Placebos in der Psychotherapieforschung – eine systematische Analyse am Beispiel der systematischen Desensibilisierung

Hintergrund: Die Voraussetzungen der randomisierten, Placebo-kontrollierten Evaluation - die Ununterscheidbarkeit der Therapiebedingungen für die Patienten und die Verblindung der Therapeuten - sind in der Psychotherapieforschung nicht uneingeschränkt gegeben. Das Ziel dieser qualitativen systematischen Übersichtsarbeit ist es, am Beispiel der systematischen Desensibilisierung (SD) die Vorgehensweisen zur Bestimmung der Behandlungsspezifität zu beschreiben und deren theoretische und praktische Implikationen zu diskutieren. Methodik: Auf der Basis einer systematischen Literaturrecherche in PsycINFO und PubMed für den Zeitraum von 1976-2015 wurden Psychotherapiestudien gesucht, in denen Patienten mit Angstsymptomen einer SD- oder Placebo-Gruppe zugewiesen und verglichen wurden. Nach Extraktion der gewählten Moderator-Variablen konnten 11 Studien eingeschlossen werden. Ergebnisse: Die Ergebnisse zu den spezifischen Effekten der SD waren nicht einheitlich. Eine durchgeführte Moderator-Analyse zeigte, dass der Nachweis spezifischer Effekte von der Glaubwürdigkeit des Placebos und dem dabei erlebten Ausmaß emotionaler Erfahrungen abhängig ist. Schlussfolgerung: Ob ein bestimmtes psychotherapeutisches Verfahren als spezifisch einzustufen ist, hängt von der Operationalisierung der Placebo-Kontrolle ab. Insbesondere bei SD scheint die Einschränkung des zu bearbeitenden Themas und in der Folge die Unterbindung der emotionalen Erfahrung des Patienten innerhalb der Kontrollbedingung eine Voraussetzung dafür zu sein, spezifische Effekte der SD zu finden

Partielle Quadrizepssehnenruptur bei einem sechsjährigen Jungen

Zusammenfassung: Bei Kindern werden Ausrissfrakturen der Patella häufiger beobachtet als Rupturen der Quadrizepssehne. Bei verdächtigen Verletzungen der Quadrizepssehne ist differenzialdiagnostisch ein Vergleich zwischen beiden Patellae mit Hilfe von konventionellem Röntgen und Ultraschall sinnvoll. Eine Arthroskopie empfiehlt sich für die Diagnose von begleitenden intraartikulären Knieläsionen und ermöglicht die Kniegelenkspülung mit Evakuierung des Hämarthro

Partielle Quadrizepssehnenruptur bei einem sechsjährigen Jungen

Zusammenfassung: Bei Kindern werden Ausrissfrakturen der Patella häufiger beobachtet als Rupturen der Quadrizepssehne. Bei verdächtigen Verletzungen der Quadrizepssehne ist differenzialdiagnostisch ein Vergleich zwischen beiden Patellae mit Hilfe von konventionellem Röntgen und Ultraschall sinnvoll. Eine Arthroskopie empfiehlt sich für die Diagnose von begleitenden intraartikulären Knieläsionen und ermöglicht die Kniegelenkspülung mit Evakuierung des Hämarthro

Ground States in the Spin Boson Model

We prove that the Hamiltonian of the model describing a spin which is linearly coupled to a field of relativistic and massless bosons, also known as the spin-boson model, admits a ground state for small values of the coupling constant lambda. We show that the ground state energy is an analytic function of lambda and that the corresponding ground state can also be chosen to be an analytic function of lambda. No infrared regularization is imposed. Our proof is based on a modified version of the BFS operator theoretic renormalization analysis. Moreover, using a positivity argument we prove that the ground state of the spin-boson model is unique. We show that the expansion coefficients of the ground state and the ground state energy can be calculated using regular analytic perturbation theory

Positive Emotions Program for Schizophrenia (PEPS): a pilot intervention to reduce anhedonia and apathy.

