Activation émotionnelle chez les troubles de personnalité

Six traitements psychothérapiques des troubles de personnalité sont brièvement présentés dans cette revue de la littérature. Ces traitements se basent sur des modèles théoriques différents, les approches cognitive-comportementale, psychodynamique et interpersonnelle et ont déjà fait leurs preuves cliniques et empiriques en termes de leur efficacité. Se centrant sur les processus de changement thérapeutique, les auteurs émettent l’hypothèse que le processus d’activation émotionnelle est l’un des ingrédients les plus intéressants de ces traitements. Les traitements sont discutés sous l’angle de cette hypothèse et de ses implications cliniques.There are at least six psychotherapeutic treatments of personality disorders having received empirical and clinical validation in terms of their efficacy. These treatments are based on different theoretical models, namely the cognitive-behavioural, psychodynamic and interpersonal models. This article briefly presents these treatments, focusing on the process of therapeutic change. It is assumed that the process of emotional activation is one of the most interesting theoretical psychotherapy ingredient in treatments of these patients. The treatments are discussed regarding this hypothesis and its clinical implications.En esta revisión de la literatura se presentan brevemente seis tratamientos psicoterapéuticos de los trastornos de la personalidad. Estos tratamientos se basan en modelos teóricos diferentes, los enfoques cognitivo-comportamentales, psicodinámicos e interpersonales, cuya eficacia ya ha sido probada clínica y empíricamente. Al centrarse en los procesos de cambio terapéutico, los autores plantean la hipótesis de que el proceso de activación emocional es uno de los componentes más interesantes de estos tratamientos. Los tratamientos se discuten bajo el punto de vista de esta hipótesis y sus implicaciones clínicas.Seis tratamentos psicoterápicos dos transtornos de personalidade são apresentados brevemente nesta revista da literatura. Estes tratamentos baseiam-se em modelos teóricos diferentes, abordagens cognitivo-comportamental, psicodinâmica e interpessoal, e já passaram por provas clínicas e empíricas com respeito à sua eficácia. Concentrando-se nos processos de mudança terapêutica, os autores levantam a hipótese de que o processo de ativação emocional é um dos ingredientes mais interessantes destes tratamentos. Os tratamentos são discutidos sob o ângulo desta hipótese e destas implicações clínicas

One-Year Randomized Controlled Trial and Follow-Up of Integrated Neurocognitive Therapy for Schizophrenia Outpatients

Objective: Cognitive remediation (CR) approaches have demonstrated to be effective in improving cognitive functions in schizophrenia. However, there is a lack of integrated CR approaches that target multiple neuro- and social-cognitive domains with a special focus on the generalization of therapy effects to functional outcome. Method: This 8-site randomized controlled trial evaluated the efficacy of a novel CR group therapy approach called integrated neurocognitive therapy (INT). INT includes well-defined exercises to improve all neuro- and social-cognitive domains as defined by the Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative by compensation and restitution. One hundred and fifty-six outpatients with a diagnosis of schizophrenia or schizoaffective disorder according to DSM-IV-TR or ICD-10 were randomly assigned to receive 15 weeks of INT or treatment as usual (TAU). INT patients received 30 bi-weekly therapy sessions. Each session lasted 90min. Mixed models were applied to assess changes in neurocognition, social cognition, symptoms, and functional outcome at post-treatment and at 9-month follow-up. Results: In comparison to TAU, INT patients showed significant improvements in several neuro- and social-cognitive domains, negative symptoms, and functional outcome after therapy and at 9-month follow-up. Number-needed-to-treat analyses indicate that only 5 INT patients are necessary to produce durable and meaningful improvements in functional outcome. Conclusions: Integrated interventions on neurocognition and social cognition have the potential to improve not only cognitive performance but also functional outcome. These findings are important as treatment guidelines for schizophrenia have criticized CR for its poor generalization effect

Integrated psychological therapy: effectiveness in schizophrenia inpatient settings related to patients' age

