogen ."
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"Die juristische Auseinandersetzung Osheroff versus Chestnut Lodge hat im American Journal of Psychiatry \" \" zu einer Diskussion der Frage gefuehrt , ob eine Psychotherapie oder eine Pharmakotherapie die angemessene Behandlung einer schweren Depression sei . Wir referieren die wesentlichen Details dieser Auseinandersetzung , aus denen sich klinische und wissenschaftliche Implikationen ergeben . Weiterhin untersuchen wir die Frage , inwieweit Psychiater und Psychotherapeuten sich in bezug auf die diagnostische und therapeutische Beurteilung depressiver Stoerungen unterscheiden und analysieren dazu Befunde der ICD-10 Forschungskriterienstudie . Deren Ergebnisse zeigen , dass Psychotherapeuten bei der Beurteilung einer Kasuistik mit der ICD-10-Diagnose einer Dysthymia ( F34.1) im Vergleich mit den Psychiatern haeufiger eine reaktive Aetiologie und eine Neurose angenommen haben . Umgekehrt sind die Psychiater haeufiger von einer endogenen Aetiologie ausgegangen , haben haeufiger eine Psychose diagnostiziert und eine Psychopharmakotherapie empfohlen . Abschliessend betonen wir die Bedeutung der Integration verschiedener theoretischer Konzepte und Therapiemethoden als eine wesentliche Aufgabe von Psychotherapeuten und Pharmakotherapeuten . Fuer bestimmte Patienten darf von einer kombinierten Therapie ein groesserer Therapieeffekt erwartet werden ."
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Psychotherapeut.80430080.ger.abstr | Psychotherapeut.80430080.ger.abstr | [
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"Die Titelbilder und Schlagzeilen von sieben der auflagenstaerksten ueberregional erscheinenden deutschen Zeitschriften und Magazinen fuer ein breites Lesepublikum ( Bunte Focus , Spiegel , Stern ; , Frankfurter Allgemeine Magazin , Sueddeutsche Zeitung Magazin , Zeitmagazin ) sowie die von Psychologie \" Heute \" aus den Jahren 1947 bis 1995 wurden inhaltsanalytisch untersucht in Hinblick darauf , wie haeufig und auf welche Weise in den Schlagzeilen verbal auf \" Psycho \" -Berufe ( Psychotherapeutinnen und -therapeuten , Psychologinnen und Psychologen , Psychiaterinnen und Psychiater , Psychoanalytikerinnen und -analytiker ) und Psychotherapie Bezug genommen wird und wie \" Psycho \" -Personen visuell dargestellt werden . 0,12% aller untersuchten Titel der allgemeinen Zeitschriften ( n=9771) thematisierten visuell und/oder verbal Personen mit Psycho \" \" -Berufen oder Psychotherapie , 0,08% stellten \" Psychos \" visuell dar . Bei Psychologie \" Heute \" lagen die Werte erwartungsgemaess hoeher ( 2,7% bzw. 2,3% ) . Journal-spezifische Trends sind ansonsten schwach ausgepraegt Focus \" und \" SZ Magazin \" : \" bilden am haeufigsten \" Psycho \" -bezogene Titel ab . Im historischen Verlauf zeichnet sich eine Zunahme der Bedeutung von Psycho \" \" -Themen ab : Von 1947-1979 erfuellte nur einer der Titel der allgemeinen Zeitschriften unsere Kriterien , in den 80er Jahren waren es 0,12% ( 3 Titel ) und in der ersten Haelfte der 90er 0,39% ( 8 Titel ) . In den visuellen Darstellungen von Psycho \" -Personen ( \" n=15 Personen auf 14 Titeln ) handelte es sich - mit einer Ausnahme - immer um einen Mann , meist im mittleren Alter , haeufig mit Brille , grauen oder weissen Haaren und Haarausfall . Er zeigt in der Regel einen ernsten Gesichtsausdruck . In der Haelfte der Faelle wurde Sigmund Freud persoenlich abgebildet . Weitere Ergebnisse zur aeusseren Erscheinung , \" dem raeumlichen Kontext , Accessoires , Charakteristika der mit dargestellten Klientinnen und Klienten und der Interaktion zwischen Therapeut und Klient/in werden beschrieben . Implikationen der Befunde in Hinblick auf Public Image \" \" -Probleme von Psycho \" \" -Personen werden diskutiert ."
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"Mythen ueber die Entwicklung in der Lebensmitte werden aufgrund neuer Forschungsergebnisse beleuchtet . Diese zeigen , dass die Lebensmitte eine eigenstaendige Entwicklungsphase ist , die nur in geringem Masse aus den frueheren vorherzusagen ist . Die Annahme einer automatisch einsetzenden depressiven Krise muss ebenso verworfen werden wie positive Mythen \" , \" die die Einschraenkungen in bestimmten Lebensbereichen verleugnen . Entwicklungsaufgaben und Entwicklungsmoeglichkeiten werden beschrieben . Dargestellt wird ein klinisches Konzept einer phasenspezifischen \" Rueckkehr des Verdraengten \" . Moeglichkeiten der Beratung und Therapie von Paaren in der Lebensmitte werden skizziert ."
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Psychotherapeut.80430111.ger.abstr | Psychotherapeut.80430111.ger.abstr | [
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"Aspekte der Selbstentwicklung in der Adoleszenz werden - im Sinne von Entwicklungsaufgaben - als moegliche Stressoren bei der Entstehung juveniler Psychosen dargestellt . Die praepsychotische Persoenlichkeitsentwicklung wird unter Bezug auf empirische Ergebnisse der Adoleszenzforschung modellhaft als Entwicklung eines imaginierten \" Selbst \" beschrieben , das aus Phantasien und Fiktionen zusammengesetzt und nicht an Fakten und sozialen Realitaeten orientiert ist . Das imaginierte Selbst stabilisiert voruebergehend ein bedrohtes adoleszentaeres Selbst , erweist sich gegenueber aktuellen Anpassungsaufgaben aber als Risikofaktor in Richtung von Identitaetsdiffusion und Depersonalisation ."
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Psychotherapeut.80430117.ger.abstr | Psychotherapeut.80430117.ger.abstr | [
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"Klinische Beobachtungen zeigen , dass in der Kindheit koerperlich oder sexuell missbrauchte Personen dazu neigen in spaeteren Beziehungen erneut Missbrauchssituationen , zu konstellieren , weiterhin , dass solche Opferbindungen eine hohe Stabilitaet aufweisen . Die Befunde der Bindungsforschung zeigen bei Missbrauchsopfern einen hohen Anteil unsicherer Bindungen an die primaeren Bindungsfiguren . Unter den typischen organisierenden Mustern der Beziehung wird das Muster der Rollenumkehr ( Parentifizierung ) hervorgehoben . Aus der Sicht der Psychoanalyse leistet die Theorie der Introjektion missbraeuchlicher Beziehungsmuster in Verbindung mit den neueren Masochismustheorien einen wertvollen Beitrag zum Verstaendnis des Bindungsverhaltens von Missbrauchsopfern . Abschliessend werden einige Konsequenzen fuer den therapeutischen Umgang mit Missbrauchsopfern dargestellt ."
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Psychotherapeut.80430143.ger.abstr | Psychotherapeut.80430143.ger.abstr | [
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"Diese Uebersichtsarbeit gibt einen Literaturueberblick ueber den gleichermassen hinsichtlich Krisenverstaendnis und Therapiemethoden als auch hinsichtlich professioneller Zustaendigkeit sehr inhomogenen Behandlungsschwerpunkt der akuten psychosozialen Krisen . Im einzelnen werden allgemeine Behandlungsmodelle psychotherapeutischer Krisenintervention , spezielle stoerungs- und ereignisspezifische Konzepte und Arbeiten zur Krisenintervention mit Kindern , Jugendlichen und Adoleszenten aus den letzten 10 Jahren beschrieben . Ergaenzend werden die Beitraege der empirischen Psychotherapieforschung , soweit sie fuer die Krisenintervention Relevanz besitzen , mit ihren Ergebnissen vorgestellt ."
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"30-40% der Patienten eines Hausarztes leiden an psychogenen Erkrankungen . Nur 50% dieser Patienten werden vom Hausarzt ausreichend diagnostiziert . Fuer die Diagnose und Therapie ist die Qualitaet des Arzt-Patienten-Gespraechs von ausschlaggebender Bedeutung . Waehrend in den 70er Jahren der Gespraechsstil des Arztes als Persoenlichkeitsvariante betrachtet wurde , legen aktuelle empirische Studien zum Arzt-Patienten-Gespraech nahe , das Gespraechsverhalten des Arztes als einen interaktiven Prozess zu verstehen , indem beide Kommunikationspartner ( Arzt-Patient ) ihr Gespraechsverhalten aufeinander abstimmen . Schulungsprogramme zur Verbesserung der hausaerztlichen psychosomatischen Basiskompetenz zeigen oftmals nur geringe Erfolge , da sie der Bedeutung der Verbesserung der interaktiven Kompetenz nicht ausreichend Rechnung tagen . Diese steht im Zentrum des Duesseldorfer Trainings- und Schulungsprogramms zur Psychosomatischen Grundversorgung . Das Fortbildungskonzept sowie Erfahrungen mit diesem werden abschliessend dargestellt und diskutiert ."
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Psychotherapeut.80430171.ger.abstr | Psychotherapeut.80430171.ger.abstr | [
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"Die Versorgung der Bevoelkerung mit stationaerer Psychotherapie erfolgt in Deutschland ueberwiegend in Psychosomatischen Fachkliniken \" . \" Deren Zielbestimmung ist oft unklar , wie ueberhaupt ihre Stellung im Gesamtsystem der gesundheitlichen Versorgung . Obwohl sie von ihrem ( juristischen ) Status her in der Regel Rehabilitationskliniken sind , verstehen sie sich vielfach als Fachkliniken , in denen zwischen Behandlung und Rehabilitation nicht unterschieden wird . Diese Unklarheiten fuehren zu mannigfaltigen strukturellen Konflikten , die den Handlungsspielraum der in ihnen Taetigen wesentlich mitbestimmen und die therapeutische Arbeit beeinflussen . Das gilt insbesondere fuer den Arzt , der in der psychosomatischen Rehabilitation drei soziale Rollen uebernimmt : die des Koerperarztes , die des Psychotherapeuten und die des sozialmedizinischen Sachverstaendigen gegenueber der Rentenversicherung . Zwischen diesen sozialen Rollen als einem Komplex von Verhaltenserwartungen aus unterschiedlichen Bezugssystemen ( Sozialversicherungs- Kliniks , Behandlungs- , Patientensystem ) , an die soziale Position des Arztes kommt es zu bestimmten Konflikten . Dies wird als Beitrag zur konzeptuellen Weiterentwicklung der psychosomatischen Rehabilitation naeher analysiert ."