BACKGROUND: Recent literature has distinguished the negative symptoms associated with a diminished capacity to experience (apathy, anhedonia) from symptoms associated with a limited capacity for expression (emotional blunting, alogia). The apathy-anhedonia syndrome tends to be associated with a poorer prognosis than the symptoms related to diminished expression. The efficacy of drug-based treatments and psychological interventions for these symptoms in schizophrenia remains limited. There is a clear clinical need for new treatments. METHODS: This pilot study tested the feasibility of a program to reduce anhedonia and apathy in schizophrenia and assessed its impact on 37 participants meeting the ICD-10 criteria for schizophrenia or schizoaffective disorders. Participants were pre- and post-tested using the Scale for the Assessment of Negative Symptoms (SANS) and the Calgary Depression Scale for Schizophrenia (CDSS). They took part in eight sessions of the Positive Emotions Program for Schizophrenia (PEPS)--an intervention that teaches participants skills to help overcome defeatist thinking and to increase the anticipation and maintenance of positive emotions. RESULTS: Thirty-one participants completed the program; those who dropped out did not differ from completers. Participation in the program was accompanied by statistically significant reductions in the total scores for Avolition-Apathy and Anhedonia-Asociality on the SANS, with moderate effect sizes. Furthermore, there was a statistically significant reduction of depression on the CDSS, with a large effect size. Emotional blunting and alogia remain stable during the intervention. DISCUSSION: Findings indicate that PEPS is both a feasible intervention and is associated with an apparently specific reduction of anhedonia and apathy. However, these findings are limited by the absence of control group and the fact that the rater was not blind to the treatment objectives. CONCLUSIONS: PEPS is a promising intervention to improve anhedonia and apathy which need to be tested further in a controlled study. TRIAL REGISTRATION NUMBER: ISRCTN registry ISRCTN74048461, registered 18 may 2015

Absence of Ground States for a Class of Translation Invariant Models of Non-relativistic QED

We consider a class of translation invariant models of non-relativistic QED with net charge. Under certain natural assumptions we prove that ground states do not exist in the Fock space

The Utility of Physiological Measures in Assessing the Empathic Skills of Incarcerated Violent Offenders.

Since lack of empathy is an important indicator of violent behaviors, researchers need consistent and valid measures. This study evaluated the practical significance of a potential physiological correlate of empathy compared to a traditional self-report questionnaire in 18 male violent offenders and 21 general population controls. Empathy skills were assessed with the Interpersonal Reactivity Index (IRI) questionnaire. Heart-Rate Variability (HRV) was assessed with an electrocardiogram. The RMSSD (Root Mean Square of the Successive beat-to-beat Differences), an HRV index implicated in social cognition, was calculated. There were no group differences in IRI scores. However, RMSSD was lower in the offender group. Positive correlations between RMSSD and IRI subscales were found for controls only. We conclude that psychometric measures of empathy do not discriminate incarcerated violent offenders, and that the incorporation of psychophysiological measures, such as HRV, could be an avenue for forensic research on empathy to establish translatable evidence-based information

Approach to ground state and time-independent photon bound for massless spin-boson models

It is widely believed that an atom interacting with the electromagnetic field (with total initial energy well-below the ionization threshold) relaxes to its ground state while its excess energy is emitted as radiation. Hence, for large times, the state of the atom+field system should consist of the atom in its ground state, and a few free photons that travel off to spatial infinity. Mathematically, this picture is captured by the notion of asymptotic completeness. Despite some recent progress on the spectral theory of such systems, a proof of relaxation to the ground state and asymptotic completeness was/is still missing, except in some special cases (massive photons, small perturbations of harmonic potentials). In this paper, we partially fill this gap by proving relaxation to an invariant state in the case where the atom is modelled by a finite-level system. If the coupling to the field is sufficiently infrared-regular so that the coupled system admits a ground state, then this invariant state necessarily corresponds to the ground state. Assuming slightly more infrared regularity, we show that the number of emitted photons remains bounded in time. We hope that these results bring a proof of asymptotic completeness within reach.Comment: 45 pages, published in Annales Henri Poincare. This archived version differs from the journal version because we corrected an inconsequential mistake in Section 3.5.1: to do this, a new paragraph was added after Lemma 3.

Analyticity of The Ground State Energy For Massless Nelson Models

We show that the ground state energy of the translationally invariant Nelson model, describing a particle coupled to a relativistic field of massless bosons, is an analytic function of the coupling constant and the total momentum. We derive an explicit expression for the ground state energy which is used to determine the effective mass.Comment: 33 pages, 1 figure, added a section on the calculation of the effective mas