Elderly people with schizophrenia often suffer from cognitive impairments, which affect their social functioning. Today, only a few therapy approaches for middle-aged and older patients are available. The Integrated Psychological Therapy (IPT) combines neurocognitive and social cognitive interventions with social skills approaches. The aim of this study was to evaluate (1) whether IPT is effective in younger patients (age < 40 years) and middle-aged patients (age ≥ 40 years) and (2) whether control conditions (treatment as usual or unspecific group activities) reveal some change in outcome depending on age

WIRKSAMKEIT INTEGRIERTER THERAPIEANSÄTZEN BEI SCHIZOPHREN ERKRANKTEN

This article outlines two examples of cognitive-behavior group therapy approaches for an integrative treatment of psychosis: the Integrated Psychological Therapy (IPT) and the Integrated Neurocognitive Therapy (INT). We present their theoretical background, content and conceptualization as well as recent empirical evidence for their efficacy. The article concludes that adapting these approaches to early intervention for people with high risk of psychosis seems promising.Dieser Artikel stellt beispielhaft zwei kognitiv-behaviorale Gruppentherapieansätze für die integrierte Psychosebehandlung vor: Das Integrierte Psychologische Therapieprogramm (IPT) und die Integrierte Neurokognitive Therapie (INT). Ihr theoretischer Hintergrund, Inhalt und Konzeption sowie aktuelle Wirksamkeitsnachweise werden dargestellt. Der Artikel schließt mit dem Ausblick, dass eine Anpassung dieser Ansätze einen vielversprechenden Beitrag für die Frühintervention leisten könnte

Focus: Implementing participation - Advancement of social services in analog and digital spaces

Digitale Informations- und Kommunikationstechnologien gewinnen als fester Bestandteil zunehmend Bedeutung in den alltäglichen Lebenswelten einer wachsenden Zahl von Menschen. Ihre Entwicklung und selbstverständliche Nutzung schreiten in einem immer rasanteren Tempo voran; die vielfältigen Anwendungsmöglichkeiten adressieren längst alle Lebensbereiche. Während der Digitalisierung von Kommunikationsprozessen zuweilen demokratisierende Kräfte zugesprochen werden, scheint eine kritische Reflexion möglicher Potentiale und Auswirkungen digitaler Informations- und Kommunikationstechnologien auf Teilhabedynamiken in unterschiedlichen Lebensbereichen dringend erforderlich. Die Autorinnen und Autoren möchten mit dieser SI:SO-Schwerpunktausgabe einen Beitrag zu einer kritischen Reflexion digitaler Innovationen und ihrer Auswirkungen auf die zukünftige Gestaltung sozialer Dienste leisten. Mit der zweisprachigen Ausgabe ist zudem die Hoffnung verbunden, diesen Beitrag auch einem europäischen und weltweiten Publikum zugänglich zu machen.Digital information and communications technologies are becoming an increasingly important part in everyday life of a growing number of people. Their development and natural use are progressing even faster with a wide range of possible applications addressing all areas of life. While the digitization of communication processes is sometimes said to have democratizing forces, critical reflection on the potential and impact of digital information and communication technologies on participation dynamics in different areas of life seems urgently needed. The Authors would like to contribute to a critical reflection on digital innovations and their impact on the future design of social services. The bilingual edition further aims to make this contribution accessible to a European and global audience

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Atlas of prostate cancer heritability in European and African-American men pinpoints tissue-specific regulation

Although genome-wide association studies have identified over 100 risk loci that explain ∼33% of familial risk for prostate cancer (PrCa), their functional effects on risk remain largely unknown. Here we use genotype data from 59,089 men of European and African American ancestries combined with cell-type-specific epigenetic data to build a genomic atlas of single-nucleotide polymorphism (SNP) heritability in PrCa. We find significant differences in heritability between variants in prostate-relevant epigenetic marks defined in normal versus tumour tissue as well as between tissue and cell lines. The majority of SNP heritability lies in regions marked by H3k27 acetylation in prostate adenoc7arcinoma cell line (LNCaP) or by DNaseI hypersensitive sites in cancer cell lines. We find a high degree of similarity between European and African American ancestries suggesting a similar genetic architecture from common variation underlying PrCa risk. Our findings showcase the power of integrating functional annotation with genetic data to understand the genetic basis of PrCa