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Psychotherapeut.80430209.ger.abstr | Psychotherapeut.80430209.ger.abstr | [
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"Hypnose Autogenes Training , Progressive Relaxation und Biofeedback , sind empirisch gut fundierte Entspannungsverfahren und werden auch als kompatible Techniken im Rahmen von Therapieplaenen in Psychotherapeutischer Medizin und Psychiatrie eingesetzt . Die Uebergaenge zu Techniken der Koerpertherapie \" \" sind unscharf . Die Entspannungsverfahren grenzen sich durch ihre wissenschaftliche Orientierung insbesondere von der aus religioesen Systemen stammenden Meditation ab . In lehr- und lernbarer Form schaffen die Verfahren Bedingungen , in denen die psycho-physiologisch bestimmte Entspannungsreaktion einsetzen kann . Hierbei spielt das Fokussieren , Imaginieren und Attribuieren eine ebenso bedeutsame Rolle wie das regelmaessige ( autonome ) Ueben mit seinen positiven Effekten auf die Selbstregulation und das Selbstwertgefuehl . Kontrollierte Studien belegen fuer alle Verfahren Wirkungen bei einer Vielzahl psychosomatischer Stoerungen ( z.B. ( Kopf- ) Schmerz , ess . Hypertonie ) sowie bei Angst- und Schlafstoerungen . Darueber hinaus ergeben sich Hinweise auf positive Effekte in Therapieprogrammen , z.B. bei Substanz-Abhaengigkeiten , nicht aber bei Psychosen . Entspannungsverfahren erfuellen die Forderungen , die an moderne wissenschaftlich begruendete Psychotherapie zu stellen sind und haben daher zu Recht ihren festen Stellenwert in der Versorgung und in den Weiterbildungs-Curricula ."
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Psychotherapeut.80430221.ger.abstr | Psychotherapeut.80430221.ger.abstr | [
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"Nach einer Darstellung der verhaltenstheoretischen Ausgangsposition fuer psychische Folgen sexueller Gewalt werden die Diagnostik , therapeutischen Ziele und Interventionen in bezug auf die in der Verhaltensanalyse erfassten Ebenen vorgestellt . Dem Aufbau der therapeutischen Beziehung und den fuer die Behandlung guenstigen Faktoren wird fuer die verschiedenen Handlungsfelder besonders Rechnung getragen ( aktuelle Krisenbewaeltigung , Angst und Zwang , depressive Reaktionen , sexuelle Dysfunktionen ) . Die klinische Bedeutung der Kenntnisse von Zusammenhaengen von psychischen Stoerungen mit erlebter sexueller Gewalt wird anhand eines Fallbeispiels aus der ambulanten Versorgungspraxis herausgehoben ."
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Psychotherapeut.80430229.ger.abstr | Psychotherapeut.80430229.ger.abstr | [
{
"id": "Psychotherapeut.80430229.ger.abstr-passage-0",
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"text": [
"Es werden Kasuistiken von Patientinnen vorgestellt , welche vermuten , in der Kindheit von ihrem Vater sexuell missbraucht worden zu sein und in einer Therapie dieses Trauma aufdecken und bearbeiten moechten . Aufgrund von Uebertragungs- und Gegenuebertragungsphaenomenen entsteht dabei beim Therapeuten ein Gefuehl von Misstrauen , Unglaeubigkeit und dem Gefuehl , in eine \" hysterische Inszenierung \" mit einbezogen zu werden , so dass sich diese Therapien als sehr schwierig gestalten . In der vorliegenden Arbeit soll versucht werden , Verstaendnis fuer diese Patientinnen zu wecken und psychodynamische Hintergruende sowie den Sinn dieser Inszenierung zu untersuchen . Anhand der Kasuistiken koennen einige psychodynamische Hypothesen aufgestellt werden : 1 ) Die Inzestphantasie als narzisstischer Restitutionsversuch . 2 ) Die Inzestphantasie als symbolische Repraesentanz . 3 ) Die Inzestphantasie als symbolische Wunscherfuellung im Falle der Elternteil-Kind-Interaktion . Anschliessend wird versucht , an einigen Fallvignetten die Rolle dieser Phantasien im Uebertragungsgeschehen zu beobachten und schliesslich diagnostische Kriterien zu erarbeiten , um diese Patientinnen von anderen mit real erlebtem Missbrauch unterscheiden und behandlungstechnische Konsequenzen ziehen zu koennen ."
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Psychotherapeut.80430238.ger.abstr | Psychotherapeut.80430238.ger.abstr | [
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"Eine Form nonverbaler Psychotherapie wird dargestellt , die Arbeit mit Klang- , Pulsations- und Rhythmusinstrumenten : Monochord Gong , Trommel . , Sie veraendern den Bewusstseinszustand des Patienten , tragen zu einem multimedialen therapeutischen Fluss bei , wie er vor allem fuer schwerer gestoerte Patienten bedeutsam ist , die durch Worte allein nicht ausreichend erreichbar sind . Die Instrumente euphorisieren nicht , wecken ebenso tiefe Schmerzen wie tiefe Ressourcen . Sie ermoeglichen eine koerpernahe Psychotherapie , die Koerpertherapie vorbereiten oder mit ihr kombiniert werden kann . Perinatale , transpersonale und Todeserfahrungen liegen in ihrer natuerlichen Reichweite ."
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Psychotherapeut.80430265.ger.abstr | Psychotherapeut.80430265.ger.abstr | [
{
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"In dieser Uebersichtsarbeit wird die Entwicklung der psychoanalytisch und verhaltenstherapeutisch begruendeten stationaeren Psychotherapie als eigenstaendiger spezieller Versorgungsbereich fuer sogenannte psychogene Stoerungen dargestellt . Die strukturellen Eckdaten wie Groesse der Einrichtungen als Abteilung oder Fachklinik , Finanzierung , Verweildauer und Personalbemessung werden diskutiert . Ein Schwerpunkt wird auf die Entwicklung der Methodik gelegt . In den psychoanalytisch begruendeten Konzepten steht gemaess der psychoanalytischen Therapie die multimodale Teamtherapie unter Beruecksichtigung der multidimensionalen Uebertragungsprozesse mit dem Schwerpunkt auf Gruppentherapie im Vordergrund . In den verhaltenstherapeutischen Konzepten stehen die stoerungsspezifischen , psychoedukativen , einzel- und gruppentherapeutischen Konzepte mit dem zentralen Ziel , das Selbstmanagement des Patienten fuer seine Erkrankung zu verbessern im Vordergrund . In der juengsten Zeit werden in der psychoanalytisch begruendeten stationaeren Psychotherapie zunehmend verhaltenstherapeutische Methoden integriert und umgekehrt ."
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Psychotherapeut.80430277.ger.abstr | Psychotherapeut.80430277.ger.abstr | [
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"Der gegenwaertige Stand der stationaeren psychoanalytischen Therapie wird aus dem Blickwinkel der Beratungs- und Supervisionserfahrungen des Verfassers diskutiert . Im Anschluss an das integrierte Behandlungsmodell von Janssen werden Schwierigkeiten der Umsetzung psychoanalytischer Therapieprinzipien dargestellt , auf ihre Gruende zurueckgefuehrt und Moeglichkeiten der Ueberwindung durch einen loesungsorientierten psychoanalytisch-systemischen Ansatz skizziert . Als wichtigste Gruende werden die einseitige Mangelorientierung der psychoanalytischen Diagnostik und die sich daraus ergebende Unterbewertung loesungsorientierter suggestivtherapeutischer Interventionsmoeglichkeiten herausgestellt . Anschliessend werden die wichtigsten Prinzipien einer loesungsorientierten psychoanalytisch-systemischen Klinikbehandlung skizziert , und es wird gezeigt , wie dadurch die genannten Schwierigkeiten der Kommunikation und Kooperation sowohl innerhalb der Behandlungsteams als auch der Teams mit den Patienten ueberwunden werden koennen ."
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Psychotherapeut.80430282.ger.abstr | Psychotherapeut.80430282.ger.abstr | [
{
"id": "Psychotherapeut.80430282.ger.abstr-passage-0",
"type": "abstract",
"text": [
"Im Rahmen stationaerer Psychotherapie werden traditionell verschiedene Therapieformen miteinander kombiniert . Gewoehnlich sind dies verbale Verfahren unterschiedlicher Orientierung als Einzel- oder Gruppentherapie , averbale Verfahren , vor allem Musik- und Gestaltungstherapie sowie koerperbezogene Verfahren . Die Kombination erfolgt additiv integrativ oder eklektisch . , Ueber die Wechselwirkung solcher Kombinationsbehandlung ist wenig bekannt . Anhand der definierten additiven Kombination von psychodynamischer Therapie und kognitiver Verhaltenstherapie bei Agoraphobien und Zwangsstoerungen wird ein Rational der Wechselwirkung diskutiert , das eine Grundlage fuer weitere Klaerungsansaetze darstellen koennte ."
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Psychotherapeut.80430296.ger.abstr | Psychotherapeut.80430296.ger.abstr | [
{
"id": "Psychotherapeut.80430296.ger.abstr-passage-0",
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"text": [
"Die Kombination der stationaeren konfliktorientierten Psychotherapie mit nonverbalen Therapien ( z.B. Gestaltung Tanz und Bewegung , Entspannungstraining , Koerperwahrnehmung ) , ist bei vielen Patienten mit psychogenen und psychosomatischen Krankheiten nicht ausreichend . Nicht nur fuer die Verhaltenstherapie , sondern auch fuer die psychoanalytisch orientierte Behandlung wird inzwischen die explizite Erstellung und Ueberpruefung von Therapiezielen gefordert ( Broda u. Senf 1996 ) . Deshalb wurde bei der konflikt- und loesungsorientierten stationaeren psychoanalytischen Therapie zusaetzlich zu der einsichtsorientierten eine loesungsorientierte ( behavioral-kognitive ) Komponente zentral in das Konzept der stationaeren Behandlung integriert . Dafuer werden gemeinsam mit den Patienten Therapieziele erarbeitet sowie konkrete Schritte zur Umsetzung formuliert , deren Erreichung woechentlich ueberprueft wird . Dies ermoeglicht , sowohl auf der loesungsorientierten als auch auf der konfliktorientierten Ebene , allerdings auf der Basis der psychoanalytischen Theorie , zu intervenieren . Ausserdem koennen problematische Therapieverlaeufe kurzfristig erfasst werden . Gemeinsamkeiten bzw. Unterschiede dieses Ansatzes in Bezug auf andere Modifikationen der psychoanalytischen Therapie bzw. Kombinationen mehrerer Therapieverfahren werden diskutiert ."
