Recent studies have shown that the perceptual processing of human faces is affected by context information, such as previous experiences and information about the person represented by the face. The present study investigated the impact of verbally presented information about the person that varied with respect to affect (neutral, physically threatening, socially threatening) and reference (self-referred, other-referred) on the processing of faces with an inherently neutral expression. Stimuli were presented in a randomized presentation paradigm. Event-related potential (ERP) analysis demonstrated a modulation of the evoked potentials by reference at the EPN (early posterior negativity) and LPP (late positive potential) stage and an enhancing effect of affective valence on the LPP (700-1000 ms) with socially threatening context information leading to the most pronounced LPP amplitudes. We also found an interaction between reference and valence with self-related neutral context information leading to more pronounced LPP than other related neutral context information. Our results indicate an impact of self-reference on early, presumably automatic processing stages and also a strong impact of valence on later stages. Using a randomized presentation paradigm, this study confirms that context information affects the visual processing of faces, ruling out possible confounding factors such as facial configuration or conditional learning effects.

New theoretical models of nonsuicidal self-injury (NSSI) postulate that symptoms subsequent to childhood maltreatment rather than childhood maltreatment itself may lead to engagement in NSSI. However, little is known concerning which specific syndromes serve as underlying mechanisms. In this study we sought to examine the mediating effects of dissociative, posttraumatic, and depressive symptoms, 3 often comorbid syndromes following childhood trauma. In addition, we aimed to assess differences between women with and without NSSI. A sample of 87 female inpatients with a history of childhood abuse and neglect was divided into 2 subgroups (NSSI: n = 42, no NSSI: n = 45). The assessment included measures of NSSI characteristics; adverse childhood experiences; and posttraumatic, dissociative, and depressive symptoms. The NSSI group reported significantly more cases of childhood maltreatment and higher levels of current dissociative, posttraumatic, and depressive symptoms than patients without NSSI. The results of a path analysis showed that only dissociation mediated the relationship between a history of child maltreatment and NSSI when all 3 psychopathological variables were included in the model. The findings point toward a strong and rather specific association between dissociative experiences and NSSI and therefore have important implications for clinical practice.

Human information processing is sensitive to aversive stimuli, in particular to negative cues that indicate a threat to physical integrity. We investigated the extent to which these findings can be transferred to stimuli that are associated with a social rather than a physical threat. Event-related potentials were recorded during silent reading of neutral, positive, physically threatening, and socially threatening words, whereby socially threatening words were represented by swear words. We found facilitated processing of positive and physically threatening words in contrast to both neutral and socially threatening words at a first potential that emerged at about 120 ms after stimulus onset. At a semantic processing stage reflected by the N400, processing of all classes of affective words, including socially threatening words, differed from neutral words. We conclude that socially threatening words as well as neutral words capture more attentional resources than positive and physically threatening words at early stages. However, social threatening words are processed in a manner similar to other emotional words and different from neutral words at higher levels.

Social anxiety disorder (SAD) is associated with heightened sensitivity to threat cues, typically represented by emotional facial expressions. To examine if this bias can be transferred to a general hypersensitivity or whether it is specific to disorder relevant cues, we investigated electrophysiological correlates of emotional word processing (alpha activity and event-related potentials) in 20 healthy participants and 20 participants with SAD. The experimental task was a silent reading of neutral, positive, physically threatening and socially threatening words (the latter were abusive swear words) while responding to a randomly presented dot. Subsequently, all participants were asked to recall as many words as possible during an unexpected recall test. Participants with SAD showed blunted sensory processing followed by a rapid processing of emotional words during early stages (early posterior negativity - EPN). At later stages, all participants showed enhanced processing of negative (physically and socially threatening) compared to neutral and positive words (N400). Moreover, at later processing stages alpha activity was increased specifically for negative words in participants with SAD but not in healthy controls. Recall of emotional words for all subjects was best for socially threatening words, followed by negative and positive words irrespective of social anxiety. The present findings indicate that SAD is associated with abnormalities in emotional word processing characterised by early hypervigilance to emotional cues followed by cognitive avoidance at later processing stages. Most importantly, the specificity of these attentional biases seems to change as a function of time with a general emotional bias at early and a more specific bias at later processing stages.

Low-intensity cognitive behavioural therapy (LI-CBT) depicts interventions that aim at increasing access to evidence-based psychological therapies. This is achieved by (1) reducing the amount of time in which the practitioner is in contact with individual patients, (2) using practitioners that have been specifically trained to deliver low intensity interventions and without any prior formal health professional qualifications and (3) use of interventions with varying intensity. Stepped care and collaborative care constitute the organizational frame to deliver low-intensity interventions. Whereas large-scale research and health service projects abroad are focussing on LI-CBT, research in German is lagging far behind. Particularly in the light of the growing demands and utilization of mental health care as well as governmental claims to develop and evaluate new forms of providing mental health services, LI-CBT represents a promising approach.

BackgroundThe interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD) has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms.MethodsTwenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D) to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status.ResultsSymptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups.ConclusionResults support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

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Zusammenfassung Hintergrund Psychotherapie ist ein essenzieller Bestandteil in der Behandlung psychisch kranker Menschen, bleibt allerdings im Bereich der stationären psychiatrischen Behandlung hinter dem Bedarf zurück. Im Rahmen des ärztlichen Gesamtbehandlungsplans ist die Anwendung psychotherapeutischer Interventionen durch andere Berufsgruppen in Deutschland nicht regelhaft üblich. Fragestellung Welche Implikationen für die psychiatrische Pflege lassen sich aus internationalen Forschungsdaten zur Verbesserung der psychotherapeutischen Behandlung ableiten? Methode Anhand einer Literaturrecherche werden internationale Entwicklungen analysiert und als Modell für ein deutsches Ausbildungscurriculum genutzt. Ergebnis Ein 18 Monate dauerndes Ausbildungsprogramm für Pflegefachpersonen wird vorgestellt. Dieses Curriculum vermittelt neben störungsspezifischen Kompetenzen auch störungsübergreifende psychotherapeutische Interventionen. Schlussfolgerung Die Zusammenarbeit unterschiedlicher Gesundheitsberufe hat sich als wirksam und hilfreich in der Behandlung psychisch kranker Menschen erwiesen. Um den wachsenden Bedarf an Psychotherapie in der stationären Behandlung besser abdecken zu können, sollten Pflegefachpersonen zukünftig stärker einbezogen werden.