Beeinträchtigungen exekutiver Funktionen bei Schizophrenie

In zwei Übersichtsartikeln und drei empirischen Studien wurde das Muster der Beeinträchtigungen verschiedener Subkomponenten exekutiver Handlungskontrolle bei schizophrenen Patienten analysiert. Zu den untersuchten exekutiven Bereichen gehörten spezifische exekutiv vermittelte Gedächtnisprozesse, die Fähigkeit zum Verstehen metaphorischer Sprachäußerungen sowie Reaktionsinhibition, kognitive Flexibilität, Aufgabenkoordination und Arbeitsgedächtnis. Die Befunde zeigen auf, dass bei schizophrenen Patienten über eine Reihe von exekutiven Domänen hinweg Beeinträchtigungen auftreten, die sich insbesondere dann manifestieren, wenn erhöhte Anforderungen an die Verarbeitung von Kontextinformationen gestellt werden. Die Defizite variieren in Abhängigkeit von Symptomatik und dem Vorliegen komorbider Suchterkrankungen, weisen relativ zu anderen psychiatrischen Gruppen spezifische Muster auf und deuten insgesamt auf eine gestörte fronto-subkortikale Konnektivität bei schizophrenen Psychosen hin

The effects of Autonomous Sensory Meridian Response (ASMR) videos versus walking tour videos on ASMR experience, positive affect and state relaxation

$\bf Objective$ Autonomous Sensory Meridian Response (ASMR), the experience of a pleasant tingling on the neck and scalp, is known to be triggered by a characteristic type of videos (ASMR videos). The present study examines whether this experience is indeed specific to these ASMR videos, or whether it can also be triggered by other types of videos, e.g. walking tour videos. A further goal was to investigate differences between ASMR-responders and ASMR-non-responders regarding their ASMR sensation and to compare ASMR and walking tour videos with regard to the elicitation of positive affect and state relaxation. $\bf Method$ Two online assessments were carried out in two different predominantly student samples, one involving ASMR videos (n = 205) and the other one walking tour videos (n = 96). In both groups, ASMR experience, positive affect and state relaxation were assessed. $\bf Results$ Compared to the walking tour video group, the ASMR-responders in the ASMR video group reported a pronounced ASMR sensation, higher state relaxation and higher positive affect scores. For ASMR-non-responders, lower scores in ASMR sensation, state relaxation and positive affect were revealed compared to the walking tour group. Without differentiating ASMR responder types, the ASMR group showed higher ASMR scores and lower positive affect scores compared to the walking tour group. $\bf Conclusions$ Watching ASMR videos induced significantly more characteristic ASMR sensations compared to walking tour videos. Since ASMR videos typically include a simulated interaction of the video protagonist with the viewer and walking tour videos do not, the simulated interaction with the viewer might be one important factor for triggering ASMR. As the ASMR observer type (responder or non-responder) is crucial for benefitting from ASMR videos, future scientific evaluation of ASMR needs to consider this differention when evaluating effects of ASMR on mental heath associated domains

Turn to me

The processing of emotional faces and bodies has been associated with brain regions related to empathic responding in interpersonal contexts. The aim of the present Electroencephalography (EEG) study was to investigate differences in the time course underlying the processing of bodies and faces showing neutral, happy, or angry expressions. The P100 and N170 were analyzed in response to the presentation of bodies and faces. Stimuli were presented either from a perspective facing the observer directly or being averted by 45° to manipulate the degree to which the participants had the impression of being involved in a dyadic interpersonal interaction. Participants were instructed to identify the emotional expression (neutral, happy, or angry) by pressing the corresponding button. The result pattern mirrored poorer behavioral performance for averted relative to frontal stimuli. P100 amplitudes were enhanced and latencies shorter for averted relative to frontal bodies, while P100 and N170 components were additionally affected by electrode position and hemisphere for faces. Affective trait empathy correlated with faster recognition of facial emotions and most consistently with higher recognition accuracy and larger N170 amplitudes for angry expressions, while cognitive trait empathy was mostly linked to shorter P100 latencies for averted expressions. The results highlight the contribution of trait empathy to fast and accurate identification of emotional faces and emotional actions conveyed by bodies

"… dann gründen Sie doch eine Neuropsychologische Hochschulambulanz!"