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Psychotherapeut.80430331.ger.abstr | Psychotherapeut.80430331.ger.abstr | [
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"Psychotherapie und Pharmakotherapie verkoerpern jeweils eigenstaendige Zugangsweisen zu psychisch kranken Patienten . Eine Kombination in einem integrativen Behandlungsmodell traegt der multifaktoriellen Aetiopathogenese von psychischen Stoerungen Rechnung . Sie verlangt eine besondere Beachtung der Psychologie der Medikamentenverschreibung und -einnahme . Bewusste und unbewusste Bedeutungen der Medikamente fuer und in der aktuellen psychotherapeutischen Beziehung sind grundlegend fuer eine sichere Pharmakotherapie . Sie vermitteln aber auch entscheidende Uebertragungs- und Gegenuebertragungsmuster im psychotherapeutischen Prozess . Fuer diagnostisch definierte , nicht-psychotische Stoerungen ( depressive Angst- , Zwangs- und Persoenlichkeitsstoerungen ) , werden vorliegende empirische Studien zur Pharmako- und Psychotherapie referiert und im Hinblick auf eine Kombinationsbehandlung reflektiert ."
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Psychotherapeut.80430352.ger.abstr | Psychotherapeut.80430352.ger.abstr | [
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"Die methodische und institutionelle Distanz zwischen somatischer und psychotherapeutischer Medizin wird derzeit in den USA angesichts umfassender Veraenderungen im Gesundheitswesen grundlegend infrage gestellt . Nicht zuletzt als Antwort auf die radikale Markt- und Wettbewerbsorientierung der Managed Care Konzepte gewinnt in der ambulanten und stationaeren Versorgung das kooperative Behandlungsmodell der Systemischen Familienmedizin ( Collaborative Family Health Care ) zunehmend an Bedeutung . Ziel der Systemischen Familienmedizin ist die integrierte bio-psycho-soziale Gesamtbehandlung koerperlicher und psychischer Beschwerden des Patienten unter Einbeziehung seiner Familie . Eckpunkte dieses Behandlungskonzepts sind eine intensivierte Kooperation der Behandler untereinander und mit der Familie des Patienten sowie die konsequente Ressourcenaktivierung im primaeren sozialen Netz . Fuer eine solchermassen verdichtete Kooperation zwischen somatischen , psychotherapeutischen und psychosozialen Behandlern liegt inzwischen ein ermutigendes Erfahrungswissen vor . Grundhaltungen und therapeutische Techniken der Psychotherapie , insbesondere der systemischen Psychotherapie , lassen sich in diesem Arbeitsfeld gut nutzen . Die verstaerkte Integration von Psychotherapeuten in die medizinische Versorgung modifiziert allerdings deren eigene Professionskultur im Umgang mit Zeit , Raum und Kooperation , schafft jedoch zugleich Chancen , die Kultur des Medizinbetriebs zu beeinflussen ."
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"Obgleich Patientenbeschwerden von den Kostentraegern als negatives Qualitaetskriterium ernst genommen werden , fehlen wissenschaftliche Arbeiten zu diesem Thema . Ausgehend von der Darstellung der Besonderheiten der stationaeren psychosomatischen Rehabilitation werden alle Beschwerden von 2 Jahrgaengen der Abteilung Rehabilitation der Psychosomatischen Klinik Bad Neustadt/Saale inhaltlich ausgewertet hinsichtlich Gegenstand der Beschwerden , Behandlungserwartungen und Arzt-Patient-Beziehung . Selbsteinschaetzungen der Behandlung werden mit den uebrigen Patienten und den Fremdbeurteilungen der Therapeuten anhand der Basisdokumentation verglichen . Beschwerdefuehrer sind zu einem hoeheren Anteil Rentenantragsteller und haben infolge gehaeufter Abbrueche eine kuerzere Behandlungsdauer als die uebrigen Patienten . Beschwerden richten sich vor allem auf die medizinische Betreuung , oft auch die psychische Betreuung , die sozialmedizinische Beurteilung , Therapieangebot und Behandlungsrahmen . Fuer die Entstehung einer Beschwerde sind das Fehlen eines uebereinstimmenden Behandlungskontrakts , einer tragfaehigen therapeutischen Beziehung und die Zielsetzung der Kompensation durch eine neue \" Kur \" massgeblich . Hierzu tragen seitens der Patienten Vorbehalte gegenueber der Zuweisung in die Psychosomatik , passive Kur- und Erholungserwartungen , ein rein somatisches Krankheitskonzept und geringe Offenheit bei . Die Unvereinbarkeit dieser Einstellungen mit Behandlungserwartungen und -auftrag der Therapeuten traegt zu Uebertragungs-Gegenuebertragungsproblemen bei . Loesungsansaetze werden im Hinblick auf das therapeutische Vorgehen diskutiert ."
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Psychotherapeut.80430369.ger.abstr | Psychotherapeut.80430369.ger.abstr | [
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"Es wird ein aus der klinischen Praxis gewachsenes psychodynamisches Konzept der Behandlung strukturell schwer gestoerter Patientinen Patienten in einer integrativen stationaeren Psychotherapie vorgestellt . In den einzelnen Therapiephasen sich herauskristallisierende Prozessmerkmale werden beschrieben und der Leitkategorie \" Objektbeziehungen \" zugeordnet . Besonderes Gewicht wird auf die Darstellung des therapeutischen Vorgehens gelegt . Anhand der entwickelten beziehungsorientierten Modellvorstellungen zu Ebenen und Phasen des Therapieprozesses koennen die in der Behandlung von strukturell schwergestoerten Patienten/innen vielgestaltig auftretenden Phaenomene in idealtypische Zusammenhaenge eingeordnet werden . Das Verstaendnis dieser psychodynamischen Zusammenhaenge schafft differenzierte Voraussetzungen fuer konstruktiv wirksame Interventionen insbesondere bei Krisen und Stagnationen des Therapieprozesses und kann somit die Prognose der Patienten/innen guenstiger gestalten ."
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Psychotherapeut.90440001.ger.abstr | Psychotherapeut.90440001.ger.abstr | [
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"In Auseinandersetzung mit neueren Forschungsergebnissen wird gezeigt , dass viele gaengige Konzepte der psychosomatischen Medizin einer empirischen Ueberpruefung nicht standhalten koennen . Dieses betrifft sowohl die Spezifitaetsmodelle wie auch den Dualismus zwischen Koerper und Psyche oder zwischen Krankheit und Gesundheit . Die monokausal-psychogenetische Betrachtungsweise wurde abgeloest durch ein komplexes Zusammenspiel von gestuften somatopsychischen Zirkeln , die in einem biosemiotischen Modell zu integrieren sind . In dem Bezugssystem Selbst-Objekt-Koerper bekommen Affekte eine groessere kommunikative Bedeutung und Handeln erhaelt eine wichtige interaktive Funktion . Die Wirkung der veraenderten theoretischen Positionen auf neue Therapieansaetze wird diskutiert ."
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Psychotherapeut.90440013.ger.abstr | Psychotherapeut.90440013.ger.abstr | [
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"54 internistische Patienten , die am Ende einer integrierten psychosomatischen Behandlung in einem Allgemeinen Krankenhaus bereits einmal befragt worden waren , wurden 3 Monate spaeter zu Hause erneut untersucht . Sie beurteilten sowohl die klinische als auch die aktuelle ambulante Behandlung positiv , gaben geringe bis mittelgradig ausgepraegte Krankheitsbelastungen an , wiesen ein als adaptiv zu bewertendes Bewaeltigungsmuster auf und waren ueberraschend gut adaptiert . Der Vergleich der beiden Messungen ergab zum Nachbefragungszeitpunkt bei 1/4 der untersuchten Parameter eine kritischere bzw. unguenstigere Sichtweise der Patienten , bei den erhobenen Skalen eine hohe Variabilitaet der Ergebnisse . Gruende fuer diese Ergebnisse werden diskutiert . Langfristig duerfte die Krankheitsverarbeitung internistischer Patienten vor allem durch Interventionen von seiten der Hausaerzte zu verbessern sein ."
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Psychotherapeut.90440020.ger.abstr | Psychotherapeut.90440020.ger.abstr | [
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"Anliegen der Arbeit ist es , auf den Bereich der Kurzpsychotherapie in der psychosomatischen Rehabilitation mit seinen hohen Anforderungen in einer Ausbildungssituation aufmerksam zu machen und zu zeigen , wie das Konzept der Fokaltherapie zur Loesung dieses Problems beitragen kann . Der Fokus begrenzt den therapeutischen Prozess und gibt eine Orientierung . Das Fokalkonzept ermoeglicht eine bessere Strukturierung der Behandlung und laesst sich fuer die Zusammenarbeit und Entwicklung des Teams nutzen ."
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Psychotherapeut.90440025.ger.abstr | Psychotherapeut.90440025.ger.abstr | [
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"Die therapeutische Arbeitsbeziehung hat als prognostischer Faktor in der Psychotherapieforschung grosse Aufmerksamkeit erfahren . Die Bedeutung der therapeutischen Beziehung fuer den diagnostischen Prozess wurde bisher nur wenig untersucht . Ziel der vorliegenden Studie ist es , das emotionale Erleben des Therapeuten im diagnostischen Interview zu beschreiben , Zusammenhaenge mit patientenbezogenen Merkmalen zu untersuchen und Effekte auf die Indikationsentscheidung zu pruefen . Grundlage sind die Beurteilungen von n=301 Patienten durch n=12 Diagnostiker auf 31 Items zum emotionalen Erleben . Faktorenanalytisch lassen sich die Items vier Dimensionen zuordnen : 1. Aerger , 2. Sympathie , 3. Hilfsbereitschaft , 4. Hoffnungslosigkeit . Positive Gegenuebertragungsgefuehle stehen mit Kompetenzen des Patienten , der Wahrnehmung eines gemeinsamen Krankheitsverstaendnisses , der Einschaetzung einer guten therapeutischen Arbeitsbeziehung und einer guenstigen Prognosebeurteilung in Zusammenhang . Clusteranalytisch lassen sich fuenf Subgruppen von Patienten definieren , die sich durch unterschiedliche Muster der Gegenuebertragungsreaktion auszeichnen . Zwischen den Clustern bestehen statistisch signifikante und klinisch bedeutsame Unterschiede in der Haeufigkeit diagnostischer Stoerungskategorien und der Indikation von therapeutischem Verfahren und Setting . Die Ergebnisse , die die grosse Bedeutung des emotionalen Erlebens des Therapeuten fuer Indikationsentscheidungen belegen , werden vor dem Hintergrund einer interaktionellen Perspektive des diagnostischen Prozesses diskutiert ."
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Psychotherapeut.90440074.ger.abstr | Psychotherapeut.90440074.ger.abstr | [
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"Der Autor gibt einen kurzen Ueberblick ueber die Veraenderungen im Menschenbild , die in der psychoanalytischen Entwicklungspsychologie seit Freud stattgefunden haben . Er skizziert ausgewaehlte Ergebnisse der neueren Kleinkindforschung und behandelt dann ausfuehrlich einen ihrer zentralen Befunde : Die Bedeutung niederer Spannungszustaende fuer die Bildung normaler und pathologischer psychischer Strukturen . Als Resultat der Ueberlegungen ergibt sich , dass der Einfluss alltaeglicher undramatischer Interaktionserfahrungen , auf die Charakterbildung von der Psychoanalyse lange Zeit unterschaetzt wurde . Abschliessend wird die Frage diskutiert , ob diese Rehabilitierung \" des Alltags \" eine Verharmlosung der Freudschen Anthropologie darstellt oder eine notwendige Korrektur ."
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Psychotherapeut.90440083.ger.abstr | Psychotherapeut.90440083.ger.abstr | [
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"Tiefenpsychologische Kurzzeitpsychotherapie und tiefenpsychologisch fundierte Langzeitpsychotherapie sind in den untersuchten Praxen mit insgesamt 54,6% die am haeufigsten praktizierten Behandlungsverfahren . Die analytische Psychotherapie stellt mit 32% ebenfalls einen hohen Anteil am Gesamt der untersuchten Behandlungen . Die Anzahl der Therapien , die laenger als 2,5 Jahre dauern ist dennoch gering ( ca. 15% ) . Im Behandlungsverlauf kommt es zu eine Reduktion der Arbeitsunfaehigkeit , der Verabreichung von Psychopharmaka und der Inanspruchnahme medizinischer Leistungen . Die Ergebnisse werden unter drei Gesichtspunkten diskutiert : der Zugaenglichkeit zur ambulanten Fachpsychotherapie , der Differentialindikation fuer unterschiedliche Psychotherapieverfahren und der Aussagekraft von Ereignisparametern \" \" zur Verlaufsbeurteilung von Psychotherapien ."
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Psychotherapeut.90440108.ger.abstr | Psychotherapeut.90440108.ger.abstr | [
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"Dargestellt wird das modellhaft durchgefuehrte Konzept einer stationaeren verhaltenstherapeutisch-psychodynamischen Kombinationsbehandlung fuer Angst- und Zwangsstoerungen am Beispiel einer Patientin mit ausgepraegter Zwangsstoerung . Die Konzeption dieser Kombinationsbehandlung resultiert vor allem aus der Hypothese , dass es eine noch zu identifizierende Subgruppe von Patienten gibt , die von einer aufeinander bezogenen Kombination beider Therapieansaetze profitieren koennten , mehr als von einer Verhaltenstherapie alleine , dem nach dem aktuellen Forschungsstand effektivsten Verfahren bei der Behandlung von Angst- und Zwangsstoerungen . Die 12woechige Kombinationsbehandlung umfasst von psychodynamischer Seite im wesentlichen eine hochfrequente tiefenpsychologisch orientierte Gruppentherapie mit definiertem Behandlungsfokus . Die Verhaltenstherapie wird im Einzelsetting mit kotherapeutischer Unterstuetzung durchgefuehrt und beinhaltet als zentrales Behandlungselement eine massierte Reizkonfrontation mit Reaktionsverhinderung . Im Behandlungsverlauf konnte bei der Patientin eine signifikante und anhaltende Verbesserung der Zwangssymptomatik erreicht werden . Neben einer konkreten Beschreibung der therapeutischen Vorgehensweisen werden psychometrische Evaluationsdaten , einschliesslich einer 6-Monats-Katamnese, dargestellt ."
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Psychotherapeut.90440139.ger.abstr | Psychotherapeut.90440139.ger.abstr | [
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"Modelle Varianten und Methoden , der Supervision von Psychotherapie werden vor dem Hintergrund eines sich aendernden Supervisionsverstaendnisses dargestellt . Es wird aufgezeigt , worin diese Veraenderungen bestehen , auf welche empirische Basis sich die Behauptung von der qualitaetssichernden Funktion der Supervision stuetzt , und was unternommen wird , um die Qualitaet der Supervision selbst zu sichern ."
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Psychotherapeut.90440153.ger.abstr | Psychotherapeut.90440153.ger.abstr | [
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"Die Encephalomyelitis disseminata ( Multiple Sklerose ) als haeufigste organische , zumeist progredient oder schubfoermig verlaufende neurologische Erkrankung in unseren Breiten , bietet in ihrer vielfaeltigen Auspraegung psychopathologische Normabweichungen unterschiedlichsten Ausmasses . In die neurologische Rehabilitationsklinik kommen die Patienten zu Lasten verschiedenster Kostentraeger nahezu ausnahmslos vordiagnostiziert . Nicht selten sind Wiederholungsbehandlungen , so dass Verlauf Progredienz oder Stillstand , gut zu objektivieren sind . Psychopathologische Veraenderungen werden haeufig beschrieben , wobei die Aetiologie von Persoenlichkeitsstoerungen unterschiedlich beurteilt wird . Neben dem Begriff der organischen Wesensaenderung \" \" werden auch reaktive Phaenomene diskutiert , wie Probleme der Krankheitsverarbeitung , soziale Konflikte u.ae. Anhand einer ausfuehrlichen Kasuistik wird die Komplexitaet des Krankheitsbilds im Zusammenspiel mit verschiedenen Persoenlichkeitsanteilen und ihre Auswirkung auf Befindlichkeit , Verlauf und Therapie dargestellt . Ausgehend von diesem Einzelfall werden Hypothesen erarbeitet mit dem Versuch , die seelischen Grundprobleme dieser Patientengruppe so transparenter darzustellen . Daneben soll die Notwendigkeit einer mehrdimensionalen Diagnostik aufgezeigt werden , wobei im Verlauf einer Behandlung jeweils verschiedene Ebenen im Vordergrund stehen koennen , die sich verzahnen . Ein phaenomenologisch ausgerichteter , kontaktorientierter therapeutischer Zugang , der die verschiedenen Diagnoseebenen beruecksichtigt , erscheint der individuellen Problemlage der Patienten angemessen ."
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Psychotherapeut.90440159.ger.abstr | Psychotherapeut.90440159.ger.abstr | [
{
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"Ausgehend von Bindungsstilen als umschriebenen Mustern der Wahrnehmung , des Denkens , Fuehlens , der Erwartungen und der Handlungsbereitschaften in bindungsrelevanten Situationen ( Bowlby 1975 ; Ainsworth et al. 1978 ; Main 1990 ) war es Ziel , diese Muster im Sinne ihrer urspruenglichen Definition angemessen , d.h. als spezifische Merkmalskonfigurationen zu operationalisieren . Beschreibungen der drei Bindungsstile \" sicher \" , \" vermeidend und \" ambivalent \" \" wurden uebersetzt in Selbstbeschreibungen von Klienten zu Beginn einer therapeutischen Beziehung . Anhand faktorenanalytischer Ergebnisse wurden drei Skalen gebildet : \" Akzeptanzprobleme Oeffnungsbereitschaft \" und \" Zuwendungsbeduerfnis \" . \" , \" 374 stationaere Patienten ( 56,3% weiblich , 43,7% maennlich ) fuellten zu Beginn ihrer Psychotherapie den BFKE aus . Die Clusteranalyse ergab fuenf Cluster , die als Bindungsstile interpretiert werden koennen : \" sicher \" , zwei Varianten von unsicher-ambivalent \" ( \" verschlossen \" und \" anklammernd \" ) \" und zwei Varianten von unsicher-vermeidend \" ( \" \" verschlossen und \" kooperationsbereit \" ) . \" Die Diskriminanzanalyse dieser Cluster ergab Diskriminanzfunktionen , die denen von Collins u. Read ( 1990 ) sowie Ainsworth et al. ( 1978 ) entsprechen ."
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Psychotherapeut.90440203.ger.abstr | Psychotherapeut.90440203.ger.abstr | [
{
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"text": [
"Die Prozess-erlebnisorientierte Psychotherapie ist eine neohumanistische Behandlungsform , in der versucht wird , eine kreative Verbindung zwischen einer eher klientzentrierten , echten , wertschaetzenden und empathischen Beziehung und einem eher aktiven , aufgabenorientierten und prozess-direktiven Stil der Gestalt-Psychotherapie herzustellen . Diese Therapieform ist wissenschaftlich fundiert ( im Sinne von Grawe 1997 ) . Ihre Krankheitslehre wurde durch Beitraege aus der modernen psychologischen Theorie ergaenzt . Die Behandlung umfasst eine Reihe wesentlicher therapeutischer Aufgaben , die charakterisiert sind durch spezifische Hinweise oder Zeichen auf Klientenseite , Loesungsstufen , verschiedene Schritte , die ein Klient auf dem Weg zur Loesung der Aufgaben durchlaeuft und therapeutische Interventionen , die den Klienten auf diesem Weg unterstuetzen . Dieser Beitrag gibt im ersten Teil einen Ueberblick ueber die prozess-erlebnisorientierte Therapie einschliesslich ihrer theoretischen Grundlagen , i.e. der Emotionstheorie , des dialektischen Konstruktivismus und der Prozessorientierung sowie ueber die Grundprinzipien des Behandlungsmodells ."