Zusammenfassung: Neuropsychologische Hochschulambulanzen sind im Gegensatz zu Psychotherapeutischen Hochschulambulanzen eher rar. Sie stellen aber eine gute Möglichkeit dar, sowohl die neuropsychologische Unterversorgung auszugleichen als auch gleichzeitig den neuropsychologischen Nachwuchs auszubilden. Durch die Neugestaltung des universitären klinischen Masterstudienganges und die Möglichkeit einer spezifischen Weiterbildung im Bereich der Klinischen Neuropsychologie, welche derjenigen im Bereich Psychologische Psychotherapie gleichgestellt ist, ist es dringend erforderlich, Strukturen zu schaffen, die mit denen der Psychotherapieweiterbildung vergleichbar sind. Die Gründung einer Neuropsychologischen Hochschulambulanz klingt erst einmal einfach, stellt die antragstellende Person aber meistens vor einige Probleme, die im Detail und auch in Abhängigkeit von den Gesetzen des jeweiligen Bundeslandes gelöst werden müssen. Der vorliegende Artikel stellt die Gründung des Neuropsychologischen Therapie Centrums, der Hochschulambulanz an der Ruhr-Universität Bochum, mit allen Tücken und Anforderungen dar.Abstract: Neuropsychological university outpatient clinics are rarer than psychotherapeutic university outpatient clinics. Nevertheless, they provide a good opportunity both to compensate for the underuse of neuropsychological services and at the same time to train the next generation of neuropsychologists. With the reorganization of the university clinical master’s program, along with the possibility of specific further training in the field of clinical neuropsychology equivalent to that in the field of psychological psychotherapy, it is urgently necessary to create structures that are comparable to those found in further training in psychotherapy. The foundation of a neuropsychological university outpatient clinic may sound simple at first, but it usually presents the applicant with numerous problems that have to be solved in detail and also depends on the laws of the respective federal state. This article describes the establishment of the Neuropsychological Therapy Centre, the university outpatient clinic at the Ruhr University Bochum, with all its pitfalls and requirements

What is on your mind?

Within the past decades, long-term survival was achieved in a substantial fraction of primary central nervous system lymphoma (PCNSL) patients, expanding the focus of research to their quality of life (QoL). Social relationships crucially contribute to well-being in the context of adversity. Therefore, abilities that facilitate social interactions essentially determine QoL. The present study specifically targeted those sociocognitive abilities. Forty-three PCNSL patients with ongoing complete remission to therapy for at least one year and 43 healthy controls matched for age, gender and education were examined with standardized self-report and behavioral measures of social cognition. An impaired ability to comprehend others' feelings was found in patients for both positive and negative mental states. Patients had difficulties in identifying the awkward element in challenging social situations, whereas the degree of discomfort experienced in those situations was comparable between groups. Both the production of optimal solutions for social situations and the mere recognition of these among less optimal strategies were impaired in patients. Clinicians should be aware of possible sociocognitive impairment and ought to address this in additional supportive interventions. Impaired sociocognitive abilities may entail social conflicts at a time when patients rely on social support. This, in turn, could detrimentally affect QoL

Point-of-care testing using a neuropsychology pocketcard set

Neurocognitive screening instruments usually require printed sheets and additional accessories, and can be unsuitable for low-threshold use during ward rounds or emergency workup, especially in patients with motor impairments. Here, we test the utility of a newly developed neuropsychology pocketcard set for point-of-care testing. For aphasia and neglect assessment, modified versions of the Language Screening Test and the Bells Test were validated on 63 and 60 acute stroke unit patients, respectively, against expert clinical evaluation and the original pen-and-paper Bells Test. The pocketcard aphasia test achieved an excellent area under the curve (AUC) of 0.94 (95% CI: 0.88–1, $\it p$ < 0.001). Using an optimal cut-off of $\geq$2 mistakes, sensitivity was 91% and specificity was 81%. The pocketcard Bells Task, measured against the clinical neglect diagnosis, achieved higher sensitivity (89%) and specificity (88%) than the original paper-based instrument (78% and 75%, respectively). Separately, executive function tests (modified versions of the Trail Making Test [TMT] A and B, custom Stroop color naming task, vigilance 'A' Montreal Cognitive Assessment item) were validated on 44 inpatients with epilepsy against the EpiTrack® test battery. Pocketcard TMT performance was significantly correlated with the original EpiTrack® versions (A: $\it r$ = 0.64, $\it p$ < 0.001; B: $\it r$ = 0.75, $\it p$ < 0.001). AUCs for the custom Stroop task, TMT A and TMT B for discriminating between normal and pathological EpiTrack® scores were acceptable, excellent and outstanding, respectively. Quick point-of-care testing using a pocketcard set is feasible and yields diagnostically valid information

Die berufsqualifizierende Tätigkeit im Studiengang klinische Psychologie und Psychotherapie