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Psychotherapeut.90440214.ger.abstr | Psychotherapeut.90440214.ger.abstr | [
{
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"text": [
"In der vorliegenden Studie wird der Einfluss des Bildungsstandes auf Psychotherapieindikation , Wahl des Behandlungsverfahrens und Behandlungsdauer innerhalb der psychoanalytisch begruendeten Verfahren untersucht . Grundlage sind Erstantraege auf Kostenuebernahme im Rahmen der Psychotherapierichtlinien der gesetzlichen Krankenversicherung . Dabei wurden als Stichprobe alle entsprechenden Antraege eines Jahrgans ( n=274) gewaehlt , fuer welche der Erstautor als Gutachter herangezogen wurde . Es fanden sich deutliche Zusammenhaenge zwischen dem Bildungsstand auf der einen sowie der Wahl des Behandlungsverfahrens und der Behandlungsdauer auf der anderen Seite . Waehrend in unserer Stichprobe 43,5% ueber das Abitur verfuegen , sind es in der jahrgangsgleichen Durchschnittsbevoelkerung 25,1% . Dieser Zusammenhang wird noch deutlicher , wenn man zwischen tiefenpsychologisch fundierter und analytischer Psychotherapie unterscheidet . Unter den Patienten , bei denen eine analytische Psychotherapie beantragt wurde , betraegt der Anteil der Abiturienten 51,7% , der der Hauptschueler hingegen nur 13,2% bei 48,7% Hauptschuelern in der Gesamtbevoelkerung . Auch die Behandlungsdauer ist allein vom Bildungsstand , nicht hingegen von soziodemographischen Parametern wie Geschlecht , Alter oder Art der Versicherung ( Ersatzkasse/Primaerkasse ) abhaengig . Die Befunde werden diskutiert und abgeleitete Fragen fuer weitere Untersuchungen dargestellt ."
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Psychotherapeut.90440220.ger.abstr | Psychotherapeut.90440220.ger.abstr | [
{
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"Ausgehend von den Fragen nach Bedarf , Inanspruchnahme und Effektivitaet psychosomatischer Konsiliar-/Liaisondienste wurde in der vorliegenden Studie die Effektivitaet einer psychosomatisch-dermatologischen Konsiliartaetigkeit erstmals genauer untersucht . Das Ausmass der Compliance nach Behandlungsempfehlung wurde erfasst und ihr Zusammenhang mit moeglichen Einflussfaktoren wie Haeufigkeit der Gespraechskontakte , Voreinstellung und Zufriedenheit mit der Konsultation sowie klinischen und demographischen Merkmalen ueberprueft . Zwei Jahre nach der Konsultation wurden zu diesem Zweck Katamnesefragebogen versandt und die Krankenakten ausgewertet . Bei einer Stichprobe von insgesamt n=69 Patienten mit einer Handlungsempfehlung ergab sich eine Compliancerate von 78,3% , bezogen auf die Subgruppe mit einer Psychotherapieempfehlung eine Rate von 69% . Es zeigte sich kein bedeutsamer Zusammenhang mit klinischen oder demographischen Merkmalen , ebenso hatte die Haeufigkeit der Gespraechskontakte keinen Einfluss . Dabei wurde in 70,5% der Faelle nur ein Gespraech gefuehrt . Compliancefoerdernd wirkten sich eine positive Voreinstellung zur Konsultation sowie ein angenehmes Gespraechserleben aus . Insgesamt konnte also mit relativ wenig Zeit- und Arbeitsaufwand eine hohe Effektivitaet erreicht werden ."
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Psychotherapeut.90440227.ger.abstr | Psychotherapeut.90440227.ger.abstr | [
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"Vorgestellt wird die deutsche Uebersetzung des Karolinska Psychodynamic Profile - \" KAPP \" , das mit dem Ziel entwickelt wurde , ein reliables und valides Fremdbeurteilungsinstrument zur Erfassung komplexer psychodynamisch relevanter Persoenlichkeitsmerkmale , zur Verfuegung zu stellen . Die Arbeit beschreibt die Entwicklung des Instruments in Abgrenzung zu und Weiterentwicklung von aelteren Verfahren und stellt erste Ergebnisse zu Testguete und Validitaet vor . Es zeigt sich , dass das KAPP eine reliable , valide und oekonomische Methode von mittlerer Komplexitaet ist , die eine sinnvolle Ergaenzung zu in Deutschland bestehenden Instrumenten ( OPD ) darstellen kann ."
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Psychotherapeut.90440234.ger.abstr | Psychotherapeut.90440234.ger.abstr | [
{
"id": "Psychotherapeut.90440234.ger.abstr-passage-0",
"type": "abstract",
"text": [
"Es werden einige Konsequenzen fuer die Gestaltung von Vergleichsgruppen in der Psychotherapieforschung auf der Grundlage der auf M. Scriven zurueckgehenden Unterscheidung zwischen nicht-vergleichenden oder isolierten und vergleichenden Evaluationen dargestellt . In isolierten Evaluationen wird als allgemeines Evaluationsziel die Feststellung der Wirksamkeit einer Therapieform A gegen eine Kontrolltherapie B formuliert , die sich idealerweise nur hinsichtlich ihrer Therapieziele von der zu evaluierenden Therapie A insofern unterscheidet , als sie deren Ziele nicht anstrebt und auch nicht tangiert , waehrend ihre Randbedingungen ( Dauer Art und Intensitaet , der Kontakte usw. ) denen von A angeglichen werden ( Ziel der Versuchsplanung ) . Die Ziele , die eine Therapie erreichen soll , koennen dabei therapie-spezifisch sein ( etwa Symptomreduktion ) : oder auch \" von aussen \" an sie gestellt werden ( z.B. Reduktion der Anzahl der Krankenhausaufenthalte ) . In dem Umfange , in dem dieses der Kontrolle dienende versuchsplanerische Ziel in der Forschungs-Praxis nicht erreicht werden kann , sind entsprechend vorsichtigere Interpretationen vorzunehmen . In einer vergleichenden Evaluation soll die relative Wirksamkeit verschiedener Therapien ermittelt werden , die die gleichen Ziele verfolgen , waehrend sich die Randbedingungen therapiespezifisch unterscheiden und auch im Sinne eines fairen \" Vergleichs \" nicht geaendert werden sollten . Verschiedene Zwischenformen \" \" der Idealformen von Vergleichsgruppen werden angesprochen ."
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Psychotherapeut.90440241.ger.abstr | Psychotherapeut.90440241.ger.abstr | [
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"In der Psychosomatischen Klinik des Mainzer Universitaetsklinikums werden Patienten bestimmter Diagnosegruppen mit einer Kombination aus psychodynamischen und verhaltenstherapeutischen Therapiekonzepten behandelt . Diese modellhafte Kombination beider Verfahren wird bei Patienten mit Zwangsstoerungen und Angststoerungen angewendet und im folgenden am Beispiel eines Patienten mit einer Agoraphobie und einer narzisstischen sowie selbstunsicher-abhaengigen Persoenlichkeitsstoerung beschrieben . Das Behandlungskonzept beruht auf der Annahme , dass zumindest eine Subgruppe von Patienten von einer Kombinationsbehandlung mehr profitiert als von einem der genannten Therapieverfahren alleine . Auf der Ebene der ICD-10 Klassifikation beschrieben , koennte diese Subgruppe aus Patienten mit ausgepraegter Komorbiditaet , insbesondere im Bereich der Persoenlichkeitsstoerungen , bestehen . Die ueberwiegende Mehrheit der in Kombination behandelten Patienten erfuellte neben den Kriterien mindestens einer symptomorientierten Diagnose auch die Kriterien einer Persoenlichkeitsstoerung . Die 12woechige Kombinationsbehandlung umfasst von psychodynamischer Seite im wesentlichen eine hochfrequente tiefenpsychologisch orientierte Gruppentherapie mit einem definierten Behandlungsfokus . In zusaetzlichen Einzelgespraechen wird vor allem das Interaktions- und Beziehungsverhalten des Patienten auf der Station und in der Therapiegruppe thematisiert und zusaetzlich darauf geachtet , dass sich beide Therapien tatsaechlich ergaenzen und nicht gegenseitig hemmen . Die Verhaltenstherapie wird im Einzelsetting mit kotherapeutischer Unterstuetzung durchgefuehrt und beinhaltet als zentrales Behandlungselement eine massierte Reizkonfrontation mit Reaktionsverhinderung . Im Behandlungsverlauf konnte bei dem Patienten eine signifikante und anhaltende Verbesserung der Angstproblematik erreicht werden . Neben einer konkreten Beschreibung der therapeutischen Vorgehensweisen werden psychometrische Evaluationsdaten , einschliesslich einer 18-Monats-Katamnese, dargestellt ."
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"Sexualwissenschaftliche Zeitdiagnosen konstatieren einen dramatischen kulturellen Wandel der Sexualitaet , eine neosexuelle Revolution \" . \" In diesem Beitrag werden einige Symptome zusammengefasst , die zu dieser Diagnose fuehren , beispielsweise Veraenderungen sexueller Moralvorstellungen , eine zunehmende Aufloesung von Unterschieden zwischen den Geschlechtern und sexuellen Orientierungen und ein Wandel der Beziehungen . All diese Erscheinungen koennen die Psychotherapie , speziell die psychotherapeutische Behandlung sexueller Probleme nicht unbeeinflusst lassen . Potentielle Folgen des kulturellen Wandels fuer die Psychotherapie werden in dieser Uebersicht im Hinblick auf neue Stoerungsbilder , die Bedeutung sexueller Gewalt und Traumatisierung , die Medikalisierung der Sexualitaet und die psychoanalytische Theorie diskutiert ."
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"Es werden einige Aspekte der fruehkindlichen Entwicklung beschrieben , die sich auf das Entdecken der Genitalien , die Konstituierung des Koerperbilds und die Uebernahme der Geschlechtsrolle beziehen . Den Freudschen Vorstellungen ueber die weibliche psychosexuelle Entwicklung werden dabei moderne theoretische Ansaetze gegenuebergestellt . Nach einer Darstellung der Klassifikation sexueller Funktionsstoerungen wird auf die Psychodynamik des Mannes und der Frau bei Vorliegen einer sexuellen Funktionsstoerung eingegangen und in Anlehnung an Kernberg die Psychodynamik der Sexualitaet des Paares beschrieben . Abschiessend wird diskutiert , warum die moderne Psychoanalyse sich so wenig mit sexuellen Funktionsstoerungen beschaeftigt und auf die Wichtigkeit der Behandlung des Symptoms , nicht nur der dahinter liegenden Konflikte , hingewiesen ."
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Psychotherapeut.90440300.ger.abstr | Psychotherapeut.90440300.ger.abstr | [
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"Neben eingehender Psychodiagnostik , therapeutischer Begleitung durch den Alltagstest , Hormonbehandlung und geschlechtsangleichenden Operationen hat sich Psychotherapie als notwendiger Teil der Behandlung von transsexuellen Patienten erwiesen , der wesentlich zu einem guenstigen Langzeitverlauf beitraegt . Spezifische Modifikationen psychotherapeutischer Arbeit und Zielsetzungen werden dargestellt . Bei der \" Behandlung in einer Hand \" muss die jeweils moegliche \" psychotherapeutische Arbeit \" vom Behandler geleistet werden , der auch die Indikation zur somatischen Geschlechtsumwandlung stellt . Im Setting der \" verteilten Behandlung \" wird die Psychotherapie von einem Psychotherapeuten uebernommen , der die Indikation zu geschlechtsangleichenden Massnahmen dem Behandler ueberlaesst . Eine Verteilung der Behandlung laesst dem Patienten die groesstmoegliche Freiheit und schafft fuer den Psychotherapeuten die besten Voraussetzungen , im eigentlichen Sinn psychotherapeutisch arbeiten zu koennen . Die Chancen , dass die Patienten Wege ( Optionen ) finden , ohne Operation auszukommen vergroessern sich . Die Gefahr von Fehlindikationen irreversibler Operationen kann damit verringert werden ."
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Psychotherapeut.90440313.ger.abstr | Psychotherapeut.90440313.ger.abstr | [
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"In einer Fragebogenstudie wurden 470 konsekutiv aufgenommene Patientinnen einer Fachklinik fuer suchtkranke Frauen und eine Kontrollgruppe von 181 Frauen , die in einer Medizinischen Klinik aufgenommen wurden und nicht suchtkrank waren , untersucht . Suchtkranke Frauen wurden als Kinder signifikant haeufiger sexuell missbraucht ( 24,5% ) als Frauen , die spaeter nicht suchtkrank wurden ( 10,2% ) . Bei den spaeteren Suchtpatientinnen kamen die Taeter haeufiger aus dem sozialen Nahbereich bzw. der Kernfamilie . Bei den Suchtpatientinnen ueberwiegen die schwereren Missbrauchsformen . Die Eltern dieser Gruppe verhielten sich wenig unterstuetzend . So kam bei diesen Patientinnen eine unglueckliche Verbindung von Risikofaktoren und fehlenden protektiven Faktoren zusammen , die die Entstehung einer Suchtkrankheit unterstuetzen . Es ist daher erforderlich , in der Therapie dieses Thema sorgfaeltig aufzuarbeiten ."
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Psychotherapeut.90440340.ger.abstr | Psychotherapeut.90440340.ger.abstr | [
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"Die Prozess-erlebnisorientierte Psychotherapie ist eine neohumanistische Behandlungsform , in der versucht wird , eine kreative Verbindung zwischen einer eher klientzentrierten , echten , wertschaetzenden und empathischen Beziehung und einem eher aktiven , aufgabenorientierten und prozess-direktiven Stil der Gestalt-Psychotherapie herzustellen . Diese Therapieform ist wissenschaftlich fundiert ( im Sinne von Grawe 1997 ) . Ihre Krankheitslehre wurde durch Beitraege aus der modernen psychologischen Theorie ergaenzt . Die Behandlung umfasst eine Reihe wesentlicher therapeutischer Aufgaben , die charakterisiert sind durch spezifische Hinweise oder Zeichen auf Klientenseite , Loesungsstufen , verschiedene Schritte , die ein Klient auf dem Weg zur Loesung der Aufgaben durchlaeuft und therapeutische Interventionen , die den Klienten auf diesem Weg unterstuetzen . In diesem zweiten Teil der Uebersicht werden spezifische therapeutische Aufgaben beschrieben . Schliesslich werden praktische Implikationen diskutiert und Ergebnisse zum Therapieeffekt berichtet ."
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Psychotherapeut.90440350.ger.abstr | Psychotherapeut.90440350.ger.abstr | [
{
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"text": [
"Allgemeine Psychotherapie stellt keine neue Therapieform dar , sondern kann ein Leitbild fuer alle empiriegeleiteten Psychotherapeuten sein . Das Leitbild wird inhaltlich definiert . Es wird begruendet , dass und warum sich die Therapiepraxis an empirisch fundierten Handlungsregeln statt an Therapiemethoden orientieren solle . Die Handlungsregeln sollten durch eine theoretische Konzeption des psychischen Funktionierens miteinander verbunden werden , aus der ihr Stellenwert und ihre Indikation ableitbar sind . Es wird ein neuronales Modell des psychischen Funktionierens umrissen , aus dem sich Schlussfolgerungen fuer die Entstehung und Aufrechterhaltung psychischer Stoerungen einerseits und fuer die Indikation verschiedener therapeutischer Vorgehensweisen andererseits ergeben . Die Vorteile dieses Modells im Hinblick auf die Verwirklichung einer Allgemeinen Psychotherapie werden diskutiert ."
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Psychotherapeut.90440360.ger.abstr | Psychotherapeut.90440360.ger.abstr | [
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"Die Frage nach Einheit oder Vielfalt \" \" ist nicht nur ein Thema fuer die Psychotherapie , sondern betrifft die gesamte Psychologie . In dem vorliegenden theoretischen Beitrag wird die Frage nach der Einheitlichkeit an Beispielen aus verschiedenen Gebieten der Psychologie , die mit der Psychotherapie verknuepft sind , beantwortet ."
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Psychotherapeut.90440367.ger.abstr | Psychotherapeut.90440367.ger.abstr | [
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"Psychodynamische Psychotherapie bezeichnet Therapieformen , deren gemeinsames Merkmal der Bezug zur psychoanalytischen Theorie ist . Es wird versucht , Kennzeichen einer uebergreifenden psychodynamischen Therapie zu bestimmen - soweit dies bei der weitgespannten theoretischen und klinischen Vielfalt moeglich ist . Die beiden Grundpositionen der konfliktorientierten versus supportiven psychodynamischen Therapie reichen in die \" Allgemeine Psychotherapie \" hinein . Trotz der Notwendigkeit eines gemeinsamen bio-psycho-sozialen psychotherapeutischen Handlungsrahmens wird die Moeglichkeit einer Allgemeinen \" Psychotherapie \" kritisch beleuchtet ."
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Rechtsmedizin.00100045.ger.abstr | Rechtsmedizin.00100045.ger.abstr | [
{
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"Die dramatisch fortschreitende Altersumschichtung stellt unser Fach vor neue Aufgabengebiete , in deren Mittelpunkt die aus der Altenpflege ( 1,7 Mill. ) erwachsenden forensischen Problembereiche stehen , insbesondere : Vernachlaessigung und Gewalt . Pflegeschaeden stehen an der Spitze . Bei staendig wachsenden Zahlen ambulanter Pflegedienste ( 1998 : 11.730 ) verschaerft sich der Konkurrenzkampf , zumal nur \" anlassbezogene Qualitaetskontrollen ( \" u.a. Anzeige ) stattfinden . So bleiben Pflegeschaeden vielfach unentdeckt bzw. werden erst post mortem erfasst . Jaehrlich werden in der BRD ca. 16.000 ( ! ) ueber 60-Jaehrige Opfer von Gewaltkriminalitaet . Im Zusammenhang mit den dabei erlittenen Verletzungen gewinnen die aus anderen Bereichen der forensischen Traumatologie ( u.a. Verkehrsmedizin gewonnenen Erkenntnisse ) besondere Bedeutung . Die Gefahr einer Therapiebegrenzung nimmt bei verletzten alten Menschen und bei Erkrankungen nicht zuletzt aus Kostengruenden zu . Die teils im sozialen Bereich liegenden Gruende zur Propagierung \" \" der aktiven Sterbehilfe \" \" werden diskutiert . Hier hat auch die Langzeittherapie u.a. mit Psychopharmaka einen weiteren Problembereich geschaffen . Bei der Erkennung neuer Gefahren fuer alte Menschen kommt der Rechtsmedizin als Fruehwarnsystem \" \" und Koordinator aller Abwehrmoeglichkeiten eine zentrale Bedeutung zu ."
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"Die Analyse mitochondrialer DNA fand waehrend der letzten Dekade zunehmend Anwendung in der rechtsmedizinischen Praxis , in der Archaeologie sowie in evolutions- und populationsgenetischen Studien . Die Struktur der mitochondrialen DNA unter besonderer Beruecksichtigung der nichtkodierenden hypervariablen Regionen wird beschrieben . Ferner wird die Bedeutung der Sequenzpolymorphismen fuer evolutionsbiologische Untersuchungen eroertert . Der forensische Wert von Sequenzdatenbanken sowie Anforderungen an deren Umfang und deren Struktur werden erlaeutert . Ergebnisse experimenteller Arbeiten mit dem Ziel der Gewinnung mitochondrialer DNA aus bodengelagerten Zaehnen , Haarschaeften sowie kontaminierten Spuren werden dargestellt . Schliesslich werden drei Spurenfaelle vorgestellt , die mit Hilfe der mtDNA Analyse geklaert werden konnten ."