Das $\textit {Gesetz zur Reform der Psychotherapeutenausbildung}$ bringt es mit sich, dass Studierende in Deutschland in stärkerem Maße auf die klinisch-praktische Patient*innen­behandlung vorbereitet werden müssen. Ein wichtiger Teil dieser berufsvorbereitenden Ausbildung besteht aus der sogenannten berufsqualifizierenden Tätigkeit (BQT): Im Rahmen dieser Seminare soll die Behandlung psychischer Störungen sowohl theoretisch als auch praktisch-übend vermittelt werden. Im Beitrag wird ein – auf 90 Studierende ausgerichtetes – Lehrkonzept vorgestellt, welches derzeit an der Ruhr-Universität Bochum geplant und favorisiert wird und das wir hier mit Fokus auf die Umsetzung der universitären (BQT II) und ambulanten Teile der BQT (BQT III) beschreiben. Zunächst werden die einzelnen Bestandteile der BQT und ihre Gliederung im Studienverlauf skizziert. Dann wird dargelegt, wie die in der BQT geforderte Wissensvermittlung in theoretischen Fallseminaren realisiert werden soll und wie die Studierenden dann im Rahmen der BQT III mittels $\textit {praktischer Fallseminare}$ und $\it Therapieassistenzen$ in die Patient*innenbehandlung eingebunden werden sollen. Am Ende des Artikels wird die Personalbedarfsplanung für unser Konzept vorgestellt.The law to reform the training of psychotherapists entails that students in Germany must be prepared to a greater extent for clinical-practical patient treatment. An important part of this preparatory training should take place within the framework of the so-called "berufsqualifizie­rende Tätigkeit" (BQT, practice-oriented training), in which the treatment of mental disorders should be taught both theoretically and practically. In the paper a teaching concept for 90 students is presented, which is currently planned and favoured at the Ruhr University Bochum and which we describe here with a focus on how the university (BQT II) and outpatient parts (BQT III) of the BQT are implemented. At first, we outline the individual components of the BQT and their structure in the course of the study. Then we explain how we want to implement the knowledge transfer required in the BQT II in theoretical case seminars and how the students should then be integrated into patient treatment in the context of BQT III by means of practical case seminars and as therapy assistants. At the end of the article, we describe the personnel requirement planning for our concept

Kurzfassung und interdisziplinäre Kommentierung der internationalen INCOG-2.0-Leitlinie "Kognitive Kommunikationsstörungen nach Schädelhirntrauma"

Kognitive Kommunikationsstörungen (Cognitive Communication Disorders = CCDs) bezeichnen kommunikative Beeinträchtigungen, die v. a. die kommunikativ-pragmatischen Fähigkeiten betreffen und primär durch begleitende kognitive Störungen, z. B. der Gedächtnis-, Aufmerksamkeits-, und exekutiven Planungsfunktionen bedingt sind. Eine besondere Rolle spielen außerdem Beeinträchtigungen Sozialer Kognition (z. B. Empathie, Theory of Mind). Somit fällt die Diagnostik und Behandlung der CCDs interdisziplinär in den Zuständigkeitsbereich der Klinischen Neuropsychologie und der Sprachtherapie. Ein internationales, interdisziplinäres Netzwerk, die sog. INCOG-Arbeitsgruppe, hat im Jahre 2023 aktualisierte, evidenzbasierte Empfehlungen zur Diagnostik und Behandlung von CCDs und begleitender soziokognitiver Störungen spezifisch nach mittelschweren bis schweren Schädel-Hirn-Traumata veröffentlicht. Diese sollen im vorliegenden Artikel zusammenfassend vorgestellt und kommentiert werden. Es werden erste Vorschläge zur konkreten interdisziplinären Zusammenarbeit von Klinischer Neuropsychologie und Sprachtherapie abgeleitet.Synopsis and Interdisciplinary Commentary on the International INCOG 2.0-Guidelines "Cognitive Communication Disorders After Traumatic Brain Injury" Cognitive communication disorders (CCDs) mainly affect communicative pragmatics, primarily as a result of associated cognitive impairment of memory, attention, and executive functioning. Impairments of social cognition (e. g., empathy, theory of mind) play a particularly important role. It is thus obvious why the assessment and treatment of CCDs is relevant for both neuropsychologists and speech language therapists. In 2023, an international, interdisciplinary network, the so-called INCOG-Group, published updated evidence-based guidelines for the assessment and treatment of CCDs and associated sociocognitive disorders, specifically following moderate to severe traumatic brain injury. The article presents these guidelines in a condensed and commented fashion. Initial suggestions are made for the interdisciplinary treatment of CCDs by clinical neuropsychologists and speech therapists