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Rechtsmedizin.00100061.ger.abstr | Rechtsmedizin.00100061.ger.abstr | [
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"Die Zusammensetzung der Amalgame als Fuellungswerkstoff in der Zahnheilkunde hat sich seit der Einfuehrung durch Adolf Witzel in Deutschland vor ca. 100 Jahren in der Zusammensetzung mehrfach geaendert . Mittels der Roentgen-Mikroanalyse EDAX koennen die Metalle in der Legierung sowohl qualitativ als auch quantitativ bestimmt werden . Durch die quantitative Bestimmung der einzelnen Legierungsbestandteile ist die Zuordnung zu bestimmten Amalgamtypen moeglich . Da die unterschiedlichen Legierungstypen auf Grund von Beschluessen , wie z . B. der FDI Spezifikation Nr. 1 und veraenderten Qualitaetsanforderungen , z . B. gamma-2-freie Amalgame , zu unterschiedlichen Zeitpunkten eingefuehrt wurden , wird dadurch eine grobe zeitliche Eingrenzung moeglich . Metallographische Strukturuntersuchungen unterstuetzen das analytische Verfahren und lassen gegebenenfalls Rueckschluesse auf das Fabrikat zu . Diese Untersuchungsmethoden , die an aktuellen Skelettfunden getestet wurden , koennen bei der Eingrenzung der Leichenliegezeit hilfreich sein ."
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Rechtsmedizin.00100065.ger.abstr | Rechtsmedizin.00100065.ger.abstr | [
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"Bei jedem Fuenften ( 19/102 ) der zwischen Februar 1994 und Februar 1998 im Institut fuer Rechtsmedizin der RWTH Aachen registrierten Drogentodesfaelle wurde eine Beteiligung des Opioides Methadon festgestellt . Obwohl sich die gesamte Anzahl der opiatsubstituierten Patienten in Stadt und Kreis Aachen im genannten Zeitraum etwa verzehnfachte , kam es jaehrlich gleichbleibend zu 4 bis 6 methadonassoziierten Todesfaellen , zumeist infolge von Mischintoxikationen . Zwei Drittel aller in Methadonprogrammen substituierten Opiatabhaengigen starben waehrend der ersten drei Behandlungstage . Soweit diese Faelle polizeilich untersucht worden sind , wurde in jedem Fall von dem behandelnden Arzt eine ueberhoehte Methadon-Initialdosis verabreicht , darueber hinaus waren manche Patienten nicht ausreichend opiattolerant . Keiner der untersuchten Faelle war zuvor Patient in einem lege artis durchgefuehrten Methadonprogramm ."
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"Die Pyomyositis ist eine meist durch Staphylococcus aureus hervorgerufene eitrig-abszedierende Entzuendung der Skelettmuskulatur , die vorwiegend bei Maennern auftritt . Die klinische Diagnose einer Pyomyositis bereitet aufgrund des uncharakteristischen Beschwerde- und Befundbilds und des relativ seltenen Vorkommens in nicht-tropischen Laendern oft Schwierigkeiten . In fortgeschrittenen Stadien der Erkrankung kann die Pyomyositis im Rahmen einer Sepsis zum Tode fuehren . Obwohl die Pathogenese nicht abschliessend geklaert ist , sind einige praedisponierende Faktoren bekannt , welche in forensisch-medizinischer Hinsicht von besonderem Interesse sind : Vorausgegangene Trivial- ) Traumen ( der Muskulatur oder aussergewoehnlich starke Muskelbeanspruchungen , das gleichzeitige Vorliegen anderer oft unscheinbarer entzuendlicher Fokusse , sowie eine vorbestehende geschwaechte Immunabwehr , etwa bei Diabetes mellitus , i.v. -Drogenabhaengigen oder HIV-Infizierten . Anhand von 3 eigenen Faellen \" nicht-tropischer \" Pyomyositis sowie ausgewaehlter Literatur wird unter besonderer Beruecksichtigung forensischer autoptischer und histomorphologischer Gesichtspunkte , auf epidemiologische und kausalpathogenetische Faktoren der Pyomyositis eingegangen ."
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Rechtsmedizin.00100166.ger.abstr | Rechtsmedizin.00100166.ger.abstr | [
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"Dargestellt werden 21 akute Asthma-Todesfaelle von 12 weiblichen und 9 maennlichen Personen zwischen 2 und 75 Jahren ohne Haeufung in einem bestimmten Lebensalter . Hiervon ereigneten sich 18 Faelle zu Hause ( zumeist nachts ) , einer im Krankenhaus , einer im Pflegeheim und einer in einer Haftanstalt . Die Diagnose eines chronischen ) Asthmas ( war regelmaessig gestellt . Forensische Fragen zielten auf einen Ausschluss von Fremdverschulden oder eines aerztlichen Behandlungsfehlers ."
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Rechtsmedizin.00100170.ger.abstr | Rechtsmedizin.00100170.ger.abstr | [
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"In Deutschland wird Methadon sowohl als Racemat ( dl-Methadon als ) auch in der allein wirksamen l-Form ( Levomethadon ) als Substitutionsmittel angewandt . Die Wirkung von Methadon ist stereospezifisch , auch der Metabolismus ist stereoselektiv . Wenn man sich daher insbesondere aus forensischer Sicht der Frage einer Dosis/Wirkungsbeziehung von Methadon naehern will , ist eine strereoselektive Analytik Voraussetzung . Eine HPLC-Methode wurde hierfuer insbesondere zur routinemaessigen Anwendung an Leichenblutproben optimiert : Nach fl . /fl.-Extraktion mit 1-Chlorbutan wurde der Extrakt auf einer Saeulenkombination aus 4 cm CN- und 10 cm chiraler AGP-Phase mit AcN/ 0,01 M PO4-Puffer pH 5,0/Dimethyloctylamin ( 15/85/0 05 ) , aufgetrennt . Die Methadon-Enantiomeren eluieren Basislinien-getrennt bei ca. 15 min ( l-Form ) bzw. 18 min ( d-Form ) . Die beiden EDDP-Enantiomeren und typische Beigebrauchsstoffe ( Heroin Kokain , Benzodiazepine , trizyklische Antidepressiva , Antiepileptika , u. a. ) stoeren nicht . Mit dieser Methode wurde das l/d-Verhaelt-nis in 93 Serumproben von lebenden Probanden und 106 Leichenblutproben bestimmt und aus der mit anderen Methoden ( GC-MS , RP-HPLC ) ermittelten Gesamtmethadonkonzentration die Levomethadonkonzentration berechnet . In etwa der Haelfte der Todesfaelle lag die Levomethadonkonzentration ueber 0,3 mg/l , ein Wert , der bei den Lebenden nur in einem Fall ueberschritten wurde . Bei Racemataufnahme lag das individuelle l/d-Verhaeltnis im Blut bei Lebenden wie Leichen etwa zwischen 25/75 und 75/25 , im Mittel bei 50/50 . In Proben aus 1999 wurden in ca. 20% der Faelle ausschliesslich Levomethadon gefunden . Auffallend waren einige Faelle , in denen offensichtlich eine gemischte Versorgung mit Levomethadon plus Racemat erfolgt ist . Anlass zu Bedenken geben Todesfaelle mit hohen Levomethadonkonzentration ( > 1 mg/l ) , bei denen das l/d-Racematverhaeltnis ausnahmslos deutlich ueber 50/50 lag . Dies koennte als Hinweis darauf gewertet werden , dass in diesen Faellen eine besonders langsame Metabolisierung von l-Methadon zu einer toedlichen Kumulation von l-Methadon gefuehrt hat . Unsere Faelle aus der forensischen Praxis zeigen die Notwendigkeit einer stereoselektiven Quantifizierung von Levomethadon sowohl zum therapeutic drug monitoring als auch in forensischen Faellen ."
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"Der Kurs Rechtsmedizin an der Medizinischen Hochschule Hannover sah im Wintersemester 1998/99 fuer jeden Studierenden 26 Pflichtstunden vor . Er bestand aus mehreren 2-stuendigen Seminaren und einer kursbegleitenden Vorlesung . Die Seminare hatten folgende Inhalte : Praktische Durchfuehrung einer Leichenschau , Teilnahme an einer Sektion mit Protokollerstellung und Nachbesprechung , Berufsrecht und -kunde sowie klinische Rechtsmedizin mit Verletzungsbegutachtung . Zusammen mit den zusaetzlichen Lehrangeboten umfasste die Lehre fuer das Fach Rechtsmedizin etwa 15 Semesterwochenstunden . Die Akzeptanz des Curriculums sollte durch eine Befragung der Studierenden ueberprueft werden . Von insgesamt 361 Studierenden beteiligten sich 72% an der Befragung . Auf einer Notenskala von 1-6 wurde der Kurs insgesamt mit der Durchschnittsnote 1,7 bewertet . Auf einer Skala von 1 ( = trifft nicht zu ) bis 7 ( = trifft zu ) wurden Aussagen zu Struktur und Inhalt von Vorlesungen und Seminaren eingeordnet . Mit einer durchschnittlichen Bewertung von ueber 6 Punkten wurden logischer Aufbau , Organisation , Anschaulichkeit und interessante Darbietung des Stoffes bewertet . Auch fuer die kommenden Semester ist eine kontinuierliche Lehrevaluation vorgesehen ."
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"Eine 31 Jahre alte Frau wurde tot mit anhaengender Infusionsflasche und peripherem Venenzugang im Bereich des linken Handrueckens aufgefunden . Bei der Leichenschau fielen ausgepraegte Hautblasen mit seroes-blutigem Inhalt sowie eine extreme Darstellung des Hautvenennetzes an der gesamten linken oberen Extremitaet auf . Autolyseerscheinungen waren bei kurzer postmortaler Liegezeit ( maximal ca. 24 h ) nicht nachweisbar . Bei der toxikologischen Untersuchung wurde das bestimmungsgemaess als Kurznarkotikum eingesetzte Barbiturat Thiopental nachgewiesen . Auffaellig war eine hohe Thiopentalkonzentration in der Hautblasenfluessigkeit von 1025 µg/ml, die die Konzentration im Oberschenkelvenenblut ( 5,35 µg/ml) um nahezu einen Faktor 200 ueberstieg . Ein Teil der anliegenden Thiopentalinfusion wurde folglich bei reduzierter bzw. bereits aufgehobener Kreislauftaetigkeit aufgenommen und blieb somit weitgehend im Bereich des linken Armes lokalisiert . Die Ausbildung einer ausgepraegten Barbiturat-induzierten vaskulaeren Schaedigung mit Hautblasenbildung trat im vorliegenden Fall also in der supravitalen bzw. fruehen postmortalen Phase als rein lokales Phaenomen auf . Bei der Bewertung der Barbituratblasenbildung als vitale Reaktion sollte daher Zurueckhaltung geuebt werden . Durch differenzierte toxikologische Analyse verfuegbarer Koerperfluessigkeiten muss daher angestrebt werden , die lokale und systemische Verteilung des applizierten Barbiturats zu charakterisieren ."
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"Ein 23 Jahre alter Rekrut brach bei sommerlichen Temperaturen waehrend eines Uebungsmarsches ploetzlich zusammen . Bei der Aufnahme in das Krankenhaus war der Patient nicht mehr ansprechbar , die Koerperkerntemperatur betrug 41,9 Grad C. Waehrend der naechsten Stunden kam es zu ausgedehnten Haut- und Weichteilblutungen , einer drastischen Verbrauchskoagulopathie und einem exzessiven Anstieg von Myoglobin , Kreatinin und verschiedener Serumenzyme . Am naechsten Morgen verstarb der junge Mann . Die Obduktionsbefunde entsprachen den klinischen Feststellungen , allerdings konnte das morphologische Korrelat untersuchter Muskelproben das laborchemisch festgestellte Ausmass frischer Muskelnekrosen nur z . T. bestaetigen . Nach Durchfuehrung der histologischen , chemisch-toxikologischen und molekulargenetischen Untersuchungen wurde per exclusionem die Diagnose einer anstrengungsbedingten idiopathischen Rhabdomyolyse gestellt . Bei der abschliessenden Begutachtung war u. a. zu straf- und zivilrechtlichen Aspekten Stellung zu nehmen ."
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"Generalisierte intrathorakale sowie auf den Kopfbereich beschraenkte Petechien , treten bei einer Vielzahl von Erkrankungen und Gewalteinwirkungen auf und sollten deshalb nicht als Erstickungsblutungen \" \" bezeichnet werden . Intrathorakale Petechien sind bei ploetzlichen Kindstodfaellen deutlich haeufiger nachweisbar als bei anderen Todesursachen im Saeuglingsalter . Sie zeigen bei den ploetzlichen Kindstodfaellen keine Geschlechtsabhaengigkeit , sie sind nicht hypostasebedingt , werden nicht durch Reanimationsmassnahmen verursacht , haben eine typische Haeufigkeit und Dichte , und sind ein nuetzliches diagnostisches Kriterium . Dass sie in einem Teil der ploetzlichen Kindstodfaelle fehlen , deutet auf eine nicht einheitliche Pathogenese hin . Nach den vorliegenden Daten aus Tierversuchen scheint ihre Entstehung Folge einer vermehrten Atemarbeit mit einer protrahierten Hypoxie bei intaktem Kreislauf zu sein . Beguenstigend wirken bestehende Infektionen , eine erhoehte Katecholaminkonzentration und ein negativer intrathorakaler Druck . Ueber die Haeufigkeit subkonjunktivaler Petechien im Saeuglingsalter gibt es nur wenige Untersuchungen . Danach sind sie untypisch fuer ploetzliche Kindstodfaelle , und sie sollten immer Anlass fuer eine genaue Untersuchung sein , insbesondere dann , wenn sie in hoeherer Dichte vorliegen . Im Gegensatz zu Strangulationstodesfaellen , bei denen sie , bis auf wenige Ausnahmen , nachweisbar sind , fehlen sie in der Mehrzahl der Todesfaelle durch weiche Bedeckung ."
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Rechtsmedizin.70070152.ger.abstr | Rechtsmedizin.70070152.ger.abstr | [
{
"id": "Rechtsmedizin.70070152.ger.abstr-passage-0",
"type": "abstract",
"text": [
"Die Polyvinylalkoholmethode ( PVAL ) zur Sicherung von Schussrueckstaenden an den Haenden wurde in 30 Ermittlungsverfahren angewandt . Es handelte sich um 22 Suizide , 3 Unfaelle und 5 Toetungsdelikte . In diesen Faellen waren 16 Pistolen , 7 Revolver , 2 Flinten und 2 Buechsen benutzt worden . In 75% der Waffen handelte es sich um kleine Kaliber ( . 22 lr bis 7,65 mm ) . In zwei Faellen hatten bleifreie Anzuendsaetze zinkhaltige Spuren verursacht . Die PVAL-Handschuhe wurden mikroradiographisch und chemographisch untersucht . Die PVAL-Methode fuehrte in 29 Faellen zum Erfolg und half in der Mehrzahl der Faelle , die Haltung der Waffe bei Schussabgabe zu rekonstruieren . Ausserdem wurden 16 weitere Handpaare mit Klebefolien behandelt . In 6 Suizidfaellen wiesen die Folien bleihaltige Spuren auf und bewiesen die Schussabgabe . Ein Unfall mit bleifreier Munition konnte ebenfalls rekonstruiert werden . In 3 von 9 Faellen von kriminellem Schusswaffengebrauch enthielten die Folien keine Schussrueckstaende . Das Spurenaufkommen auf den Folien erreichte nicht die Ausbeute im PVAL . PVAL-Handschuhe zeigten bessere und bestaendigere Faerberesultate . Folien versagten , wenn sich zuviel Blut an den Haenden befand . Die Faerbeergebnisse der blutigen Folienabzuege waren unzureichend ."
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Rechtsmedizin.70070157.ger.abstr | Rechtsmedizin.70070157.ger.abstr | [
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"Im Rahmen unserer Studie wurden mittels automatischer Laser-Fluoreszenz-Analyse am A.L.F. Express fuenf effiziente STR-Systeme untersucht . HumACTBP2 und die Kombinationen der Systeme HumVWA/FGA und HumTH01/D12S391 in Duplex-Reaktionen wurden analysiert . DNA-Proben konnten mit hoher Sensitivitaet ( 100 pg reproduzierbar und ) ohne Allel-drop-out \" \" typisiert werden . Bei der Verwendung locusspezifischer Allelleitern fuer die Typisierung lag die inter- und intra- Gelabweichung deutlich unter 0,5 bp . Die Allelfrequenzen , die allgemeinen Vaterschaftsausschlusschancen und die Diskriminierungspotentiale werden fuer alle fuenf Loci dargestellt . Die Kombination der fuenf Systeme ergibt ein Diskriminierungspotential von 99,9999989% ."
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Rechtsmedizin.70070162.ger.abstr | Rechtsmedizin.70070162.ger.abstr | [
{
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"text": [
"In einem Fall von Schuetteltrauma mit intracerebraler Blutung bei einem 3 Wochen alten Saeugling wurde als Schutzbehauptung angegeben , die Blutung muesse alt sein , sie sei geburtsbedingt ; fuer den Fall des Nachweises einer frischen Blutung im Liquor sei diese durch die Punktion selbst verursacht . In Zytozentrifugaten des blutigen Liquors wurden neben gut erhaltenen Erythrozyten , einzelnen Lymphozyten und gering vermehrten neutrophilen Granulozyten insbesondere auch immunzytochemisch junge Makrophagen nachgewiesen , die in kleinen Verbaenden darstellbar waren . Erythrophagozytose- und Haemosiderinnachweis fehlten . Die Ergebnisse schliessen ein Blutungsalter von drei Wochen und eine punktionsbedingte , artifizielle Haemorrhagie aus . Der Zeitraum des Blutungsbeginns konnte auf 12 bis 18 ( bis 48 ) Stunden vor der Liquorentnahme eingeengt werden ."
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"Es wurde behauptet [ 2 ] , Opfer der fruehkindlichen indischen Leberzirrhose entwickelten keine Totenstarre . Der zur Erklaerung dieses vermeintlichen Phaenomens vorgeschlagene biochemische Mechanismus ist jedoch nicht ueberzeugend . Bei geringer Muskelmasse gibt es allerdings die unfuehlbare Totenstarre`, , dieser Zustand kann mit fehlender Totenstarre verwechselt werden ."
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"Bei massiver koerperlicher Gewalt mit Kontakt ungeschuetzter Hautflaechen ( Schlagen Greifen ) , kam es im Probandenversuch zur wechselseitigen Behaftung mit Hautzellen , davon ueberwiegend Korneozyten und vereinzelt kernhaltige Zellen des Stratum granulosum . Schlagversuche auf folienbedeckte Sandsaecke fuehrten zu einem gleichartigen Zellabtrag . Nach Faustschlaegen auf die Oberarme gelang in einigen Faellen eine Taeter-Opfer-Zuordnung \" \" ueber DNA-Typisierung . Die DNA stammte nicht nur aus den wenigen in der Spur enthaltenen Zellkernen sondern auch aus den Korneozyten selbst , wie Untersuchungen sicher kernfreier Zellsuspensionen ergaben . Die Groessenordnungen der im Modellversuch in der Spur erreichten Zellzahlen zeigten jedoch , dass der Wert einer derartigen Spur durch das Vorhandensein kernhaltiger Zellen bestimmt wird . Die vorliegenden Ergebnisse rechtfertigen die Forderung , bei entsprechend gelagerter Kasuistik , zusammen mit der Kriminalpolizei , moeglichst umgehend Abstriche der entsprechenden Hautregionen vorzunehmen ."
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Rechtsmedizin.70070184.ger.abstr | Rechtsmedizin.70070184.ger.abstr | [
{
"id": "Rechtsmedizin.70070184.ger.abstr-passage-0",
"type": "abstract",
"text": [
"Es werden die chromatographischen Eigenschaften von Acetyl- und PFP- ( Perfluorpropionyl- ) derivaten einiger synthetisch dargestellter Alkylglucuronide auf einer OV-1-Kapillarsaeule sowie die massenspektrometrischen Daten mitgeteilt . Die homologen Derivate zeigen weitgehende Uebereinstimmung im Fragmentierungsmuster . Es wird hieraus auf die Struktur von Diacyl-alkylglucuronidlactonen geschlossen . Es wird die Bestimmung von Ethylglucuronid als PFP-Derivat im Serum unter Zusatz von 20 mg/L Propylglucuronid als innerem Standard beschrieben , wobei eine Parallelprobe nach Zusatz von 20 mg/L Propylglucuronid und Ethylglucuronid in gleicher Weise aufgearbeitet wird , so dass auf eine externe Kalibration verzichtet werden kann ."
],
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"id": "Rechtsmedizin.70070184.ger.abstr-s1-t1",
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"text": [
"Acetyl-"
],
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"Standard"
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